Christiana Murakami

Risk Indicators for Erosive Tooth Wear in Brazilian Preschool Children

The aim of this study was to assess the prevalence and risk indicators for erosive tooth wear (ETW) in Brazilian preschool children. A total of 967 children aged 3–4 years were examined. ETW was assessed using a modified version of the index recommended by O’Brien [London, Her Majesty’s Stationary Office, 1994]. The 16 examiners were trained and calibrated. Hierarchical logistic regression was applied to investigate the association between ETW and socio-economic, environmental, nutritional and behavioural factors, as well as factors related to the child’s characteristics. ETW was present in 51.6% of children. Most lesions were confined to enamel (93.9%) and involved over two thirds of the tooth surface’s area (82%). There were no significant associations between ETW and socio-economic, environmental and nutritional variables. ETW was significantly associated with soft drink intake twice or 3 or more times a day (p = 0.043 and 0.023, respectively), frequent reported gastro-oesophageal reflux (p = 0.005) and age (p = 0.003). In conclusion, there was a high prevalence of ETW in the preschool children examined, and the risk indicators were frequent consumption of soft drinks, reported gastro-oesophageal reflux and age.

Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth

OBJECTIVE To assess the effect of a fluoride varnish and gel on the erosive wear of primary and permanent teeth. DESIGN Sixty human primary (n=30) and permanent (n=30) enamel specimens were randomly assigned to one of the following groups: APF gel (1.23% F), NaF varnish (2.26% F), and control (no treatment). Fluoride gel was applied for 4 min and fluoride varnish for 24 h. Six daily demineralisation-remineralization cycles of 5 min of immersion in a cola drink (pH 2.3) and 30 min in artificial saliva were conducted during 7 days. All specimens were stored in artificial saliva between and after cycles. Surface Knoop microhardness (%SMHC) readings were performed at baseline, 48 h and 7 days. Data were tested using ANOVA and Tukeys tests (p<0.05). RESULTS For primary enamel, the mean %SMHC (+/-SD) after 48 h and 7 days was, respectively: gel (31.0+/-14.4 and 36.9+/-7.5), varnish (26.7+/-9.5 and 38.3+/-8.7), and control (35.8+/-8.6 and 45.0+/-8.6). For permanent enamel, such values were: gel (37.5+/-7.7 and 27.8+/-7.5), varnish (31.7+/-9.6 and 27.4+/-11.1) and control (48.6+/-6.4 and 43.1+/-6.4). In primary enamel, erosion inhibition by fluoride was not significant at 48 h (p=0.203) and 7 days (p=0.082). In permanent specimens, both products showed a significant effect (p<0.001). CONCLUSIONS Both fluoride varnish and gel were able to inhibit erosive enamel loss but mainly in the permanent experimental groups. Primary and permanent enamel substrates reacted differently to both demineralization by a cola drink and remineralization by fluoridated compounds.

Prevalence and associated factors of dental erosion in children and adolescents of a private dental practice.

BaCKGROUND. The prevalence of dental erosion seems to be rising in young populations, particularly among individuals of higher socioeconomic status. AIM. To assess the prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. DESIGN. A total of 232 participants, aged 2-20 years, were examined. Dietary habits, oral hygiene, and medical data were collected from dental records. Logistic regression analyses were conducted. RESULTS. Dental erosion prevalence was of 25.43% and was highest on the occlusal surfaces (76%). Associated factors were: frequent consumption of soft drinks (OR = 2.33; 95% CI = 1.01-5.38) and candies (OR = 3.23; 95% CI = 1.25-8.32); and interaction between these two factors (OR = 3.95; 95% CI = 1.60-9.75). On anterior teeth, associated factors were: frequent consumption of fruits (OR = 2.53; 95% CI = 1.09-5.91); and age (OR = 1.07 95% CI = 1.01-1.14). Milk consumption was associated with a lower prevalence of dental erosion (OR = 0.40; 95% CI = 0.17-0.94). CONCLUSIONS.  A relatively high prevalence of erosion was found in association with frequent intake of soft drinks, candies, and fruits. The consumption of milk seemed to protect against dental erosion on anterior teeth.

Medical problems and oral care of patients with Down syndrome: a literature review.

When planning the dental treatment of patients with Down syndrome (DS), dental practitioners should always consider their general health, in order to achieve a holistic and interdisciplinary approach. This article presents a literature review of the primary medical conditions in patients with DS that may affect their general health care and the appropriate clinical delivery of oral health care.

Focal dermal hypoplasia: a case report and literature review

Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data

OBJECTIVE To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables. METHODS Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Childrens Vaccination day. Calibrated examiners performed the childrens oral examination for TCI according to Andreasens criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables. RESULTS The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P < 0.05). Childrens age was associated with TCI in all the surveys. Male gender, presence of anterior open bite and inadequate lip coverage were associated with TCI in some surveys along the years (P < 0.05). CONCLUSION This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with childrens age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy.

Dental treatment of children with Angelman syndrome: a case report

Angelman syndrome (AS) is a rare genetic neurological disorder. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, speech impairment, movement or balance disorder, and a behavioural uniqueness. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking/swallowing disorder, mandibular prognathism, a wide mouth, frequent drooling, and excessive chewing behaviour. The dental literature on the syndrome is scarce. The purpose of paper is to describe the interesting aspects of the dental treatment of a child with AS.

Does erosive tooth wear affect the oral health-related quality of life of preschool children?

Objective The aim of this study was to investigate the impact of erosive tooth wear on the Oral Health-Related Quality of life (OHRQoL) of preschool children. Methods Dental examinations were conducted on 815 children aged 3-4 years during the Children’s Vaccination National Day when their parents were also invited to answer the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). ETW prevalence and severity were measured using a modified version of the O’Brien index (1994). Data collected included socioeconomic factors and childs variables. OHRQoL was measured through B-ECOHIS domains and total score. Poisson regression was used to associate ETW to the outcome and this association was adjusted for dental caries and dental trauma. Results The proportion of children who had at least 1 ETW tooth was 51.2%. Most erosive lesions were confined to enamel (42.7%). The multivariate adjusted model showed that childs age (children aged 4year-old) was associated to a negative impact on the symptom domain (RR=1.70; p=0.010), functional limitation domain (RR=1.85; p=0.005) and total B-ECOHIS score (RR= 1.63; p=0.006). Families with 2 or more children in the house have a negative impact on the self-image/social interaction domain (RR=5.41; p=0.043). ETW was not associated to total B-ECOHIS scores (RR= 0.79; p=0.163) and individual domains. Conclusion Erosive tooth wear does not affect the OHRQoL in this sample of preschool children. Indexing terms: Oral health-related quality of life. Prevalence. Tooth erosion.