Caries indicators in relation to healthcare access and hygienic-dietary habits in Spanish preschoolers.

INTRODUCTION: Dental caries continues to be a public healthcare problem due to its high prevalence and morbidity. It was proposed to evaluate caries indicators in relation to healthcare access and hygienic-dietary habits in Spanish preschoolers. MATERIALS AND METHODS: A cross-sectional study was carried out on a random sample consisting of 343 patients ranging from 3 to 5 years of age in the primary care setting, the main measurements were: dental care access, hygienic-dietary habits, and caries registration according to WHO criteria. RESULTS: The prevalence of caries was 35.3% and mean ± standard deviation (SD) dft was 1.51 ± 2.93. Preschoolers who had ever visited the dentist had a higher dft occurrence than those who had never attended the dentist. The lower prevalence of caries was significantly associated with the frequency of two daily brushings versus non-daily brushing (p = 0.007; 25.3% vs. 47.1%) and was 10.7% lower in patients who had the habit of night brushing (p = 0.041). The consumption of sugary liquids between meals implied a higher dft index. CONCLUSIONS: The high prevalence of early childhood caries and the dental care access associated with poor oral health suggest the need to implement a multidisciplinary oral healthcare program that involves both healthcare and dental healthcare professionals in Primary Health Care Units without forgetting the participation of the community and local administrations.

Cariogenic Diet Assessment and Analysis Tools in Children and Adolescents: A Systematic Review.

PURPOSE: To collect and evaluate the available evidence on existing tools used in research and clinical practice to assess and analyse the diet of children and adolescents for its cariogenicity. MATERIALS AND METHODS: Multiple databases were searched up to October 2022, with no date, publication, or language restrictions, followed by a manual search. Study screening, data extraction, and risk of bias assessment were performed in duplicate. Dietary assessment tools and dental clinical parameters tested were retrieved for qualitative assessment and synthesis. RESULTS: Of the 2896 papers identified, 9 cohort and 23 cross-sectional studies fulfilled the inclusion criteria. To assess dietary data, 13 studies used a 24-h recall, 11 used a food diary, and 7 used a food frequency questionnaire. For analysis, five studies reported using the Healthy Eating Index, ten used a score based on consumption of sugars, and the remaining analysed cariogenic diet based on the weight and frequency of sugars consumed, or the daily caloric intake from free sugars. Risk of bias assessment suggested that 65.7% of the studies were of moderate and 31.5% of high quality. CONCLUSION: Inconsistency exists regarding methods used for the assessment and analysis of dietary cariogenicity. Although every dietary assessment tool has different strengths and limitations, the 24-h recall was the most commonly used method for the assessment of dietary cariogenicity and the most consistent in detecting a positive relationship between sugary diet and carious lesions. A standardised method for cariogenic analysis of dietary data needs to be determined.

Determinantes sociais de saúde de crianças em consulta de puericultura: das condições socioeconômicas aos aspectos relacionados à saúde bucal / Social determinants of health of children in child care consultation: from socioeconomic conditions to aspects related to oral health / Determinantes sociales de la salud de los niños en la consulta infantil: de las condiciones socioeconómicas a los aspectos relacionados con la salud bucal

A imaturidade do sistema imunológico, associado a Determinantes Sociais de Saúde (DSS), promove doenças na infância. Especificamente, na cavidade oral, os DSS, representados pelo consumo elevado de açúcar, limitado acesso aos serviços de saúde e deficiência na higiene bucal, favorecem transtornos locais e sistêmicos. Assim, o estudo objetivou associar os DSS, no contexto das condições socioeconômicas, do acompanhamento pelo serviço de saúde e dos aspectos relacionados à saúde bucal de crianças atendidas em Unidades Básicas de Saúde (UBS) de um município cearense. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães em Acarape - CE. Após consentimento, essas preencheram um questionário. Os dados foram analisados. Das 70 mães, 87,14% e 90,00% tinham idade inferior ou igual a 30 anos e renda de até um salário mínimo, respectivamente. Das 70 crianças, 87,14% tinham seus dentes/gengiva higienizados por seus pais ou responsável. Do total, 94,29% nunca se submeteram a atendimento odontológico. Observou-se associação significativa entre a mãe ter escolaridade superior ao ensino fundamental incompleto e higienizar os dentes/gengiva do filho com escova dental e dentifrício. Constatou-se associação significativa entre a criança ingerir bolacha doce/recheada, não consumir refrigerante e usar escova dental e dentifrício na higienização oral. Conclui-se que as crianças eram acompanhadas nas UBS regularmente; no entanto, esse serviço não esteve relacionado ao atendimento odontológico. Apesar da ausência desse tipo de acompanhamento e do consumo de alimentos cariogênicos, as mães se preocupavam com a saúde bucal das crianças, higienizando a cavidade oral diariamente, com meios adequados.

The immaturity of the immune system, associated with Social Determi- nants of Health (SDH), promotes diseases in childhood. Specifically, in the oral cavity, SDH, represented by high sugar consumption, limited access to health services, and poor oral hygiene, favors local and systemic disorders. Thus, the study aimed to associate the SDH, in the context of socioeconomic conditions, monitoring by the health service and aspects related to children's oral health assisted in Basic Health Units (BHU) of a muni- cipality in Ceará. This is an observational, analytical, cross-sectional study with a quan- titative approach conducted with children and their mothers in Acarape - CE. After con- sent, they filled out a questionnaire. Data were analyzed. Of the 70 mothers, 87.14% and 90.00% were aged less than or equal to 30 years and had income up to one minimum wage, respectively. Of the 70 children, 87.14% had their teeth/gums cleaned by their pa- rents or guardian. Of the total, 94.29% never underwent dental care. There was a signifi- cant association between the mother having higher education than incomplete elementary school and cleaning the child's teeth/gums with a toothbrush and toothpaste. A significant association was found between the child eating sweet/stuffed biscuits, not consuming soft drink, and using a toothbrush and dentifrice for oral hygiene. It is concluded that the chil- dren were regularly monitored at the BHU; however, this service was not related to dental care. Despite the absence of this type of follow-up and the consumption of cariogenic foods, the mothers were concerned about their children's oral health, cleaning the oral cavity daily with adequate means.

La inmadurez del sistema inmunológico, asociada a los Determinantes So- ciales de la Salud (DSS), promueve enfermedades en la infancia. Específicamente, en la cavidad bucal, los DSS, representados por el alto consumo de azúcar, el acceso limitado a los servicios de salud y la mala higiene bucal, favorecen los trastornos locales y sisté- micos. Así, el estudio tuvo como objetivo asociar el DSS, en el contexto de las condicio- nes socioeconómicas, el seguimiento por el servicio de salud y los aspectos relacionados con la salud bucal de los niños atendidos en las Unidades Básicas de Salud (UBS) de un municipio de Ceará. Se trata de un estudio observacional, analítico, transversal con enfo- que cuantitativo, realizado con niños y sus madres en Acarape ­ CE. Después del consen- timiento, completaron un cuestionario. Los datos fueron analizados. De las 70 madres, 87,14% y 90,00% tenían edad menor o igual a 30 años e ingresos hasta un salario mínimo, respectivamente. De los 70 niños, al 87,14% se les limpió los dientes/encías por sus pa- dres o tutores. Del total, el 94,29% nunca realizó atención odontológica. Hubo una aso- ciación significativa entre la madre con educación superior a la primaria incompleta y la limpieza de los dientes/encías del niño con cepillo y pasta dental. Se encontró una asoci- ación significativa entre el niño que come galletas dulces/rellenas, no consume gaseosas y usa cepillo de dientes y dentífrico para la higiene bucal. Se concluyó que los niños eran monitoreados periódicamente en la UBS; sin embargo, este servicio no estaba relacionado con el cuidado dental. A pesar de la ausencia de este tipo de seguimiento y del consumo de alimentos cariogénicos, las madres se preocupan por la salud bucal de sus hijos, reali- zando la limpieza de la cavidad bucal diariamente, con medios adecuados.

Caries dental y factores asociados en población de 5-12 años

Introducción: Las enfermedades bucales se encuentran entre las cinco de mayor demanda de atención en los servicios de salud a nivel mundial. Materiales y métodos: Se realizó una investigación observacional analítica retrospectiva de casos y controles, con el objetivo de determinar el grado de asociación entre la caries dental y los factores de riesgo en la población infantil de 5 a 12 años del Consultorio del Médico de la Familia no. 3, pertenecientes al Policlínico Docente Belkis Sotomayor Álvarez, del municipio Ciego de Ávila, durante el período de octubre de 2021 a marzo de 2022. El grupo de casos estuvo integrado por 62 niños, al igual que el grupo control. Se utilizó la técnica de independencia basada en la distribución de Chi-cuadrado, para determinar la presencia de asociación estadística entre variables cualitativas, y se realizó el cálculo del Odd ratio para la cuantificación de riesgo. Resultados: El grupo de 5 a 8 años fue el de mayor número de niños con caries dental, para un 59,7 %. El 62,9 % solo se cepillaban los dientes con una frecuencia de dos o menos veces al día. El antecedente de caries dental, la enfermedad gingival y la ingestión de alimentos azucarados, estuvieron relacionados con la aparición de caries dental. Conclusiones: La dieta cariogénica resultó ser el factor de riesgo con mayor puntaje en la incidencia de la caries dental en la muestra estudiada.

Introduction: Oral diseases are among the five diseases demanding more care in health services worldwide. Materials and methods: A descriptive, analytic, observational research of cases and controls was carried out, with the objective of determining the association degree between dental caries and risk factors in the child population aged from 5 to 12 years from the Family Physician Consultation Nr. 3, belonging to the Teaching Polyclinic Belkis Sotomayor Alvarez, in the municipality Ciego de Avila, during the period from October 2021 to March 2022. The case group consisted of 62 children, the same as the control group. The independence technique based on the Chi-square distribution was used to determine the presence of statistical association between qualitative variables, and the Odd ratio was calculated for risk quantification. Results: The group from 5 to 8 years was the one with higher number of children with dental caries, for 59.7%. 62.9% only brushed their teeth with a frequency of two or less times a day. History of dental caries, gingival disease and sugary food ingestion were related to the appearance of dental caries. Conclusions: The cariogenic diet proved to be the risk factor with the higher score in the incidence of dental caries in the sample studied.

Cross-Cultural Validity of a Dietary Questionnaire for Studying Dental Caries in Japanese Children.

This study examines the cross-cultural validity of the Japanese version of the Food Frequency Questionnaire (FFQ), designed for studies on dental caries to assess dietary intake in Japanese children. Parent-reported dietary data were collected (274 children, 3-6 years old) using the 38-item FFQ, whose reliability and validity have been demonstrated in adults. Factor analysis was used to determine dimensionality. Dietary cariogenicity scores were compared with the levels of plaque mutans streptococci, and the decayed, missing, and filled teeth (dmft) index to evaluate the criterion validity using Pearson's correlation coefficient (r) and the Kruskal-Wallis test. The FFQ showed good criterion validity, assessed through its relationship with the dmft index (r = 0.119; p = 0.05) and Dentocult SM score (r = 0.124; p = 0.04). Factor analysis revealed six questionnaire subscales. Internal consistency was from low to acceptable (Cronbach's alpha = 0.64 for the total scale, 0.39-0.53 for each subscale). Children with a higher SM score were more likely to have higher dietary cariogenicity scores (p = 0.01; Kruskal-Wallis test). These results confirm the validity of the Japanese version of the FFQ for children, which can be used to track dietary structure dynamics regarding cariogenicity from childhood to adulthood.

Cariogenic diet consumption during lockdown.

BACKGROUND: During stressful situations such as pandemic-associated lockdowns, individuals' diets may change towards (cariogenic) 'comfort food'. This study assessed the dietary patterns during the lockdown in the Colombian population. METHODS: A cross-sectional online survey was designed. A convenience sample of 489 adults was drawn, with 50% of them being in COVID-19 lockdown and the other being not or only partially in lockdown. The questionnaire collected data about the type and frequency of food consumed, with a special focus on cariogenic (i.e., rich in free sugars and starches) food. Descriptive analyses were performed, and a generalised linear model was estimated to predict the frequency of cariogenic diet consumption in this period of time. RESULTS: Sweet whole wheat bread (38.2%, p = 0.005), flavoured milk (26.4%, p = 0.002), sugar-sweetened bubble gums (39.8%, p = 0.001), toffees (35.4%, p = 0.004), soft candies (e.g., gums) (35.4%, p = 0.018), chocolates (55.3%, p = 0.017), filled doughnuts (28.5%, p = 0.013) or grapes (51.2%, p = 0.002) were significantly consumed more during the lockdown. Multivariable generalised linear modelling showed being single, having children and being in lockdown were significantly associated with higher frequency of cariogenic food consumption. CONCLUSIONS: Lockdown was found to be associated with detrimentally altered food consumption patterns and, specifically, a more cariogenic diet. Healthcare professionals should consider this when reopening services, and political decision-makers may want to reflect on the unwarranted side effect of lockdown.

Factors associated with a cariogenic diet among adolescents: a structural equation modeling approach.

OBJECTIVE: To investigate the factors directly and indirectly associated with a cariogenic diet among southern Brazilian adolescents. MATERIALS AND METHODS: This cross-sectional study included 15-19-year-old students attending high schools in Santa Maria, southern Brazil. The participants completed a questionnaire on sociodemographic and behavioral variables. The Oral Health Impact Profile-14 was applied to collect data on oral health-related quality of life (OHRQoL). Clinical examination was used to assess the dental caries status (decayed, missing, and filled teeth index). A cariogenic diet was considered a latent variable measured by the self-perception of a healthy diet and the frequency of consumption of sugary foods and drinks. Structural equation modeling was used to analyze the direct and indirect pathways to a cariogenic diet. RESULTS: A total of 1197 adolescents were included. Low toothbrushing frequency (standardized coefficient (SC), 0.10; p < 0.05), cigarette smoking (SC, 0.15; p < 0.01), and alcoholic beverages (SC, 0.14; p < 0.01) were directly linked to a cariogenic diet, which, in turn, was directly linked to untreated dental caries (SC, 0.18; p < 0.01) and poor OHRQoL (SC, 0.16; p < 0.01). In addition, household income (via toothbrushing frequency) and age (via alcoholic beverages) were indirectly linked to a cariogenic diet. CONCLUSION: A cariogenic diet was consistently associated with a range of unhealthy behaviors during adolescence as well as poor household income. CLINICAL RELEVANCE: Health promotion strategies to restrict sugar consumption and encourage healthier lifestyles should be aware of the synergism observed among unhealthy behaviors during adolescence.

Nivel de conocimiento sobre dieta cariogénica en madres con niños de 3 a 6 años

Introducción: La salud oral tiene un impacto durante todo el proceso del ciclo vital del ser humano. Los hábitos alimenticios inciden directamente en una buena salud bucal, donde la dieta cariogénica es de interés fundamental. Objetivo: Describir el nivel de conocimiento sobre dieta cariogénica de las madres con niños entre 3 y 6 años, bailarines de la Academia Stone en Ecuador. Método: Se realizó un estudio descriptivo trasversal, el universo lo constituyeron las madres con niños en edades entre 3 y 6 años, se trabajó con todo el universo (n=25). Se definieron las variables: criterios que tomaban en cuenta para elegir los alimentos, cuidado de higiene bucal en los menores, frecuencia de ingesta de hidratos de carbonos, primera consulta odontológica, diagnóstico dado y motivo para no asistir a la consulta. Para la recolección de la información se utilizó un cuestionario tipo Likert. Resultados: El 75 % de las madres se basó en una tabla nutricional al momento de elegir un alimento. El 25 % refirió no leer una tabla nutricional por falta de tiempo y el 32 % refirió consumir alimentos fuera de casa los fines de semana. El 20 % no cepillaba los dientes de sus niños. En la primera consulta el 60 % indicó que ya contaban con caries y el 50 % no había asistido a dicha consulta, de estos últimos el 30 % debido a limitaciones económicas. Conclusiones: El nivel de conocimiento sobre dieta cariogénica en madres con niños de 3 a 6 años es insuficiente.

Introduction: Good oral health has an essential impact throughout the human life cycle. The correct eating habits have proven to be effective on good oral health, where cariogenic diet is of fundamental interest. Objective: To describe the level of knowledge about cariogenic diet of mothers with children between 3 and 6 years old, dancers at the Stone Dance Academy in Ecuador. Method: A descriptive cross-sectional study was carried out; the universe was constituted of mothers (n=25) with children between 3 and 6 years of age, involved all of them in the research. The following variables were defined: criteria they took into account when choosing food for children, oral hygiene care they maintained in children, frequency of carbohydrates, first dental consultation, diagnosis given at the dentist's office, and which was the reason why the mothers not taken their children to their first dental visit. A Likert-type questionnaire was used for the information collected. Results: The 75% of mothers relied on a nutritional table when choosing the food for their children intake. The 25% reported not reading a nutritional table due to lack of time and 32% reported consuming food away from home on weekends. The 20% 20 % did not brush their children's teeth. At the first dental check-up, 60% indicated that they already had caries, 50% had never been attended such a consultation, where from them 30% reported never been attend due to low income. Conclusions: The level of knowledge about cariogenic diet in mothers with children from 3 to 6 years of age is insufficient.

Introdução: A saúde oral tem impacto em todo o processo do ciclo de vida do ser humano. Os hábitos alimentares afetam diretamente a boa saúde bucal, onde a dieta cariogênica é de fundamental interesse. Objetivo: Descrever o nível de conhecimento sobre dieta cariogênica de mães com filhos de 3 a 6 anos, bailarinas da Academia Stone do Equador. Método: Realizou-se um estudo descritivo transversal, o universo foi constituído por mães com filhos entre os 3 e os 6 anos, trabalhamos com todo o universo (n=25). Foram definidas as variáveis: critérios tidos em conta para a escolha dos alimentos, cuidados de higiene oral nos menores, frequência da ingestão de hidratos de carbono, primeira consulta dentária, diagnóstico dado e motivo da não comparência à consulta. Para a coleta de informações, foi utilizado um questionário do tipo Likert. Resultados: 75% das mães se basearam na tabela nutricional para escolher um alimento. 25% relataram não fazer a leitura da tabela nutricional por falta de tempo e 32% relataram consumir alimentos fora de casa nos finais de semana. 20% não escovavam os dentes dos filhos. Na primeira consulta, 60% indicaram que já tinham cárie e 50% não compareceram à consulta, destes 30% por limitações econômicas. Conclusões: O nível de conhecimento sobre dieta cariogênica em mães com filhos de 3 a 6 anos é insuficiente.

Impact of Dietary Patterns on Plaque Acidogenicity and Dental Caries in Early Childhood: A Retrospective Analysis in Japan.

This study aimed to assess the relationship of dietary patterns, such as frequency, timing, and cariogenicity of food/beverage consumption, with plaque acidogenicity and early childhood caries (ECC) in Japan. A total of 118 children aged 1-4 years who had visited the pediatric dental clinic were enrolled. We retrospectively reviewed their records to collect data including age, sex, medical history, medication, caries status, and plaque acidogenicity level at the first dental visit. The plaque acidogenicity level was measured using Cariostat®. Dietary data were collected from 3-day dietary records, and the dietary cariogenicity score was calculated from these data. Children with ECC or high plaque acidogenicity consumed between-meal sugars more frequently than did their counterparts (p = 0.002 and p = 0.006, respectively). Children with ECC or high plaque acidogenicity drank juices between meals more frequently than at mealtimes (p = 0.02). Frequent consumption of between-meal sugars was associated with higher plaque acidogenicity and ECC, and frequent breast/bottle feeding was associated with ECC. No differences were found in the dietary cariogenicity scores between these groups. Therefore, the frequency and timing of sugar consumption, might affect plaque acidogenicity and ECC, and reducing the frequency of sugar intake could prevent ECC.

Cambios del pH salival por ingesta cariogénica y no cariogénica en preescolares de Huaura, Perú / Salivary pH changes caused by cariogenic and non-cariogenic food intake in preschoolers from Huaura, Peru

Introducción: El tipo de dieta influye directamente en el valor del pH salival, el cual es un factor importante para evitar la formación de caries. Objetivo: Evaluar el cambio del pH salival por ingesta cariogénica y no cariogénica en preescolares de una institución educativa de Huaura, Perú. Métodos: Esta investigación fue de tipo observacional, comparativo y longitudinal. El tamaño de muestra fue de 30 preescolares. Después que los niños consumieron dieta cariogénica y no cariogénica, se evaluó su pH a diferentes tiempos. Para el contraste de resultados se utilizó la prueba T Student y U de Mann-Whitney. Resultados: El pH salival con dieta no cariogénica a los cinco minutos fue 7,11 ± 0,19 y 7,09 ± 0,20, y, a los 40 minutos, 7,46 ± 0,19 y 7,42 ± 0,22, en mujeres y hombres, respectivamente. El pH salival con dieta cariogénica en mujeres fue 6,56 ± 0,21 a los cinco minutos y 7,15 ± 0,12 a los 60 minutos; mientras que, en los hombres, para iguales rangos de tiempos fue 6,47 ± 0,32 y 7,23 ± 0,22, respectivamente. Al realizar las comparaciones entre grupos de dieta cariogénica y no cariogénica se observaron diferencias muy significativas (p < 0,01). Conclusiones: Para la dieta cariogénica el pH disminuye como máximo a los cinco minutos y se restablece a partir de los 60 minutos. Para la dieta no cariogénica disminuye en el mismo tiempo pero se recupera a los 40 minutos, siendo este proceso similar en ambos géneros(AU)

Introduction: Salivary pH, an important factor in caries prevention, is under the direct influence of diet type. Objective: Evaluate salivary pH changes caused by cariogenic and non-cariogenic food intake in preschoolers from an educational institution in Huaura, Peru. Methods: An observational longitudinal comparative study was conducted of a sample of 30 preschoolers. After the children consumed cariogenic and non-cariogenic food, their salivary pH was evaluated at various times. Student's t-test and the Mann-Whitney U test were used to contrast results. Results: Salivary pH with a non-cariogenic diet at five minutes was 7.11 ± 0.19 and 7.09 ± 0.20; whereas at 40 minutes it was 7.46 ± 0.19 and 7.42 ± 0.22, in female and male participants, respectively. Salivary pH with a cariogenic diet in women was 6.56 ± 0.21 at five minutes and 7.15 ± 0.12 at 60 minutes, whereas values in men for the same time ranges were 6.47 ± 0.32 and 7.23 ± 0.22, respectively. Comparison between the cariogenic and non-cariogenic diet groups revealed very significant differences (p < 0.01). Conclusions: With a cariogenic diet, pH is reduced at five minutes maximum, and is restored as of 60 minutes. With a non-cariogenic diet, pH is reduced in the same time period, but is restored at 40 minutes. This process is similar in the two genders(AU)

Dieta, higiene bucal y riesgo de caries dental en niños escolares de Concepcion, durante el confinamiento por COVID-19

RESUMEN Introducción: El confinamiento por el covid 19 alejó a los niños del acompañamiento odontológico preventivo que favorece a las practicas que disminuyen el riesgo de instalación y desarrollo de la caries dental. Objetivo: Describir características de la dieta, en cuanto a consumo de azucares libres y la higiene bucal, de niños escolares de la ciudad Concepción, Paraguay, durante el confinamiento por el Covid 19. Materiales y Métodos: Se realizaron entrevistas vía telefonía celular a padres o encargados y a un hijo/a matriculado en el 1er o 2do ciclo de la institución, luego de obtener consentimiento informado del adulto responsable, a través de un mensaje de texto. Fueron realizadas las entrevistas hasta completar el tamaño de la muestra, establecido en 110, con un intervalo de confianza del 95%. Los encuestadores fueron calibrados en 3 encuentros virtuales en el manejo del instrumento de encuesta/recuento de alimentos de 24 horas, adaptado para este trabajo. Resultados: En cuanto a la dieta, 108 niños consumían azúcares libres "AL" en diferentes horarios, 60 de ellos (55%) = o > a 4 momentos de AL/día, esto mostró asociación con el nivel de educación primario de los padres o encargados (p=.03). A su vez, 56 niños (51%) consumían AL entre comidas, con más frecuencia, en las siguientes presentaciones: confitería 48%; jugos artificiales 39%. Se cepillan los dientes 2 a 3 veces al día (85%). Conclusión: Poco más de la mitad de los niños e consumía 4 o más veces alimentos con azúcares libres durante el día; el 51% de niños lo consumen entre comidas, principalmente en las siguientes presentaciones: productos de confitería y jugos azucarados, estas características de la dieta podrían poner a los niños en riesgo de caries dental.

ABSTRACT Introduction: Confinement due to Covid 19 kept children away from preventive dental care, which favors practices that reduce the risk of dental caries development. Objective: To describe the dietary intake patterns, in terms of free sugar consumption, and oral hygiene, of school-aged children in the city of Concepción, Paraguay, during confinement by Covid 19. Materials and Methods: Interviews were conducted via cell phone with parents or guardíans and a child enrolled in the 1st or 2nd cycle of elementary education, after obtaining informed consent from the responsible adult, through a text message. Interviews were carried out until the sample size was completed, established at 110, with a 95% confidence interval. The interviewers were trained during 3 virtual meetings on how to handle the 24-hour food survey / counting instrument, adapted for this study. Results: Regarding diet, 108 children consumed free sugars (FS) at different times, 60 of them (55%) > 4 servings of FS / day, this was associated with the parents' or caregivers' level of primary education (p = .03). At the same time, 56 children (51%) consumed FS between meals, more frequently, in the following presentations: Baked goods 48%; artificial juices 39%. Subjects brushed their teeth 2 to 3 times a day (85%). Conclusion: Just over half of children ate 4 or more foods with free sugars during the day; 51% of children consumed them between meals, mainly in the following presentations: baked goods and sugary juices. These dietary patterns could put children at risk of dental caries.

Saúde bucal de pré-escolares: do processo carioso aos fatores determinantes e moduladores / Preschool oral health: from carious process to determining and modulators

Objetivo: objetivou-se avaliar a experiência de cárie e seus fatores determinantes e moduladores em pré- -escolares de um centro de educação infantil localizado no estado do Ceará. Método: trata-se de um estudo exploratório, descritivo e de abordagem quantitativa realizado com crianças do infantil IV e V do Centro de Educação Infantil Francisca Arruda de Pontes (Redenção, CE) e suas mães. Após consentimento, as mães responderam um questionário contendo perguntas desde os aspectos socioeconômicos e acompanhamento pelo serviço de saúde a conhecimento das doenças bucais. Posteriormente, as crianças foram submetidas à avaliação odontológica para registro do índice CEO-D, o qual corresponde à soma do número de dentes decíduos cariados (c), com extração indicada (e) e restaurados (o). Os dados foram tabulados e descritos como frequência relativa e absoluta. Resultados: das mães, 80,75% tinham renda de até 1 salário mínimo, 61,53% utilizavam creme dental na higiene oral de seu filho e 48,07% desconheciam as doenças bucais. Das crianças, 65,38% não eram atendidas pelo cirurgião-dentista e 50,00% consumiam diariamente bolacha doce. Das crianças avaliadas, 52,50% tinham dentes cariados, 70,00% não apresentavam dentes com extração indicada e nenhuma tinha dentes obturados/restaurados. A média do índice CEO-D foi 1,325. Conclusão: conclui-se que as crianças, apesar de terem baixa prevalência de cárie, apresentam, como fatores de risco determinantes, uma dieta cariogênica e, como fatores de risco moduladores, um reduzido conhecimento sobre doenças bucais, higiene oral inadequada, renda familiar insuficiente, baixa escolaridade e limitada procura por serviço de saúde, especialmente o odontológico.(AU)

Objective: to evaluate the experience of caries and its determining and modulating factors in preschoolers at an early childhood education center located in the state of Ceará. Method: this is an exploratory, descriptive study with a quantitative approach carried out with children from infant IV and V of the Francisca Arruda de Pontes Early Childhood Center (Redenção, CE) and their mothers. After consent, the mothers answered a questionnaire containing questions from the socioeconomic aspects and monitoring by the health service to knowledge of oral diseases. Subsequently, the children underwent dental evaluation to record the dmf Index, which corresponds to the sum of the number of decayed primary teeth (d), missing (m) and filled (f). The data were tabulated and described as relative and absolute frequency. Results: of the mothers, 80.75% had an income of up to 1 minimum wage, 61.53% used toothpaste in their child's oral hygiene and 48.07% were unaware of oral diseases. Of the children, 65.38% were not attended by the dentist and 50.00% consumed sweet cookies daily. Of the children evaluated, 52.50% had decayed teeth, 70.00% did not have teeth with indicated extraction and none had filled/ restored teeth. The average of the dmf Index was 1.325. Conclusion: it is concluded that children, despite having a low prevalence of caries, present, as determining risk factors, a cariogenic diet and, as modulating risk factors, a reduced knowledge about oral diseases, inadequate oral hygiene, family income insufficient, low education and limited demand for health services, especially dental care.(AU)

El conocimiento sobre salud bucal de padres y maestros de la Escuela especial La Edad de Oro / Oral health knowledge of parents and teachers at La Edad de Oro special school

RESUMEN Introducción: los escolares discapacitados se caracterizan por presentar numerosos factores de riesgo asociados a diversas enfermedades bucales. En esta etapa se requiere de la participación de padres y educadores que les enseñen hábitos básicos para el cuidado de la salud bucal. Objetivo: evaluar el nivel de conocimiento en salud bucal de padres y educadores. Métodos: se realizó un estudio transversal en la escuela primaria especial La Edad de Oro, de Holguín, de enero a abril de 2016. El universo estuvo constituido por 203 adultos y la muestra por 126. Se aplicó un cuestionario con temas relacionados con la higiene bucal, la dieta cariogénica y los hábitos bucales deformantes. Resultados: el nivel de conocimiento sobre salud bucal fue regular en el sexo femenino, en el 71,6%, y en el masculino fue malo, en el 46,7%. De acuerdo con el nivel de escolaridad, el de secundaria presentó nivel de conocimiento malo (53,3%); sólo el 8,6% de los adultos obtuvo mal. Se desconocían hábitos bucales deformantes, como la deglución atípica, la queilofagia y los hábitos posturales, en el 91,3%, el 90,5% y el 85,7% de los participantes, respectivamente. Conclusiones: los padres y educadores de los niños discapacitados presentaron en su mayoría, niveles de conocimientos regulares sobre salud bucal.

ABSTRACT Introduction: handicapped children may present different symptoms of several buccal diseases. Parents and teachers concern are required in order to teach them basic habits to keep a good oral health. Objective: to evaluate parents and teachers level of knowledge about oral health. Method: a cross sectional research at La Edad de Oro Special Primary School, was carried out in Holguín from January to April 2016. Universe was 203 adults and sample 126. A survey including several topics related to oral hygiene, cariogenic diet and deformation of buccal habits, was applied. Results: the level of knowledge about oral health was regular for females (71.6%) and it was bad for males (46.7%). High level participants presented bad knowledge with 53.3 % and only 8.6% showed a poor knowledge level. Deforming oral habits suchs as: atypical swallowing (91.3%), cheilophagia (90.5%) and postural habits (85.7%) were ignored by the participants at these levels. Conclusions: most handicapped children's parents and teachers showed regular knowledge levels about oral health.

Short-term and Long-lasting Effects of Hypo-Cariogenic Dietary Advice and Oral Care on Oral Flora: a Randomised Clinical Trial.

PURPOSE: To investigate the short- and long-term effects of different combinations of dietary instructions on cariogenic food intake and salivary cariogenic bacteria (Streptococcus mutans [SM] and Lactobacillus [LB]). MATERIALS AND METHODS: In this randomised 2-arm parallel study, 75 6-year-old subjects were assigned to repeated (group A; 19M/19F) or isolated (group B; 17M/20F) verbal and/or written dietary advice (VWDA), with foods classified by cariogenic potential. Both groups underwent a baseline salivary test for SM/LB, kept a monthly food diary, and attended 4 weekly visits (T1-T4). At T1-T2; group A only received VDA. At T3, both groups received VWDA. At T4, participants handed in their food diaries and underwent another salivary test. After 1 year (T5), subjects were recalled for weekly food diary monitoring and salivary testing. Relative risk (RR) of high-to-low SM/LB density was calculated at T4 and T5. RESULTS: Comparing groups A and B, VDA determined an increase in the intake of weakly cariogenic food (p < 0.05) and a decrease in that of intermediately cariogenic food (p < 0.05). After VWDA, a statistically significant increase in intake of weakly cariogenic food and a statistically significant decrease in the RR of high-density SM/LB colonies occurred in both groups. At T5, group A showed less intake of highly cariogenic food than did group B (p = 0.05) and persistent, although non-significant, reduction in the RR of high-density SM/LB colonies. CONCLUSIONS: Reinforcement measures on behavioural changes towards a noncariogenic diet not only help maintain long-lasting, healthier eating habits, but also decrease the cariogenic bacterial load in the short term, which tends to persist over time.

Free Sugars Consumption around Bedtime and Dental Caries in Children: A Systematic Review.

This systematic review aimed to assess the association between food and drink consumption around bedtime-specifically, food and drinks containing free sugars-and the risk of dental caries in children. Five electronic databases were searched (PubMed, Ovid Medline, EMBASE, Web of Science, and Scopus) to identify studies that investigated any relationship between food and drink around bedtime and dental caries in 3- to 16-y-old children. The Agency for Healthcare Research and Quality domain guidelines were used to assess the quality of the individual studies, while GRADE guidelines assessed the quality of studies based on the body of evidence. From 1,270 retrieved titles, 777 remained after removal of duplicates. Of these, 72 were reviewed in full. Eighteen studies fulfilled the inclusion criteria and were included in the analysis: 13 cross-sectional, 4 cohort, and 1 case-control. Studies were categorized into 3 age groups: 3- to 5-y-old, 6- to 11-y-old, and 12- to 16-y-old children. Based on the Agency for Healthcare Research and Quality criteria, 6 of the 18 studies were rated as providing good-quality evidence; 8 were rated as fair; and 4 were categorized as being of poor quality. It was not possible to conduct a meta-analysis, because of the considerable variations in the type of bedtime exposure and outcome measures. The studies showed a consistent positive association across the 3 age groups, with all 7 studies on preschool children reporting significant positive associations. However, the quality of the body of evidence pertaining to the consumption of food and drinks at bedtime (specifically, food and drinks containing free sugars) and risk of caries was rated as "very low." The results suggest that restricting free sugars before and at bedtime may reduce the risk of caries, but studies with improved design are needed to confirm this. Knowledge Transfer Statement: This is the first systematic review of the evidence assessing the association between caries risk in children and the consumption of food or drinks at bedtime-specifically, foods and drinks containing free sugars. Although the data showed a consistent positive association, the quality of evidence was very low. This means that the current recommendation to restrict food and drinks containing free sugars before bedtime in children, while based on a sound physiologic premise, is supported only by very low-quality published evidence as measured by GRADE guidelines.

Risk factors associated with new caries lesions in permanent first molars in children: a 5-year historical cohort follow-up study.

OBJECTIVE: The objective of this study is to analyze the factors associated with the occurrence of caries in the permanent teeth (PT) and in the permanent first molar (PFM) 5 years after their eruption. MATERIAL AND METHODS: Children born in 2005 and enrolled in a community dental program were included. The inclusion criteria were: age 10 years in 2015; the availability of clinical dental history (CDH) data from before eruption of the PT and a follow-up period of 5 years after eruption of the PT. A total of 206 children were enrolled. Risk factors evaluated were: caries experience in the mother, educational level of the mother, frequent drug use, systemic diseases, eating habits, brushing frequency, presence of molar incisor hypomineralization (MIH) in PT, and caries in deciduous teeth (DT). Associations between explanatory factors and the DMF-T (decayed, missing, filled teeth in PT) and DMFT-M (DMF in PFM) indexes, independently considering cavitated or cavitated and non-cavitated caries as outcomes, were evaluated by poisson regression with robust variance analysis. RESULTS: In the multivariate analysis, a cariogenic diet, especially soft drinks, was associated to high DMF-T and DMFT-M scores when both cavitated and non-cavitated caries were considered. A brushing frequency < 1 a day was significantly associated to high DMF-T scores. The presence of df-t (decayed and filled temporary teeth) score > 0 and MIH conditioned high DMF-T or DMFT-M values, considering cavitated or cavitated and non-cavitated caries. CONCLUSIONS: The intake of sweets and soft drinks, brushing frequency, caries in DT, and MIH in PT were the best predictors of caries in PT. CLINICAL RELEVANCE: Control of risk factors in early childhood is important for preventing caries in PT.

Intervención educativa sobre caries dental en escolares de sexto grado / Educational intervention on dental caries in sixth grade school children

Introducción: la caries dental es el problema de salud pública que más aqueja a la sociedad, desde los grandes faraones egipcios hasta los actuales presidentes, casi todos, en algún momento de su vida, han padecido esta enfermedad. Objetivo: evaluar la efectividad de una intervención educativa referente a la caries dental en escolares de sexto grado. Métodos: se realizó un estudio de intervención educativa, en escolares de sexto grado de la escuela primaria Dalquis Sánchez, de Holguín, en el período septiembre de 2015-abril de 2016. El universo de la investigación fue de 138 escolares, la muestra conformada por 58 pacientes diagnosticados con caries dental. Se estudiaron variables, como sexo y nivel de conocimiento sobre la enfermedad. Resultados: de los escolares afectados con caries dental 31 (53,4%) pertenecían al sexo masculino, con predominio sobre el femenino. Antes de aplicar el programa educativo, 43 escolares (74,1%) presentaban conocimientos inadecuados sobre generalidades de caries y algunos factores de riesgo; luego el 52 (89,7%) de los escolares tuvieron un conocimiento adecuado. Previo a la labor educativa, el 84,5% de los participantes poseían conocimiento inadecuado en lo que respecta al correcto cepillado y su frecuencia; al realizarla, el 91,4% logró un conocimiento adecuado. Al analizar lo referente a la dieta cariogénica y dieta protectora, observamos que al inicio de la intervención sólo 11 estudiantes presentaban un conocimiento adecuado del tema en cuestión, al aplicar el programa 48 escolares (82,8%) tuvieron una apreciación correcta del tema. Conclusiones: el nivel de conocimiento referente a caries dental era inadecuado antes de aplicar el programa educativo, luego de aplicado, la intervención educativa demostró ser un método certero, lo cual comprobó la efectividad del programa implementado.

Introduction: tooth decay is the public health problem that afflicts most of society, from the great Egyptian pharaohs to the current presidents, almost everyone at some point in their lives, have suffered from this disease. Objective: to evaluate the effectiveness of an educational intervention regarding dental caries in sixth grade school students. Methods: an educational intervention study was carried out in 6th grade students of the Dalquis Sánchez primary school in Holguín, in the period September 2015-April 2016. The universe of the research was 138 patients, in a sample consisting of 58 patients diagnosed with dental caries. Variables were studied, such as sex and level of knowledge about the disease. Results: of the students affected with dental caries 31 (53.4%) belonged to the male sex, with predominance over the female. Before applying the educational program, 43 schoolchildren (74.1%) had inadequate knowledge about dental caries and some risk factors; then 52 (89.7%) of the students had adequate knowledge. Prior to the educational work, 84.5% of the participants had inadequate knowledge regarding the correct brushing and its frequency; 91.4% achieved adequate knowledge. When analyzing the reference to the cariogenic diet and protective diet, it was found that at the beginning of the intervention only 11 students had an adequate knowledge of the subject in question, when applying the program 48 students (82.8%) had a correct appreciation of the topic. Conclusions: the level of knowledge regarding dental caries was inadequate before applying the educational program, after applied the educational intervention proved to be an accurate method, which proved the effectiveness of the implemented program.

Situación de Salud Bucal de 20 familias pertenecientes al Policlínico Docente Plaza. 2014 / Oral Healths situation of 20 families from Plaza Polyclinic. 2014

Introducción: los análisis de situación de salud diagnostican problemas de salud e identifican las causas, conjuntamente con la comunidad, para darle solución a los mismos. Además contribuyen a la formación de los estudiantes de Estomatología y otros profesionales de la salud en las instituciones docentes. Objetivo: identificar factores de riesgo asociados a las principales enfermedades bucales de 20 familias pertenecientes al Policlínico Docente Plaza. Material y Métodos: se efectuó un estudio observacional descriptivo, de corte transversal en un consultorio del policlínico Plaza, donde se identificaron las enfermedades bucales más prevalentes y las posibles causas. Se utilizaron fuentes de información primaria y secundaria, se aplicó el índice de Higiene Bucal Simplificado y el índice COP D. Para la identificación de los problemas se utilizó el método cuantitativo de indicadores y el cualitativo de consenso Asamblea Comunitaria. Resultados: como principales enfermedades bucales se identifican las caries dentales (36.0 por ciento), y las periodontopatías (25.3 por ciento). Y los principales riesgos asociadas a estas, la higiene bucal deficiente (62.8 por ciento), la educación para la salud deficiente (52.6 por ciento), el tabaquismo (41.0 por ciento) y la dieta cariogénica (26.9 por ciento). Se consideró la trascendencia social del problema teniendo en cuenta la necesidad de la población. Conclusiones: Los factores de riesgo que más prevalecen en la población estudiada son la higiene bucal y la deficiente educación para la salud deficientes, el tabaquismo y la dieta cariogénica como posibles causas de las caries y periodontopatías, principales enfermedades identificadas(AU)

Introduction: The health situation analyses enable the problem diagnosis and the explanation of its causes in order to provide solutions to them, together with the community. Furthermore they contribute to the training of stomatology students and another professional of health in educational institutions. Objective: To identify risk factors associated with major oral diseases in 20 families belonging to the Plaza Teaching Polyclinic. Materials and Methods: Descriptive observational cross-sectional study was conducted in a clinic associated to the Polyclinic Plaza, where the most prevalent oral disease and possible causes were identified. Primary and secondary sources of information were used, we also apply the Simplified Oral Hygiene index and COP - D index. In order to identify the problems we utilize the quantitative method of indicators and the qualitative of consensus, Community Assembly. Results: The main oral diseases identified are caries (36.0 percent), and periodontopathies (25.3 percent), and the main risks associated to these are, poor oral hygiene (62.8 percent), inefficient health education (52.6 percent), tobacco smoking (41.0 percent) and a cariogenic diet (26.9 percent). The social significance of this problem was taken into account considering the need of the population.Conclusions: The major risk factors in the studied population are the oral hygiene and an inefficient health education and tobacco smoking and a cariogenic diet like possible causes of caries and periodontopathies, as main identified diseases(AU)

Knowledge of triathlon athletes about the relationship between oral health and performance

Introduction: The triathlon athletes have great energy loss due to physical activity of high intensity and resets are based on a highcarbohydrate diet and acid elements (acids replacers), both substrates to decay and periodontal disease. Objective: This study aimed to evaluate, through a questionnaire whether triathlon athletes relate oral health to their physical performance. Material and methods: We developed a questionnaire with 20 objective questions and applied during marathons and at fitness centers, in the city of Curitiba, in 2015. Results: The majority of athletes use supplements with high levels of carbohydrates and acids for energy replacement daily and do not brush their teeth after workouts / nutrition. Of the 254 respondents, only 96 relate oral health to their performance in sports. Conclusion: The athletes do not relate the importance of oral health care to performance and largely do not brush the teeth after the activities, leaving the oral environment more susceptible to the onset of periodontal disease and caries, which can decrease their performance. It is necessary to inform triathlon athletes about the relationship oral health x systemic health x performance, as well as the dentists about the need of oral health care for these athletes.