Evaluating conceptual model measurement and psychometric properties of Oral health-related quality of life instruments available for older adults: a systematic review.

BACKGROUND: Older adults present a variety of oral diseases and conditions, in addition to co-morbidities and limited access to dental care, which significantly impact their oral health-related quality of life (OHRQoL). There are many instruments published to measure OHRQoL. However, it is challenging for clinicians and researchers to choose the best instrument for a given purpose. PURPOSE: To identify OHRQoL instruments available for older adults and summarize the evidence on the conceptual and measurement model, psychometric properties, interpretability, and administration issues of OHRQoL instruments available for older adults through a systematic review. METHODS: A systematic search was conducted in MEDLINE, EMBASE, LILACS, and CENTRAL up to February 2023. Articles reporting information on the concept model measurement, psychometric properties, and administration issues of an instrument measuring OHRQoL in older adults were included. Two researchers independently evaluated each instrument using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. The overall score and seven attribute-specific scores were calculated (range 0-100): Conceptual and measurement model, Reliability, Validity, Responsiveness, Interpretability, Burden, and Alternative forms. RESULTS: We identified 14 instruments evaluated in 97 articles. The overall score varied between 73.7 and 8.9, with only six questionnaires over the threshold score 50.0. EORTC QLQ OH-15 (cancer-specific questionnaire) achieved the highest score (73.7), followed by OHIP (generic OHRQoL questionnaire) (66.9), GOHAI (generic OHRQoL questionnaire) (65.5), and OHIDL (generic OHRQoL questionnaire) (65.2). Overall, the Conceptual and measurement model and Validity showed the best performance, while Responsiveness and Interpretability showed the worst. Insufficient information was presented for an overall evaluation of DSQ and OHAI. CONCLUSION: The evidence supports using EORTC QLQ-OH15 as a specific instrument to assess OHRQoL in cancer patients and the OHIP-49, GOHAI, or OHIDL as generic instruments to assess OHRQoL either for cross-sectional or longitudinal studies in older adults.

Inulin as a Fat-Reduction Ingredient in Pork and Chicken Meatballs: Its Effects on Physicochemical Characteristics and Consumer Perceptions.

Fat reduction in meat products represents a technological challenge, as it affects the physicochemical and sensory properties of foods. The objective of the present investigation was to develop reduced-fat pork and chicken meatballs. In the initial stage, a survey was performed on 387 individuals, in order to determine the consumer perception of the meaning of a healthy meatball and the likelihood that they would consume such a product. In the second stage, four pork and chicken meatball formulations were developed: control meatballs (AC), meatballs with inulin (AI), meatballs with fructo-oligosaccharides (AF), and meatballs with inulin and fructo-oligosaccharides (AM). In the third stage, physicochemical properties were evaluated (water activity, humidity, fat, protein, ash, weight loss, pH, color, and texture) and a sensorial profile was created with semi-trained panelists for the four meatball formulations. In the fourth stage, AI was selected as the meatball with sensorial and physicochemical characteristics most similar to AC. An analysis of nutritional characteristics and a home test (84 consumers) were performed. The present study established that the inclusion of inulin as a fat substitute in the preparation of pork and chicken meatballs, in the amount of 3.5 g of fiber/100 g of the mixture, imitates the technological properties characteristic of fat and showed acceptance by consumers.

Questions and health outcomes prioritization for the development of a COVID-19 dental clinical practice guideline: A case study.

RATIONALE, AIMS AND OBJECTIVES: In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical. The guideline development process includes prioritization of the guideline topic, questions and health outcomes. This case study describes the application of a new methodology to prioritize questions and rate the importance of health outcomes for a COVID-19 dental guideline. METHODS: Panel members rated the topic and the questions' overall importance, using a 9-point scale (1 = least important; 9 = most important). In addition, they rated six criteria if multiple questions received the same overall importance rating: common in practice, uncertainty in practice, variation in practice, new evidence available, cost consequences, not previously addressed. Panellists also rated the importance of each outcome, defined with health outcome descriptors, using a 9-point scale and the utility of health outcomes on a visual analogue scale. The correlation between each criterion and overall question importance was tested by Spearman correlation coefficient. RESULTS: Of seven topics, four were rated as high priority and three were rated as important, but not of high priority. Thirty-six percent of the questions (18/50) were rated as high priority to address in the guideline and 64% (32/50) were rated as an important question but not of high priority. Of the 11 outcomes, 72.7% were rated as critical for decision making. The mean utility rating was 0.57 (SD 0.32), with a minimum mean rating of 0.16 and a maximum of 0.76 (SD 0.23). CONCLUSION: This case study demonstrated that this approach provides a rigorous and transparent methodology to conduct the prioritizations of guideline topics, questions and health outcomes.

QUALITY APPRAISAL OF CLINICAL PRACTICE GUIDELINES ON PROVISION OF DENTAL SERVICES DURING THE FIRST MONTHS OF THE COVID-19 PANDEMIC.

OBJECTIVES: To evaluate the quality of clinical practice guidelines (CPGs) on dental services provision during the first months of the COVID-19 pandemic. MATERIALS AND METHODS: We systematically searched in MEDLINE, EMBASE, LILACS, Epistemonikos, Trip databases, websites of CPG developers, compilers of CPGs, scientific societies and ministries of health to identify documents with recommendations intended to minimize the risk of COVID-19 transmission during dental care. Reviewers independently and in duplicate assessed the included CPGs using the AGREE II instrument. We calculated the standardized scores for the 6 domains and made a final recommendation about each CPG. The inter-appraiser agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS: Twenty-three CPGs published were included. Most of the CPGs were from America (n = 15) and Europe (n = 6). The overall agreement between reviewers was very good (ICC = 0.93; 95%CI 0.87-0.95). The median score for each domain was the following: Scope and purpose 67% (IQR 20%); Stakeholder involvement 33% (IQR 14%); Rigour of development 13% (IQR 13%); Clarity of presentation 64% (IQR 31%); Applicability 19% (IQR 17%) and Editorial independence 8% (IQR 8%). Twenty two guidelines were not recommended by the reviewers. Only one of the CPGs was recommended with modifications. The median overall rate was 3 (IQR 1). All CPGs were classified as low quality. CONCLUSIONS: The overall quality of CPGs on dental services provision during the first months of the COVID-19 pandemic was low, which makes its implementation difficult for clinicians and policy makers. Therefore, it is critical that developers are transparent and forthcoming about the difficulties that have arisen during the CPG development process.

Recommendations for Safe Dental Care: A Systematic Review of Clinical Practice Guidelines in the First Year of the COVID-19 Pandemic.

In the context of a pandemic, the rapid development of clinical practice guidelines (CPGs) is critical to guide dental staff towards the safe provision of dental care; detailed knowledge of the recommendations will help to achieve the intended results. We carried out a systematic review of the recommendations in clinical practice guidelines (CPGs) on the provision of dental care issued during the first year of the COVID-19 pandemic. A systematic database search was performed in MEDLINE, EMBASE, LILACS, Epistemonikos, and Trip databases to identify documents with recommendations intended to minimize the risk of COVID-19 transmission during dental care. The selection process and data extraction were carried out by two researchers independently. The majority of CPGs recommended the use of rubber dam, high-volume evacuator, mouthwash prior to dental care, four-handed work, and mechanical barriers. The use of aerosol-generating equipment should be avoided whenever possible. In aerosol-generating procedures, the use of a N95 respirator (or similar) is recommended, in addition to a face protector, an impermeable disposable apron/gown, a cap, and gloves. The CPGs developed during the first year of the pandemic offer recommendations which guide dental staff in providing safe dental care, minimizing exposure to SARS-CoV-2 and reducing the risk of COVID-19 infection in the clinical environment. Such recommendations must, however, be updated as new evidence arises.

Distributed Channel Ranking Scheduling Function for Dense Industrial 6TiSCH Networks.

The Industrial Internet of Things (IIoT) is considered a key enabler for Industry 4.0. Modern wireless industrial protocols such as the IEEE 802.15.4e Time-Slotted Channel Hopping (TSCH) deliver high reliability to fulfill the requirements in IIoT by following strict schedules computed in a Scheduling Function (SF) to avoid collisions and to provide determinism. The standard does not define how such schedules are built. The SF plays an essential role in 6TiSCH networks since it dictates when and where the nodes are communicating according to the application requirements, thus directly influencing the reliability of the network. Moreover, typical industrial environments consist of heavy machinery and complementary wireless communication systems that can create interference. Hence, we propose a distributed SF, namely the Channel Ranking Scheduling Function (CRSF), for IIoT networks supporting IPv6 over the IEEE 802.15.4e TSCH mode. CRSF computes the number of cells required for each node using a buffer-based bandwidth allocation mechanism with a Kalman filtering technique to avoid sudden allocation/deallocation of cells. CRSF also ranks channel quality using Exponential Weighted Moving Averages (EWMAs) based on the Received Signal Strength Indicator (RSSI), Background Noise (BN) level measurements, and the Packet Delivery Rate (PDR) metrics to select the best available channel to communicate. We compare the performance of CRSF with Orchestra and the Minimal Scheduling Function (MSF), in scenarios resembling industrial environmental characteristics. Performance is evaluated in terms of PDR, end-to-end latency, Radio Duty Cycle (RDC), and the elapsed time of first packet arrival. Results show that CRSF achieves high PDR and low RDC across all scenarios with periodic and burst traffic patterns at the cost of increased end-to-end latency. Moreover, CRSF delivers the first packet earlier than Orchestra and MSF in all scenarios. We conclude that CRSF is a viable option for IIoT networks with a large number of nodes and interference. The main contributions of our paper are threefold: (i) a bandwidth allocation mechanism that uses Kalman filtering techniques to effectively calculate the number of cells required for a given time, (ii) a channel ranking mechanism that combines metrics such as the PDR, RSSI, and BN to select channels with the best performance, and (iii) a new Key Performance Indicator (KPI) that measures the elapsed time from network formation until the first packet reception at the root.

Prevalencia y Severidad de Caries Dental en los Niños Beneficiarios del Programa de Salud Oral Asociados a Escuelas de Chile / Prevalence and severity of dental caries in beneficiary children in the oral health program associated with schools in Chile

La caries es la enfermedad crónica más prevalente en niños constituyendo un problema de salud pública a nivel mundial. El objetivo de este estudio fue determinar la prevalencia y severidad de caries en niños y niñas pertenecientes al Programa de Salud Oral asociado a escuelas de la Junta Nacional de Auxilio Escolar y Becas (JUNAEB). Se realizó un estudio de corte trasversal basado en datos del año 2015 del Sistema Informático del Programa de Salud Oral de JUNAEB. Las variables de estudio fueron presencia y severidad de caries (índices ceod y COPD) y las variables de asociación exploratorias fueron zona geográfica, provincias, sexo, tipo de dependencia administrativa del colegio, tipo de enseñanza, sistema de salud, situación de extrema pobreza, tipo de dentición y tipo de atención. La asociación independiente entre las variables se analizó mediante el test de Chi2 y t-test. La muestra quedó constituida por 162.116 individuos, siendo el 50 % mujeres. La población estudiada mostró una prevalencia de 49 % y un índice ceod y COPD de 2,48 y 1,55 respectivamente. La mayor prevalencia (63 %) fue la zona centro sur y la región del Bío-Bío mostró los mayores índices de severidad (p<0,001). Las asociaciones más significativas fueron entre caries y el nivel socioeconómico y zona geográfica (p<0,001). Este estudio evidencia la asociación de la prevalencia/ severidad de caries y el nivel socioeconómico, y la distribución geográfica de la caries; lo cual hace necesario implementar medidas preventivas que compensen la ruralidad o la falta de fluoración del agua en algunas zonas geográficas de pobreza extrema.

Caries is the most prevalent chronic disease in children, constituting a worldwide public health problem. The aim of this study was to determine the prevalence and severity of caries in children included in the Oral Health Program associated to schools of the National Board of School Aid and Scholarships (JUNAEB). A cross- sectional study based on data from 2015 electronic register JUNAEB Oral Health Program was carried out. The main variables studied were presence and severity of caries (dmft and DMFT indices) and association variables were geographical area, sex, type of administrative dependency of the school, type of education, health system, and situation of extreme poverty, type of teething and type of care. The independent association between the variables was analyzed using the Chi2 test and the t-test.The sample consisted of 162,116 individuals, 50 % being women. The studied population showed a prevalence of 49 % and a CEOD and COPD index of 2.48 and 1.55, respectively. The highest prevalence (63 %) was the south-central zone and the Bío- Bío region showed the highest severity indices (p <0.001). The most significant associations were between caries and socioeconomic level and geographic area (p <0.001). This study shows the association between caries prevalence / severity and socioeconomic level, and the geographical distribution of caries, which make necessary the implementation of preventive measures that compensate rurality, or the lack of water fluoridation in some areas of extreme poverty.

Adaptation and validation of the PEDSQL™ oral health scale for toddlers in Chilean population.

BACKGROUND: The Pediatric Quality of Life Inventory™ (PedsQL™) Oral Health Scale was developed to measure oral health-related quality of life (OHRQoL). The aim of this study was to cross-culturally adapt the parent-reported version for toddlers of PedsQL™ Oral Health Scale into Spanish and to assess the acceptability, reliability and validity of this version in Chilean preschool population. METHODS: The PedsQL™ Oral Health Scale for toddlers was cross-culturally adapted for the Spanish language using the recommended standards. To assess metric properties, a cross-sectional study was carried out with 301 children aged 2 to 5 years in Carahue, Chile. Chilean versions of the PedsQL™ Oral Health Scale, PedsQL™ 4.0 Generic Core Scales, and Early Childhood Oral Health Impact Scale (ECOHIS) were completed by the children's parents. Dental caries, malocclusion and dental trauma were examined by trained dentists. The PedsQL™ Oral Health Scale was administrated a second time 14-21 days after. The reliability of the scale was verified by analysis of internal consistency (Cronbach's alpha) and reproducibility (Intraclass correlation coefficient - ICC). The validity of the construct was assessed by confirmatory factor analysis and known groups method. The convergent validity was assessed by calculating the Spearman's correlation with the ECOHIS questionnaire. RESULTS: The PedsQL™ Oral Health Scale demonstrated good reliability, with Cronbach's alpha coefficient of 0.79 and ICC of 0.85. A moderate-to-strong correlation was found between the PedsQL™ Oral Health Scale and the ECOHIS questionnaire (- 0.64); the PedsQL™ Oral Health Scale score was lower in children with poor than those with excellent/very good oral health (median 100 vs 85, p < 0.001); it also was lower in children with caries than in those caries-free (median 100 vs 90, p < 0.001). No statistically significant differences were found among groups according to malocclusion and traumatic dental injuries. CONCLUSIONS: The PedsQL™ Oral Health Scale for toddlers in Spanish showed to be equivalent to the original version, and its psychometric properties were satisfactory for application in a Chilean pre-school population.

Assessing oral health-related quality of life in children and adolescents: a systematic review and standardized comparison of available instruments.

OBJECTIVES: To obtain a systematic and standardized evaluation of the current evidence on development process, metric properties, and administration issues of oral health-related quality of life instruments available for children and adolescents. MATERIALS AND METHODS: A systematic search until October 2016 was conducted in PubMed, Embase, Lilacs, SciELO, and Cochrane databases. Articles with information regarding the development process, metric properties, and administration issues of pediatric instruments measuring oral health-related quality of life were eligible for inclusion. Two researchers independently evaluated each instrument applying the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0-100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms. RESULTS: We identified 18 instruments evaluated in 132 articles. From five instruments designed for preschoolers, the Early Childhood Oral Health Impact Scale (ECOHIS) obtained the highest overall EMPRO score (82.2). Of nine identified for schoolchildren and adolescents, the best rated instrument was the Child Perceptions Questionnaire 11-14 (82.1). Among the four instruments developed for any age, the Family Impact Scale (FIS) obtained the highest scores (80.3). CONCLUSION: The evidence supports the use of the ECOHIS for preschoolers, while the age is a key factor when choosing among the four recommended instruments for schoolchildren and adolescents. Instruments for specific conditions, symptoms, or treatments need further research on metric properties. CLINICAL RELEVANCE: Our results facilitate decision-making on the correct oral health-related quality of life instrument selection for any certain study purpose and population during the childhood and adolescence life cycle.

Validation and usability of a mobile phone application for epidemiological surveillance of traumatic dental injuries.

BACKGROUND/AIM: Traumatic dental injuries (TDI) are a public health problem, given their prevalence and consequences. However, their epidemiology is uncertain due to a general lack of quality data capture. The aim of this study was to evaluate the validity and usability of a mobile phone-based application for community-based surveillance of traumatic dental injuries. MATERIALS AND METHODS: A mobile phone-based application, Dental Trauma Tracker (DTT), was developed. This system involves a mobile application for general users to report TDIs and a Web application for researchers to generate epidemiological data. The DTT evaluation used mixed methods and was conducted in three phases: (a) validation of a trauma identification system using preselected TDI images; (b) design evaluation by experts; and (c) usability evaluation measured by the reporting of three fictitious TDI cases and using the System Usability Scale (SUS). RESULTS: In the first phase, 182 participants participated. Most images showed over 95% accuracy, indicating that they adequately represented the type of dentoalveolar trauma being evaluated (κ = 0.75). The design evaluation identified nine usability problems-four of them with a "High priority" to be fixed, four with "Low priority," and one "No fix necessary." A total of 29 volunteers participated in the usability evaluation. The mean time for users to complete all of the reports was 7.8 ± 3.0 minutes. Mean SUS score was 67.4 ± 21.9 (Range: 0-100; worst to best). The global agreement between cases registered with the gold standard was also "Substantial" (κ = 0.71). CONCLUSIONS: This preliminary evaluation confirmed the App's usability, using a sample of potential users, as well as reporting on the results of an expert panel review of the DTT. These are the minimum requirements necessary before further expansion and widespread implementation occurs to confirm these results.

Cross-cultural adaptation and psychometric evaluation of the early childhood oral health impact scale (ECOHIS) in chilean population.

BACKGROUND: The Early Childhood Oral Health Impact Scale (ECOHIS) measures the impact of dental diseases on Oral Health-Related Quality of Life both in children and their families. The aim of this study was to develop a Chilean Spanish version of the ECOHIS that is conceptually equivalent to the original and to assess its acceptability, reliability and validity in the preschool population of Chile. METHODS: The Chilean version of the ECOHIS was obtained through a process including forward and back-translation, expert panel, and cognitive debriefing interviews. To assess metric properties, a cross-sectional study was carried out in Carahue, Southern Chile (April-October 2016). Children younger than six years old without systemic diseases, disabilities or chronic medication from eleven public preschools were included. Parents were invited to complete the Chilean version of the ECOHIS, PedsQL™4.0 Generic Core and PedsQL Oral Health scales, and to answer global questions about their children's general and oral health. A subsample was administrated ECOHIS a second time 14-21 days after. A clinical examination was performed to assess dental caries, malocclusion, and traumatic dental injuries. Reliability was evaluated using measures of internal consistency (Cronbach's alpha) and reproducibility (Intraclass correlation coefficient - ICC). Construct validity was assessed by testing hypotheses based on available evidence about known groups and relationships between different instruments. RESULTS: The content comparison of the back-translation with the original ECOHIS showed that all items except one were conceptually and linguistically equivalent. The cognitive debriefing showed a suitable understanding of the Chilean version by the parents. In the total sample (n = 302), the ECOHIS total score median was 1 (IQR 6), floor effect was 41.6%, and ceiling effect 0%. Cronbach's alpha was 0.89 and the ICC was 0.84. The correlation between ECOHIS and PedsQL™4.0 Generic Core was weak (r = 0.21), while it was strong-moderate (r = 0.64) with the PedsQL Oral Health scale. In the known groups comparison, the ECOHIS total score was statistically higher in children with poor than excellent/very good oral health (median 11.6 vs 0, p < 0.01), and in the high severity than in the caries-free group (median 8 vs 0.5, p < 0.01). No differences were found according to malocclusion and traumatic dental injuries groups. CONCLUSIONS: These results supported the feasibility, reliability and validity of the Chilean version of ECOHIS questionnaire for preschool children through proxy.

Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: A randomized control trial.

OBJECTIVES: Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. METHODS: A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24-month follow-up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention-to-treat (ITT) approach was used for the primary analysis. RESULTS: We included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow-up showed a between-group prevention fraction of 18.9% (-2.9%-36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported. CONCLUSIONS: In conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries.

Prevalence of early childhood caries in non-fluoridated rural areas of Chile / Prevalencia de caries temprana de la infancia en zonas rurales sin agua fluorada de Chile

Introduction: early Childhood Caries (ECC) is a serious public health concern worldwide, especially in communities without water fluoridation. Objective: To determine the prevalence of ECC in 2 and 3 year old children attending rural daycare centers without access to water fluoridation. Methods: A cross-sectional study at community level was performed during 2012. The eligible population was composed of 2 and 3 year-old children from rural daycare centers located in nonfluoridated areas in regions La Araucania, Los Rios, and Los Lagos, Chile. Four calibrated examiners (ICC=0.83) measured the prevalence of dental caries based on criteria proposed by the WHO. Data were analyzed using chi-square test, t-test and logistic regression models. Results: The study sample consisted of 587 children; two-year-olds accounted for 53.32 percent, and 52.47 percent were female. Prevalence of ECC was 51.62 percent with a mean dmft index of 2.53. Region de la Araucania had the highest ECC prevalence (52.79 percent). Variables that showed association were age, OHI-S and type of health insurance coverage (p<0.05). Conclusion: A high prevalence of ECC was found in areas with a non-fluoridated water supply.

Introducción: la Caries temprana de la infancia (CTI) constituye un serio problema de salud pública a nivel mundial, sobre todo en zonas rurales sin acceso a agua florada. Objetivo: Determinar la prevalencia de CTI en niños de 2 y 3 años que asisten a jardines infantiles sin acceso agua potable florada. Métodos: Se realizó un estudio de corte transversal a nivel comunitario durante el 2012. La población elegible fueron niños de 2 y 3 años asistentes a Jardines rurales de zonas no fluoradas de las regiones de La Araucanía, Los Ríos y Los Lagos. Cuatro examinadores calibrados (ICC= 0,83) determinaron la prevalencia de caries usando los criterios propuestos por la OMS. La información fue analizada utilizando el test chi cuadrado, la prueba t-test y modelos de regresión logística. Resultados: La muestra quedo constituida por 587 niños de los cuales el 53,32% tenían 2 años y el 52,47 por ciento eran mujeres. La prevalencia de CTI fue de 51,62 por ciento con un índice ceod promedio de 2,53. La región con más alta prevalencia fue la Araucanía con un 52,79 por ciento. La variables que mostraron asociación fueron edad, IHO-S y previsión (p<0,05). Conclusión: La prevalencia de CTI en las zonas rurales sin agua florada es alta.

Disponibilidad de Flúor en Saliva y Biofilms en Escolares Expuestos a Leche o Agua Fluorurada / Availability of Fluoride in Saliva and Biofilms in School Children Exposed to Fluoride in Water or Milk

La caries sigue siendo un problema de Salud Pública, por la alta prevalencia y severidad que afecta a la población. En Chile, la incorporación de flúor en el agua y la leche, son medidas de salud pública en la prevención de caries que se distribuye en zonas urbanas y rurales respectivamente. La evidencia científica nos permite sostener que el fluoruro disponible en saliva y placa bacteriana es el principal responsable del efecto preventivo de este compuesto en el proceso de caries. El objetivo fue comparar los niveles de flúor en saliva y placa bacteriana, antes y después de la ingesta de leche, de los escolares que consumen leche fluorurada y de los que consumen leche sin flúor preparada con agua potable fluorurada de la Región de la Araucanía de Chile. Se realizó un estudio de muestras repetidas de saliva y placa bacteriana en 165 niños(as) incorporados(as) en el Programa PAE de 16 escuelas rurales y urbanas. Se tomaron muestras de saliva y placa bacteriana antes del desayuno, muestras de saliva 60 min después y muestras de placa bacteriana 120 minutos después del desayuno. La concentración de fluoruro en saliva se observa muy similar sin importar el vehículo a través del cual se le administre, sea este leche fluorurada o leche sin fluor preparada con agua fluorurada, tanto en las muestras basales como en las muestras obtenidas después del desayuno. En cambio en placa bacteriana si se observan pequeñas diferencias que, siendo estadísticamente significativa, pueden no tener mucha relevancia clínica por ser demasiado pequeñas. Estos resultados refuerzan la hipótesis de que la estrategia de leche fluorurada tiene resultados similares al agua fluorurada.

Caries continue to be a public health problem, due to their high prevalence and their severe effect on people. Currently in Chile, adding fluoride to water and milk are public health measures to prevent caries that are distributed in urban and rural areas respectively. Scientific evidence supports the availability of fluoride in saliva and bacterial plaque being the most effective prevention against caries. The goal was to compare the levels of fluoride in saliva and bacterial plaque before and after drinking milk, among school-children who consume fluoridated milk and those who consume un-fluoridated milk prepared with fluoridated drinking water, in the La Araucanía Region of Chile. A study was conducted of repeated samples of saliva and bacterial plaque in 165 children within the PAE program at 16 rural and urban schools. Saliva and bacterial plaque samples were taken before breakfast, saliva samples were taken 60 minutes after breakfast and bacterial plaque samples were taken 120 min after breakfast. The concentration of fluoride in saliva was found to be very similar regardless of the manner in which it was administered. So it was similar in children drinking fluoridated milk and un-fluoridated milk prepared with fluoridated water, and similar both before and after breakfast. In contrast, we found small differences for bacterial plaque, that are statistically significant. However, they may not be clinically significant as they are too small. These results reinforce the hypothesis that the strategy of adding fluoride to milk has similar results to adding fluoride to water.

Enseñanza de la bioética en el currículo de las carreras de odontología desde la perspectiva de los estudiantes / Ensino da bioética no currículo dos cursos de odontologia sob a perspectiva dos estudantes / Training on bioethics in dentistry curriculum from the perspective of students

Se realizó un estudio de tipo descriptivo, a través del análisis de contenido, con la finalidad de conocer las percepciones de los estudiantes de odontología sobre la enseñanza de la bioética en el currículo de la carrera de Odontología de la Universidad de la Frontera. La recolección de los datos se realizó mediante la técnica de grupos focales, en dos sesiones de doce alumnos cada uno, representados por dos alumnos de los diferentes niveles de la carrera. La interrelación entre los participantes se estimuló a través de una pauta de conducción previamente diseñada. Los datos, registrados a través de grabaciones, fueron transcritos para el análisis de contenido, efectuado manualmente mediante triangulación entre los investigadores. A partir del análisis de contenido de los datos primarios, se estableció una serie de categorías, agrupadas en cuatro grandes dimensiones: concepto de bioética, importancia de la bioética en el ejercicio profesional, enseñanza-aprendizaje de la bioética y modalidad de enseñanza de la bioética. Los estudiantes de odontología de la Universidad de la Frontera transitan de manera muy asertiva por los tópicos que componen la compleja dimensión de la enseñanza de la bioética y reconocen la importancia de la bioética en su formación.

A descriptive study was carried out through content analysis, with the goal of knowing the perceptions of dentistry students about bioethics training in Dentistry curriculum of Frontera University. Data collected was carried out through focal group technique in two sessions of 12 students each, represented by two students from de different levels of the career. The interrelation among participants was stimulated through a guide for conduction previously designed. Data registered through tape recording were transcribed for content analysis, carried out manually by triangulation among researchers. Several categories were established by content analysis of primary data, grouped in four big dimensions: concept of bioethics, importance of bioethics in professional exercise, teaching-learning of bioethics and modality of teaching of bioethics. Dentistry students of Frontera University walked in assertive way through issues belonging to the complex dimension of bioethics training and recognize the importance of bioethics in their training.

Foi realizado um estudo de tipo descritivo, através da análise de conteúdo, com a finalidade de conhecer as percepções dos estudantes de odontologia sobre o ensino da bioética no currículo do curso de Odontologia da Universidad de laFrontera. A coleta dos dados foi realizada mediante a técnica de grupos focais, nas seções de doze alunos cada uma, representados por dois alunos dos diferentes níveis do curso. A inter-relação entre os participantes foi estimulada por meio de uma pauta de condução previamente projetada. Os dados, registrados através de gravações, foram transcritos para a análise de conteúdo, efetuado manualmente mediante triangulação entre os investigadores. A partir da análise de conteúdo dos dados primários, se estabeleceu uma série de categorias, agrupadas em quatro grandes dimensões: conceito de bioética, importância da bioética no exercício profissional, ensino-aprendizagem da bioética e modalidade de ensino da bioética. Os estudantes de odontologia da Universidad de laFrontera transitam de maneira muito assertiva pelos tópicos que compõem a complexa dimensão do ensino da bioética e reconhecem a importância da bioética em sua formação.