Antonio Bento Alves de Moraes

Consequences of bottle-feeding to the oral facial development of initially breastfed children

OBJECTIVE To identify and assess the possible consequences of bottle-feeding on the oral facial development of children who were breastfed up to at least six months of age. METHOD Two hundred and two children (4 years of age) enrolled in an early health attention program participated in the study. The sample was divided into two groups: G1 (children who used only a cup to drink) and G2 (those who used a bottle). RESULTS Lip closure was observed in 82% of the children in G1 and in 65% of those in G2 (p = 0.0065). The tongue coming to rest in the maxillary arch was found in 73% of the children in G1 and in 47% of those in G2 (p = 0.0001). Nasal breathing was observed in 69% of G1 and in 37% of G2 (p = 0.0001). The maxilla was shown to be normal in 90% of G1 and in 78% of G2 (p = 0.0206). CONCLUSION Use of the bottle, even among breastfed children interferes negatively with oral facial development.

Conseqüências do uso da mamadeira para o desenvolvimento orofacial em crianças inicialmente amamentadas ao peito

OBJETIVO: Identificar e avaliar as possiveis consequencias do uso da mamadeira sobre o desenvolvimento orofacial em criancas que foram amamentadas ate pelo menos, os 6 meses de vida. METODOS: Participaram do estudo 202 criancas (4 anos de idade) que frequentaram o Programa de Atencao Precoce a Saude. A amostra foi dividida em: G1 (criancas que utilizaram apenas copo para ingestao de liquidos) e G2 (utilizaram mamadeira). RESULTADOS: Selamento labial foi observado em 82% das criancas do G1 e em 65% do G2 (p = 0,0065). Repouso da lingua no arco superior foi encontrado em 73% das criancas do G1 e em 47% do G2 (p < 0,0001). Observou-se maior ocorrencia de respiracao nasal em 69% do G1 e em 37% do G2 (p < 0,0001). A maxila mostrou-se normal em 90% do G1 e em 78% do G2 (p = 0,0206). CONCLUSAO: Usar mamadeira, mesmo entre criancas que receberam aleitamento materno, interfere negativamente sobre o desenvolvimento orofacial.

Prospective study of potential sources of Streptococcus mutans transmission in nursery school children.

Transmission of Streptococcus mutans, a major dental caries pathogen, occurs mainly during the first 2.5 years of age. Children appear to acquire S. mutans mostly from their mothers, but few studies have investigated non-familial sources of S. mutans transmission. This study prospectively analysed initial S. mutans oral colonization in 119 children from nursery schools during a 1.5-year period and tracked the transmission from child to child, day-care caregiver to child and mother to child. Children were examined at baseline, when they were 5-13 months of age, and at 6-month intervals for determination of oral levels of S. mutans and development of caries lesions. Levels of S. mutans were also determined in caregivers and mothers. A total of 1392 S. mutans isolates (obtained from children, caregivers and mothers) were genotyped by arbitrarily primed PCR and chromosomal RFLP. Overall, 40.3 % of children were detectably colonized during the study, and levels of S. mutans were significantly associated with the development of caries lesions. Identical S. mutans genotypes were found in four nursery cohorts. No familial relationship existed in three of these cohorts, indicating horizontal transmission. Despite high oral levels of S. mutans identified in most of the caregivers, none of their genotypes matched those identified in the respective children. Only 50 % of children with high levels of S. mutans carried genotypes identified in their mothers. The results support previous evidence indicating that non-familial sources of S. mutans transmission exist, and indicate that this bacterium may be transmitted horizontally between children during the initial phases of S. mutans colonization in nursery environments.

O tratamento odontológico como gerador de ansiedade

La situacion de tratamiento odontologico es potencialmente ansiogenica para todos los involucrados. Del punto de vista del paciente, aspectos clinicos - en especial los invasivos, tales como la inyeccion de la anestesia - y aspectos relacionados a los comportamientos del profesional pueden generar ansiedad y respuestas de elusion al tratamiento. Para el cirujano dentista, la necesidad de lidiar con la ansiedad del paciente, que requiere, muchas veces, estrategias diferenciadas de manejo del comportamiento, ademas de toda exigencia por la perfeccion tecnica y actualizacion de conocimientos clinicos, pueden volver estresante su rutina de trabajo. La situacion se agrava a medida que la formacion del profesional de odontologia sea deficiente en la adquisicion de conocimientos teoricos y practicos sobre la relacion profesional-paciente y estrategias de manejo de comportamientos.

Fatores que influenciam o desmame precoce e a extensão do aleitamento materno

O objetivo deste trabalho foi identificar fatores que influenciam a ocorrencia do desmame precoce e do aleitamento prolongado. A metodologia envolveu a selecao de dois grupos de 40 maes, cujos filhos eram atendidos pelo Centro de Pesquisa e Atendimento Odontologico para Pacientes Especiais, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas. O grupo I era constituido de maes que desmamaram seus filhos antes do sexto mes de vida e o grupo II, de maes que estenderam a amamentacao alem do primeiro ano. As participantes responderam, primeiramente, a entrevistas individuais por meio de um questionario especifico e, posteriormente, a um questionario socioeconomico. A entrevista foi gravada em fita de audio para evitar a perda de informacoes verbais. Os resultados mostraram que as variaveis demograficas estao relacionadas ao sucesso ou insucesso da amamentacao natural. Programas de saude que analisam essas variaveis podem identificar mulheres com alto risco para a ocorrencia do desmame precoce e proporcionar-lhes uma atencao mais sistematizada.

Determinantes do abandono do aleitamento materno exclusivo em crianças assistidas por programa interdisciplinar de promoção à amamentação

OBJETIVO: Identificar as variaveis potencialmente relacionadas ao abandono da amamentacao exclusiva entre criancas participantes de um programa interdisciplinar de incentivo ao aleitamento materno. METODOS: Foi realizado um estudo longitudinal, por meio de acompanhamento clinico de 111 diades mae-bebe, durante os seis primeiros meses de vida da crianca. Para a avaliacao de fatores associados a interrupcao do aleitamento exclusivo, realizou-se analise univariada e regressao logistica multipla. RESULTADOS: As diades participantes foram divididas em dois grupos, segundo o tipo de alimentacao recebida pela crianca aos seis meses de vida: um composto por 57 criancas em aleitamento materno exclusivo e outro por 54 criancas em aleitamento materno complementado ou predominante. Apos analise de regressao logistica, as variaveis uso de chupeta (OR 4,65; IC95% 1,66-12,99), alto nivel socioeconomico (OR 11,46; IC95% 3,09-42,37) e trabalho materno (OR 2,44; IC95% 0,91-5,62) comportarem-se como fatores associados ao abandono do aleitamento exclusivo. CONCLUSOES: O uso de chupeta pela crianca, alto nivel socioeconomico e trabalho materno estao associados a interrupcao do aleitamento exclusivo.

Psicologia e odontopediatria: a contribuição da análise funcional do comportamento

75Alguns estudos sugerem que o repertorio decomportamentos da crianca, exposta a situacao deatendimento odontologico, resulta do manejo inadequadodo cirurgiaoŒdentista (Prins, Weerkamp, Horst, Jong & Tan,1987; Weinstein, Getz, Ratener & Domoto, 1982). Entretanto,poucos autores analisam, especificamente, o comportamentodo profissional e como este O afetado funcionalmente pelocomportamento do paciente. A habilidade para interagir e secomunicar com o paciente O essencial para criar uma boarelacao profissional. Caldana e Biasoli-Alves (1990) ressaltamque conhecer o comportamento do paciente permite ummelhor desempenho odontologico. Ten-Berge, Veerkamp eHoogstraten (1999) observam que o comportamento dodentista exerce influŒncia relevante sobre o desenvolvimentodo medo de tratamento odontologico em criancas.De maneira geral, os odontopediatras reconhecem anecessidade de melhorar e expandir seus conhecimentossobre manejo do comportamento de criancas, mas a exposicaoa programas de treinamento e a aceitacao de novas estratOgias,

Verbalizações de alunos de odontologia sobre a inclusão social de pessoas com deficiência

The aim of this study was to assess different ways students of Dentistry express themselves as they are asked questions concerning individuals with disabilities. A questionnaire consisting of examples of inclusive situations was applied prior to and after a teaching module focusing handicapped patients. Answers to the questionnaire were categorized as positive tendency (e.g. approval), negative tendency (e.g. pitiful), or neutral. Also, distinctions were made between the answers focusing on the individual and those focusing on inclusive actions. Results revealed the highest values for positive responsiveness, increasing after the teaching module application. Answers focusing on the individual showed higher values when compared to those regarding inclusive actions. This study emphasizes the contribution of Human Sciences approaches to dental students learning and their preparation to deal with handicapped patients.The aim of this study was to assess different ways students of Dentistry express themselves as they are asked questions concerning individuals with disabilities. A questionnaire consisting of examples of inclusive situations was applied prior to and after a teaching module focusing handicapped patients. Answers to the questionnaire were categorized as positive tendency (e.g. approval), negative tendency (e.g. pitiful), or neutral. Also, distinctions were made between the answers focusing on the individual and those focusing on inclusive actions. Results revealed the highest values for positive responsiveness, increasing after the teaching module application. Answers focusing on the individual showed higher values when compared to those regarding inclusive actions. This study emphasizes the contribution of Human Sciences approaches to dental students learning and their preparation to deal with handicapped patients.

Motivação e comportamento preventivo de saúde bucal em programa de assistência odontopediátrica na primeira infância

The purpose of this paper was to identify the feeding routines of children and the compliance of mothers with the recommendations on oral health. Two hundred dental records of patients (with ages between 1 and 20 months) from the Research and Dental Treatment Center for Special Patients (Cepae/FOP/UNICAMP) were examined in order to establish the kind of feeding, the products that were added to the milk and the presence of sucrose in these products. In addition, the prevalence of caries was determined both when the children were introduced in the program and after 1 year. From the 200 dental records examined, it was observed that 85% of the children were bottle-fed and, out of these, 81.8% received milk associated with some product which contained sucrose. Considering the 200 children studied, 8% began the program with caries as shown in their first dental examination. The compliance of the mothers with the dietary recommendations during the program was obtained in 27% of the cases. A cognitive model for change of behavior is proposed to understand the behavior of mothers related with the oral health of their children, while taking part in a preventive dental program. Guidance and training are necessary but not sufficient to change the behavior of mothers.

Análise de variáveis biopsicossociais relacionadas ao desmame precoce

The objective of this study was to identify factors that influence early weaning occurrence, including an assessment of the stress experimented by mothers influence on breastfeeding interruption. The study comprised 40 mothers whose children were treated by Research and Dental Treatment Center for Special Patients - FOP - UNICAMP. As an inclusion criterion in the study, weaning should have taken place before the child was six months old. Mother inclusion and data collection occurred, at most, one month after breastfeeding interruption. The participants were interviewed individually, using a particular script, and then, the Inventory of Stress Symptom (ISS) was applied. Results showed a positive relation among mothers coming back to work, demonstration of stress symptoms and decreased milk production with the early weaning.