Rosana de Fátima Possobon

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.

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.

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,

Prevalência da Síndrome de Burnout em uma amostra de professores universitários brasileiros

Professors are part of a risk group for the development of Burnout Syndrome. This study investigated the prevalence of burnout in 169 university professors in Piracicaba-SP through the Burnout Inventory (Brazilian version). The value of Cronbachs alpha was satisfactory for all dimensions of the questionnaire. The results showed that 11.2% of the professors showed Profile 1 and 3% Profile 2 of burnout. This prevalence of burnout is cause for concern and deserves attention, not only for the damage it causes at physical, mental and social training, but also for the influence on the quality of education offered.

A amamentação entre filhos de mulheres trabalhadoras

OBJECTIVE: To analyze employment benefits and factors associated with the maintenance of breastfeeding indexes among working mothers. METHODS: The sample was constituted by 200 formal women workers who returned to work before the child had reached six months of life, in the city of Piracicaba (Southeastern Brazil). Among the participants, 100 mother-infant dyads received guidance and support for the practice of breastfeeding within an oral health prevention program, and the other 100 dyads were addressed in a child vaccination campaign. Multiple logistic regression analysis was carried out to identify variables related to weaning in the fourth month of life. RESULTS: The majority of the participants were primiparous women who underwent cesarean section, initiated breastfeeding within four hours after birth and stayed with their child in the room. The following women had higher odds of stopping breastfeeding: mothers not participating in the incentive program (OR = 3.04 [95%CI: 1.35;6.85]), mothers who did not have a 30-minute break during the working hours (OR = 4.10 [95%CI: 1.81;9.26]), and mothers whose children used pacifiers (OR = 2.68 [95%CI: 1.23;5.83]) or bottles (OR = 14.47 [95%CI: 1.85;113.24]. CONCLUSIONS: The mothers who participated in the breastfeeding incentive group, who did not offer pacifiers and bottles to their babies and who had a break during the working hours stopped breastfeeding after the fourth month. Support and information on lactation management and on their rights guaranteed by law, together with the increase in the length of maternity leave, may play an important role in maintaining breastfeeding.OBJECTIVE To analyze employment benefits and factors associated with the maintenance of breastfeeding indexes among working mothers. METHODS The sample was constituted by 200 formal women workers who returned to work before the child had reached six months of life, in the city of Piracicaba (Southeastern Brazil). Among the participants, 100 mother-infant dyads received guidance and support for the practice of breastfeeding within an oral health prevention program, and the other 100 dyads were addressed in a child vaccination campaign. Multiple logistic regression analysis was carried out to identify variables related to weaning in the fourth month of life. RESULTS The majority of the participants were primiparous women who underwent cesarean section, initiated breastfeeding within four hours after birth and stayed with their child in the room. The following women had higher odds of stopping breastfeeding: mothers not participating in the incentive program (OR = 3.04 [95%CI: 1.35;6.85]), mothers who did not have a 30-minute break during the working hours (OR = 4.10 [95%CI: 1.81;9.26]), and mothers whose children used pacifiers (OR = 2.68 [95%CI: 1.23;5.83]) or bottles (OR = 14.47 [95%CI: 1.85;113.24]. CONCLUSIONS The mothers who participated in the breastfeeding incentive group, who did not offer pacifiers and bottles to their babies and who had a break during the working hours stopped breastfeeding after the fourth month. Support and information on lactation management and on their rights guaranteed by law, together with the increase in the length of maternity leave, may play an important role in maintaining breastfeeding.

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.

Medo Odontológico entre Pacientes Atendidos em um Serviço de Urgência

Ansiedade ao tratamento odontologico; Medo; Relacoes denti sta-paciente. Dental Anxiety; Fear; Denti st-pati ent relati ons.

Oral cavities of healthy infants harbour high proportions of Streptococcus salivarius strains with phenotypic and genotypic resistance to multiple classes of antibiotics

Emerging antibiotic resistance in the oropharyngeal microbiota, of which Streptococcus salivarius is a prominent species, represents a challenge for treating paediatric populations. In this study, we investigated the role of Streptococcussalivarius as a reservoir for antibiotic resistance genes (ARG) in the oral microbiota by analysing 95 Streptococcussalivarius isolates from 22 healthy infants (2-16 months of age). MICs of penicillin G, amoxicillin, erythromycin, tetracycline, doxycycline and streptomycin were determined. ARG profiles were assessed in a subset of 21 strains by next-generation sequencing of genomes, followed by searches of assembled reads against the Comprehensive Antibiotic Resistance Database. Strains resistant to erythromycin, penicillins and tetracyclines were isolated from 83.3, 33.3 and 16.6 %, respectively, of infants aged 2 to 8 months with no prior antibiotic treatment. These percentages were100.0, 66.6 and 50.0 %, by 13 to 16 months of age. ARG or polymorphisms associated with antibiotic resistance were the most prevalent and involved genes for macrolide efflux (mel, mefA/E and macB), ribosomal protection [erm(B), tet(M) and tet(O)] and β-lactamase-like proteins. Phylogenetically related strains showing multidrug-resistant phenotypes harboured multidrug efflux ARG. Polymorphic genes associated with antibiotic resistance to drugs affecting DNA replication, folate synthesis, RNA/protein synthesis and regulators of antibiotic stress responses were detected. These data imply that Streptococcussalivarius strains established during maturation of the oral microbiota harbour a diverse array of functional ARG, even in the absence of antibiotic selective pressures, highlighting a potential role for this species in shaping antibiotic susceptibility profiles of oropharyngeal communities.