Evaluation of partially dentate patients' knowledge about caries and periodontal disease

Objective: This investigation evaluated the knowledge of dental caries and periodontal disease among removable partial denture (RPD) wearers.Method: A total of 127 partially dentate patients participated in this observational study. A structured questionnaire, which included eight questions referring to knowledge about aetiology and prevention of dental caries and periodontal disease, was developed in the local language (Portuguese) and used to collect the data of all the partial denture wearers. A descriptive analysis of data was performed by means of drafting tables.Results: The results demonstrated that 68.5% of patients interviewed had previously received information about oral health care. With regard to bacterial plaque, it was observed that only 34.6% reported having knowledge of this. Whereas, in relation to caries, 76.4% of the interviewees replied that they knew the meaning of this. Nevertheless, 28.3% referred to caries as a whole in the teeth, 16.5% as bad teeth and 9.4% bacteria/creatures on the teeth. Only 17.3% of the partially edentulous patients evaluated were shown to know what disease of the gingiva was.Conclusion: By means of the methodology applied, it could be concluded that the patients who wore RPDs presented deficient knowledge with regard to the prevention, aetiology and development of dental caries and periodontal disease.

Efficacy of dip slide test for mutans streptococci in caries risk assessment

The aim of this study was to evaluate the efficacy of a dip slide test for mutans streptococci in caries risk assessment, when the microbiological results were compared to well-defined clinical criteria (DCC) for caries risk, clinically measured through high and low caries activity. Eighty-one volunteers from the 6(th) to 8(th) grades from public schools of Piracicaba, São Paulo, Brazil, were evaluated for dental caries. All free smooth surfaces were evaluated to check whether or not there were white spots. Based on the subjects' caries experience, a calibrated clinician divided them into groups of high and low caries activity. The subjects were submitted to a salivary test (CARITEST SM (R)) from the same batch number. Kappa statistics (kappa) were applied to verify the reproducibility of the simplified test, checked through interexaminer agreement when the results were classified by independent and blind means. The microbiological results were validated according to expressions of sensitivity and specificity. A moderate agreement was verified as the results were classified according to 6 scores (kappa =0.55), and the agreement was substantial when the results were classified according to high and low microbiological count (kappa =0.78). The sensitivity and specificity values were 0.59 and 0.85, respectively, showing that the test was more specific than sensitive, and could thus better identify the low caries risk subjects.

Occlusal caries prevention in high and low risk schoolchildren. A clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caries risk tests and salivary levels of immunoglobulins to Streptococcus mutans and Candida albicans in mouthbreathing syndrome patients

The aim of this study was to compare microbiological and salivary variables possibly related to caries risk in treated and untreated mouthbreathing syndrome (MBS) children and control children. Thirty control children, 30 mouthbreathers and 25 treated mouthbreathers were studied for the numbers of lactobacilli, mutans streptococci and yeasts in their saliva. Snyder's test, salivary flow and buffering capacity were also evaluated. Levels of immunoglobulins to Candida albicans and Streptococcus mutans in the saliva were quantified using ELISA. Considering the results obtained for the microbiological and salivary caries risk tests, no significant differences were observed among the proportions of patients with small/negative and high/moderate caries risk in the studied groups. The level of IgG to S. mutans was significantly higher in the treated MBS group in relation to MBS patients. on the other hand, the median anti-S. mutans IgM level was lower in the treated MBS patients than in the other groups. For the studied anti-Candida immunoglobulins, IgM level was significantly lower in the treated MBS group than in the other groups. No differences were observed for anti-S. mutans and anti-Candida IgA levels among the groups. The findings suggest that mouthbreathing cannot be considered a risk factor for dental caries. Copyright (C) 2003 S. KargerAG, Basel.

Microbiological or Chemical Models of Enamel Secondary Caries Compared by Polarized-Light Microscopy and Energy Dispersive X-ray Spectroscopy

Different secondary caries models may present different results. The purpose of this study was to compare different in vitro secondary caries models, evaluating the obtained results by polarized-light microscopy (PLM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Standardized human enamel specimens (n = 12) restored with different materials (Z250 conventional composite resin-CRZ, Freedom polyacid-modified composite resin-CRF, Vitremer resin-modified glass-ionomer-GIV, and Fuji IX conventional glass-ionomer cement-GIF) were submitted to microbiological (MM) or chemical caries models (CM). The control group was not submitted to any caries model. For MM, specimens were immersed firstly in sucrose broth inoculated with Streptococcus mutans ATCC 35688, incubated at 37 degrees C/5% CO(2) for 14 days and then in remineralizing solution for 14 days. For CM, specimens were submitted to chemical pH-cycling. Specimens were ground, submitted to PLM and then were dehydrated, gold-sputtered and submitted to SEM and EDS. Results were statistically analyzed by Kruskall-Wallis and Student-Newman-Keuls tests (alpha = 0.05). No differences between in vitro caries models were found. Morphological differences in enamel demineralization were found between composite resin and polyacid-modified composite resin (CRZ and CRF) and between the resin-modified glass-ionomer and the glass-ionomer cement (GIF and GIV). GIF showed higher calcium concentration and less demineralization, differing from the other materials. In conclusion, the glass-ionomer cement showed less caries formation under both in vitro caries models evaluated. (C) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 90B: 635-640, 2009

Ability of different restorative materials to prevent in situ secondary caries: analysis by polarized light-microscopy and energy-dispersive X-ray

Secondary caries is the main cause of direct restoration replacement. The purpose of this study was to analyze enamel adjacent to different restorative materials after in situ cariogenic challenge using polarized-light microscopy (PLM), scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDS). Twelve volunteers, with a low level of dental plaque, a low level of mutans streptococci, and normal salivary flow, wore removable palatal acrylic appliances containing enamel specimens restored with Z250 composite, Freedom composite, Fuji IX glass-ionomer cement, or Vitremer resin-modified glass-ionomer for 14 days. Volunteers dripped one drop of 20% sucrose solution (n = 10) or distilled water (control group) onto each specimen 8 times per day. Specimens were removed from the appliances and submitted to PLM for examination of the lesion area (in mm(2)), followed by dehydration, gold-sputtering, and submission to SEM and EDS. The calcium (Ca) and phosphorus (P) contents were evaluated in weight per cent (%wt). Differences were found between Z250 and Vitremer, and between Z250 and FujiIX, when analyzed using PLM. Energy-dispersive X-ray analysis results showed differences between the studied materials regarding Ca %wt. In conclusion, enamel adjacent to glass-ionomer cement presented a higher Ca %wt, but this material did not completely prevent enamel secondary caries under in situ cariogenic challenge.

Effect of Caries Infiltration Technique and Fluoride Therapy on Microhardness of Enamel Carious Lesions

Enamel white spot subsurface lesions compromise esthetics and precede cavitation; therefore, they must be halted. The aim of this study was to evaluate the effect of a caries infiltration technique and fluoride therapy on the microhardness of enamel carious lesions. Subsurface carious lesions were produced in 60 bovine specimens with polished enamel surfaces. The specimens were divided into four groups (n=15), according to the treatment used: CON, control immersion in artificial saliva; DF, daily 0.05% fluoride solution; WF, weekly 2% fluoride gel; and IC, resin infiltration (Icon). The specimens were kept in artificial saliva and evaluated for microhardness at five points: baseline, after caries production, after four and eight weeks of treatment, and a final evaluation after being submitted to a new acid challenge. The repeated-measures analysis of variance showed significant differences according to the type of treatment (TREAT; p=0.001) and time of evaluation (EV; p=0.001). The results of the Tukey test were TREAT: CON = 45.18 (+/- 29.17)a, DF = 107.75 (+/- 67.38)b, WF = 83.25 (+/- 51.17)c, and IC = 160.83 (+/- 91.11)d. Analysis of correlation between the TREAT and EV factors showed no significant differences for DF (138.63 +/- 38.94) and IC (160.99 +/- 46.13) after the new acid challenge. The microhardness results in decreasing order after eight weeks were IC > DF > WF > CON. It was concluded that the microhardness of carious lesions increased with the infiltration of resin, while the final microhardness after a new acid challenge was similar for DF and IC.

Effect of caries preventive measures directed to expectant mothers on caries experience in their children

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Changes in caries prevalence in 7-12-year-old children from Araraquara, São Paulo, Brazil: 1989-1995

O objetivo deste estudo foi comparar a prevalência de cárie em crianças de sete a 12 anos em Araraquara, São Paulo, Brasil, em 1989 e 1995. Foi utilizada amostragem sistemática para selecionar crianças de escolas públicas. Examinadores treinados realizaram levantamentos epidemiológicos, utilizando o índice CPOD e os critérios de diagnóstico da OMS. em todas as idades, houve aumento da porcentagem de crianças livres de cárie na dentição permanente (de 29% em 1989 para 51% em 1995). Para crianças aos 12 anos de idade, foram observados índices CPOD de 3,8 em 1989 e de 2,6 em 1995. Detectaram-se também reduções nas porcentagens de crianças classificadas nas seguintes categorias do CPOD: um a três (de 40% em 1989 para 31% em 1995); quatro a seis (de 26,6% em 1989 para 16,5% em 1995) e sete ou mais (de 4,4% em 1989 para 1,5% em 1995). A meta da OMS/FDI para o ano 2000, de que aos 12 anos os indivíduos apresentem em média índice CPOD menor ou igual a três, foi atingida pelos escolares em estudo. Esforços devem ser empreendidos para que haja redução da porcentagem de crianças com experiência de cárie e sejam alcançadas as metas de saúde bucal da OMS/FDI para o ano 2010.

Epidemiology of fluorosis and dental caries according to different types of water supplies

O objetivo do presente artigo é investigar a relação fluorose/cáries em escolas, de acordo com o nível de fluoreto no abastecimento público de água. A amostra consistiu em 360 alunos de doze anos de idade, de ambos os sexos, que frequentam as escolas próximas da região em que nasceram. As escolas foram classificadas em três grupos de acordo com a presença de fluoreto no abastecimento de água: 1) fluoretação na Estação de Tratamento de Água (ETA); 2) fluoretação direta em poços; e 3) áreas não fluoretadas (ANF). Os testes deχe de Goodman (significância = 5%) foram utilizados para avaliar a associação entre a origem da água e o grau de fluorose. Os resultados mais predominantes foram presença de cáries em toda a amostra (P<0,05); ausência de fluorose em ambos gêneros, para indivíduos brancos e aqueles vivendo em áreas abastecidas com água fluoretada diretamente de poços e não fluoretadas (P<0,05). Não houve diferença no grau de severidade da fluorose entre as fontes de abastecimento de água (P>0,05). As cáries ainda são uma importante questão nessa população, apesar do estabelecimento de medida preventiva. A observação da fluorose em alunos vivendo em áreas não fluoretadas confirma a presença de outras fontes de fluorose.

Dental caries and the nutritional status of preschool children: a spatial analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)