Periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life in patients with anorexia and bulimia nervosa.

BACKGROUND: Anorexia and bulimia nervosa can have significant effects on oral health. Assessment of enzyme concentrations in saliva can be useful for obtaining information on molecular biomarkers for the prevention, monitoring, and diagnosis of oral diseases. This study investigated the periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life (OHRQoL) in patients with anorexia and bulimia nervosa. METHODS: The study comprised 60 women patients who attended a Brazilian medical school. Participants were divided into two groups: patients with anorexia and bulimia nervosa (ABN; n = 30) and control patients (CN; n = 30). Oral clinical examinations were carried out to evaluate the periodontal condition by Community Periodontal Index, and interviews using the Oral Health Impact Profile (OHIP-14) were conducted to assess OHRQoL. Saliva samples were collected for the evaluation of salivary concentrations of total protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and thiobarbituric acid reactive substance (TBARS), and salivary flow rate. RESULTS: Periodontal condition in the ABN group was significantly worse than that in the CN group. The ABN group showed significantly higher salivary concentrations of total protein, AST, ALT, and LDH than the CN group. There was no significant difference in the salivary concentrations of TBARS among the groups. The OHIP-14 score was higher in the ABN group than in the CN group. CONCLUSION: Anorexia and bulimia nervosa are associated with poor periodontal condition, elevated salivary concentrations of total protein, AST, ALT, and LDH, decreased salivary flow rate and a significant adverse impact on OHRQoL.

Saúde bucal no Brasil: uma nova política de enfrentamento para a realidade nacional / Brazilian oral health: a new fronting politic at national reality

A implantação de Centros de Especialidades Odontológicas (CEO) no Brasil constitui-se atualmente em uma das principais frentes da Política Nacional de Saúde Bucal, cujo desafio é ampliar e qualificar a oferta de serviços odontológicos especializados. Com o objetivo de analisar a implantação e a distribuição geográfica dos CEO no Brasil e relacioná-las com indicadores de saúde bucal e indicadores sociais amplos desenvolveu-se este estudo, fruto da exploração de fontes secundárias. Os resultados obtidos mostram que o Brasil conta atualmente com 339 CEO implantados, distribuídos de forma relativamente homogênea em 283 dos 5.560 municípios brasileiros, presentes nas cinco Grandes Regiões. A maioria dos CEO encontra-se implantada em municípios de grande porte. Os dados expuseram que as regiões Sudeste, Centro-Oeste e Nordeste obtêm as maiores porcentagens de municípios cobertos pelos CEO (7,6%; 6,5%; 6,1%, respectivamente), enquanto as regiões Norte e Sul apresentam as menores taxas de cobertura (4,0% e 4,5%, respectivamente). Com relação às necessidades sociais e de saúde bucal da população, as regiões Norte e Nordeste são portadoras das condições menos favoráveis, situação contrária às regiões Sul, Sudeste e Centro-Oeste que apresentam as melhores condições. Embora os resultados da implantação dos CEO no Brasil sejam ainda tímidos, frente às características geográficas e populacionais do país e à necessidade de expansão de serviços odontológicos de maior complexidade, esta iniciativa representa um avanço real na reorganização da prática odontológica.

The implement of Specialized's Dentistry Centers in Brazil is, on present day, one of the prime faces of Oral Health Brazilian Political, of which is to amplify and to qualify the specialized's dentistry services proffer. The aim of this study, done with indirect dates, was to analyze the implantation and geographical distribution of these Centers in Brazil and try to make a relationship between this information and social and oral health factors. The results obtained showed the presence of 339 Centers already implanted in Brazil, homogeneously allocated in 283 cities, by a total of 5.560 brazilian cities, presented in the five Greater Regions. The most of the Centers were presented in large load cities. The data showed Southeast, Central West and Northeast regions with the major percentage of cities carrying Specialized's Dentistry Centers (7,6%; 6,5%; 6,1%, respectively), while North and South regions present the minor covering taxes (4,0% and 4,5%, respectively). Relation to population's social and buccal needs, North and Northeast Regions have the most adverse conditions, on the contrary to South, Southeast and Central West Regions who show the best one. Although the finded results were not so expressive, reflecting the brazilian geographical and populational characteristics and the essential development of specialized dentistry services, this initiative presents a real progress over the reorganization of dentistry's practice.

Infant formula and enamel fluorosis: a systematic review.

BACKGROUND: Researchers have considered infant formula consumption a potential risk factor for enamel fluorosis in the U.S. population. The authors conducted a systematic review of controlled studies regarding the risk of developing enamel fluorosis associated with use of infant formula. METHODS: One reviewer independently conducted systematic searches in eight databases. The authors then abstracted information, assessed study quality and combined odds ratios (ORs), when obtainable, by using a random-effects model. RESULTS: After evaluating 969 potentially eligible published studies, the reviewers found that the authors of 41 studies had evaluated the effect of infant formula on enamel fluorosis risk. Authors of 14 of the 41 studies did not report their findings in their results. The authors of the remaining 27 published studies reported the findings of 19 observational studies; authors of 17 of these 19 studies reported ORs and, among these, infant formula consumption was associated with a higher prevalence of enamel fluorosis in the permanent dentition (summary OR 1.8, 95 percent confidence interval [CI] 1.4-2.3). There was significant heterogeneity among studies (I(2) 66 percent) and evidence of publication bias (P = .002). A metaregression analysis indicated that the ORs associating infant formula with enamel fluorosis increased by 5 percent for each 0.1-part-per-million increase in the reported levels of fluoride in the water supply (OR 1.05, 95 percent CI 1.02-1.09). CLINICAL IMPLICATIONS: Infant formula consumption may be associated with an increased risk of developing at least some detectable level of enamel fluorosis, which depends on the level of fluoride in the water supply. The evidence that the fluoride in the infant formula caused enamel fluorosis was weak, as other mechanisms could explain the observed association.

O processo ensino-aprendizagem na percepção do graduando de odontologia / The education and learning process as perceived by undergraduate dentistry students

O aprendizado é um processo contínuo que induz o ser humano a adquirir novas condutas de pensamento e comportamento, e a universidade constituise parte essencial dessa constante aprendizagem. Os cursos de Odontologia passam atualmente por um processo de reestruturação para atender às Diretrizes Curriculares Nacionais. Nesse contexto, a avaliação do ensino assume papel importante, pois fornece informações fundamentais para o processo de readequação do ensino. O objetivo deste estudo foi analisar os dados da avaliação realizada na Faculdade de Odontologia de Araçatuba-UNESP com relação ao processo ensino-aprendizagem, na percepção dos graduandos (n = 367). Foi utilizado um questionário no qual o aluno expressava suas opiniões de acordo com o grau de concordância, nas categorias: Concorda (C), Indeciso (I) e Discorda (D), sobre informações pertinentes ao objetivo do curso, ensino, aprendizagem, questões psicosociais e ambiente educacional. Os resultados mostraram que para os alunos (75,25%) os objetivos a serem atingidos no curso são bem esclarecidos, o ensino os ajuda a desenvolverem a autoconfiança (70,8%) e os encoraja a serem aprendizes (63,5%). Assim como, consideram (67,5%) estar sendo bem preparados para a profissão. Para grande parte (39,8%) o ensino é centrado no professor e discordam que o tempo de ensino é bem utilizado (49,5%). Conclui-se que o processo ensino-aprendizagem foi satisfatoriamente classificado, no entanto, ressalta-se a necessidade de uma avaliação do papel docente e um melhor aproveitamento do tempo de ensino, proporcionando um ambiente educacional mais motivador e adequado que contribuirá de forma significativa para o aprendizado (AU).

Learning is a continuous process that induces the human being to acquire new ways of thinking and behaving, and the university is an essential part of this constant learning process. At present, Dentistry courses are undergoing a process of restructuring to comply with the National Curricular Guidelines. In this context, the evaluation of teaching takes on an important role, because it provides basic information needed for the process of realigning teaching. The aim of this study was to analyze the data obtained from the evaluation carried out in the School of Dentistry of Araçatuba-UNESP regarding the teaching-learning process, as perceived by the undergraduate students (n=367). In the questionnaire applied, the student expressed his opinions according to extent of agreement, in the following categories: Agrees (C), Undecided (I) and Disagrees (D) on the information relevant to course objective, teaching, learning, psychosocial issues and educational environment. The results showed that in the opinion of the students (75.25 %), the objectives to be achieved in the course are explained well, the teaching offered helps them develop self-confidence (70.8 %) and encourages them as learners (63.5 %). They also think (67.5 %) that they are well prepared for their profession. Most (39.8 %) feel that the teaching offered is centered on the teacher and they disagree that teaching time is used well (49.5 %). It can be concluded that the teaching-learning process was classified satisfactorily; however, it should be stressed that the role of professors needs to be evaluated, and that teaching time should be used better in order to provide a more motivated and suitable educational environment that will contribute significantly to the learning process (AU).

Association between breast-feeding practices and sucking habits: a cross-sectional study of children in their first year of life.

In addition to providing nutrition and immunological protection, breast-feeding has positive effects on the development of the infant's oral cavity. The aim of the present study is to assess breast-feeding patterns and to analyze the influence of breast-feeding practices and maternal sociodemographic variables on the prevalence of non-nutritive sucking habits in a sample of Brazilian infants. This cross-sectional study was carried out in Southern Brazil. A random sample of 100 mothers of infants up to 12 months of age was interviewed during the National Vaccination Campaign Day. The prevalence and median duration of breast-feeding were assessed. Breast-feeding practice, the exposure factor, was categorized as exclusive breast-feeding, predominant breast-feeding, complementary breast-feeding, or weaning. Maternal sociodemographic variables included age, race, marital status, educational level, profession, and family income. The outcome investigated was the prevalence of sucking habits (pacifier use and thumb sucking). We used two-sample tests, the chi-square test and FISHER'S EXACT TEST for statistical analyses of the data. The study revealed that 75% of infants were being breast-fed. Pacifier use and thumb sucking were common in 55%. Bottle-feeding was prevalent in 74% of infants. Breast-feeding was negatively correlated with pacifier use and thumb sucking (OR=0.11; 95% CI: 0.03 to 0.4). Bottle-feeding was strongly associated with weaning (p=0.0003). Among the sociodemographic variables, only marital status showed a statistical association with sucking habits (p=0.04). These findings suggest that breast-feeding can prevent the occurrence of sucking habits. Although we could not evaluate causality assessment, malocclusion prevention seems to be yet one more reason for promoting breast-feeding practices.

Dental caries of lifetime residents in Baixo Guandu, Brazil, fluoridated since 1953--a brief communication.

OBJECTIVES: This study aimed to verify the dental caries prevalence in Baixo Guandu, the first Brazilian city to fluoridate its public water supplies; to compare the findings with the data from the national survey; and also to compare the prevalence in the 12-year-old age group with the data obtained before the beginning of the fluoridation. METHODS: All the lifetime residents aged 5, 12, 15 to 19, and 35 to 44 years old were clinically examined (World Health Organization). RESULTS: The means of dmft/DMFT were lower than in the Brazilian population living in fluoridated communities. The DMFT Index in 12-year-old residents decreased between 1953 and 2005 from 8.61 to 1.55. CONCLUSIONS: The addition of fluoride to public water supplies was an important ally in the improvement of the oral health of Baixo Guandu inhabitants.

Análise clínico-radiográfica da pulpotomia: de dentes submetidos a tratamento endodôntico conservador / Microradiographic analysis of pulpotomy of teeth submitted do conservative endodontic treatment

O presente trabalho tem como objetivos: avaliar clínica e radiograficamente o sucesso do tratamento endodôntico conservador, pulpotomia, realizado por alunos de graduaçäo no SEMO (Serviço Extra Mural Odontológico). Foram realizados levantamentos nos fichários do SEMO, a fim de detectar pacientes que se submeteram a pulpotomia. Selecionados os pacientes, estes foram convocados, para avaliaçäo clínico-radiográfica do tratamento realizado. Durante o exame clínico, procurou-se notar a integridade da coroa e o silêncio clínico do dente frente a testes de percussäo (vertical e horizontal) e térmicos (quente e frio). No exame radiográfico verificou-se selamento coronário, lâmina dura e formaçäo da ponte de tecido duro. Concluímos que a pulpotomia, quando bem indicada e realizada com os devidos cuidados, obtém bons resultados, mostra-se um método conservador eficaz, podendo ser facilmente utilizado por clínicos gerais

A utilizaçäo de fichas clínicas e sua importância na clínica odontológica / Clinical records: their use and importance in the dental practice

Selecionou-se uma amostra aleatória de 76 cirurgiöes-dentistas de Araçatuba e regiäo, para se verificar o seu conhecimento odonto-legal, as formas de anotaçäo nas fichas clínicas e se o conteúdo destas obedecia às normas propostas pelo C.F.O. Realizaram-se entrevistas com os profissionais, observando-se que aproximadamente 4 por cento deles näo fazem uso das fichas clínicas. Também, 30,2 por cento das fichas näo possuem assinatura nem do cirurgiäo-dentista, nem do paciente e 52,1 por cento näo possuem espaço para exames complementares. Concluiu-se que as fichas clínicas utilizadas näo estäo de acordo com o proposto pelo C.F.O e que os profissionais têm idéia das implicaçöes odonto-legais, mas negligenciam dados no preenchimento de suas fichas