Untreated Dental Caries in a Brazilian Paediatric AIDS Patient Population

Purpose: The objective of the present study was to assess the prevalence of untreated caries in a Brazilian paediatric acquired immunodeficiency syndrome (AIDS) patient population and its association with sociodemographic, behavioural and clinical characteristics. Materials and Methods: The study group was comprised of 125 HIV-infected patients (aged 3 to 15 years) who had already manifested AIDS and were assisted in a specialised health care unit. Dental examinations followed the World Health Organization`s guidelines for oral health surveys. Family caregivers provided information about the socioeconomic standing and the behaviour of their children. Patients` medical records in the hospital provided information on the clinical status of patients. A Poisson regression analysis was used for assessing the covariates for the prevalence of untreated dental caries, as adjusted by age. Results: The prevalence of untreated caries was 58%; a higher prevalence was found in younger children with primary and mixed dentition. The prevalence of untreated caries associated significantly with lower socioeconomic status (household crowding and schooling of the caregiver), dietary habits (higher frequency of sugar consumption) and poorer clinical status (HIV viral load and symptom severity). Conclusions: The high burden of untreated caries on paediatric AIDS patients reinforced the importance of integrating the clinician with the interdisciplinary health care team that assisted these children. The identification of socioeconomic and behavioural factors associated with caries experience reinforced the importance of the attention that children with AIDS received within their own households for the prevention of dental disease, particularly a proper nutritional advisement and monitoring of dental hygiene.

Pharmacokinetics of ingested fluoride: Lack of effect of chemical compound

Fluoride in drinking water may be present from natural sources or added as sodium fluoride (NaF), sodium silicofluoride (Na2SiF6) or fluorosilicic acid (H2SiF6). Results from an early study with rats suggested that, when ingested as Na2SiF6, the absorption and excretion of fluoride were greater than when ingested as NaF. Objective: The present single-blind, crossover study with 10 adults was done to determine three key pharmacokinetic parameters: the maximum plasma fluoride concentrations (C-max), the elapsed time to reach the maximum concentrations (T-max) and the 6-h areas under the time-plasma concentration curves (AUCs) after ingestion of 500 ml, of water containing 0.67 or 5.45 mg F/L present naturally or added as NaF or H2SiF6. Design: Blood was collected prior to and at nine time points during 6 h after ingestion of the test solutions. Plasma was analysed by electrode after HMDS-facilitated diffusion and the data were analysed for statistically significant differences using repeated measures ANOVA. Results: The C-max, T-max and AUC values after ingestion of the solutions containing natural fluoride, NaF or H2SiF6 did not differ significantly at either dose level. Further, the Tmax values associated with the 0.67 and SAS mg/L solutions did not differ significantly indicating that the absorption, distribution and elimination rates were not affected by the dose size. Conclusions: Considered together with published reports, the present findings support the conclusion that the major features of fluoride metabolism are not affected differently by the chemical compounds commonly used to fluoridate water nor are they affected by whether the fluoride is present naturally or added artificially. (C) 2008 Elsevier Ltd. All rights reserved.