Conocimientos y conductas de estudiantes de posgrado de Pediatría y pediatras sobre la salud bucodental infantil

Objetivo: Analizar los antecedentes de formación, conductas y conocimientos sobre salud bucodental infantil en un grupo de pediatras en formación y recientemente graduados. Materiales y métodos: Estudio descriptivo mediante la aplicación de una encuesta anónima de 18 ítems, autoadministrada, enviada en forma virtual a estudiantes y graduados de un posgrado de Pediatría de la Universidad Maimónides en la Ciudad Autónoma de Buenos Aires, Argentina. Resultados: Se obtuvieron 60 respuestas. El 80 % de los participantes fueron mujeres, en su mayoría sin hijos, pertenecientes a los 3 años de formación del posgrado o con menos de 2 años de experiencia. El 78,90 % no consigna habitualmente la información del estado de salud bucodental en la historia clínica del paciente. Un 72 % de los encuestados fallaron en determinar la prevalencia de la caries dental con relación a otras patologías de la infancia. También se encontraron errores de concepto en cuanto a la etiología de la caries. Un 67,20 % no había recibido hasta el momento ninguna capacitación en salud bucodental; los que la habían recibido refirieron que esta había sido insuficiente. La autopercepción para llevar adelante acciones de prevención fue poco homogénea, y se identificaron dificultades para el reconocimiento temprano de lesiones. Un 60 % tuvo dificultades para establecer la cantidad adecuada de pasta dental que un niño debe utilizar y tampoco se sintió capacitado para dar recomendaciones sobre la técnica correcta del cepillado. Asimismo, en la muestra no se observó un criterio correcto y uniforme para la primera visita del niño sano al odontopediatra. Conclusiones: Al igual que lo manifestado por otros autores, se encuentran deficiencias en la formación y, por ende, en la autopercepción de los pediatras en formación y recientemente graduados en temas relacionados con la salud bucodental. A pesar de las dificultades reconocidas por los participantes, hubo consenso en la importancia del rol del pediatra en la prevención de la salud bucodental y en el impacto de esta en la calidad de vida del niño.

Objective: To analyze child oral health training background, habits and knowledge in a group of pediatric graduate students and recently graduated pediatricians. Materials and methods: A descriptive study using an anonymous self-administered 18-item survey sent via Google Forms to students and graduates of a master's program in Pediatrics from Universidad Maimonides in the Autonomous City of Buenos Aires, Argentina. Results: Sixty participants completed the survey: 80 % were women, most of them with no children, who were pursuing one of the three years of a master's program or had less than two years of clinical experience. Out of the respondents, 78.9 % did not usually record information on oral health in the patients' medical records, and 72 % failed to establish the prevalence of cavities in relation to other childhood illnesses. Misconceptions were also found regarding cavities etiology. A total of 67.2 % have had no prior oral health training, and those who had had such training stated that it had been insufficient. The self-perception to carry out preventive actions was uneven, and difficulties were identified for the early detection of dental disease. Sixty percent were unable to establish the right amount of toothpaste recommended for a child and felt unprepared to offer advice on the right brushing technique. Likewise, in the sample there were no correct and uniform criteria for the first visit of healthy children to pediatric dentists. Conclusions: As stated by other authors, deficiencies were found in pediatric graduate students' and recently graduated pediatricians' training and, therefore, self-perception of topics related to oral health. Despite the difficulties participants identified, they agreed on the key role pediatricians play in oral health prevention and its impact on children's quality of life.

Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control.

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.

Estimulación odontológica temprana en niños con discapacidad / Early stimulation for children with disabilities

La estimulación temprana para cuidados de la salud bucal puede definirse como el conjunto de acciones encaminadas a la aplicación de programas preventivos secuenciales sistemáticos que tienen como finalidad reducir alguna anomalía y potenciar la adquisición de habilidades y destrezas. El propósito de la presente experiencia fue demostrar a través de la estimulación temprana odontológica que es posible mantener la salud bucal de niños con discapacidad. Mediante motivación, asesoramiento dietético y enseñanza de higiene bucal, es posible intervenir en forma preventiva en edades tempranas, evitando la instalación de afecciones bucodentales. Se seleccionaron dos grupos de niños con diferentes discapacidades y edades comprendidas entre 7 meses y 3 años que nunca han utilizado un cepillo dental y tienen gran rechazo al abordaje odontológico. A un grupo se le realizó estimulación temprana, mostrando una reducción significativa en los factores de riesgo cariogénico. Desde la odontopediatría, se propuso tener en cuenta el principio de igualdad de oportunidades de un sector de la población especialmente indefenso y con alta vulnerabilidad a las caries. La repetición de diferentes acciones que aumentan el control emocional y neuromadurativo, proporcionan al niño una sensación de seguridad para poder sobrellevar el temor en las futuras consultas odontológicas. De acuerdo con los resultados obtenidos en el presente trabajo, los niños a los cuales se les realizó estimulación odontológica precoz fueron los más motivados en el momento de la consulta, logrando estrechos vínculos con el profesional y la apropiación del hábito de cepillado.

An Rpb4/Rpb7-like complex in yeast RNA polymerase III contains the orthologue of mammalian CGRP-RCP.

The essential C17 subunit of yeast RNA polymerase (Pol) III interacts with Brf1, a component of TFIIIB, suggesting a role for C17 in the initiation step of transcription. The protein sequence of C17 (encoded by RPC17) is conserved from yeasts to humans. However, mammalian homologues of C17 (named CGRP-RCP) are known to be involved in a signal transduction pathway related to G protein-coupled receptors, not in transcription. In the present work, we first establish that human CGRP-RCP is the genuine orthologue of C17. CGRP-RCP was found to functionally replace C17 in Deltarpc17 yeast cells; the purified mutant Pol III contained CGRP-RCP and had a decreased specific activity but initiated faithfully. Furthermore, CGRP-RCP was identified by mass spectrometry in a highly purified human Pol III preparation. These results suggest that CGRP-RCP has a dual function in mammals. Next, we demonstrate by genetic and biochemical approaches that C17 forms with C25 (encoded by RPC25) a heterodimer akin to Rpb4/Rpb7 in Pol II. C17 and C25 were found to interact genetically in suppression screens and physically in coimmunopurification and two-hybrid experiments. Sequence analysis and molecular modeling indicated that the C17/C25 heterodimer likely adopts a structure similar to that of the archaeal RpoE/RpoF counterpart of the Rpb4/Rpb7 complex. These RNA polymerase subunits appear to have evolved to meet the distinct requirements of the multiple forms of RNA polymerases.