Work absenteeism by parents because of oral conditions in preschool children

OBJECTIVE

The aim of the present study was to evaluate the influence of oral conditions in preschool children and associated factors on work absenteeism experienced by parents or guardians.

METHODS

A preschool-based, cross-sectional study was conducted of 837 children, 3-5 years of age, in Campina Grande, Brazil. Parents or guardians answered the Brazilian version of the Early Childhood Oral Health Impact Scale. The item 'taken time off work' was the dependent variable. Questionnaires addressing sociodemographic variables, history of toothache and health perceptions (general and oral) were also administered. Clinical examinations for dental caries and traumatic dental injury (TDI) were performed by three dentists who had undergone training and calibration exercises. Cohen's kappa (κ) was 0.83-0.88 for interexaminer agreement and 0.85-0.90 for intra-examiner agreement. Descriptive, analytical statistics were conducted, followed by logistic regression for complex samples (α = 5%).

RESULTS

The prevalence of parents' or guardians' work absenteeism because of the oral conditions of their children was 9.2%. The following variables were significantly associated with work absenteeism: mother's low schooling [odds ratio (OR) = 2.31; 95% confidence interval (95% CI): 1.31-4.07]; history of toothache (OR = 6.33; 95% CI: 3.18-12.61); and avulsion or luxation types of TDI (OR = 8.54; 95% CI: 1.80-40.53).

CONCLUSION

Other oral conditions that do not generally cause pain, such as dental caries with a low degree of severity or inactive dental caries and uncomplicated TDI, were not associated with parents' or guardians' work absenteeism of preschool children. It is concluded that toothache, avulsion, luxation and a low degree of mother's schooling are associated with work absenteeism.

Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis

BACKGROUND

To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM.

METHODS

The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI).

RESULTS

There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21).

CONCLUSIONS

There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.

Oral Health Problems and Smile Avoidance Among Preschool Children

PURPOSE

The purpose of this study was to evaluate the influence of oral health problems on the avoidance of smiling among preschool children.

METHODS

A cross-sectional study was conducted with 835 three- to five-year-old children. Caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale and a questionnaire on sociodemographic data. The avoided smiling item of the child section was the dependent variable. An oral examination was performed by three dentists who had undergone calibration exercises (Kappa=0.85 to 0.90). Poisson hierarchical regression (PR) was used to determine the significance of associations between the avoidance of smiling and oral health problems (α equals five percent). The multivariate model was constructed with two hierarchical levels: (1) sociodemographic aspects and (2) oral health problems.

RESULTS

Seven percent of the children avoided smiling, which was associated with cavitated lesions and five years of age (PR=5.070; 95 percent confidence interval=1.57 to 16.39).

CONCLUSIONS

Age and cavitated lesions on the maxillary incisors were determinant factors for the avoidance of smiling.

Parental Perceptions of Oral Health Status in Preschool Children and Associated Factors

<p>The aim of the present study was to evaluate parental perceptions of oral health status in preschool children. A cross-sectional study was carried with 843 Brazilian children between 3 and 5 years of age. Parents/guardians answered a self-administered questionnaire on the health of their children and sociodemographic data. Parental perceptions of their child's oral health were determined by the responses to the following question: "How would you describe your child's oral health?" The Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) was answered by parents/guardians and used to measure the impact of oral health-related quality of life (OHRQoL) on preschool children and their families. Three examiners performed oral exams on the children (K= 0.85-0.90). Descriptive analytical statistics were carried out, followed by logistic regression for complex samples (α=5%). The following variables were significantly associated with parental perceptions of children's oral health: parental perception of general health as poor (OR=18.25; 95% CI: 3.36-98.96), negative impact on family's OHRQoL (OR=13.82; 95% CI: 4.27-44.72), child aged five years (OR=7.40; 95% CI: 1.49-36.63) and the interaction between history of toothache and dental caries (OR=10.02; 95% CI: 1.17-85.61). Thus, parental perceptions of oral health are influenced only by clinical conditions with symptoms, such as dental caries with toothache. Other oral conditions, such as malocclusion or traumatic dental injury, were not associated with parental perceptions of their child's oral health.</p>

Perceived Impact of Dental Pain on the Quality of Life of Preschool Children and Their Families

The aim of the present study was to evaluate the perceived impact of dental caries and dental pain on oral health-related quality of life (OHRQoL) among preschool children and their families. A cross-sectional study was conduct with 843 preschool children in Campina Grande, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, their child's general/oral health and history of dental pain. The Brazilian version of the Early Childhood Oral Health Impact Scale was administered to determine the perceived impact of caries and dental pain on OHRQoL. The children underwent an oral examination. Logistic regression for complex sample was used to determine associations between the dependent and independent variables (OR: Odds ratio, α = 5%). The independents variables that had a p-value <0.20 in the bivariate analysis were selected for the multivariate model. The prevalence of dental caries and dental pain was 66.3% and 9.4%, respectively. Order of birth of the child, being the middle child (OR: 10.107, 95%CI: 2.008-50.869) and youngest child (OR: 3.276, 95%CI: 1.048-10.284) and dental pain (OR: 84.477, 95%CI: 33.076-215.759) were significant predictors of the perceived impact on OHRQOL for children. Poor perception of oral health was significant predictor of the perceived impact on OHRQOL for family (OR=7.397, 95%CI: 2.190-24.987). Dental caries was not associated with a perceived impact on the ORHQoL of either the children or their families. However, order of child birth and dental pain were indicators of impact of OHRQoL on preschool children and poor perception of oral health was indicators of impact on families.

Association between oral conditions and functional limitations in childhood

The aim of this study was to evaluate the impact of oral conditions on functional limitations among preschoolers. A preschool-based, cross-sectional study was carried out with 843 preschoolers in Campina Grande, Brazil. Parents/caregivers answered a questionnaire addressing socio-demographic characteristics and perceptions regarding the general/oral health of their children as well as the Brazilian version of the Early Childhood Oral Health Impact Scale. The nonparametric Kruskal-Wallis test followed by Mann-Whitney test (α = 5%) was used to compare mean children's quality-of-life scores for each independent variable. Poisson regression analysis was used to test associations between the independent and dependent variables (difficulties eating, drinking and speaking) (α = 5%). The multivariate regression model involved a hierarchical approach with four levels (distal to proximal determinants): (i) socio-demographic aspects; (ii) health perceptions; (iii) oral conditions; and (iv) pain conditions. The prevalence of negative impact on function was 24.7% for eating/drinking and 8.0% for speaking. Significant associations were found between toothache and negative impact on eating/drinking (PR = 5.38; 95%CI: 3.20-9.02) as well as between high severity dental caries and negative impact on speaking (PR = 14.91; 95%CI: 1.98-112.32). Dental caries, traumatic dental injury and malocclusion were not significantly associated with a negative impact on eating or drinking. However, toothache was an indicator of negative impact on eating/drinking and dental caries severity was an indicator of negative impact on speaking.

Association between parental guilt and oral health problems in preschool children: a hierarchical approach

Background

Dental caries and traumatic dental injury (TDI) can play an important role in the emergence of parental guilt, since parents feel responsible for their child’s health. The aim of the present study was to evaluate the influence of oral health problems among preschool children on parental guilt.

Methods

A preschool-based, cross-sectional study was carried out with 832 preschool children between three and five years of age in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The item "parental guilt" was the dependent variable. Questionnaires addressing socio-demographic variables (child’s sex, child’s age, parent’s/caregiver’s age, mother’s schooling, type of preschool and household income), history of toothache and health perceptions (general and oral) were also administered. Clinical exams for dental caries and TDI were performed by three dentists who had undergone a training and calibration exercise (Kappa: 0.85-0.90). Poisson hierarchical regression was used to determine the significance of associations between parental guilt and oral health problems (α = 5%). The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.

Results

The frequency of parental guilt was 22.8%. The following variables were significantly associated with parental guilt: parental perception of child’s oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

Conclusion

Based on the present findings, parental guilt increases with the occurrence of oral health problems that require treatment, such as dental caries and TDI of greater severity. Parental perceptions of poor oral health in their children and history of toothache were predictors of greater feelings of parental guilt.

Malocclusion and socioeconomic indicators in primary dentition

The aim of the present study was to determine the prevalence of malocclusion and associations with socioeconomic indicators among preschoolers. A cross-sectional study was conducted with 732 children 3 to 5 years of age in the city of Campina Grande, Brazil. Three dentists underwent a calibration exercise (K = 0.85–0.90) and diagnosed malocclusion based on the criteria proposed by Foster & Hamilton and Grabowski et al. Parents/guardians answered a questionnaire addressing sociodemographic aspects. Data analysis involved descriptive statistics and bivariate Poisson regression (PR; α = 5%). The prevalence of malocclusion was 62.4%. The most frequent types were increased overjet (42.6%), anterior open bite (21%) and deep overbite (19.3%). An association was found between malocclusion and age: the prevalence of malocclusion was greater among younger children, with the highest prevalence among 3-year-olds (PR = 1.116; 95%CI = 1.049–1.187). The prevalence of malocclusion was high. Mother's schooling and household income were not associated with malocclusion. Socioeconomic factors were also not associated with the occurrence of malocclusion.

Effects of quercetin on oxidative stress biomarkers in methimazole - induced hypothyroid rats

The objective of the present study was to evaluate the effect of quercetin on oxidative stress biomarkers in methimazole (MMI) - induced hypothyroidism male rats. Hypothyroidism was induced by administering MMI at 20 mg/100 ml in the drinking water, for 1 month. After achieved hypothyroidism, rats received orally 10 or 25 mg/kg of quercetin (QT) for 8 weeks. 60 male wistar rats were randomly divided into 6 groups (group I, control; group II, QT10; group III, QT25; group IV, hypothyroid; group V, hypothyroid+QT10; group VI, hypothyroid+QT25). Liver, kidney and serum TBARS levels significantly increased in hypothyroid rats when compared to controls, along with increased protein carbonyl (PCO) in liver and increased ROS levels in liver and kidney tissues. QT10 and QT25 were effective in decreasing TBARS levels in serum and kidney, PCO levels in liver and ROS generation in liver and kidney. MMI - induced hypothyroidism also increased TBARS levels in cerebral cortex and hippocampus that in turn were decreased in rats treated with QT25. Moreover, the administration of QT25 to hypothyroid rats resulted in decreased SOD activities in liver and whole blood and increased liver CAT activity. Liver and kidney ascorbic acid levels were restored with quercetin supplementation at both concentrations. QT10 and QT25 also significantly increased total oxidative scavenging capacity in liver and kidney tissues from hypothyroid rats. These findings suggest that MMI - induced hypothyroidism increases oxidative stress parameters and quercetin administration could exert beneficial effects against redox imbalance in hypothyroid status.

Impact of oral health conditions on the quality of life of preschool children and their families: a cross-sectional study

BACKGROUND

Dental caries, traumatic dental injury (TDI) and malocclusion are common oral health conditions among preschool children and can have both physical and psychosocial consequences. Thus, it is important to measure the impact these on the oral health-related quality of life (OHRQoL) of children. The aim of the present study was to assess the impact of oral health conditions on the OHRQoL of preschool children and their families.

METHODS

A preschool-based, cross-sectional study was carried out with 843 preschool children in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian Early Childhood Oral Health Impact Scale and a questionnaire addressing socio-demographic data as well as the parent's/caregiver's perceptions regarding their child's health. Clinical exams were performed by three researchers who had undergone a calibration process for the diagnosis of dental caries, TDI and malocclusion (K = 0.83-0.85). Hierarchical Poisson regression was employed to determine the strength of associations between oral health conditions and OHRQoL (α = 5%). The multivariate model was run on three levels obeying a hierarchical approach from distal to proximal determinants: 1) socio-demographic data; 2) perceptions of health; and 3) oral health conditions.

RESULTS

The prevalence of impact from oral health conditions on OHRQoL was 32.1% among the children and 26.2% among the families. The following variables were significantly associated with a impact on OHRQoL among the children: birth order of child (PR = 1.430; 95% CI: 1.045-1.958), parent's/caregiver's perception of child's oral health as poor (PR = 1.732; 95% CI: 1.399-2.145), cavitated lesions (PR = 2.596; 95% CI: 1.982-3.400) and TDI (PR = 1.413; 95% CI: 1.161-1.718). The following variables were significantly associated with a impact on OHRQoL among the families: parent's/caregiver's perception of child's oral health as poor (PR = 2.116; 95% CI: 1.624-2.757), cavitated lesions (PR = 2.809; 95% CI: 2.009-3.926) and type of TDI (PR = 2.448; 95% CI: 1.288-4.653).

CONCLUSION

Cavitated lesions and TDI exerted a impact on OHRQoL of the preschool children and their families. Parents'/caregivers' perception of their child's oral health as poor and the birth order of the child were predictors of a greater impact on OHRQoL.

Alterations in the cholinesterase and adenosine deaminase activities and inflammation biomarker levels in patients with multiple sclerosis

Multiple sclerosis (MS) is one of the main chronic inflammatory diseases of the CNS that cause functional disability in young adults. It has unknown etiology characterized by the infiltration of lymphocytes and macrophages into the brain. The aim of this study was to evaluate the acetylcholinesterase (AChE) activity in lymphocytes and whole blood, as well as butyrylcholinesterase (BChE) and adenosine deaminase (ADA) activities in serum. We also checked the levels of nucleotides, nucleosides, biomarkers of inflammation such as cytokines (interleukin (IL)-1, IL-6, interferon (IFN)-γ, tumor necrosis factor-alpha (TNF-α) and IL-10) and C-reactive protein (CRP) in serum from 29 patients with the relapsing-remitting form of MS (RRMS) and 29 healthy subjects as the control group. Results showed that AChE in lymphocytes and whole blood as well as BChE, and ADA activities in serum were significantly increased in RRMS patients when compared to the control group (P<0.05). In addition, we observed a decrease in ATP levels and a significant increase in the levels of ADP, AMP, adenosine and inosine in serum from RRMS patients in relation to the healthy subjects (P<0.05). Results also demonstrated an increase in the IFN-γ, TNF-α, IL-1, IL-6 and CRP (P<0.05) and a significant decrease in the IL-10 (P<0.0001) in RRMS patients when compared to control. Our results suggest that alterations in the biomarkers of inflammation and hydrolysis of nucleotides and nucleosides may contribute to the understanding of the neurological dysfunction of RRMS patients.

Prevalence and Associated Factors for the Development of Anterior Open Bite and Posterior Crossbite in the Primary Dentition

The aim of the study was to verify the prevalence of anterior open bite (AOB) and posterior cross-bite (PC) in the primary dentition and the association with sociodemographic factors, presence and duration of nutritive and non-nutritive habits. A cross-sectional study was carried out with 732 preschoolers in Campina Grande, PB, Brazil. Clinical exams were performed by three calibrated examiners (Kappa: 0.85-0.90). A questionnaire addressing sociodemographic data as well as nutritive and non-nutritive sucking habits was administered to parents/caregivers. Data analysis involved descriptive statistics and Poisson regression analysis (α=5%). The prevalence of AOB and PC was 21.0% and 11.6%, respectively. AOB was significantly associated with the three-year-old age group (PR: 1.37; 95%CI: 1.24-1.52), enrollment in public school (PR: 1.09; 95%CI: 1.01-1.17) and duration of pacifier sucking ≥36 months (PR: 1.41; 95%CI: 1.30-1.53). PC was associated with pacifier use (PR: 1.11; 95%CI: 1.05-1.17) and duration of breastfeeding <12 months (PR: 1.05; 95%CI: 1.00-1.10). Socioeconomic factors appear not to be related to AOB or PC in the primary dentition, except type of preschool. Breastfeeding should be encouraged for longer periods and the use of pacifier beyond 3 years of age represents a predisposing factor for both types of malocclusion, especially AOB.

Predisposing Factors for Traumatic Dental Injury in Primary Teeth and Seeking of Post-trauma Care

The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the child's history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (α=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U$312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parent's age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parent's age is a crucial determinant for seeking dental care.

Acute effects of resistance exercise and intermittent intense aerobic exercise on blood cell count and oxidative stress in trained middle-aged women

The aim of this study was to compare the effect of an intermittent intense aerobic exercise session and a resistance exercise session on blood cell counts and oxidative stress parameters in middle-aged women. Thirty-four women were selected and divided into three groups: RE group (performing 60 min of resistance exercises, N = 12), spinning group (performing 60 min of spinning, N = 12), and control group (not exercising regularly, N = 10). In both exercise groups, lymphocytes and monocytes decreased after 1-h recuperation (post-exercise) compared to immediately after exercise (P < 0.05). Immediately after exercise, in both exercised groups, a significant increase in TBARS (from 16.5 ± 2 to 25 ± 2 for the spinning group and from 18.6 ± 1 to 28.2 ± 3 nmol MDA/mL serum for the RE group) and protein carbonyl (from 1.0 ± 0.3 to 1.6 ± 0.2 for the spinning group and from 0.9 ± 0.2 to 1.5 ± 0.2 nmol/mg protein for the RE group) was observed (P < 0.05). A decrease in antioxidant activities (non-protein sulfhydryl, superoxide dismutase, catalase) was also demonstrated with a negative correlation between damage markers and antioxidant body defenses (P < 0.05). These results indicate that an acute bout of intermittent or anaerobic exercise induces immune suppression and increases the production of reactive oxygen species, causing oxidative stress in middle-aged and trained women. Furthermore, we demonstrated that trained women show improved antioxidant capacity and lower oxidative damage than sedentary ones, demonstrating the benefits of chronic regular physical activity.

Association between socioeconomic factors and the choice of dentifrice and fluoride intake by children

It is questionable whether socioeconomic factors influence the choice of marketed children’s dentifrices and whether these products are associated with greater fluoride (F) intake in children. The present cross-sectional study involving 197 children (mean age: 40.98 ± 6.62 months) was carried out in Montes Claros, Brazil. Parents completed a questionnaire on socioeconomic status and the tooth brushing habits of their children. The children brushed their teeth and saliva residues were collected for F analysis. F intake from dentifrice was determined with an ion-specific electrode. Univariate analysis and logistic regression were used to test whether the type of dentifrice (children’s or family) and F dose (<0.05 and ≥0.05 mg F/Kg of body weight/day) were associated with the independent variables (p < 0.05). No differences were found between children’s and family dentifrices regarding daily F intake (0.046 and 0.040 mg F/Kg/day, respectively; p = 0.513). The following were strong predictors for the use of a children’s dentifrice: studying at a private kindergarten (OR: 6.89; p < 0.001); age that the child begun to tooth brush <2 years (OR: 2.93; p = 0.041), and the interaction between the variables “use of the same dentifrice as parents” and “type of tooth brush used” (OR: 27.20; p < 0.001). “The amount of dentifrice used” and “frequency of tooth brushing” (p ≤ 0.004) had a statistically and synergistic effect over the daily F dose. The present study found a social influence over the choice of dentifrice: children with a high socioeconomic status tend to use a children’s dentifrice. The amount of dentifrice used can strongly increase the risk of exposure to higher doses of F, regardless of the type of dentifrice.

Parents' perceptions of oral health conditions depicted in photographs of anterior permanent teeth

AIM

The aim of this study was to evaluate parents' perceptions of dental fluorosis and other oral health conditions depicted in photographs of anterior teeth.

MATERIALS AND METHODS

The sample comprised 120 parents (average age 39.3 years) whose children were undergoing dental treatment at the School of Dentistry of the Federal University of Minas Gerais. Seven photographs were selected: P1, open bite; P2, dental fluorosis TF 1 associated with open bite; P3, dental fluorosis TF 1; P4, midline deviation and crowding; P5, dental hypoplasia; P6, teeth without oral problems; P7, dental fluorosis TF 3. All photographs were randomly shown to all the parents, who classified the conditions observed based on a numeric scale: 0-19 (very unsatisfactory), 20-39 (unsatisfactory), 40-59 (neutral), 60-79 satisfactory and 80-100 (very satisfactory). The reasons for dissatisfaction and the possible treatment choice were examined.

RESULTS

P6 (normal teeth) was the most satisfactory photograph according to the parents (mean 61.2), and all photographs were statistically significantly different from one another (Mann-Whitney test, p ≤ 0.05), except the following pairs: P1 (mean 52.9) and P7 (mean 50.2) (p 0.537); P2 (mean 32.6) and P3 (mean 39.0) (p 0.073); and P5 (mean 18.9) and P4 (mean 18.4) (p 0.923). Alignment and crowding were considered the most prevalent problem in all cases (27.5 to 90.8% of parents) and orthodontic treatment was the most frequently cited option for treating all conditions (34.2 to 89.2% of parents).

CONCLUSION

In general, parents were dissatisfied with the oral conditions depicted in all photographs. Midline deviation associated to crowding (P4) and dental hypoplasia (P5) were considered the most unsatisfactory conditions. The most frequently cited oral problems by the parents were alignment and crowding. Orthodontic treatment was considered the best option by the majority of parents.

Fingernail may not be a reliable biomarker of fluoride body burden from dentifrice

Fingernail has been suggested as a biomarker of fluoride (F) body burden, but there is no consensus if it would be a reliable indicator of F exposure from dentifrice. Therefore, the present study was conducted to investigate if fingernails would have sensitivity to detect F exposure from dentifrice in young children. Twenty-three 1-3-year-old children living in the city of Piracicaba (0.72 ppm F in water), Brazil, were enrolled in two phases of different F exposure: in phase A (1st to 11th week), they were exposed to the combination of F from diet (solids and liquids) and dentifrice (1,500 microg F/g as MFP), and in phase B (12th to 29th week), only to F from diet (the use of F dentifrice was interrupted). Fingernails were weekly clipped during 35 weeks for F determination. F intake from diet and dentifrice in each phase was also determined. Both analyses were made with ion-specific electrode. F intake (Mean +/- SD) was significantly higher (p<0.01) when the children were exposed to F from diet+dentifrice than only to F from diet (0.086 +/- 0.032 and 0.040 +/- 0.009 mg F/day/kg body weight, respectively). However, F concentrations in nails collected during the whole experimental period of 35 weeks presented great variation with no trend of decreasing after F dentifrice intake interruption. The findings suggest that fingernail may not be a reliable F biomarker of body burden from dentifrice.

Available fluoride in toothpastes used by Brazilian children

Toothpastes should have a minimum concentration of 1000 ppm of fluoride (F) to control caries and also the active F agent must be chemically free (soluble) in the formulation. Thus, the aim of this study was to evaluate the concentration of soluble F in dentifrices used by 206 Brazilian children. The concentrations of total fluoride (TF), total soluble fluoride (TSF) and fluoride ion were determined. From these analyses, the concentrations of F as sodium monofluorophosphate (MFP) and % of insoluble F were calculated. F was analyzed with an ion specific electrode in duplicates. The majority of dentifrices used (96%) contained F and in 84% of them, TF concentration was according to that declared by the manufacturers. In the F-toothpastes, 78% showed TSF concentration ≥1000 ppm, varying from 422.3 to 1432.3 ppm F (mean ± SD of 1017.6 ± 239.4). These findings suggest that most dentifrices used by Brazilian children present available fluoride concentration for caries control.

Agreement in the diagnosis of dental fluorosis in central incisors performed by a standardized photographic method and clinical examination

The aim of this study was to assess agreement in the diagnosis of dental fluorosis performed by a standardized digital photographic method and a clinical examination (gold standard). 49 children (aged 7-9 years) were clinically evaluated by a trained examiner for the assessment of dental fluorosis. Central incisors were evaluated for the presence or absence of dental fluorosis and were photographed with a digital camera. Photographs were presented to three pediatric dentists, who examined the images. Data were analyzed using Cohen's kappa and validity values. Agreement in the diagnosis performed by the photographic method and clinical examination was good (0.67) and accuracy was 83.7%. The prevalence of dental fluorosis was reported to be higher in the clinical examination (49%) compared with the photographic method (36.7%). The photographic method presented higher specificity (96%) than sensitivity (70.8%), a positive predictive value (PPV) of 94.4% and a negative predictive value (NPV) of 77.4%. The diagnosis of dental fluorosis performed using the photographic method presented high specificity and PPV, which indicates that the method is reproducible and reliable for recording dental fluorosis.

Agreement between data obtained from repeated interviews with a six-years interval

The objective of the study was to compare information collected through face-to-face interviews at first time and six years later in a city of Southeastern Brazil. In 1998, 32 mothers (N=32) of children aged 20 to 30 months answered a face-to-face interview with structured questions regarding their children's brushing habits. Six years later this same interview was repeated with the same mothers. Both interviews were compared for overall agreement, kappa and weighted kappa. Overall agreement between both interviews varied from 41 to 96%. Kappa values ranged from 0.00 to 0.65 (very bad to good) without any significant differences. The results showed lack of agreement when the same interview is conducted six years later, showing that the recall bias can be a methodological problem of interviews.

Agreement between data obtained from repeated interviews with a six-years interval

The objective of the study was to compare information collected through face-to-face interviews at first time and six years later in a city of Southeastern Brazil. In 1998, 32 mothers (N=32) of children aged 20 to 30 months answered a face-to-face interview with structured questions regarding their children's brushing habits. Six years later this same interview was repeated with the same mothers. Both interviews were compared for overall agreement, kappa and weighted kappa. Overall agreement between both interviews varied from 41 to 96%. Kappa values ranged from 0.00 to 0.65 (very bad to good) without any significant differences. The results showed lack of agreement when the same interview is conducted six years later, showing that the recall bias can be a methodological problem of interviews.