Maria Salete Nahás Pires Corrêa

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.

Os defeitos do esmalte e a erupcão dentária em criancas prematuras

BACKGROUD: The purpose of this study was to analyze the relation between enamel defects and delay of dental eruption with prematurity. METHODS: the sample consisted of 100 premature children ranging from six months to six years of age, observed in the Children Institute of the Medical School of the USP. An anamnesis of the oral cavity was carried out by just one observer who analyzed the chronology of teeth eruption as well as the occurrence of enamel defects. A medical evaluation was also conducted in order to detect potential problems during the prenatal, neonatal and postnatal periods. The statistical assessment included descriptive analysis, average frequency and a confidence interval of 95%. RESULTS: Defects appeared in 35% of the premature children; 51.43% of those affected had been born with a low weight ( 2500g). No relationship was found between the occurrence of defects with a low Apgar score during the first minute, second minute and five minutes (p=0.628; p=0.308;p=0.,193). The most common defects were white opacities, in the deciduous (19.0%) as well as in the permanent dentition (100%). The incisor and cervical halves of the vestibular faces were the most affected reaching values of 88.04% for the deciduous dentition and of 100% for the permanent one. In about 42% of children eruption of teeth took place between 6 to 10 months of age. CONCLUSIONS: Premature children may have enamel defects caused by different factors that appear during pregnancy with a possible association between low weight and enamel defects. Furthermore, premature children had teeth eruption in a normal period, nevertheless, until 36 months of age with less teeth total than children born at normal term.

Erosive potential of different types of grape juices

The purpose of the present study was to evaluate the erosive potential of different types (concentrated and powdered) and commercial brands of industrialised grape juices. The pH of all five fruit drinks was measured at two time points: immediately after preparation and 24 hours later. Sixty specimens of bovine enamel were randomly allocated and immersed in different types of grape juice (n = 10) for 10 minutes four times a day for fifteen days. The enamel alteration was analysed using surface Knoop microhardness (KHN) and surface roughness (Ra) tests at baseline and on the 5(th), 10(th) and 15(th) days of the experiment. Two way ANOVA, Tukeys post hoc and Pearsons correlation tests were used for statistical analysis (α = 5%). The grape juices presented pH values ranging from 2.9 to 3.5. All of the tested juices promoted significant enamel mineral loss (p < 0.05) on the first evaluation (5(th) day of immersion) and produced a significant increase in the mean roughness from the 10(th) day on when compared to the control group (p < 0.05). By the 15(th) day, all of the beverages had produced surface roughnesses that were significantly higher than that of the control group. The results suggest that all grape juices, regardless of their commercial presentation, present erosive potential.

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.

Enamel microabrasion in an individual with Cohen syndrome

This case report describes the esthetic dental treatment of a patient with Cohen syndrome where microabrasion was used to treat dental fluorosis. The patients teeth had white and light yellow spots, which were diagnosed as moderate dental fluorosis. These spots were treated with microabrasion using pumice paste and 37% phosphoric acid. The paste was applied with a rubber cup on a low-speed handpiece and manually using a wooden stick. It took four appointments to treat all of the patients teeth. Topical neutral fluoride was applied after each appointment to decrease any dental sensitivity. The esthetic result was satisfactory. Esthetic dental treatment may result in positive emotional and behavioral changes in patients with special needs.

Exploring some aspects associated with dentine hypersensitivity in children.

Background. The etiology of dentine hypersensitivity (DH) is still inconclusive and there are few studies concerning it in children. Aim. To evaluate clinical, dietary, and salivary variables in children with DH complaints. Design. Forty-eight children were asked about DH. Data regarding dietary habits were collected from the childrens parents and an examination was performed to determine dental erosion. Dental biofilm was estimated by oral hygiene status, according to Greene and Vermillions Simplified Oral Hygiene Index (OHI-S). Whole saliva was collected under mechanical stimulation and evaluated salivary flow rate, initial pH, buffer capacity, and calcium and phosphate concentrations. The temperature of soft drinks, drinking method, sense of bitter taste, and other variables were also determined. Possible factors associated with DH were analyzed by univariate and multiple Poisson regression analyses. The prevalence ratio (PR) values and 95% confidence intervals (95% CI) were calculated. Results. DH was associated with the presence of dental erosion (PR; 95% CI = 2.23; 1.05 to 4.71) and salivary flow rate (2.49; 1.05 to 5.91). When the presence of erosion was not included, other variables were retained as follows: bitter taste (2.36; 1.38 to 4.03), OHI-S (0.47; 0.23 to 0.97). Conclusion. DH in children is associated with factors related to dental erosion.

Dental Anxiety and Behavior in Young Children Undergoing Different Distraction Techniques

Objective: To evaluate anxiety and behavior in groups of children undergoing various distraction techniques during dental treatment in a public clinic. Material and Methods: The research was a randomized study with a systematic convenience sample consisting of 62 children with 4-6 years (5.18±0.77) in both genders; they were divided in four groups (G1 - control group and three experimental Groups: G2 - mirror and conversation, G3 - toys and G4 - childrens stories) and evaluated in the first 2 visits to the dentist. Age and previous experience were also evaluated. The Facial Image Scale (FIS) and the Behavior Rating Scale (BRS) were applied, the data was analyzed using the Chi-square test with a significance level of p < 0.05 and the Spearman correlation coefficient. Results: In comparison to the studied variables (anxiety and behavior), the distraction technique during dental care could not reduce anxiety and improve the behavior in all groups in the first visit, but the group receiving the distraction technique with a hand mirror reached the best results in behavior in the second visit (p=0.022; Raj:-2.68). There is no influence on anxiety among children with or without previous experience (p = 0.603), but the age of 4 years showed higher levels of anxiety (p=0.039). Conclusion: Only the distraction technique with the mirror was able to reduce anxiety and improve behavior in the second visit.

Histogenesis and clinical analysis of 2 cases of congenital gingival granular cell tumour.

Dentistry for babies aims to contribute to the formation of a generation with fewer dental problems, higher quality of oral health and more aware of the importance of prevention. The congenital gingival granular cell tumour (CGCT) is a rare benign soft tissue tumour in the newborn that can lead to respiratory difficulties and feeding. The aim of this work was to report two cases of CGCT in babies and discuss the clinical and histological differential diagnosis and their treatment, as well as the importance of knowledge of this pathology for dentists. Clinical features and treatment approaches are presented and discussed. The surgical approach improved the child quality of life and restored the parents confidence and emotional stability. Knowledge of this pathology helps in better diagnosis and treatment, which lead to a better quality of life of children and return confidence and emotional stability to parents.