Indiana University-Purdue University Indianapolis (IUPUI) / Occlusal pits and fissures are ideal places for caries development. Placement of dental sealants has been reported to be effective in preventing this process. However, the effectiveness of dental sealants has been reported to be influenced by clinical factors, such as preparation and placement techniques. A report recently published by the American Dental Association on the clinical recommendations for use of pit-and-fissure sealants included critical evaluation and a summary of relevant scientific evidence on the use of sealants aimed at assisting clinicians. The report addressed concerns such as: Does placing sealants over early (noncavitated) lesions prevent progression of the lesions? Are there any techniques that could improve sealants’ retention and ffectiveness in caries prevention? The investigators concluded that there is limited and conflicting evidence to support that mechanical preparation with a bur results in higher retention rates in children and recommend that pit-and-fissure sealants should be placed on early (noncavitated) carious lesions. The purpose of this in vitro study was to evaluate two methods of fissure treatment before sealant placement on different caries levels. In this study, 135 extracted human molars (ICDAS codes 0 to 2) were collected and ranked by a calibrated examiner into three groups. These were further divided into three subgroups (nine total). Occlusal surfaces were prepared with: 1) a ¼-mm round bur, 2) air abrasion, and 3) no treatment as a control. All groups were etched with 3.0- percent phosphoric acid for 15 seconds, rinsed thoroughly, and dried with an air water syringe. Opaque dental sealants were placed on the etched occlusal surfaces according to the accepted clinical standards and light-cured for 30 seconds. All groups were thermocycled for 5000 cycles. The roots of the teeth were painted with nail varnish, root apices were sealed with wax, and the occlusal surfaces were immersed in 1.0-percent methylene blue for a full 24 hours. The next day the teeth were cleaned, and the roots were sectioned to expose the crowns. Crowns were cut along the occlusal surfaces in the buccolingual direction. The sectioned surfaces were examined under the Nikon SMZ 1500 microscope for sealant penetration in the fissure and microleakage along the sealant enamel interface. The analyses were performed on a transformation of the sealant penetration percentage commonly used for calculated percentages: sin-1(p1/2). The effects of the type of group, the ICDAS code, and the fissure type on sealant penetration percentage were compared using ANOVA. The effects on microleakage and bubbles were compared using GEE methods applied to logistic regression. The effects on dye penetration were compared using GEE methods applied to cumulative logistic regression to account for the ordered categories of the dye penetration scale. In the findings of sealant penetration, the group type did not have a significant effect on sealant penetration (p = 0.195). ICDAS codes had a significant effect on sealant penetration (p = 0.0113) where ICDAS Code 0 had greater penetration than ICDAS codes 1 and 2. Fissure type had a significant effect on sealant penetration (p = 0.0001) where fissure types V and U had greater sealant penetration than Fissure types Y and W. In the findings of microleakage, the type of group had a significant effect on microleakage (p = 0.0004) where the abrasion group had increased microleakage as compared with the 1/4 round bur and control groups. ICDAS code had a significant effect on microleakage (p = 0.0022) where ICDAS code 0 had less microleakage as compared with ICDAS code 1 and 2. Fissure types V, U, Y, and W did not have a significant effect on microleakage (p = 0.721).

Epidemiological data reveal that one of the most common diseases in the world is dental disease. Scientific knowledge is available to prevent the vast majority of dental disease. Thus, individuals are not taking the necessary action to prevent caries and periodontal disease. Dental professionals try to facilitate primary prevention of disease through education and the correction of skill deficits with patients. Still billions of dollars are spent each year in the treatment of these diseases. This presents a major health and economic liability and demonstrates a clear need to implement additional behavioral management techniques in the field of dentistry. This study implements two behavioral management strategies, self-monitoring and monetary incentives, in a free dental clinic to explore the effects of these treatments on subject"s dental flossing rate. / M.S.

<p>Dental caries is a multi-factorial disease that affects everyone irrespective of race, class or gender, however, the burden of the disease is often found in children from lower socio-economic backgrounds. The nature of the disease is such that it can be prevented. Various international studies on fluoride have shown a reduction in the prevalence of dental caries. By using geographical information systems, oral health data can be linked to the fluoride levels and further analysis could be done to identify areas at risk of dental caries as well as show patterns in the distribution of dental caries. The aim of this study was therefore to assess the effects of different levels of fluoride on the prevalence of dental caries in selected towns in the Northern Cape and Westen Cape. It also examined the application of Geographical Information Systems (GIS) to oral health data.</p>

RESUMO Este estudo avaliou a influência da educação precoce em saúde bucal do núcleo familiar e do uso de dentifrícios fluoretados sobre a prevalência de cárie dentária na primeira infância. Foram compostos dois grupos de crianças na faixa etária de 6 a 30 meses, diferindo entre si quanto ao acesso à atenção odontológica. O grupo I foi formado por 152 crianças pertencentes ao Projeto Odontobebê (Universidade Federal do Pará), enquanto o grupo II constituído por 94 crianças que não haviam recebido atendimento odontológico até a data do exame. Foi aplicado um questionário às mães com 19 perguntas a respeito dos hábitos alimentares, condutas de higiene bucal e utilização de dentifrícios fluoretados pelas crianças. Sinais clínicos da doença cárie, incluindo lesões cavitadas e manchas brancas ativas, além da presença de biofilme visível, foram avaliadas através do exame clínico. Os dados coletados foram submetidos à análise estatística, utilizando-se o software estatístico Minitab versão 11.0 com um nível de significância de 5% (P<0.05). Houve diferença estatisticamente significativa entre o número de superfícies cariadas e a extensão das lesões de cárie nos grupos I e II (P< 0.001). Um menor número de crianças com cárie, mancha branca ativa e biofilme visível foi encontrado no grupo I, embora os resultados não tenham se revelado estatisticamente significantes. A atenção odontológica fornecida pelo Projeto Odontobebê influenciou positivamente na prevalência de cárie dentária na primeira infância, pois as crianças com cárie neste grupo apresentaram menor número de superfícies cariadas e lesões menos extensas, com predomínio de cavidades em esmalte, quando comparadas as crianças do grupo II. / SUMMARY This paper has evaluated the influence of early education in oral health care of the family nucleus and the use of fluoridated dentifrices on the prevalence of dental caries in early childhood. Two groups of children were made up from children aged o0 t0 30 months, differing one another as to dentistry attention. Group I was made up with 152 children from “Projeto Odontobebê" (Universidade Federal do Pará), while group II was constituted by 94 children which never given any dental care until the examination date. It was applied a form to mothers with 19 questions about eating and oral hygiene habits and the use of fluoridated dentifrices by children. Clinical signs of caries disease, including cavity lesions and active white spots, besides the presence of visible biofilm were evaluated through clinical examination. The data collected were submitted to statistics analyses with statistics Minitab 11.0 software at 5% of significance level (P<0.05). There was a statistically 114 significant difference between the number of caries surfaces and the extension of caries lesions on groups I and II (P<0.001). A lower number of children with caries, active white spot and visible biofilm was found in group I, although the results had not revealed statistically significant. Dental care attention supplied by “Projeto Odontobebê" has presented a positive influence on the prevalence of dental caries in early childhood, for children with caries in such group presented a lower number of caries surfaces and less extended lesions, with a predominance of cavities in enamel when compared to group II children.

<p>Dental caries is a multi-factorial disease that affects everyone irrespective of race, class or gender, however, the burden of the disease is often found in children from lower socio-economic backgrounds. The nature of the disease is such that it can be prevented. Various international studies on fluoride have shown a reduction in the prevalence of dental caries. By using geographical information systems, oral health data can be linked to the fluoride levels and further analysis could be done to identify areas at risk of dental caries as well as show patterns in the distribution of dental caries. The aim of this study was therefore to assess the effects of different levels of fluoride on the prevalence of dental caries in selected towns in the Northern Cape and Westen Cape. It also examined the application of Geographical Information Systems (GIS) to oral health data.</p>

Made available in DSpace on 2014-06-11T19:27:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-02-03Bitstream added on 2014-06-13T18:31:56Z : No. of bitstreams: 1 alves_kmrp_me_araca.pdf: 718342 bytes, checksum: 06ff8987209e3528863547ccbcd084ff (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Dentifrícios com concentração reduzida de flúor podem oferecer menor risco à fluorose dentária, porém sua efetividade deve ser mantida. O objetivo deste estudo in vitro foi avaliar o potencial anticárie a abrasividade de dentifrícios fluoretados com pH ácido. Para isso, foram utilizados 240 blocos de esmalte bovino, selecionados pela microdureza de superfície e dentifrícios experimentais contendo 0 (placebo), 275, 412, 550 e 1100 mg F/g (pH 7,0 e 4,5) e comerciais Crest® (1100 mg F/g, padrão) e Colgate Baby® (500 mg F/g). Blocos de esmalte (n=120) foram submetidos à ciclagem de pH e ao tratamento (2x/dia) com suspensão de dentifrícios. Em seguida, calculou-se a variação da microdureza de superfície, o conteúdo mineral e a quantidade de flúor, cálcio e fósforo no esmalte e nas soluções após a ciclagem. Para o teste de abrasividade (n=120) dos dentifricios utilizou-se maquina de escovacao e posterior analise perfilometrica. Os blocos de esmalte tratados com dentifricios acidos apresentaram menor perda mineral (ANOVA; p<0,05) quando comparados aos neutros. Os dentifricios 412 e 550 uÊg F/g acidos apresentaram resultados semelhantes (p>0,05) aos dos dentifricios 1100 uÊg F/g neutro e Crest. Houve correlacao positiva (Pearson; p<0,05) entre as concentracoes de fluor nos dentifricios, no esmalte e nas solucoes, com tambem com o fosforo presente nas solucoes. A abrasividade dos dentifricios acidos foi semelhante (p>0,05) a dos neutros e os comerciais apresentaram menor abrasao (p<0,05). Conclui-se que os dentifricios com 412 e 550 mg F/g acidos possuem acao anticariogenica semelhante a do Crest e que o pH nao influência a abrasividade dos dentifrícios. / Low-fluoride dentifrices may reduce the risk to enamel fluorosis; however, their effectiveness must be maintained. This in vitro study evaluated the anticariogenic potential and abrasiveness of acidic fluoride dentifrices. Enamel bovine blocks (n=240) were selected according to their surface microhardness and divided into groups containing 0 (placebo), 275, 412, 550 and 1,100 mg F/g (pH 4.5 or 7.0). Two commercial dentifrices were also studied: Crest (positive control) and Colgate Baby (500 mg F/g). Enamel blocks (n=120) were submitted to pH cycling and treatment (2 times/day) with dentifrice slurries. Variations in surface microhardness, mineral content and amount of fluoride, calcium and phosphate in enamel and slurries after pH cycling were calculated. Enamel blocks (n=120) and an automated toothbrushing machine were used to test dentifrice abrasiveness, which was evaluated by profilometry. Enamel blocks treated with acidic dentifrices exhibited less mineral loss compared to those exposed to neutral dentifrices (ANOVA; p<0.05). Acidic dentifrices with 412 and 550 ìg F/g presented similar outcomes (p>0.05) as neutral dentifrice with 1100 ìg F/g and Crest. Positive correlation (Pearson; p<0.05) was found between fluoride concentration in dentifrices and in enamel and slurry, as well as phosphate in slurries. The abrasiveness of acidic dentifrices was similar (p>0,05) to the neutral, whereas commercial dentifrices yielded lower abrasion (p<0.05). It was concluded that acidic dentifrices with 412 and 550 ìg F/g had the same anticariogenic action as the positive control. The pH had no influence on dentifrice abrasiveness.

RESUMO Este estudo avaliou a influência da educação precoce em saúde bucal do núcleo familiar e do uso de dentifrícios fluoretados sobre a prevalência de cárie dentária na primeira infância. Foram compostos dois grupos de crianças na faixa etária de 6 a 30 meses, diferindo entre si quanto ao acesso à atenção odontológica. O grupo I foi formado por 152 crianças pertencentes ao Projeto Odontobebê (Universidade Federal do Pará), enquanto o grupo II constituído por 94 crianças que não haviam recebido atendimento odontológico até a data do exame. Foi aplicado um questionário às mães com 19 perguntas a respeito dos hábitos alimentares, condutas de higiene bucal e utilização de dentifrícios fluoretados pelas crianças. Sinais clínicos da doença cárie, incluindo lesões cavitadas e manchas brancas ativas, além da presença de biofilme visível, foram avaliadas através do exame clínico. Os dados coletados foram submetidos à análise estatística, utilizando-se o software estatístico Minitab versão 11.0 com um nível de significância de 5% (P<0.05). Houve diferença estatisticamente significativa entre o número de superfícies cariadas e a extensão das lesões de cárie nos grupos I e II (P< 0.001). Um menor número de crianças com cárie, mancha branca ativa e biofilme visível foi encontrado no grupo I, embora os resultados não tenham se revelado estatisticamente significantes. A atenção odontológica fornecida pelo Projeto Odontobebê influenciou positivamente na prevalência de cárie dentária na primeira infância, pois as crianças com cárie neste grupo apresentaram menor número de superfícies cariadas e lesões menos extensas, com predomínio de cavidades em esmalte, quando comparadas as crianças do grupo II. / SUMMARY This paper has evaluated the influence of early education in oral health care of the family nucleus and the use of fluoridated dentifrices on the prevalence of dental caries in early childhood. Two groups of children were made up from children aged o0 t0 30 months, differing one another as to dentistry attention. Group I was made up with 152 children from “Projeto Odontobebê” (Universidade Federal do Pará), while group II was constituted by 94 children which never given any dental care until the examination date. It was applied a form to mothers with 19 questions about eating and oral hygiene habits and the use of fluoridated dentifrices by children. Clinical signs of caries disease, including cavity lesions and active white spots, besides the presence of visible biofilm were evaluated through clinical examination. The data collected were submitted to statistics analyses with statistics Minitab 11.0 software at 5% of significance level (P<0.05). There was a statistically 114 significant difference between the number of caries surfaces and the extension of caries lesions on groups I and II (P<0.001). A lower number of children with caries, active white spot and visible biofilm was found in group I, although the results had not revealed statistically significant. Dental care attention supplied by “Projeto Odontobebê” has presented a positive influence on the prevalence of dental caries in early childhood, for children with caries in such group presented a lower number of caries surfaces and less extended lesions, with a predominance of cavities in enamel when compared to group II children.

Indiana University-Purdue University Indianapolis (IUPUI) / Etching of enamel caries lesions has been demonstrated to enhance remineralization. However, this effect reaches a plateau after a period of time. This study aimed at investigating the effectiveness of additional acid etching on remineralization. Forty 1 mm × 2 mm human enamel blocks with chemically induced artificial incipient lesions were used. Ten specimens were randomly selected at the end of demineralization for transverse microradiography (TMR) analysis. The remaining specimens were then divided into three groups (n = 10). Group A was remineralized by a pH cycling system with 1100 ppm sodium fluoride for 20 days. In group B, the specimens were etched with 35-percent phosphoric acid for 30 s and then remineralized. Group C was remineralized by same procedure as group B plus and given an additional acid etch after 10 days of remineralization. Mineral density was measured by x-ray microtomography (µ-CT). The volumetric mineral content [VM (µm3×105)] was determined between 91 and 0-wt%. The µ-CT % mineral recovery (%) was calculated using the formula 100×(remineralize VM - demineralization VM) / (sound VM - demineralization VM). One-hundred-μm sections of demineralized and remineralized specimens were used to assess the mineral loss (IML: vol%×µm) and lesion depth (µm) using TMR. The three groups showed no significant difference in mineral change or mineral content for µ-CT or TMR lesion depth. The TMR IML showed a significant difference between the demineralized specimens and the three remineralized groups. The correlation between TMR IML and TMR lesion depth was 0.66 (p < 0.0001). The µ-CT percent mineral recovery from demineralization was correlated with neither TMR IML nor TMR lesion depth. When evaluated with µ-CT, the twice-acid-etched group presented lower mineral gain values than the group etched only once with acid. Also, the twice-etched group presented lower mineral gain and greater TMR IML compared with the non-acid etch group. TMR images revealed reduction of surface layer in the acid-etched groups, especially in the twice-etched group, in which significant reduction or loss of surface layer occurred. Based on these results, we conclude that additional acid etching with 35-percent phosphoric acid does not enhance remineralization compared with a single application of acid etching. We believe that the viable existence of the surface layer is essential for remineralization of the lesion. Further investigations into the accuracy of µ-CT to detect minute mineral changes in incipient caries lesions are probably needed.

Indiana University-Purdue University Indianapolis (IUPUI) / The majority of currently marketed fluoride varnishes (FV) have not been evaluated for their effectiveness in preventing dental caries. Fundamental research on FVs and how different formulations affect adherence to teeth, fluoride release into saliva and uptake by teeth is virtually non-existent. The objective of this work was to investigate the anti-caries potential, measured as fluoride release into saliva, change in surface microhardness of early enamel caries lesions, and enamel fluoride uptake, of multiple commercially available FVs. We have found that FVs differed in their release characteristics, rehardening capability, and ability to deliver fluoride to demineralized lesions. In addition to our in vitro work, we have conducted a clinical study that aimed to compare saliva and plaque fluid fluoride concentrations following the application of three commercially available FV treatments at predetermined post application time points. We also investigated the change in fluoride concentration in saliva and plaque fluid fluoride from baseline to each post application predetermined time point. We found that FVs varied in their release of fluoride into saliva and plaque fluid but shared common trends in release characteristics. The outcomes of our in vitro and in vivo investigations demonstrate a great variation in anti-caries potential of FVs. This may be attributed to different compositions and physical properties of the tested FVs.