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Early childhood caries is a persistent worldwide problem. The etiologic contribution of feeding practices has been less frequently investigated in prospective studies of young children. The Porto Alegre Early Life Nutrition and Health Study has followed a birth cohort of 715 mother-child pairs, recruited from municipal health centers, originally involved in a cluster-randomized controlled trial of healthcare worker training. The birth cohort links prospectively collected socio-demographic, infant feeding, and general and oral health information. To date, oral health data, including caries status and oral health-related quality of life, have been collected for 458 children at the age of 2-3 years. Studies are underway to investigate possible determinants and consequences of oral health among these children.

Efeitos de uma intervenção baseada na implementação dos Dez Passos para uma Alimentação Saudável: Guia Alimentar para Crianças Menores de Dois Anos sobre as condições nutricionais e de saúde de lactentes em famílias de baixa renda. Randomizou-se duzentos recém-nascidos para o grupo intervenção e trezentos para o grupo controle. O grupo intervenção recebeu orientações dietéticas no primeiro ano de vida. Os dois grupos receberam visitas aos 6 e 12 meses e acompanhamento de rotina pelos seus pediatras. Os resultados (n = 397) mostraram que a intervenção associou-se a maior proporção de aleitamento materno exclusivo aos 4 meses (RR = 1,58; IC95%: 1,21-2,06) e 6 meses (RR = 2,34; IC95%: 1,37-3,99) e amamentadas aos 12 meses (RR = 1,26; IC95%: 1,02-1,55) e a menor proporção de crianças que apresentaram diarréia (RR = 0,68; IC95%: 0,51-0,90), problemas respiratórios (RR = 0,63; IC95%: 0,46-0,85), uso de medicamentos (RR = 0,56; IC95%: 0,34-0,91) e cárie dental (RR = 0,56; IC95%: 0,32-0,96) na faixa etária de 12 a 16 meses. Não houve efeito da intervenção sobre a ocorrência de anemia, internações hospitalares e estado nutricional. Os resultados sugerem que o programa de orientações dietéticas promoveu modificações positivas nas práticas alimentares e nas condições de saúde da criança, porém foi insuficiente para prevenir a anemia ferropriva.This study assesses the impact of an intervention known as the Ten Steps to Healthy Feeding: A Nutritional Guide for Children under Two on nutritional conditions and infant health in low-income families. Two hundred newborns were randomized to the intervention group and three hundred to the control group. Parents of the intervention group received nutritional orientation during the child's first year of life. Both groups received visits at 6 and 12 months and routine follow-up by their pediatricians. The results (n = 397) showed that the intervention was associated with a higher proportion of exclusive breastfeeding at 4 months (RR = 1.58; 95%CI: 1.21-2.06) and 6 months (RR = 2.34; 95%CI: 1.37-3.99) and breastfeeding at 12 months (RR = 1.26; 95%CI: 1.02-1.55) and a lower proportion of children with diarrhea (RR = 0.68; 95%CI: 0.51-0.90), respiratory problems (RR = 0.63; 95%CI: 0.46-0.85), use of medication (RR = 0.56; 95%CI: 0.34-0.91), and dental caries (RR = 0.56; 95%CI: 0.32-0.96) in the 12-16 month bracket. The intervention had no effect on the occurrence of anemia, hospitalization, or nutritional status. The results suggest that the nutritional orientation program led to positive changes in infant feeding practices and health conditions, but that it was insufficient to prevent iron deficiency anemia.

The present in vitro study assessed the correlation between clinical and interproximal radiographic examinations in diagnosing proximal caries of primary molars. A total of 223 mesial and distal surfaces, from 125 primary teeth, were evaluated clinically and radiographically. The results demonstrated a strong correlation between the increase of depth of radiolucency in radiographic examination and the clinical stage of lesions. The interproximal radiographic examination presented an excellent capability for discriminating surfaces with and without cavities in primary molars.

– The purpose of this study was to determine the prevalence and distribution of traumatic injuries to primary anterior teeth in children from zero to 6 years old, all attendees in 28 public nursery schools in Canoas (Brazil). A total of 1545 boys and girls participated in the study. The children were clinically examined for signs of trauma according to Andreasen's classification. Traumatic injuries were identified in 35.5% of children. The largest percentage of injuries was demonstrated by 3–4-year-old child, with no significant difference between boys and girls. The maxillary central incisor was the most vulnerable to injury, without differences between the right and the left side. Single tooth injury was predominant in all age groups. Crown fractures represented 83% of all traumatic injuries. Our findings emphasize the importance of encouraging parents to visit the dentist with their child at an early stage. Furthermore, parents and educators should be advised about prevention of traumatic injuries and actions to be taken in case of an accident.

Background Observational studies have suggested that traumatic dental injuries (TDI) can lead to pain, loss of function and esthetic problems, with physical, emotional and social consequences for children and their families. However, population-based studies that investigate the impact of TDI on oral health-related quality of life (OHRQoL) among preschool children are scarce and offer conflicting results. The aim of the systematic review and meta-analysis was to evaluate the impact of TDI on OHRQoL among preschool children (PROSPERO-CRD42015032513). Methods An electronic search of six databases was performed in PubMed (MEDLINE), ISI Web of Science, Scopus, Science Direct, EMBASE and Google Scholar, with no language or publication date restrictions. The eligibility criteria were TDI as the exposure variable, OHRQoL as the outcome and a population of children up to six years of age. RevMan software was used for data analysis. Results are expressed as odds ratios with 95% confidence intervals for the total score of the Early Childhood Oral Health Impact Scale (ECOHIS) as well as the scores of the Child Impact Section (CIS) and Family Impact Section (FIS). The random effect model was chosen and heterogeneity was evaluated using the I2 test. Results 2,013 articles were initially retrieved; 1,993 articles were excluded based on title and abstracts; 10 articles excluded after full-text analysis. Ten studies comprising a population of 7,461 preschool children were included in the systematic review and nine studies were included in the meta-analysis. TDI caused a negative impact on OHRQoL based on the overall ECOHIS (OR: 1.24; 95% CI: 1.08–1.43) and CIS (OR: 1.23; 95% CI: 1.07–1.41), but not the FIS (OR: 1.09; 95% CI: 0.90–1.32). Conclusions TDI negatively impacted on OHRQoL of preschool children. The present findings indicate the need for TDI prevention and treatment programs in early childhood.

UnlabelledOral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening.ObjectivesQuantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time.MethodsRepresentative surveys of dental caries in children (age 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality).ResultsComparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality.ConclusionsOverall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.

The aim of the present study was to evaluate the effect of periodontal dressing on post-operative pain and swelling after surgical crown lengthening.A blind, randomized, clinical trial was carried out with 36 patients. Following surgical crown lengthening, the individuals were randomly allocated to the periodontal dressing group (PDG) and control group (CG, non-placement of periodontal dressing). Pain and discomfort were analyzed using a visual analog scale (VAS), verbal scale (VS) and the number of analgesics consumed in 7 days post-operatively. Post-operative infection, stability of the gingival margin and type of healing were also evaluated.The PDG had a significantly higher percentage of responses of 'strong pain' on the VS in the first day post-operatively (33.3% vs 5.3%, p = 0.03) and greater pain on the first and second days post-operatively based on the VAS. Moreover, a significant difference between groups was found regarding gingival swelling after 7 days. However, gingival recession was found in 57.8% of the sites in the CG and only 5.5% of sites in the PDG. No change in condition was found among individuals with conjunctive tissue/bone exposure in the CG in the immediate post-operative period and 80% of the patients in the PDG had healing by first intention after 7 days.The use of periodontal dressing seems to be preferable following surgical crown lengthening with connective tissue/bone exposure. However, adequate post-operative analgesic strategies should be employed due to the possibility of intense pain in the first 24 hours.

Objective The aim of the present study was to describe oral health–related quality of life (OHRQoL) and associated factors in elderly individuals treated at Family Health Units in urban areas of the city of Pelotas, Brazil. Methods The sample was composed of 438 individuals aged 60 years old or older. Demographic, socio-economic, general health and behavioural variables were collected using standardised questionnaires. OHRQoL was measured with the oral health impact profile (OHIP-14). Poisson regression analysis was employed to identify factors associated with OHRQoL. Results The mean total OHIP-14 score was 9.1 (standard deviation: 10.6), and major impacts were related to feeling conscious of psychological discomfort (28.1%) and difficulty eating (24.4%) due to teeth, mouth or dentures. The multivariate analysis revealed higher oral health impact scores among non-White individuals [Prevalence ratios (PR) = 1.33, 95% CI: 1.07–1.66; p = 0.011], those with depressive symptoms (PR = 1.61, 95% CI: 1.30–1.99; p

AIM: To explore the profile of articles on traumatic dental injuries (TDI) published in leading pediatric dental journals between 2000 and 2010 via bibliometric analysis. METHODS: A search was conducted on the PubMed database to find the six pediatric dental journals with the highest numbers of articles on TDI published between January 2000 and December 2010. All titles and abstracts of full-length articles were reviewed by two examiners. Studies focusing on TDI were independently categorized according to the following aspects: (i) year of publication; (ii) country where the study was carried out; (iii) study design; (iv) topic addressed; (v) type of TDI; and (vi) type of dentition. Data were analyzed in terms of frequency distribution. RESULTS: Of a total of 3720 articles published in the six selected journals, only 119 (3.2%) focused on TDI, with no significant variations across the journals or years. The countries with the greatest number of publications on TDI were India (19.3%), followed by the USA (15.1%), Brazil (13.4%), and Italy (11.8%). Case report and case series were the dominant study design (53%). Most studies addressed treatment of TDI (63%) and described injuries to permanent teeth (68%), especially avulsion and crown fractures. CONCLUSIONS: There is an urgent need for expanding the number and quality of research on TDI in pediatric dental journals, especially with better quality study designs. Cohort studies and investigations focusing on the assessment of health services and technologies are important targets for future research. Language: en

Objective: To test the hypothesis that malocclusion does not have an independent and negative effect on quality of life of adolescents. Materials and Methods: The cross-sectional design study comprised a sample of 519 children, aged 11 to 14 years, attending public schools in Osorio, a city in southern Brazil. One calibrated examiner carried out clinical examinations and recorded dental caries (decayed/missing/filled teeth), malocclusion (Dental Aesthetic Index), and dental trauma. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ11–14), Impact Short Form, and their parents or guardians answered questions about socioeconomic status. Simple and multivariate linear regressions were performed to assess covariates for the overall CPQ11–14 scores. Results: Greater impacts on oral health–related quality of life were observed for girls (P = .007), children with a lower household income (P = .016), those living in nonnuclear families (P < .001), and those with more decayed/missing/filled teeth (P = .001). Malocclusion was also associated with oral health–related quality of life: the severity of malocclusion was significantly related to higher scores of CPQ11–14 even after scores were adjusted for control variables. CPQ11–14 increased by approximately 1 point for each increase in the severity of malocclusion. Conclusions: Malocclusion has a negative effect on adolescents' quality of life, independent of dental caries or traumatic dental injuries. Socioeconomic inequalities and clinical conditions are important features in adolescents' quality of life.

To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) in a school-based sample of Brazilian preschool children and their families.A cross-sectional study was conducted in 1036 children aged 2-5 years attending all the public nurseries in Canoas, Brazil. Caregivers were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries, traumatic dental injuries (TDI) and malocclusion. Multivariable Poisson regression models with robust variance were fitted to assess covariates for the prevalence of impacts on OHRQoL following a theoretical hierarchical framework.17.4% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to pain, difficult drinking and eating some foods. The multivariable Poisson regression analysis showed that dental caries, TDI and malocclusion were associated with the outcome. The prevalence of having any impact on OHRQoL was almost three times higher for children with dental caries (PR 2.74 95% CI 2.02-3.72) compared to those who were caries free; and approximately 1.5 times higher for those who presented TDI (PR 1.70 95% CI 1.27-2.27) and malocclusion (PR 1.42 95% CI 1.04-1.94).The findings showed that caregivers of young children with oral disease and disorders perceived that both the children and other family members had poorer quality of life. Oral health policies should be included into general health programs based on common risk approach.

To assess, in vivo, the influence of periodontal attachment loss and gingival recession on responses to pulp sensibility tests (PSTs) with cold stimuli in mandibular incisors in adult patients.This cross-sectional study included 45 patients aged 30 to 60 years treated at a university dental health service. In each patient, 1 mandibular incisor was randomly selected for analysis. One calibrated dentist performed all periodontal assessments. Periodontal attachment loss and gingival recession were measured at 6 sites of the selected tooth followed by application of the PST on the buccal surface of the tooth by an independent operator. Each patient was asked to indicate a score for pain intensity on a numeric visual analog scale. The Pearson correlation coefficient was used to investigate and quantify the correlation between predictor variables (periodontal attachment loss and gingival recession) and reported pain. Simple and multiple linear regression analyses were performed to determine the impact of periodontal attachment loss and gingival recession on PST pain scores.Multivariate analysis showed that periodontal attachment loss contributed significantly to the prediction of pain in response to the PST (P.001). Increases of 1 mm in periodontal attachment loss resulted in a decrease of approximately 0.5 score on the pain scale. Gingival recession also contributed as a predictor of the outcome (P.001) with a decrease of approximately 0.7 in pain scores for every 1-mm increase in gingival recession. The correlations were in the opposite direction than expected.Periodontal attachment loss and gingival recession strongly influenced reported pain in response to PST with cold stimuli. The effect of both variables was constant (ie, responses to PST decreased gradually with increases in periodontal attachment loss and gingival recession).

To identify risk factors for discontinuing breastfeeding during an infant’s first year of life. A cohort study recruited mothers in a hospital in Sao Leopoldo, Brazil, which mainly serves the low-income population. In order to obtain socioeconomic, environmental, and behavioral information, face-to-face interviews with mothers were conducted after birth, and when their infants were 6 and 12 months old. The duration of breastfeeding was investigated at 6 and 12 months, and recorded separately for each month. Depressive symptoms were assessed using the Beck Depression Inventory. The multivariate model for predicting the discontinuation of breastfeeding, adjusted Kaplan–Meier survival curves and Cox regression were used. Of the 360 participants, 201 (55.8%) discontinued breastfeeding within the first 12 months. A multivariate Cox regression model revealed that symptoms of maternal depression (low levels: RR = 1.59, 95% CI 1.02–2.47; moderate to severe: RR = 2.03, 95% CI 1.35–3.01), bottle feeding (RR = 2.07, 95% CI 1.31–3.28) and pacifier use in the first month of life (RR = 3.12, 95% CI 2.13–4.57) were independently associated with the outcomes after adjusting for confounders. Breastfeeding cessation rates were lower for children who did not use bottle feeding or a pacifier in the first month of life and for the children whose mothers presented with minimal depression. Early pacifier use and bottle feeding must be strongly discouraged to support long-term breastfeeding. In addition, screening maternal depression at a primary care service can be a step forward in promoting a longer duration of breastfeeding.

The aim of the present study was to evaluate the pattern of fluoride-containing dentifrice use and associated factors in Brazilian preschoolers.A structured questionnaire was answered by parents of 432 children, who were aged 2 to 6 years, from 12 public preschools in Ijuí, South Brazil. Primary outcomes were age of starting fluoride-containing dentifrice use and amount of dentifrice applied to the toothbrush. Poisson regression with robust variance was used to determine the factors associated with the main outcomes.About 75% of the participants were introduced to fluoride-containing dentifrice before the age of 2 years. The current predominant amount of dentifrice used was obtained by transversal (57.7%), followed by longitudinal deposition on the toothbrush (33.6%), corresponding to 0.3 and 0.9 g of dentifrice, respectively. Previous dental visits and maternal education greater than 4 years were associated with the introduction of fluoride-containing dentifrice before 2 years of age. The probability of using dentifrice in amounts higher than the recommendations doubled in children aged 5 and 6 years.Oral health interventions should reinforce the importance of early introduction of fluoride-containing dentifrice, especially in less-educated mothers. Furthermore, the amount of dentifrice should be reduced to maximise the caries-preventive effect while minimising dental fluorosis.

Food preferences are established in early childhood and track later in life. Therefore, it is important to promote healthy feeding practices as early as possible. A randomized field trial was conducted with 500 mother-child pairs from a low-income area of Sao Leopoldo, State of Rio Grande do Sul, Brazil, to evaluate the impact of a nutritional intervention in the first year of life on the dietary quality of 3- to 4-y-old children. Mother-child pairs were randomized either to intervention and control groups and dietary counseling was provided for mothers in the intervention group during 10 home visits in the course of the first year of life. These visits were carried out by fieldworkers who counseled the mothers about the Ten Steps for Healthy Feeding from Birth to Two Years of Age, based on the WHO guidelines. Dietary intake was assessed at 3-4 y of age for 345 children using two 24-h food recalls. Overall diet quality was determined by the Healthy Eating Index. The prevalence of poor diet in the intervention group was lower compared with the control group [relative risk (RR) = 0.30; 95% CI = 0.13-0.71). The number of children who achieved the 75th percentile for the vegetable and fruit component score was higher in the intervention than in control group (RR = 1.95; 95% CI = 1.31-2.89 and RR = 1.49; 95% CI = 1.07-2.07, respectively). Such data provide evidence that dietary counseling for mothers during the first year of life improves the overall dietary quality of children in a low-income population.

Objective: To investigate the occurrence and management of teething symptoms during the first year of life and associated factors. Study design: 500 children were recruited at birth. Research assessments including structured interviews, anthropometric measurements and dental examination were carried out after birth, at 6 months and at one-year of age. The primary outcome of this study was defined as the occurrence of one or more teething symptoms within the first year of life, as reported by the mother. Results: Teething symptoms were reported in 73% of the children analyzed (273/375). The symptoms most frequently reported were irritability (40.5%), fever (38.9%), diarrhoea (36.0%) and itching (33.6%). Dentists had little influence on the management of symptoms and self-medication to relieve them was a common practice. The risk of reporting teething symptoms was higher for children from nuclear families (p=0.040) and for children from families with higher income (p=0.040). Conclusions: Teething symptoms were highly reported in this population. Pediatric dentists should be accessible and provide adequate orientation when symptoms can be managed at home or immediate referral to health services when more serious diseases are suspected.

To investigate the effectiveness of home visits advising mothers about healthy feeding practices during the first year of life on the occurrence of early childhood caries and severe early childhood caries at 4 years of age.We conducted a parallel randomized trial of mothers of single, full-term children with birthweightor = 2500g in São Leopoldo, Brazil. The intervention group received monthly advice up to 6 months and then at 8, 10 and 12 months by undergraduate nutrition students, based on the "Ten Steps for Healthy Feeding'', a Brazilian national health policy for primary care based on World Health Organization guidelines. The primary outcome was the occurrence of early childhood caries at age four. Secondary outcomes included the occurrence of severe early childhood caries and the number of affected teeth: decayed (white spots and cavities), missing and filled teeth (d(1+)mft). Blinded observers ascertained feeding habits in the home and one blinded dentist performed dental examinations in a municipal clinic. This study is registered with ClinicalTrials.gov, number NCT00629629.Of 500 mother-child pairs (200 intervention, 300 control) enrolled, 340 (141 intervention, 199 control) completed 4 year follow-up. As 138 (69.3%) controls but only 76 (53.9%) intervention children had early childhood caries, home counseling reduced incidence by 22% (RR 0.78; 95% CI 0.65-0.93). Severe early childhood caries incidence was reduced by 32% (RR 0.68; 95% CI 050-0.92). The mean number of affected teeth was lower for the intervention group (3.25) compared with the control group (4.15) (Mann Whitney U-test; p=0.023). No adverse effects were noted.Home nutritional advice during the first year of life decreases caries incidence and severity at four years of age in a low income community.

Objective. This cross-sectional study investigated the prevalence and severity of dental caries and their association with demographic and socio-economic variables in Brazilian preschoolers. Methods. The study population comprised 1487 0- to 5-year-old children attending government nurseries in Canoas, southern Brazil. Questionnaires regarding information related to the independent variables (age, gender, maternal level of education, and family income) were completed by the parents. Clinical examinations were carried out by five trained examiners and results were expressed using the deft index (World Health Organization criteria), including white spots. The outcomes considered in this study were caries occurrence (deft > 0) and caries severity (deft). Results. Forty per cent of the children (589/1487) presented dental caries [mean deft (SD): 1.53 (2.75)]. Deft increased with age (P

– Objectives: Assess the effectiveness of home visits for advising mothers about breast feeding and weaning on early childhood caries (ECC) at the age of 12 months. Methods: A randomized field trial was conducted in mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10 and 12 months, based on the ‘Ten Steps for Healthy Feeding’, a Brazilian national health policy for primary care, based on WHO guidelines. Both groups had research assessment at 6 and 12 months, with dental caries investigated in this last assessment; 122 children were lost in the 1-year follow-up; 378 were assessed for caries: two predentulous children were excluded from the analysis. Mann-Whitney U was used to test if the average number of decayed surfaces (DS; white spots and cavities) differed between the intervention and control groups, and logistic regression to estimate the effects of the intervention on the odds of ECC. Chi-square test was used to test for differences between the intervention and control groups in the distribution of feeding behaviours tackled by the dietary intervention. Results: 10.2% of the children in the intervention group and 18.3% of the controls had caries. The odds of caries was 48% lower for the intervention group, adjusted for number of teeth (OR = 0.52, 95% CI = 0.27–0.97). Mean DS were lower for the intervention group (0.37) when compared with the control group (0.63), (Mann-Whitney U, P = 0.03). The intervention group had significantly longer duration of exclusive breast feeding (P = 0.000), later introduction of sugar (P = 0.005), and smaller probability of ever having eaten biscuits (P = 0.000), honey (P = 0.003), soft drinks (P = 0.02), fromage-frais (P = 0.001), chocolate and sweets (P = 0.001). Conclusions: ECC is a public health problem in that population. The home visits for dietary advice appear to help reducing dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours even further, as a relevant proportion of children of the intervention group were shown to present with dental caries. Further studies should examine the effect of the intervention in the longer term.

Objetivo: O objetivo deste estudo foi o de avaliar a prevalencia da necessidade de tratamento ortodontico em adolescentes brasileiros, utilizando o Indice de Estetica Dental (DAI), investigar as associacoes entre os escores DAI e variaveis demograficas e socioeconomicas, bem como identificar os componentes do DAI que contribuem principalmente para a gravidade da maloclusao. Metodos: Este estudo transversal foi realizado em escolas publicas de Balneario Camboriu, Brasil; a amostra foi constituida por 704 adolescentes com idades entre 12-13 anos, sem historico de tratamento ortodontico. A ma oclusao foi avaliada por um ortodontista treinado e calibrado usando o DAI. Resultados: Das criancas em idade escolar, 58,7% nao tinham ma oclusao, 24,0% tinham ma oclusao definida, 10,9% tinham ma oclusao severa, e 6,4% tinham fragilizando ma oclusao. Cerca de 17% da amostra (intervalo de confianca de 95%: 14,5-20,1) necessitaram de tratamento ortodontico. Overjet maxilar (r=0,627), relacao molar antero-posterior (r=0,590), irregularidade na maxila (r=0,345), irregularidade na mandibula (r=0,332); apinhamento de incisivos (r=0,305) foram os componentes do DAI que contribuiram principalmente para as variacoes nos escores Dai. Conclusao: Quase um quinto da amostra necessitava de tratamento ortodontico. Overjet maxilar e relacao molar representaram as caracteristicas que influenciaram principalmente a necessidade de tratamento ortodontico na populacao do estudo.

This investigation aims to discuss the methodologies applied in clinical trials published about CarisolvTM, in order to assess the best scientific evidence concerning chemo-mechanical caries removal. Papers concerning the use of CarisolvTM were sought using a search strategy. The titles and abstracts of all the reports identified through the search were analyzed by a single reviewer. The inclusion criterion involved: clinical trials having CarisolvTM in one of the study groups. Then, those that fulfilled the inclusion criterion underwent methodology assessment and data extraction. Only 12 papers met the inclusion criterion. It was observed that none of these studies complied with all the evaluated research methodological principles required in order to have power of evidence generation. CarisolvTM proved to be effective in caries removal. Appointment mean time was greater, but the perceived time was shorter than that using conventional techniques due to patients' perception of more comfort and a reduction of anesthesia needs. There were no adverse effect in long-term assessments. In studies with microbiological evaluation of the remaining dentine, it was observed that both the conventional and chemo-mechanical methods produced statistically significant reduction on counts of viable microorganisms. Esta investigação objetiva discutir as metodologias aplicadas em ensaios clínicos publicados sobre Carisolv®, para verificar a melhor evidência científica concernente à remoção químico-mecânica de tecido cariado. Artigos referentes ao uso de Carisolv® foram procurados utilizando-se uma estratégia de busca. Os títulos e resumos de todos os estudos identificados pela procura foram analisados por um único revisor. O critério de inclusão envolveu: ensaios clínicos contendo o sistema Carisolv® em um dos grupos de estudo. Os estudos que preencheram o critério de inclusão foram submetidos à avaliação de metodologia e extração de dados. Somente 12 artigos preencheram o critério para inclusão. Foi verificado que nenhum desses estudos obedeceu a todos os princípios metodológicos considerados necessários para que uma pesquisa tenha poder de geração de evidências. O Carisolv® demonstrou ser eficaz na remoção de tecido cariado. O tempo de consulta foi maior, mas o tempo percebido foi inferior em comparação ao tempo das técnicas convencionais devido à percepção dos pacientes de mais conforto e de redução da necessidade de anestesia. Não houve efeito adverso em avaliações a longo prazo. Em estudos com avaliação microbiológica da dentina remanescente foi verificado que ambos os métodos convencional e químico-mecânico produziram redução significativa na contagem de microrganismos viáveis.

This cross-sectional study investigated the distribution of plaque and gingivitis and its association with demographic, socioeconomic, and orthodontic variables (spacing in anterior teeth, anterior open bite, and crossbite), and visible plaque level (low, medium, high) in Brazilian preschoolers. The sample comprised 490 3- to 5-year-old children from nursery schools in Canoas, a city in southern Brazil. One single, trained observer examined children's oral cavities and determined visible plaque index (VPI) and gingival bleeding index (GBI). Results showed that 99% of the children had visible plaque and 77% had gingivitis (GBI0). A positive (r(s)=0.32) and significant correlation was found between VPI and GBI. VPI and GBI were significantly higher in posterior teeth and buccal and lingual surfaces. VPI was significantly higher in boys, children of low-income families, and without spacing in maxillary anterior teeth. Gingivitis was associated with absence of spacing in maxillary anterior teeth and plaque level. The most prevalent areas of plaque and gingivitis identified in this study should be taken in consideration during oral hygiene instructions, which should be given to children and mothers-particularly those with a low socioeconomic status--to motivate self-care and prevent gingivitis.

The aim of this study was to assess the use of dental services and age at first dental visit in preschool children in Canela, Rio Grande do Sul State, Brazil. A representative sample of under-five children was surveyed on National Children's Vaccination Day. Children's parents completed questionnaires containing socio-demographic data and age at first dental visit. Data were analyzed using multiple logistic regression. 192 children were examined. 13.3% of the sample had already visited the dentist at least once, but only 4.3% had their first dental visit by one year of age. The number of children who had already visited a dentist increased with age. Girls showed higher odds of having visited a dentist (OR = 1.46; 95%CI: 1.01-2.1). Public health strategies are needed to determine the effectiveness of health promotion and improve the use of dental services by preschool children.

Efeitos de uma intervenção baseada na implementação dos Dez Passos para uma Alimentação Saudável: Guia Alimentar para Crianças Menores de Dois Anos sobre as condições nutricionais e de saúde de lactentes em famílias de baixa renda. Randomizou-se duzentos recém-nascidos para o grupo intervenção e trezentos para o grupo controle. O grupo intervenção recebeu orientações dietéticas no primeiro ano de vida. Os dois grupos receberam visitas aos 6 e 12 meses e acompanhamento de rotina pelos seus pediatras. Os resultados (n = 397) mostraram que a intervenção associou-se a maior proporção de aleitamento materno exclusivo aos 4 meses (RR = 1,58; IC95%: 1,21-2,06) e 6 meses (RR = 2,34; IC95%: 1,37-3,99) e amamentadas aos 12 meses (RR = 1,26; IC95%: 1,02-1,55) e a menor proporção de crianças que apresentaram diarréia (RR = 0,68; IC95%: 0,51-0,90), problemas respiratórios (RR = 0,63; IC95%: 0,46-0,85), uso de medicamentos (RR = 0,56; IC95%: 0,34-0,91) e cárie dental (RR = 0,56; IC95%: 0,32-0,96) na faixa etária de 12 a 16 meses. Não houve efeito da intervenção sobre a ocorrência de anemia, internações hospitalares e estado nutricional. Os resultados sugerem que o programa de orientações dietéticas promoveu modificações positivas nas práticas alimentares e nas condições de saúde da criança, porém foi insuficiente para prevenir a anemia ferropriva. This study assesses the impact of an intervention known as the Ten Steps to Healthy Feeding: A Nutritional Guide for Children under Two on nutritional conditions and infant health in low-income families. Two hundred newborns were randomized to the intervention group and three hundred to the control group. Parents of the intervention group received nutritional orientation during the child's first year of life. Both groups received visits at 6 and 12 months and routine follow-up by their pediatricians. The results (n = 397) showed that the intervention was associated with a higher proportion of exclusive breastfeeding at 4 months (RR = 1.58; 95%CI: 1.21-2.06) and 6 months (RR = 2.34; 95%CI: 1.37-3.99) and breastfeeding at 12 months (RR = 1.26; 95%CI: 1.02-1.55) and a lower proportion of children with diarrhea (RR = 0.68; 95%CI: 0.51-0.90), respiratory problems (RR = 0.63; 95%CI: 0.46-0.85), use of medication (RR = 0.56; 95%CI: 0.34-0.91), and dental caries (RR = 0.56; 95%CI: 0.32-0.96) in the 12-16 month bracket. The intervention had no effect on the occurrence of anemia, hospitalization, or nutritional status. The results suggest that the nutritional orientation program led to positive changes in infant feeding practices and health conditions, but that it was insufficient to prevent iron deficiency anemia.

This study assesses the impact of an intervention known as the Ten Steps to Healthy Feeding: A Nutritional Guide for Children under Two on nutritional conditions and infant health in low-income families. Two hundred newborns were randomized to the intervention group and three hundred to the control group. Parents of the intervention group received nutritional orientation during the child's first year of life. Both groups received visits at 6 and 12 months and routine follow-up by their pediatricians. The results (n = 397) showed that the intervention was associated with a higher proportion of exclusive breastfeeding at 4 months (RR = 1.58; 95%CI: 1.21-2.06) and 6 months (RR = 2.34; 95%CI: 1.37-3.99) and breastfeeding at 12 months (RR = 1.26; 95%CI: 1.02-1.55) and a lower proportion of children with diarrhea (RR = 0.68; 95%CI: 0.51-0.90), respiratory problems (RR = 0.63; 95%CI: 0.46-0.85), use of medication (RR = 0.56; 95%CI: 0.34-0.91), and dental caries (RR = 0.56; 95%CI: 0.32-0.96) in the 12-16 month bracket. The intervention had no effect on the occurrence of anemia, hospitalization, or nutritional status. The results suggest that the nutritional orientation program led to positive changes in infant feeding practices and health conditions, but that it was insufficient to prevent iron deficiency anemia.