Antibacterial Activity of a Bioactive Tooth-Coating Material Containing Surface Pre-Reacted Glass in a Complex Multispecies Subgingival Biofilm.

Bioactive materials were developed with the ability to release fluoride and provide some antimicrobial potential, to be widely used in dentistry today. However, few scientific studies have evaluated the antimicrobial activity of bioactive surface pre-reacted glass (S-PRG) coatings (PRG Barrier Coat, Shofu, Kyoto, Japan) on periodontopathogenic biofilms. This study evaluated the antibacterial activity of S-PRG fillers on the microbial profile of multispecies subgingival biofilms. A Calgary Biofilm Device (CBD) was used to grow a 33-species biofilm related to periodontitis for 7 days. The S-PRG coating was applied on CBD pins from the test group and photo-activated (PRG Barrier Coat, Shofu), while the control group received no coating. Seven days after treatment, the total bacterial counts, metabolic activity, and microbial profile of the biofilms were observed using a colorimetric assay and DNA-DNA hybridization. Statistical analyses were applied; namely, the Mann-Whitney, Kruskal-Wallis, and Dunn's post hoc tests. The bacterial activity of the test group was reduced by 25.7% compared with that of the control group. A statistically significant reduction was observed for the counts of 15 species: A. naeslundii, A. odontolyticus, V. parvula, C. ochracea, C. sputigena, E. corrodens, C. gracilis, F. nucleatum polymorphum, F. nucleatum vincentii, F. periodonticum, P. intermedia, P. gingivalis, G. morbillorum, S. anginosus, and S. noxia (p ≤ 0.05). The bioactive coating containing S-PRG modified the composition of the subgingival biofilm in vitro, thereby decreasing colonization by pathogens.

Dental caries in 12-Year-Old schoolchildren who participate in a preventive and restorative dentistry program / Caries dental en escolares de 12 años que participan en un programa de odontología preventiva y rehabilitación oral

Abstract Since 2013, the Faculty of Dentistry of the University of Costa Rica has provided a preventive and restorative oral health program at Carmen Lyra Public School. The first generation of students that received dental care from this project were examined in 2019 for caries status. A total of 62 twelve-year-old schoolchildren were examined (31 boys and 31 girls). First, all teeth surfaces were cleaned with a brush and then rinsed. Subsequently, examination was performed in each person by a calibrated examiner using the International Caries Detection and Assessment System (ICDAS). Prevalence of dental caries was 59.7%. ICDAS code 2 was the most prevalent (68.8%), followed by 1 (19.3%), 5 (4.5%), 3 (3.5%), 6 (2.5%), and 4 (1.4%). Regarding number of carious surfaces, the highest prevalence was observed in the occlusal surfaces (77.3%), followed by the vestibular (13.9%), mesial (4.2%), palatal/ lingual (4,1%) and distal (0.5%). Of these carious surfaces, 7% were caries associated with restorations and were present only on the occlusal surfaces. Boys had more cavities than girls (54.1% compared to 45.9%), however, this difference was not significant. Regarding the condition of restorations in teeth, 92 dental restorations (resin or amalgam) were found in the population studied and were well adjusted. Most of these restorations were found on the occlusal surfaces (82.6%), followed by vestibular surfaces (8.7%,) palatal/lingual (5.4%) surfaces, mesial surfaces (3.3%), and no restorations were detected on the distal surfaces. Sealants were identified in 11.3% schoolchildren; 98% were identified on the occlusal surfaces and the other 2% were found on the palatal/lingual surfaces. DMFT Index was 1.6±0.71. The prevalence of dental caries in this sample was low compared to other studies in twelve-year-old schoolchildren in Costa Rica. This may suggest that the oral health program had a positive impact in the studied population.

Resumen Desde el año 2013, la Facultad de Odontología de la Universidad de Costa Rica ha brindado un programa de prevención y rehabilitación oral en la Escuela Carmen Lyra. La primera generación de estudiantes que recibieron atención dental por parte de este programa, fueron examinados en el año 2019 para determinar la prevalencia de caries. Se examinó a 62 escolares de 12 años (31 niños y 31 niñas). Primero, todas las superficies de los dientes se limpiaron con un cepillo y luego se enjuagaron. Posteriormente, el examen fue realizado en cada participante por un examinador calibrado utilizando el Sistema Internacional de Detección y Evaluación de Caries (ICDAS). La prevalencia de caries dental fue del 59,7%. El código ICDAS 2 fue el más prevalente (68,8%), seguido de 1 (19,3%), 5 (4,5%), 3 (3,5%), 6 (2,5%) y 4 (1,4%). En cuanto al número de superficies cariadas, la mayor prevalencia se observó en las superficies oclusales (77,3%), seguidas de las vestibulares (13,9%), mesiales (4,2%), palatinas/linguales (4,1%) y distales (0,5%). De estas superficies cariadas, el 7% eran caries asociadas con restauraciones y estaban presentes solo en las superficies oclusales. Los niños tenían más caries que las niñas (54,1% en comparación con el 45,9%), sin embargo, esta diferencia no fue significativa. En cuanto al estado de las restauraciones dentales, se encontraron 92 restauraciones dentales (resina o amalgama) en la población estudiada y se encontraban bien ajustadas. La mayoría de estas restauraciones se encontraron en las superficies oclusales (82,6%), seguidas de las superficies vestibulares (8,7%), superficies palatinas/linguales (5,4%), superficies mesiales (3,3%) y no se detectaron restauraciones en las superficies distales. Se identificaron sellantes de fosas y fisuras en el 11,3% de los escolares. El 98% de estos sellantes se identificó en las superficies oclusales y el otro 2% se encontró en las superficies palatino/lingual. El índice CPOD fue de 1,6±0.71. La prevalencia de caries dental en esta muestra fue baja en comparación con otros estudios en escolares de doce años en Costa Rica. Esto sugiere que el programa de salud bucal tuvo un impacto positivo en la población estudiada.

Fluoride toothpaste, sanitary surveillance and the SUS: the case of Manaus-AM, Brazil / Dentifrício fluoretado, vigilância sanitária e o SUS: o caso de Manaus-AM

ABSTRACT OBJECTIVE To determine the anticaries potential of toothpastes distributed by the primary health care public clinics (UBS) of Manaus, AM. METHODS Ninety-nine tubes of toothpaste from four commercial brands were collected from October 7, 2019 to October 11, 2019 in 16 UBS. They were assigned a code by brand and source UBS. According to the information on the packaging, the four brands and their batches were formulated with sodium monofluorophosphate (Na2FPO3) and most (91%) had calcium carbonate (CaCO3) as an abrasive. We determined the concentrations of total fluoride (TF = TSF + InsF) and total soluble fluoride (TSF = F ions- or FPO32-), to certify whether they were in compliance with resolution ANVISA RDC No. 530 (maximum of 1,500 ppm TF) and whether they had anticaries potential (minimum of 1,000 ppm TSF). The analyses were performed with a ion- specific electrode. RESULTS The concentrations (ppm F) of TF [mean; standard deviation (SD); n] found in toothpaste brands A (1,502.3; SD = 45.6; n = 33), B (1,135.5; SD = 52.7; n = 48) and D (936.8; SD = 20.5; N = 8) were close to those stated on the package, 1,500, 1,100 and 1,000 ppm F, respectively. In toothpaste C, we found a mean of 274.1 ppm (SD = 219.7; n = 10) of TF, which diverges from the declared concentration of 1,500 ppm F. In addition, the five tubes of lot no. 11681118 of toothpaste C did not contain fluoride. Regarding TSF, with the exception of toothpaste D (937.9; SD = 40.29), the others had a lower concentration than their respective TF. CONCLUSION We found serious problems of quantity and quality of fluoride in toothpaste distributed by the SUS in Manaus, which shows the need for surveillance of these products and confirms the urgency of revising resolution RDC No. 530.

RESUMO OBJETIVO Determinar o potencial anticárie dos dentifrícios distribuídos pelas unidades básicas de saúde (UBS) de Manaus-AM. MÉTODOS Noventa e nove bisnagas de dentifrícios de quatro marcas comerciais foram coletadas de 7 de outubro de 2019 a 11 de outubro de 2019 em 16 UBS, que foram codificados por marca e UBS de origem. De acordo com a embalagem, os dentifrícios das quatro marcas e seus lotes foram formulados com monofluorofosfato de sódio (Na2FPO3) e a maioria (91%) tinha carbonato de cálcio (CaCO3) como abrasivo. Foram determinadas as concentrações de fluoreto total (FT = FST + Fins) e de fluoreto solúvel total (FST = íons F- ou FPO32-), para certificar se atendiam à resolução ANVISA RDC Nº 530 (máximo de 1.500 ppm de FT) e se tinham potencial anticárie (mínimo de 1.000 ppm de FST). As análises foram feitas com eletrodo íon específico. RESULTADOS As concentrações (ppm F) de FT [média; desvio padrão (DP); n] encontradas nos dentifrícios A (1.502,3; DP = 45,6; n = 33), B (1.135,5; DP = 52,7; n = 48) e D (936,8; DP = 20,5; n = 8) foram próximas ao descrito na embalagem, 1.500, 1.100 e 1.000 ppm F, respectivamente. No dentifrício C, foi encontrada média de 274,1 ppm (DP = 219,7; n = 10) de FT, divergindo da concentração declarada de 1.500 ppm F. Em acréscimo, as cinco bisnagas do lote no 11681118 do dentifrício C não foram fluoretadas. Quanto ao FST, à exceção do dentifrício D (937,9; DP = 40,29), os demais apresentaram concentração inferior ao seu respectivo FT. CONCLUSÃO Observou-se problemas graves de quantidade e qualidade do fluoreto nos dentifrícios distribuídos pelo SUS em Manaus, mostrando a necessidade de vigilância desses produtos e ratificando a urgência da revisão da resolução ANVISA RDC Nº 530.

The consumption of milk supplemented with probiotics decreases the occurrence of caries and the salivary concentration of hßD-3 in children.

OBJECTIVES: This study evaluated the effect of milk supplemented with Lactobacillus rhamnosus SP1 on the occurrence of caries and the salivary concentration of human ß-defensin-3 (hßD-3) in preschool children with high caries risk. MATERIALS AND METHODS: A sample of 42 children was randomly assigned to two groups; children in the intervention group were given 150 mL of milk supplemented with 107 CFU/mL of Lactobacillus rhamnosus SP1, while children in the control group were given standard milk, for 10 months. The occurrence of dental caries was assessed using the International Caries Detection and Assessment System (ICDAS), and the concentration of hßD-3 was measured in unstimulated saliva using an ELISA test at baseline and after the intervention. RESULTS: There was an increase in the number of teeth with carious lesions (dICDAS2-6 mft) in the control group, and this increase was statistically significant (p = 0.0489). The concentration of hßD-3 in saliva from the intervention group decreased from 597.91 to 126.29 pg/mL (p = 0.0061), unlike in the control group, where no change in hßD-3 salivary concentration was found. CONCLUSIONS: These findings showed that regular intake of probiotic-supplemented milk in preschool children with high caries risk decreased the occurrence of caries and the salivary levels of hßD-3. CLINICAL RELEVANCE: Our results suggest the need for developing and implementing probiotic supplementation, as adjuvants to the conventional treatments for caries and allow to considerate the salivary levels of hßD-3 as markers of oral tissue homeostasis.

Do network centrality measures predict dental outcomes of Indigenous children over time?

BACKGROUND: Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions. AIM: We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5 years. DESIGN: A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5 years. RESULTS: Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5 years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated. CONCLUSION: Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.

Contributions of school context to caries on anterior teeth: a multilevel analysis

ABSTRACT OBJECTIVE To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents. METHODS A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05). RESULTS The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24-2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13-1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05-3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07-1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78-3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05-0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98-0.99) were associated with the outcome. CONCLUSIONS Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

Factors associated with the use of Dental Health Services by Mexican Schoolchildren to receive Professionally Applied Topical Fluoride.

OBJECTIVE: To identify the prevalence of and factors associated with the use of dental health services to receive professionally applied topical fluoride (DHSU-PATF) in the 12 months prior to the study among Mexican schoolchildren aged 6 to 12 years. METHODS: A cross-sectional study was performed in 1,404 schoolchildren selected randomly from 15 public schools in the city of Pachuca, Mexico. Questionnaires were distributed to determine the demographic, socioeconomic, and behavioral variables. The dependent variable was the DHSU-PATF in the year before the study, which was dichotomized as 0 (no DHSU-PATF) or 1 (yes, DHSU-PATF). We calculated odds ratios (OR) and 95% confidence intervals. The analysis was performed in Stata 11.0. RESULTS: The prevalence of DHSU-PATF was 5.1%, but lower among younger children (OR = 0.86) and greater among children with health insurance (private insurance, OR = 3.64; insurance provided by the government owned oil company, the Army, or the Navy, OR = 5.03). The level of knowledge about oral health among guardians/ parents was also a factor (medium, OR = 2.37; high, OR = 4.05). Additionally, among the children whose parents/guardians perceived them (the children) as having good or very good oral health, the OR was 3.33; among children whose parents brushed their teeth with greater relative frequency, the OR was 8.74. Finally, DHSU-PATF was greater among children with relatively higher socioeconomic status (2nd quartile, OR = 3.29; 3rd quartile, OR = 5.99; 4th quartile, OR = 4.64). CONCLUSION: The receipt of PATF was low in this sample of Mexican schoolchildren and is associated with socioeconomic and behavioral factors. This gives us a guideline to create or improve topical fluoride application strategies in the public and private Mexican health systems.

El desarrollo de la primera pasta dental con fluoruro. Semblanza histórica: en los 50 años del Oral Health Research Institute (OHRI) / Development of the first fluoridated toothpaste. Historical review:the 50th year of the Oral Health Research Institute (OHRI)

Siempre es importante el poder llevar a cabo algún tipo de reconocimiento a las personas involucradas en haber dejado aun el más mínimo tipo de legado en nuestra profesión. A título muy personal, la utilización de los fluoruros y, muy en especial su incorporación en la formulación de pastas dentales, ha sido el factor más importante y preponderante en la disminución del índice de riesgo de caries dental en las actuales generaciones. El presente artículo pretende hacer una narración histórica sobre los eventos más sobresalientes por los que pasó el trío de científicos en las Escuelas de Química y de Odontología de la Universidad de Indiana en sus respectivos campus de Bloomington e Indianápolis para lograr el desarrollo de la primera pasta dental con fluoruro. Más que un recuento histórico, la intención principal de este escrito es hacer una semblanza y un reconocimiento al trabajo del bioquímico Harry Day, quién trabajaba en su campo especializado sobre el valor nutricional de algunos elementos y que, junto con el trabajo del dentista Joseph C. Muhler y del especialista en Química inorgánica William Nebergall, logró producir un prototipo de pasta dental en el año de 1952 y que después de los excelentes resultados de los estudios clínicos liderados por Muhler tanto en niños como en adultos, llamaron la atención de Procter and Gamble para poder lanzar al mercado la primera pasta dental con Fluoristán, a la que se llamó Crest (AU)

It is always important to express some type of acknowledgement to people that were involved on leaving any form of legacy in our profession. As a personal view, the use of fluorides and specially the implementation of it in the formulation of toothpastes have been the key and preponderant factor in the decrease on the risk of dental caries in the current generations. This article pretends to be a historic narrative of the remarkable events in the group of the three scientists of the School of Chemistry and the School of Dentistry at both campuses of Bloomington and Indianapolis of Indiana University to fulfill the goal on the development of the first fluoridated toothpaste. More than a historical narrative, the main intention of this paper is to make a resemblance and an acknowledgement to the work of Biochemist Harry Day, who worked in his field of expertise on the nutrimental value of certain trace elements and that together with the work by dentist Joseph C. Muhler and the specialist in Inorganic Chemistry William Nebergall, could produced in year 1952 a prototype of a toothpaste that after several clinical studies in children and adults conducted by Muhler showed excellent results on caries prevention, and that took the attention of Procter and Gamble to be able to put on the market the first toothpaste with Fluoristan that was called Crest (AU)

Insufficient Sleep and Incidence of Dental Caries in Deciduous Teeth among Children in Japan: A Population-Based Cohort Study.

OBJECTIVES: To examine whether late bedtime and short nighttime sleep duration at age 18 months are associated with risk of caries in deciduous teeth. STUDY DESIGN: Population-based cohort study using health check-up data of 71 069 children born in Kobe City, Japan, who were free of caries at age 18 months and had information on sleep variables at age 18 months and records of dental examinations at age 3 years. Sleep variables were assessed by standardized parent-reported questionnaires, and the incidence of caries in deciduous teeth was defined as the occurrence of at least 1 decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Logistic regression was used to estimate the effects of late bedtime and short sleep duration on dental caries with adjustment for clinical and lifestyle characteristics. RESULTS: Overall, 11 343 (16.0%) cases of caries were observed at age 3 years. aORs for children with late or irregular bedtimes compared with those with bedtimes before 21:00 were 1.26 (95% CI 1.19-1.33), 1.48 (1.38-1.58), 1.74 (1.58-1.92), 1.90 (1.58-2.29), and 1.66 (1.53-1.81) for bedtimes at 21:00, 22:00, 23:00, 0:00, and irregular bedtime, respectively. aORs for children with short or irregular sleep duration compared with those with sleep duration of ≥11 hours were 1.30 (95% CI 1.15-1.47), 1.16 (1.09-1.24), 1.11 (1.05-1.18), and 1.35 (1.25-1.46) for sleep duration of ≤ 8, 9, 10 hours, and irregular sleep duration, respectively. CONCLUSIONS: In this exploratory study, late bedtime and short sleep duration were both consistently associated with increased risk of caries in deciduous teeth.

Caries and fluoridated water in two Brazilian municipalities with low prevalence of the disease / Cárie e água fluoretada em dois municípios brasileiros com baixa prevalência da doença

ABSTRACT OBJECTIVE To analyze the association between exposure to fluoridated water and dental caries in a context of widespread use of fluoride toothpaste in Brazil, in a scenario of low prevalence of the disease. METHODS This is a cross-sectional observational study, of the census type, in the form of a double population-based epidemiological survey carried out in two municipalities of the state of São Paulo in 2014. The sample consisted of adolescents aged 11 and 12 years, exposed (n = 184) or not exposed (n = 128) to fluoridated water for at least five years. The populations studied lived in communities of the same geographic region and had small demographic size and similar socioeconomic classification, differing only in the exposure (Silveiras) or not exposure (São José do Barreiro) to fluoridated water. The experience, magnitude, and degree of polarization of dental caries in these populations were analyzed using the DMFT and SiC indexes, and the association was tested using Pearson's chi-square statistics and prevalence ratio between those not exposed and those exposed to fluoridated water. RESULTS Although caries experience (DMFT ≥ 1) was not associated with exposure to fluoridated water (chi-square = 1.78; p = 0.18; α = 5%), a significant difference was observed in the magnitude with which the disease reached the population: the means of DMFT were 1.76 in those exposed and 2.60 in those not exposed and the means of SiC were 4.04 and 6.16, respectively. The degree of polarization, indicated by the percentage of subjects with DMFT = 0, was different, being it higher (41.8%) in subjects exposed and lower (34.3%) in subjects not exposed. The prevalence ratio between those not exposed and those exposed was 1.13, indicating little expressiveness in prevalence difference. CONCLUSIONS Exposure to fluoridated water implied lower mean values for the DMFT and SiC indexes, even in the presence of the concomitant exposure to fluoridated toothpaste, in a scenario of low prevalence of the disease, and with a similar pattern of caries distribution in the populations analyzed.

RESUMO OBJETIVO Analisar a associação entre a exposição à água fluoretada e cárie dentária, em contexto de uso generalizado de creme dental fluoretado no Brasil, em cenário de baixa prevalência da doença. MÉTODOS Realizado estudo observacional transversal, de tipo censitário, na modalidade de duplo inquérito epidemiológico populacional, em dois municípios paulistas em 2014. Participaram adolescentes de 11 e 12 anos, imersos na sua condição de exposição (n = 184) ou não exposição (n = 128) à água fluoretada, há pelo menos cinco anos. As populações avaliadas residiam em comunidades da mesma região geográfica, de pequeno porte demográfico e com classificação socioeconômica similar, diferenciando-se apenas pela condição de exposição à água fluoretada (Silveiras) e de não exposição (São José do Barreiro). A experiência, a magnitude e o grau de polarização da cárie dentária nessas populações foram analisadas por meio dos índices CPOD e SiC e a associação foi testada empregando-se as estatísticas qui-quadrado de Pearson e razão de prevalência entre não expostos e expostos à água fluoretada. RESULTADOS Embora a experiência de cárie (CPOD ≥ 1) não tenha se associado com a exposição à água fluoretada (qui-quadrado = 1,78; p = 0,18; α = 5%), observou-se expressiva diferença na magnitude com que a doença atingiu a população: as médias CPOD foram de 1,76 em expostos e 2,60 em não expostos e as médias SiC foram de 4,04 e 6,16, respectivamente. O grau da polarização, indicado pela porcentagem de indivíduos com CPOD = 0, foi diferente, maior (41,8%) em expostos e menor (34,3%) em não expostos. A razão de prevalência entre não expostos e expostos foi de 1,13, indicando pouca expressividade na diferença das prevalências. CONCLUSÕES A exposição à água fluoretada implicou menores valores médios dos índices CPOD e SiC, ainda que em presença de exposição concomitante a dentifrício fluoretado, em cenário de baixa prevalência da doença e padrão similar de distribuição de cárie nas populações analisadas.

Effects of a food enriched with probiotics on Streptococcus mutans and Lactobacillus spp. salivary counts in preschool children: a cluster randomized trial

Abstract Probiotics have provided benefits to general health, but they are still insufficient to dental health. Objective: This study aimed to evaluate milk supplemented with probiotic bacteria and standard milk, measured by levels of Streptococcus mutans (S. mutans) and Lactobacillus spp., in 3-4-year-old children after 9 months of intervention. Material and Methods: The study was a triple-blind, placebo-controlled, randomized trial. The sample was composed of 363 preschoolers attending five child development centers in Cali, Colombia. They were randomized to two groups: children in the intervention group drank 200 mL of milk with Lactobacillus rhamnosus 5x106 and Bifidobacteruim longum 3x106, and children in the control group drank 200 mL of standard milk. Interventions occurred on weekdays and information was gathered through scheduled clinical examination. The primary result was the number of colony forming units (CFU) of S. mutans and Lactobacillus spp. in the saliva. Secondary results were dental caries, rated by the International Caries Detection and Assessment System (ICDAS), dental plaque, pH, and salivary buffer capacity. Results: The proportion of S. mutans was lower in the intervention group compared with the control group after 9 months; however, the differences did not reach statistical significance (p=0.173); on the other hand, statistically significant differences between groups were found in the CFU/mL of Lactobacillus spp. (p=0.002). There was not statistically significant difference in the prevalence of dental caries for both groups (p=0.767). Differences between groups were found in the salivary buffering capacity (p=0.000); neither salivary pH nor dental plaque were significantly different. Conclusions: Regular consumption of milk containing probiotics bacteria reduced CFU/mL of Lactobacillus spp. and increased salivary buffering capacity at 9 months of consumption.

Socioeconomic Inequalities in Visits to the Dentist to Receive Professionally Applied Topical Fluoride in a Developing Country.

OBJECTIVE: To determine the frequency and associated factors of visits to the dentist in the last year by Nicaraguan schoolchildren to receive professionally applied topical fluoride (PATF). MATERIAL AND METHODS: A cross-sectional study was designed in children from public schools in the city of León, Nicaragua, were included. A series of socioeconomic, sociodemographic, and behavioural variables were collected through a questionnaire. The dependent variable was the visit to the dentist to receive professionally applied topical fluoride in the last year, which was dichotomised as (0) Did not receive PATF and (1) Yes received PATF. In the statistical analysis, binary logistic regression was used. RESULTS: The mean age of the students included was 9 years, and 49.9% were girls. The prevalence of visits to the dentist in the last year to receive PATF was 3.1%. In the multivariate model, the associated characteristics (p < 0.05) were: female (OR = 2.73, 95% CI = 1.34-4.50); the positive attitude of the mother to the oral health of her child (OR = 2.15, 95% CI = 1.03-4.50); and the best socioeconomic position (OR = 2.68, 95% CI = 1.36-5.31). CONCLUSIONS: The prevalence of visits to the dentist in the last year to receive professionally applied topical fluoride was very low (3.1%). The results of the socioeconomic position suggest the existence of certain inequalities in oral health. It is necessary to implement policies and programs aimed at improving this scenario.

Probiotic Compared with Standard Milk for High-caries Children: A Cluster Randomized Trial.

The aim of this study was to compare milk supplemented with probiotic lactobacilli with standard milk for the increment of caries in preschool children after 10 mo of intervention. The study was a triple-blind, placebo-controlled randomized trial. Participants were children aged 2 and 3 y (n = 261) attending 16 nursery schools in a metropolitan region in Chile. Nursery schools were randomly assigned to 2 parallel groups: children in the intervention group were given 150 mL of milk supplemented with Lactobacillus rhamnosus SP1 (10(7) CFU/mL), while children in the control group were given standard milk. Interventions took place on weekdays for 10 mo. Data were collected through a clinical examination of participants. The primary outcome measure was the increment of caries in preschool children. This was assessed using the International Caries Detection and Assessment System (ICDAS). The dropout rate was 21%. No differences in caries prevalence were detected between the groups at baseline (P = 0.68). After 10 mo of probiotic intake, the caries prevalence was 54.4% in the probiotic group and 65.8% in the control group. The percentage of new individuals who developed cavitated lesions (ICDAS 5-6) in the control group (24.3%) was significantly higher than that in the probiotic group (9.7%). The increment of dental caries showed an odds ratio of 0.35 (P < 0.05) in favor of the probiotic group. At the cavitated lesion level, the increment of new caries lesions within the groups showed 1.13 new lesions per child in the probiotic group compared with 1.75 lesions in the control group (P < 0.05). The probiotic group showed an increment of 0.58 ± 1.17 new lesions compared with 1.08 ± 1.70 new lesions observed in the control group. The difference in caries increment was significant at the cavitated lesion level (P < 0.01). In conclusion, the regular long-term intake of probiotic-supplemented milk may reduce caries development in high-caries preschool children (ClinicalTrials.gov: NCT01648075).

Necessity to review the Brazilian regulation about fluoride toothpastes / Necessidade de revisão da regulamentação brasileira sobre dentifrícios fluoretados

The aim of this study was to evaluate the adequacy of the Brazilian legislation about fluoride toothpaste. A search was conducted in LILACS, Medline and SciELO databases about the fluoride concentration found in Brazilians toothpastes, using descriptors on health. Publications since 1981 have shown that some Brazilian toothpastes are not able to maintain, during their expiration time, a minimum of 1,000 ppm F of soluble fluoride in the formulation. However, the Brazilian regulation (ANVISA, Resolution 79, August 28, 2000) only sets the maximum total fluoride (0.15%; 1,500 ppm F) that a toothpaste may contain but not the minimum concentration of soluble fluoride that it should contain to have anticaries potential, which according to systematic reviews should be 1,000 ppm F. Therefore, the Brazilian regulation on fluoride toothpastes needs to be revised to assure the efficacy of those products for caries control.

O presente estudo analisou a adequação da regulamentação brasileira vigente sobre dentifrícios fluoretados. Foi realizada busca da literatura sobre a concentração de flúor nos dentifrícios brasileiros, tendo como fontes Lilacs, Medline e SciELO, com uso de descritores em saúde. Publicações sobre a composição de dentifrícios fluoretados brasileiros têm mostrado desde 1981 que nem todos os dentifrícios são capazes de manter durante o prazo de validade uma concentração mínima de 1.000 ppm F. Esse problema ocorre não só com dentifrícios adquiridos no mercado como com aqueles distribuídos por serviços públicos de saúde. Entretanto, a legislação brasileira (Resolução 79, Anvisa, 28/8/2000) apenas estabelece que um dentifrício não pode conter mais que 0,15% (1.500 ppm F) de flúor total, sem estabelecer o mínimo de flúor solúvel que ele deveria conter para ter potencial anticárie, a qual de acordo com revisões sistemáticas deve ser igual ou maior que 1.000 ppm F. Concluiu-se que a regulamentação brasileira sobre dentifrícios fluoretados necessita ser revisada, garantindo a eficácia desses produtos para o controle da cárie.

Multicentric caries prevention program: Mechanical control of dental plaque through periodic professional oral prophylaxis. A 10 years follow up

AIM: To verify the incidence of dental caries in a multicentric prevention program applied in pediatric dentistry clinics from different regions of Brazil for 10 years, and compare with results obtained by previous studies. MATERIAL AND METHODS: 697 children of both genders, ranging from 30 months to 15 years, were included in a primary preventive strategy program for mechanical control of dental plaque through professional prophylaxis (sodium bicarbonate jet on a monthly schedule). Diagnosis of carious lesions was assessed by monthly clinical examinations and annual radiographs. This procedure aimed to provide a biological equilibrium without producing undesirable side effects. RESULTS: The average age of children at beginning of the program was 81.71 months. Before entering the program the children presented an average of 2.66 lesions/surface, while during the program the average was 0.20 lesions/surface; the incidence rate of caries per year before starting the program was on average 0.62 lesions/surface while during the program it was 0.05 lesions/surface; the time of permanence in the program was on average 44.15 months and the absence rate was 0.14 per year. CONCLUSION: The results confirm the effectiveness of the program, even when applied by different professionals and in different groups of children, turning it into an indispensible method for the control of dental caries.

In Vitro Enamel Remineralization by Low-Fluoride Toothpaste with Calcium Citrate and Sodium Trimetaphosphate

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 µgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 µgF/g and commercial dentifrice (positive control, 1,100 µgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%∆Z). Fluoride in enamel was also determined. The data from %SH, %∆Z and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %∆Z) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 µgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.

O objetivo do presente trabalho foi avaliar in vitro o efeito de um dentifrício com reduzida concentração de fluoreto (450 µgF/g, NaF) associado ao citrato de cálcio (Cacit) e trimetafosfato de sódio (TMP) na remineralização do esmalte. Blocos de esmalte bovino tiveram sua superfície de esmalte polida seqüencialmente para determinação da dureza de superfície. Após o desenvolvimento de lesões artificiais de cárie, os blocos selecionados através da dureza de superfície foram submetidos a ciclagem de remineralização e tratamento diário com suspensões de dentifrícios (diluição em água deionizada ou saliva artificial): placebo, 275, 450, 550 e 1.100 µgF/g e com dentifrício comercial (controle positivo, 1.100 µgF/g). Ao término, determinou-se a dureza de superfície e em secção longitudinal, para cálculo da variação da dureza de superfície (%SH) e do conteúdo mineral (%∆Z). O fluoreto presente no esmalte também foi determinado. Os dados de %SH, %∆Z e fluoreto foram submetidos a análise de variância a dois critérios seguido pelo teste de Student-Newman-Keuls (p<0,05). O ganho mineral (%SH e %∆Z) foi maior para os dentifrícios diluídos em saliva (p<0,05), exceto para os dentifrícios 450 µg F/g com Cacit/TMP (p>0,05). Os dentifrícios 450 Cacit/TMP e controle positivo apresentaram resultados semelhantes (p>0,05) quando diluídos em água. Uma relação dose-resposta foi observada entre a concentração de fluoreto nos dentifrícios e o fluoreto presente no esmalte, independente da diluição. Concluiu-se que é possível melhorar a capacidade de remineralização de dentifrícios com reduzida concentração de fluoreto pela adição de compostos orgânico (Cacit) e inorgânico (TMP) com afinidade a hidroxiapatita.

Can Bayesian models play a role in dental caries epidemiology? Evidence from an application to the BELCAP data set.

OBJECTIVES: The aim of this study was to show the potential of Bayesian analysis in statistical modelling of dental caries data. Because of the bounded nature of the dmft (DMFT) index, zero-inflated binomial (ZIB) and beta-binomial (ZIBB) models were considered. The effects of incorporating prior information available about the parameters of models were also shown. METHODS: The data set used in this study was the Belo Horizonte Caries Prevention (BELCAP) study (Böhning et al. (1999)), consisting of five variables collected among 797 Brazilian school children designed to evaluate four programmes for reducing caries. Only the eight primary molar teeth were considered in the data set. A data augmentation algorithm was used for estimation. Firstly, noninformative priors were used to express our lack of knowledge about the regression parameters. Secondly, prior information about the probability of being a structural zero dmft and the probability of being caries affected in the subpopulation of susceptible children was incorporated. RESULTS: With noninformative priors, the best fitting model was the ZIBB. Education (OR = 0.76, 95% CrI: 0.59, 0.99), all interventions (OR = 0.46, 95% CrI: 0.35, 0.62), rinsing (OR = 0.61, 95% CrI: 0.47, 0.80) and hygiene (OR = 0.65, 95% CrI: 0.49, 0.86) were demonstrated to be factors protecting children from being caries affected. Being male increased the probability of being caries diseased (OR = 1.19, 95% CrI: 1.01, 1.42). However, after incorporating informative priors, ZIB models' estimates were not influenced, while ZIBB models reduced deviance and confirmed the association with all interventions and rinsing only. DISCUSSION: In our application, Bayesian estimates showed a similar accuracy and precision than likelihood-based estimates, although they offered many computational advantages and the possibility of expressing all forms of uncertainty in terms of probability. The overdispersion parameter could expound why the introduction of prior information had significant effects on the parameters of the ZIBB model, while ZIB estimates remained unchanged. Finally, the best performance of ZIBB compared to the ZIB model was shown to catch overdispersion in data.

Experiência de cárie dentária em crianças atendidas em um programa de Odontologia para bebês / Dental caries in children participating in a Dentistry for infants program

Objective: To assess the impact of the "Dentistry for Infants" early dental care program run by Jacareí County (SP) by comparing the caries of individuals participating and not participating in this program. Methods: In total, 300 children between 0 and 48 months old were assessed in the following two groups: infants not participating in the program (G1, n = 100) and infants participating in the program (G2, n = 200). Each group was further divided according to age in subgroups of 0 to 24 months and 25 to 48 months. All children were clinically assessed for carious lesions using the visual-tactile method. The data were statistically analyzed using a paired Student's t-test, Mann-Whitney test, and X² test at a 5% significance level. Results: There was a significant difference in the prevalence (P) and mean index of deciduous teeth (deft) (C) that were decayed, indicated for extraction and filled, and the highest values were observed in G1 (p < 0.0001). The values were as follows: PG1, 73%; PG2, 22%; CG1, 3.45 ± 3.84; and CG2, 0.66 ± 1.57. Conclusion: Participating in the program positively impacted the infants' oral health.

Objetivo: Avaliar o impacto na saúde bucal de crianças atendidas em um programa de atenção precoce "Odontologia para Bebês" da prefeitura do município de Jacareí (SP), por meio da comparação da experiência de cárie entre indivíduos participantes e não participantes do programa. Métodos: Foram avaliadas 300 crianças de 0 e 48 meses de idade, as quais foram divididas em 2 grupos: G1"Bebês não participantes do Programa" (n = 100) e G2 "Bebês do Programa" (n = 200). Cada grupo foi subdividido em dois, o primeiro com crianças de 0 a 24 meses, e o segundo de 25 a 48 meses. Todas as crianças receberam avaliação clínica quanto à presença de lesões de cárie (método táctil e visual). Os dados foram tabulados e analisados estatisticamente pelos testes t de Student pareado, Mann-Whitney e X², com nível de significância de 5%. Resultados: Houve diferença estatística para a prevalência (P) e o índice médio de dentes decíduos cariados, com extração indicada e obturados (ceod) (C), sendo os maiores valores observados para G1(p < 0,0001). Os valores foram: PG1 (73%), PG2 (22%), CG1 (3,45 ± 3,84), CG2 (0,66 ± 1,57). Conclusão: Concluiu-se que participar do programa interferiu positivamente na saúde bucal dos bebês.

Óleo essencial de Thymus vulgaris sobre o crescimentode Streptococcus mutans / Effect of the Thymus vulgaris essential oil on the growth of Streptococcus mutans

The traditional Mediterranean herb thyme (Thymus vulgaris) is a source of an essential oil that has been shown to possess antimicrobial activity against many microorganisms. A considerable part of the general population has dental caries and Streptococcus mutans is one of the microorganisms responsible. The aim of this study was to assess the effect of the essential oil extracted from thyme on the growth of S. mutans, the main bacterium involved in the etiology of dental caries, as well as to incorporate this oil into a toothpaste formulation for preliminary assessment. The broth dilution technique was used in threefold tests for antibacterial activity. The concentrations tested were 1%, 5% and 10% essential oil diluted in ethanol or mineral oil. The controls were triclosan at 0.25% and 0.5%, chlorhexidine digluconate at 0.06% and 0.12%, and ethanol. The 1% solution of thyme essential oil in ethanol proved to be the most efficient against Streptococcus mutans and may be considered viable as an ingredient of toothpaste, both with regard to cost and to the sensory profile of the product. Also, analyses of the characteristics of the formulation indicated that the product is stable.

Thymus vulgaris (tomilho) é uma fonte de óleo essencial que tem demonstrado atividade antimicrobiana. Uma parcela considerável da população tem apresentado problemas dentários, tais como a cárie, na qual o Streptococcus mutans é um microrganismo de fundamental importância. O objetivo deste trabalho foi avaliar o efeito do óleo essencial de tomilho sobre o crescimento do Streptococcus mutans, a principal bactéria relacionada com a etiologia da cárie dentária, bem como veicular este óleo essencial em uma formulação de creme dental para estudo preliminar. O método empregado foi diluição em caldo. As concentrações utilizadas de óleo essencial foram 1%, 5% e 10% de óleo essencial diluído em etanol ou óleo mineral. Os controles foram triclosan a 0,25% e 0,5%, bem como digluconato de clorexidina a 0,06% e 0,12%. A amostra contendo 1% de óleo essencial de tomilho diluída em etanol foi a mais eficaz, sendo efetiva contra Streptococcus mutans e, portanto considerada viável em relação ao custo e ao sensorial conferido ao produto, sendo que a formulação avaliada foi considerada estável.

Jardín Infantil de la Universidad Nacional de Colombia: evaluación de un programa para la promoción de salud bucal en la primera infancia / Kindergarten of the National University of Colombia: evaluation of a health promotion program for the early childhood

Antecedentes: la caries en la primera infancia es considerada un problema de salud públicaen muchos países. En Colombia, el 60,44 % de los niños a los cinco años tiene historia decaries. En el Jardín Infantil, la Facultad de Odontología realizó intervenciones de promociónde salud bucal en las últimas tres décadas, enmarcadas en programas académicos.Métodos: se realizó un estudio descriptivo transversal. La investigadora aplicó encuestasa los cuidadores y examinó clínicamente a 118 niños de los 150 matriculados. Resultados:el ceo-d de los niños valorados del jardín corresponde a un 0,805 que, según la OMS, estácatalogado como muy bajo. En una valoración en el 2005 se encontró un 36,06 % de niñosenfermos con caries cavitacionales contra el 14,4 % de niños con presencia de caries activascavitadas y no cavitadas. Esto demuestra mejores condiciones de salud bucal, si se comparacon el 54,4 % de niños que presentan caries a los cinco años en el ámbito nacional y el 59,3 %de niños en las mismas condiciones en Bogotá. En cuanto a educación para la salud, losresultados de las encuestas revelan que el 80 % de los cuidadores de los niños tienen unasuficiencia conceptual que les permite brindar cuidados y promover conductas para prevenirenfermedades bucales. Conclusión: en Colombia la caries de infancia temprana requiereun abordaje con programas basados en adquisición de hábitos saludables mediados poreducación con énfasis en nutrición e higiene desde antes del nacimiento y con alianzasestratégicas con escuela saludable y empresas promotoras de salud...

Background: Early childhood cavities are considered a public health problem in manycountries. In Colombia, 60.44 % children age five have a history of cavities. Since 1980, theDental School has implemented dental health promotion interventions in the kindergarten.Methods: A descriptive study was carried out. The researcher administered surveys to thecaregivers and examined 118 children out of the 150 enrolled. Results: dmf-t Index of thechildren assessed in the kindergarden was 0.805, which, according to the WHO standards,is considered very low. A study in 2005 showed that 36.06 % children suffered from cavitationalcaries, compared to 14.4 % children with active cavitated and non-cavitated caries.This shows a better dental health status when compared with 54.4 % five-year-old childrenwith dental cavities nationwide and 59.3 % children under the same conditions in Bogotá.Regarding health education, the surveys show that 80 % caregivers possess conceptualsufficiency to provide dental care and promote disease preventive habits. Conclusion: InColombia, early childhood caries should be considered a public health problem and it isnecessary to emphasize promotion and prevention programs based on the acquisition ofhealthy habits mediated by education with an emphasis on nutrition and hygiene from birth,in order to implement these strategies in schools...