Cássia Cilene Dezan

Prevalence of developmental defects of enamel in children and adolescents with asthma

OBJECTIVE This study aimed to evaluate the prevalence of developmental defects of enamel (DDEs) in relation to asthma severity, symptom onset and pharmacological treatment in pediatric asthma patients. METHODS Children and adolescents (68 asthma patients and 68 controls), 5-15 years of age and residents of the city of Londrina, Brazil, were enrolled in the study. Medical and dental histories were collected through the use of a structured questionnaire. Each participant underwent a dental examination in which the examiner employed the DDE index. RESULTS Of the 68 asthma group subjects, 61 (89.7%) presented dental enamel defects, compared with only 26 (38.2%) of those in the control group. Using multivariate logistic regression analysis, we estimated the risk of DDEs in permanent dentition to be 11 times higher in pediatric subjects with asthma than in those without (OR = 11.88, p = 0.0001). The occurrence of dental enamel defects correlated with greater asthma severity (p = 0.0001) and earlier symptom onset (p = 0.0001). However, dental enamel defects did not correlate with the initiation of treatment (p = 0.08) or the frequency of medication use (p = 0.93). CONCLUSIONS Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care.

Dental caries status and salivary properties of asthmatic children and adolescents

AIMS This study aimed to investigate the dental caries status and salivary properties in 3- to 15-year-old children/adolescents. METHODS The sample was split in two groups: asthma group (AG), composed of 65 patients who attended Public Health Service; asthma-free group (AFG), composed of 65 nonasthmatic children/adolescents recruited in two public schools. Stimulated salivary samples were collected for 3 min. Buffering capacity and pH were ascertained in each salivary sample. A single trained and calibrated examiner (kappa = 0.98) performed the dental caries examination according to WHO criteria. RESULTS The AFG showed salivary flow rate (1.10 ± 0.63 mL/min) higher (P = 0.002) than AG (0.80 ± 0.50 mL/min). An inverse relationship was observed between asthma severity and salivary flow rate (Phi coefficient, rφ: 0.79, P = 0.0001). Children with moderate or severe asthma showed an increased risk for reduced salivary flow rate (OR: 17.15, P < 0.001). No association was observed between drug use frequency (P > 0.05) and drug type (P > 0.05) with salivary flow rate. Buffering capacity was similar in both groups. No significant differences were encountered in dental caries experience between AFG and AG groups. CONCLUSIONS Although asthma can cause reduction in flow rate, the illness did not seem to influence dental caries experience in children with access to proper dental care.

Cariogenic Microorganisms and Oral Conditions in Asthmatic Children

This study evaluated the caries risk of asthmatic patients on the basis of mutans streptococci (MS) and lactobacilli levels in saliva samples as well as the index of oral hygiene and dental caries (DMFT index). The study population was composed of 80 asthmatic children, aged 3–15 years, who use specific medication, and 80 matched, healthy control children. The parents were interviewed about oral health-related factors. The World Health Organization criteria were used for dental examinations. The Köhler and Bratthal methodology was used to detect salivary MS levels and dilutions of saliva were done for lactobacilli counting. No differences between asthma and control groups were observed for caries prevalence in children aged 3–6 and 7–10 years, except in severe cases in the younger group. However, higher caries prevalence for permanent dentition was observed in 11- to 15-year-old asthmatic children. An increased dental biofilm was observed in the asthma group, as well as salivary levels of MS. No differences were observed in levels of lactobacilli. No statistical correlations were found between medication, frequency of treatment, method of consumption and caries experience, dental biofilm and salivary levels of MS or lactobacilli. However, there was a correlation between MS levels and treatment duration. The logistic regression revealed that MS level is an important risk factor for increased caries experience. Asthma should be evaluated as a risk factor for caries experience because it can increase the levels of MS and the dental biofilm.

Prevalence of dental caries in 3- and 5-year-old children living in a small Brazilian City

Despite the reduction in the prevalence of dental caries, very little is known about the prevalence of the disease, especially in deciduous teeth, in small Brazilian cities (<20,000 inhabitants). The aim of this study was to evaluate the prevalence of dental caries in children aged 3 and 5 years of age in the city of Cambira - State of Parana. All children that participated in the national vaccination campaign against poliomyelitis in 2002 at the two basic health units of the city were examined. The campaign covered 99.5% of the population aged 1 to 5 years. Two previously trained and calibrated dentists performed the clinical examinations after the children brushed their teeth and recorded their caries experience by means of the dmf index. The results showed that there was no statistically significant difference in the prevalence of the disease between the male and female genders and between the rural and urban zones. At the age of 3, 68.50% of the children were caries-free, compared to 31.10% at the age of 5. In the total population, 11.19% of the children accounted for 50.86% of the teeth affected by dental caries. The dmf index at 3 and 5 years in the study population was 2.10 and 3.51, respectively. These data showed that the city has not yet reached the goals proposed by the WHO for the year 2000, what indicates the need for greater investment in programs aimed to prevention and control of the disease.

Sublingual traumatic ulcerative lesions caused by the eruption of first primary mandibular molars: a case report

La ulceracion traumatica de la superficie ventral de la lengua es una condicion poco comun en bebes y ninos pequenos, la cual se asocia a menudo con los dientes natales y neonatales en los recien nacidos. El objetivo de este reporte es presentar un caso de ulceras bilaterales en la superficie ventral de la lengua causada por la erupcion de los primeros molares mandibulares temporales en un infante de sexo masculino de 14 meses de edad. En nino fue capaz de senalar las lesiones y se nego a consumir ciertas bebidas y alimentos, lo que favorecio un diagnostico precoz. El tratamiento clinico consistio en el suavizado manual de los bordes afilados de los primeros molares inferiores y un regimen casero de solucion de clorhidrato de lidocaina (Xilocaina®, Astra) junto a la solucion esteroidal de acetonido de triamcinolona (Omcilon - A, Brystol-Myers) para el alivio de los sintomas y curacion de la lesion respectivamente. La curacion completa de ambas lesiones y la alimentacion normal se observo en una semana del control de seguimiento. La deteccion temprana de las lesiones y el cumplimiento de los padres con los regimenes caseros recomendados, son factores claves para un resultado exitoso del tratamiento, ya que los casos no tratados de estas lesiones ulcerosas pueden provocar dificultades en la alimentacion y una evolucion inadecuada. Aunque existen varios informes de lesiones ulcerosas en la lengua causada por la erupcion dental, que se asocian generalmente con la erupcion de los incisivos mandibulares temporales (enfermedad de Riga-Fede). Sin embargo, no existen informes de lesiones ulcerosas causadas por otros dientes temporales.

The influence of asthma onset and severity on malocclusion prevalence in children and adolescents

OBJECTIVE: The influence of asthma, its severity levels and onset time on malocclusion occurrence were investigated. METHODS: The sample was composed by 176 children/adolescents, of both genders, aged 3 to 15 years, that were divided in two groups. The asthma group (AG) enrolled 88 children/adolescents that were seen at the Breathe Londrina Program. The asthma-free group (AFG) enrolled 88 preschool and school children recruited in 2 public schools. Malocclusion diagnosis was made according to WHO criteria (OMS, 1999). RESULTS: A higher prevalence in malocclusions in asthmatic patients in mixed dentition was observed when compared to controls (p 0.05) and permanent dentition (p>0.05). A significant association was seen between asthma onset time and marked maxillary overjet (p<0.05), and open bite (p<0.05) in the mixed dentition, being both conditions more common among those that have presented the symptoms of asthma prior to 12 months of age. CONCLUSION: The results of this study indicate that the early manifestation of asthma at first year of life can cause dentofacial changes. Therefore, the prompt diagnostic of the illness, as well as the establishment of a proper therapy could improve the symptoms and chronic complications of asthma and also reduce its impact on craniofacial development.