Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant

A produção das perdas dentárias: narrativas de usuários do SUS

For a complete comprehension of the effect of tooth loss is necessary to listen to the patients that have it. This study, of qualitative approach, investigate, in the dental history of users of SUS, listening to his/her experiences with the services of dental care, the reason that lead his/her to dental lost and the repercussion of this in his/her life. The collect of data was made by narrative interview, obeying to a pre-defined schema. The subjects interviewed were six (three of urban zone and three of rural zone), all of them were users of Family Health Units. The criterions of inclusion were the followings: the presence of tooth lost (total lost in both dental arch or in one of them, or partial lost in at least six elements in one of the arches); age between 25 and 59; male or female; to live in municipal district of São Tomé/RN or Natal/RN. Based on previous interviews was elaborated the odontological history of each patient. Such narratives, systemized in odontological history, were analyzed taking as base the studies of Souza71 and the proposal of Schutze, suggested for Jovchelovitch, Bauer34. The results show that toothache was the main reason for the search of odontological care. The patients confront the ache with home-made medicaments, allopathic ones, and searching for dental care. The searching for exodontics was stimulated for geographic access difficulties or for repressed demand, which as a result produced the aggravation of the lesions and the discredit in restoration s treatment. The self-care practice of tooth-brush with juá or toothpaste and the controlled ingestion of sugar was not sufficient to avoid dental lost. Guilty sentiments were identified in relation with lack of care with teeth. The acceptance of dental lost as a natural factor is an important motivation in lack of pain and in the belief that it was a simple part of life in old age. Life with dental prosthesis makes clear the difference between which was natural and which was unnatural, and difficulties with the prosthesis appeared. The limitation of the prosthesis in its functional aspect can be compensated by esthetic restitution, making possible smiling expression. Starting with this study and considering the high number of dental lost, mainly in low-rent population, which live with toothless limitations or bad-quality prosthesis which do not rehabilitate adequately, we suggested the realization of qualitative researches which include, also, another actors in heath care services such as professionals and administrators

Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil

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

Low-Fluoride Acidic Dentifrice: A Randomized Clinical Trial in a Fluoridated Area

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

The Effect of Different Fluoride Concentrations and pH of Dentifrices on Plaque and Nail Fluoride Levels in Young Children

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

The influence of daily application of fluoride products on subsurface bovine enamel lesions stored in saliva substitutes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação do conhecimento popular e práticas cotidianas em saúde bucal

OBJETIVO: Avaliar o conhecimento popular e as práticas cotidianas em saúde bucal de usuários de serviços públicos de saúde. MÉTODOS: A população estudada foi selecionada a partir de uma amostra estratificada de usuários que procuraram atendimento nas unidades sanitárias da zona urbana de Santa Maria, RS. Os dados foram coletados por meio de entrevista semi-estruturada e organizados em conjuntos de categorias descritivas, permitindo sua distribuição em tabela de freqüência. RESULTADOS: Verificou-se que predominam usuários entre 21 e 40 anos de idade, do sexo feminino e com padrão socioeconômico baixo. A busca pela saúde e o controle das doenças bucais são atribuídos à responsabilidade individual de realizar a higiene bucal e procurar tratamento dentário. A presença e os benefícios do flúor no creme dental e na água de beber não foram reconhecidos pela população estudada. CONCLUSÕES: Os programas de saúde devem considerar os aspectos relativos ao conhecimento e as práticas em saúde bucal, para viabilizar o processo de capacitação da população e promover a responsabilização coletiva da promoção da saúde em todos os níveis da sociedade.

In vitro evaluation of acidified toothpastes with low fluoride content

Fluoride toothpastes are a risk factor for the development of dental fluorosis. Products with low fluoride content offer a higher security, but their effectiveness must be proven. The aim of this in vitro study was to compare two acidified toothpastes with low fluoride concentration (412 and 550 mu g F/g) with neutral toothpastes. Bovine enamel blocks were selected by surface microhardness (SMH) and randomized to twelve groups of 13, according to the fluoride concentration in toothpaste (placebo, 275, 412, 550 or 1,100 jig F/g) and pH (7.0 or 5.5). Two commercially available toothpastes were also studied: a 1,100-mu g F/g, pH 7.0 paste (positive control) and a children's paste (500 mu g F/g, pH 7.0). The blocks were subjected to pH cycling for 7 days. The toothpaste treatment was done twice daily. Surface and cross-sectional microhardnesses were assessed to calculate the percentage change of SMH (%SMH) and the mineral loss (Delta Z). The amount of fluoride, calcium and phosphorus in the solutions after the pH cycling was also analyzed. Compared to neutral toothpastes, the acidified toothpastes reduced the %SMH in all F concentrations. Higher F and lower Ca and P concentrations were found in solutions for the acidified toothpastes. Regarding AZ, only the positive control, 1,100-mu g F/g (acidified and neutral) groups were not statistically different. The acidified toothpastes showed a dose-response relationship with all variables. For the low-fluoride toothpastes evaluated, only the 550-mu g F/g acidified paste had the same anticariogenic action as the 1,100-mu g F/g neutral paste.

Effect of saliva substitutes in combination with fluorides on remineralization of subsurface dentin lesions

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Measuring fluoride concentration in mineral waters in the Araraquara region, Brazil

It has been shown that people of all ages can benefit from the topical and systemic effects of water fluoridation. However, the increase in consumption of bottled water, either to substitute for or supplement consumption of water from public sources, has implications for safe fluoride supplementation. Taking that into consideration, in 1995 we analyzed the fluoride content in 31 commercial brands of mineral water in the region of Araraquara, state of Sao Paulo, Brazil. Fluoride concentration as determined by our analysis was compared to the concentration of fluoride specified on each label. Only 25% of the products studied listed the fluoride concentration on their labels. In addition, among 31 mineral water brands, 26 listed the date when the chemical analysis to determine chemical composition had been performed. Of these, 20 had not been put through the annual chemical analysis determined by Brazilian law. Based on these results, if the mineral waters tested had been the only source of drinking water, fluoride supplementation would have been necessary in 69% of the samples analyzed. In the case of children up to 6 years of age who use products containing fluoride, such as topical gels, mouthwashes or toothpastes, supplementation should be recommended only if commercially bottled water is the only source of water used, not only for drinking but for cooking as well.

Efeito dose-resposta de uma formulação de dentifrício com concentração reduzida de fluoreto - estudo in vitro.

The utilization of dentifrices with low fluorine concentration, for children under 6 years of age, has been suggested to reduce the risks of dental fluorosis. However, in order to have anticariogenic potential, the dentifrice should form loosely-bound fluorine (CaF2) on dental enamel. Considering that the formation of CaF2 is a function inversely related to pH, dentifrices with pH 5.5, with 275, 550 and 1,100 ppm F (NaF/silica) were developed in order to assess dose-response effects. A comparison between those dentifrices, a placebo product and the Crest toothpaste (positive control - standard) was carried out. Furthermore, the bioavailability of dentifrices, in terms of formation of total fluorine (TF), CaF2, and fluorapatite (FA) on human dental enamel, was evaluated. An ion-specific electrode was utilized for the determination of the dosage of fluorine. The results revealed that the dentifrice with 550 ppm F was more effective than both the placebo and the dentifrice with 275 ppm, presenting no difference in relation to the positive control (p > 0.05). A dose-effect correlation was observed as to the CaF2 formed. In conclusion, the modified formulation with 550 ppm F can be considered as effective as the standard dentifrice with 1,100 ppm, and its utilization would be safer with regard to dental fluorosis.

Cariostatic effect of fluoride-containing restorative systems associated with dentifrices on root dentin

Objective. The aim of this in vitro study was to evaluate the interaction between two sources of fluoride (restorative systems and dentifrices) in inhibiting artificial root caries development. Methods. One hundred and eighty tooth segments were embedded in polyester resin, and sanded flat. Cylindrical cavities 1.0 mm-deep and 1.5 mm-diameter were prepared in root dentin and randomly restored by fluoride-containing restorative systems: Ketac-fil/Espe (Ke), Fuji II LC/GC Corp (Fj), F2000/3M (F2), Surefil/Dentsply (Su) or a control: Filtek Z250/3M (Z2). Ten experimental groups were made to test the association among the five restorative systems and two dentifrices: with F - (Sensodyne Baking Soda) or without F- (Sensodyne Original) (n = 18). After surface polishing, a 1 mm-wide margin around the restorations was demarcated and initial dentin surface Knoop microhardness values (KHNi) were obtained. The specimens were submitted to a pH-cycling model, and to applications of slurries of dentifrice. Afterwards the final dentin surface Knoop microhardness values (KHNf) were measured. Results. The differences between KHNi and KHNf, and the covariate KHNi were considered by the ANCOVA and Tukey's test (α = 0.05). The interaction between restorative system and dentifrice was statistically significant (p = 0.0026). All restorative systems provided some protection against artificial caries challenge when associated with the fluoride-containing dentifrice treatment. The means (standard deviation) of reductions in Knoop hardness values for systems associated with the fluoride-containing dentifrice were: Ke: 40.0(1.02)a, Fj: 41.9(1.02)b, F2: 43.3(1.04)c, Su: 43.5(1.00)c, Z2: 44.0(1.02)c; and with the non-fluoride-containing dentifrice were: Ke: 42.9(1.02)a, Fj: 44.7(1.01)b, F2: 45.2(1.09)bc, Su: 46.0(0.99)c, Z2: 46.6(0.99)c (statistical differences were expressed by different letters). Conclusion. The cariostatic effect shown by the fluoride-containing dentifrice could enhance that shown by Ketac-fil and Fuji II LC, and could mask that shown by F2000. © 2002 Elsevier Science Ltd. All rights reserved.

Toothbrushing with vegetable oil: a clinical and laboratorial analysis.

The dentifrices currently available in the marketplace contain many anticariogenic substances, fluoride and abrasives aimed to better clean the dental surface, remove dental plaque, improve salivary flow and its buffer capacity and reduce colonies of bacteria such as S. mutans, the causative agent of dental caries. The objective of this study was to evaluate the possibility of adequately removing dental plaque using an experimental almond oil dentifrice (Titoil) with no abrasives or antiplaque agents. This study was carried out with 80 volunteers, all of them 18-year-old recruits from the military training school of Araçatuba -- SP. Saliva sampling and dental plaque disclosing were undertaken both before and after 28 days of toothbrushing with a low abrasive dentifrice (Group 1: 40 volunteers) or with Titoil (Group 2: 40 volunteers). Statistical analysis of the results revealed that the experimental dentifrice (Titoil) did not interfere with salivary flow and reduced dental plaque more than the low abrasive dentifrice, improved the salivary buffer capacity and decreased salivary S. mutans (Caritest-SM) as much as regular dentifrices. It was concluded that if the dental industry replaces abrasive by vegetable oil in dentifrices, these will be more effective in maintaining oral health and will cause less dental abrasion.

Weight loss and surface roughness of hard chairside reline resins after toothbrushing: Influence of postpolymerization treatments

Purpose: To evaluate the effect of 2 postpolymerization treatments on toothbrushing wear (weight loss) and surface roughness of 3 autopolymerized reline resins-Duraliner II (D) (Reliance Dental), Kooliner (K) (Coe Laboratories), and Tokuso Rebase Fast (T) (Tokuyama Dental)-and 1 heat-polymerized resin, Lucitone 550 (L) (Dentsply International). Materials and Methods: Specimens (40 x 10 x 2mm) of each material (n = 24) were prepared and divided into 3 groups: control (no postpolymerization treatment); water bath (immersion in water at 55°C); and microwave (microwave irradiation). Specimens were dried until constant weight was achieved and the surface roughness (Ra) was measured. Tests were performed in a toothbrush machine using 20,000 strokes of brushing at a weight of 200 g, with the specimens immersed in 1:1 dentifrice/water slurry. Specimens were reconditioned to constant weight and the weight loss (mg) and surface roughness were evaluated. Data were analyzed by 2-way analysis of variance and followed by Tukey test (α = .05). Results: In the control group, the weight loss of materials D and T was lower (P < .05) than that of L. No differences among materials were found after postpolymerization treatments (P > .05). The weight loss of material T (control = 0.5 mg) was significantly increased (P < .05) after postpolymerization treatments (water bath = 1.9 mg; microwave = 1.8 mg). For materials K and T, the toothbrushed surface roughness was higher (P < .05) after microwave and waterbath postpolymerization treatments. Material L showed increased surface roughness after microwave postpolymerization treatment. Conclusion: The toothbrushing wear resistance of L was not superior to the reline resins. The postpolymerization treatments did not improve the toothbrushing wear resistance of the materials and produced an increased surface roughness for materials L, K, and T.

Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: Influence of the dentifrice flavor

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 μgF/g), G-B (1,062 μgF/g) and G-C (1,373 μgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukey's test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022 a, 0.032 a and 0.061 b mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.