Isabela Albuquerque Passos

Flow rate, pH and calcium concentration of saliva of children and adolescents with type 1 diabetes mellitus

Alterations in salivary parameters may increase the caries risk in diabetic children, but, contradictory data on this issue have been reported. The aims of this study were to compare salivary parameters (flow rate, pH and calcium concentration) between healthy and type 1 diabetes mellitus (T1DM) individuals. The sample consisted of 7- to 18-year-old individuals divided into two groups: 30 subjects with T1DM (group A) and 30 healthy control subjects (group B). Fasting glucose levels were determined. Unstimulated and stimulated saliva was collected. The pH of unstimulated saliva was measured with paper strips and an electrode. Calcium concentrations in stimulated saliva were determined with a selective electrode. Group A individuals had inadequate blood glucose control (HbA(1C) >9%), with means +/- SD unstimulated salivary flow rate of 0.15 +/- 0.1 mL/min compared to 0.36 +/- 0.2 mL/min for group B (P < 0.01). Stimulated salivary flow rate was similar by both groups and above 2.0 mL/min. Saliva pH was 6.0 +/- 0.8 for group A and significantly different from 7.0 +/- 0.6 for group B (P < 0.01). Salivary calcium was 14.7 +/- 8.1 mg/L for group A and significantly higher than 9.9 +/- 6.4 mg/L for group B (P < 0.01). Except for elevated calcium concentrations in saliva, salivary parameters favoring caries such as low saliva pH and unstimulated salivary flow rate were observed in T1DM individuals.

Prevalência de cárie em adolescentes de escolas públicas e privadas na cidade de João Pessoa, Paraíba, Brasil

The purpose of this study was to ascertain the prevalence of cavities among adolescents in public and private schools in Joao Pessoa, Paraiba State, Brazil, comparing the DMFT in terms of gender and age, as well as education levels and quality among mothers in these two types of schools. The sample consisted of 3,330 adolescents between twelve and fifteen years old: 1,665 attending public schools and 1,665 attending private schools. The DMFT was evaluated by the WHO criteria (1997), using the Kappa (0.92) intra-examiner agreement for cavity diagnoses and the Mann-Whitney and Kruskal-Wallis statistical analyses. The prevalence of cavities in public schools was 51.6%, compared to 9.3% in private schools. The DMFT for girls was 4.79 and 3.46 for boys in public schools (p<0.0001) and 2.11 and 1.65 (p=0.0007) in private schools. At the age of 12 years, the DMFT was 3.37 in public schools and 1.35 in private schools, while for the age of 15 it was 5.65 and 2.88 for each type of school. Among children whose mothers graduated from high school, the average DMFT was 4.21 in public schools and 1.81 in private schools. The prevalence of cavities was higher among girls in public schools, increasing with age and decreasing with higher education levels among mothers.

Sucrose concentration and pH in liquid oral pediatric medicines of long-term use for children

OBJECTIVES To determine the pH and sucrose concentrations (SC) of pediatric liquid drugs of long-term use by children in order to evaluate the potential risk for dental caries and dental erosion. METHODS After assessing the pH, we analyzed 71 aqueous medicine samples for sucrose by the Lane-Eynon general volumetric method. The pH and SC values (mean +/- standard deviation (SD) were calculated according to therapeutic action. RESULTS The highest and the lowest SC values (mean +/- SD) were found in respiratory (37.75% +/- 17.23%) and endocrine drugs (11.97% +/- 15.16%) (p < 0.01). The values for medicines prescribed for daily ingestion were 47.15% +/- 9.57%, whereas for twice daily and three or four times a day, these numbers were 24.42% +/- 18.03% and 34.43% +/- 14.83%, respectively (p < 0.01). The SC (mean +/- SD)) values were higher in syrups (36.32% +/- 17.62%) than in other formulations (p > 0.05). The overall pH (mean +/- SD) was 5.89 +/- 2.02 (range 2.3 +/- 0.01 to 10.6 +/- 0.02). In products with acidic pH, the SC (mean +/- SD) was significantly lower (22.14% +/- 15.72%) than in nonacidic medicines (39.22% +/- 15.82%) (p < 0.001). CONCLUSIONS It can be concluded that the pediatric medicines studied have a high SC and low pH, which vary according to therapeutic class, daily dose, and brand. Caution about dental caries, dental erosion, and systemic diseases such as diabetes mellitus is warranted when these medicines are ingested frequently.

Radiographic diagnosis of incipient proximal caries: an ex-vivo study

The aim of this ex vivo study was to compare visual clinical and radiographic examinations to the histological analysis for proximal caries diagnosis in extracted permanent molars and premolars. The relationship between clinical aspects and carious lesions was also evaluated. Eighty-eight proximal surfaces (44 freshly extracted teeth) were longitudinally sectioned with a 370-microm diamond disk, thinned with wet silicon carbide paper and observed with a stereomicroscope at x40 magnification. Sensitivity and specificity were 65.6% and 83.3% for clinical examination and 29.7% and 95.8% for radiographic examination, respectively. Kappa values ranged from 0.64 to 0.91. The white spots corresponded to lesions restricted to enamel, while the dark spots corresponded to lesions that reached the dentinoenamel junction. In most cases, cavitation corresponded to dentin lesions. It may be concluded that interproximal radiographic examination is not a reliable method for detection of incipient proximal carious lesions.

Abordagem preventiva da doença periodontal no paciente diabético: revisão da literatura

Periodontal disease has several phases with different evolution patterns and clinical manifestations. The etiological factor is always the dental biofilm, but it is modulated by the different alteration of susceptible host. The gingivitis and periodontitis are manifestations of periodontal health/disease process. The diabetes mellitus acts as an important factor of risk to the development and progression of the periodontal disease, because the diabetics have larger susceptibility to the infection. The aim of this study is to emphasize the relationship among diabetes mellitus and periodontal disease and to describe the adequate treatment and the prevention of the disease periodontal in diabetic patients. descriptors: Diabetes mellitus Periodontitis Gingivitis Madeiro AT, Passos IA, Figueiredo CRLV. Abordagem preventiva da doença periodontal no paciente diabético: Revisão da literatura Revista de Odontologia da Universidade Cidade de São Paulo 2008 jan-abr; 20(1):76-81