Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document

Parental awareness and dental health behavior of children with congenital heart disease, with diabetes mellitus, or undergoing anti-cancer treatment, compared to healthy children

Introduction

Children with chronic diseases tend to experience a considerably higher burden of oral disease compared to their healthy peers. Low awareness of the impact of systemic diseases on oral health, lack of motivation, and discomfort may render the maintenance of good oral hygiene challenging. We conducted a study of four groups of parents: of children with congenital heart disease (CHD), with diabetes mellitus type 1 (DM), and undergoing anti-cancer treatment (ACT); and a control group of healthy children (C). We aimed to compare between the groups, parental attitudes and knowledge of their children's oral health, and their reports of their children's dental habits.

Methods

Parents who arrived with their children for routine check-ups at three main clinics: cardiology, endocrinology, and hematology-oncology were asked to respond to a questionnaire regarding their children's oral and dental health.

Results

A total of 287 questionnaires were collected from 76 parents of children with CHD, 100 parents of children with DM, 50 parents of children undergoing ACT, and 61 parents who comprised group C. Compared to the CHD and DM groups, the ACT group demonstrated significantly more awareness of the importance of maintaining oral and dental health following diagnosis of their children's medical condition. Mothers' education was found to correlate with dental health knowledge. Most children in the DM and C groups had previous dental examinations, compared to only half in the CHD and ACT groups. A higher proportion of the children in the C than the other groups brushed teeth twice daily. The groups were similar in their consumption of sugary drinks, and of sweets and snacks. The children's specialist physicians were the main source of information on oral health, especially in the ACT group.

Conclusions

Although most of the parents reported awareness to the oral health aspects of their children's disease, only part of them reported that their children visited dentists, and brushed their teeth twice daily. For the parents of children with CHD, DM, and ACT, their children's treating specialists were the primary source of information regarding oral health. This highlights the importance of clear and continuous communication between pediatric specialists and dentists.

Synthesis of novel silver-loaded clay AgF@Hec for the prevention of dental cariesin vitro

Dental caries, a chronic infectious disease characterized by tooth mineral loss caused by plaque, is one of the major global public health problems. Silver diamine fluoride (SDF) has been proven to be a highly effective anti-caries drug due to its high bacterial inhibition and remineralization ability. However, the SDF solution is unstable, which immensely limits its clinical application. Therefore, new silver-load clay named AgF@Hec was designed by replacing the NH3with hectorite in this study. Fourier transform infrared spectroscopy and x-ray diffraction spectroscopy were employed to confirm the structure of AgF@Hec. Dynamic light scattering analysis was used to reveal the effect of different hectorite concentrations on the stability of AgF@Hec. Moreover, AgF@Hec exhibits significant remineralization and hardness recovery of the initial carious lesions. Bacteriostatic experiments also proved that it has a significant inhibitory effect onA. Viscosus, S. mutans, S. sanguinis, S. salivarius, Lactobacillus sp.and both gram-positive and gram-negative bacteria. We therefore believed that AgF@Hec should be a promising biomaterial that can be applied in the prevention of dental caries.

[Tooth and pregnancy, a public health issue]

Pregnancy is a particularly risky moment for periodontal and oral healthcare. The main diseases encountered are the development or worsening of carious lesions and gestational periodontal diseases such as gingivitis, epulis or gestational periodontitis. There is a lack of knowledge from health professionals and their patients, firstly on the link between poor oral hygiene and the impact on pregnancy, and secondly on the feasibility of oral care during pregnancy. There is a link between periodontal diseases and the increase of premature delivery risk, child with low birth weight and pre-eclampsia. Periodontal care during pregnancy would lower this risk. However, no link has been highlighted to date between oral care provided during pregnancy and the reduction of premature delivery or even of pre-eclampsia. Loco-regional anaesthesia and taking x-ray images-even dental panoramic radiography-are not contraindicated for pregnant women. All periodontal and oral care can be performed during pregnancy, at all gestational ages.

Caries and quality of life in portuguese adolescents: Impact of diet and behavioural risk factors

Background

The aim of this study was to assess the impact of diet and behavioural risk factors on caries appearance, and on oral health-related quality of life (OHRQoL) among Portuguese adolescents.

Material and Methods

An epidemiological study conducted on 782 adolescents between 11-17 years, from randomly selected public schools of the 3rd cycle of basic education. All participants were asked for self-perceived general status health, about tooth-brushing habits and about the using of toothpaste with fluoride and a Food Frequency Questionnaire. The DMFT index (decayed, missing and filled teeth) was evaluated according to WHO criteria. To evaluate the OHRQoL, the 49-items Oral Health Impact Profile questionnaire (OHIP-49) was applied.

Results

Consumption more than once a week of tea with sugar, milk with sugar and biscuits were significantly associated with DMFT index. Lower levels in OHRQoL was reported by students who consumed frequently (more than once a week) fast food, chocolate flakes and those who brushed their teeth once a day or less frequently instead of 2-3 times a day.

Conclusions

Frequency of consumption of sweetened/fast food was a significant factor associated with caries and quality of life.

Key words:Oral health-related quality of life, adolescent, diet, DMFT, epidemiology.