RESUMEN
AIM: To assess in a pilot study the prevalence and severity of dental caries among pregnant women compared to non-pregnant women in the state of Rio de Janeiro, Brazil. MATERIALS AND METHODS: A cross-sectional, observational study was conducted. Data collection consisted of clinical examinations and general questionnaires concerning oral hygiene habits and recent dental visits of pregnant and non-pregnant women. Prevalence and severity of caries was determined by the CAST index and the CAST severity score. Permission for this study was granted by the National Research Ethics Commission of Brazil. Written informed consent was obtained from all participants. RESULTS: In total, 67 pregnant women were included (mean age (SD) 25.5 ± 5.4 years) and 79 non-pregnant women (26.0 ± 5.3 years). Mean number of teeth with untreated caries (CAST 4-7) among pregnant women was significantly lower (1.2 ± 1.8) compared to non-pregnant women (2.7 ± 4.0; Mann-Whitney test, p = 0.027). In both groups, 40-60% were in need of curative treatment. There was no significant difference between the two groups in frequency of dental visits (p > 0.05), but pregnant women brushed their teeth more often (Mann-Whitney test, p < 0.001). CONCLUSION: Pregnant women in the state of Rio de Janeiro have fewer untreated caries and less severe dental caries compared to non-pregnant women. Still, half of all women in this study are in need of curative treatment for at least one tooth. Effective preventive programs should therefore be developed to stimulate preventive oral care among all women.
Asunto(s)
Caries Dental , Mujeres Embarazadas , Humanos , Femenino , Embarazo , Adulto Joven , Adulto , Salud Bucal , Prevalencia , Brasil/epidemiología , Estudios Transversales , Caries Dental/epidemiología , Proyectos Piloto , Índice CPORESUMEN
Studies on dental caries suggest that in severe cases it may induce a systemic immune response. This occurs particularly when caries progresses into pulpal inflammation and results in abscess or fistula formation (AFF). We hypothesized that severe dental caries will affect the general health of children. The acute phase proteins alpha-1-acid glycoprotein (AGP), C-reactive protein (CRP) and the cytokine neopterin were chosen as parameters to monitor general health. Also, a polymorphism in the bacterial ligand CD14 (-260) was studied to investigate the relationship between genotype sensitivity for bacterial infections and AFF. In Suriname, children aged 6 years were recruited and enrolled into a dental care scheme, randomly assigned to 4 groups with different treatment strategies and monitored longitudinally. 348 children were included in the present study. Blood and saliva samples were taken at baseline and 1 year, and concentrations of serum AGP, CRP, neopterin, salivary Streptococcus mutans and CD14-260 C>T polymorphism were determined. There was no significant association between different treatment strategies and the serum parameters. Binary logistic regression analyses revealed a significant association between AFF as the outcome variable and the CD14 genotype and the concentrations of CRP and of neopterin as factors (p < 0.05). A significant negative association was found between the CD14-260 TT and AFF (p = 0.035, OR = 3.3) for the whole population. For children who had 4 or more carious lesions at baseline, the significance increased (p = 0.005, OR = 4.8), suggesting that the CD14-260 TT genotype was protective for AFF as a consequence of dental caries.
Asunto(s)
Susceptibilidad a Caries Dentarias , Caries Dental/inmunología , Proteína C-Reactiva/análisis , Niño , Citosina , Índice CPO , Caries Dental/microbiología , Caries Dental/terapia , Fístula Dental/inmunología , Fístula Dental/microbiología , Restauración Dental Permanente , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad/genética , Genotipo , Estado de Salud , Humanos , Receptores de Lipopolisacáridos/genética , Estudios Longitudinales , Masculino , Neopterin/análisis , Neopterin/sangre , Orosomucoide/análisis , Absceso Periapical/inmunología , Absceso Periapical/microbiología , Polimorfismo Genético/genética , Saliva/química , Saliva/microbiología , Streptococcus mutans/inmunología , Streptococcus mutans/aislamiento & purificación , Suriname , Timina , Extracción DentalRESUMEN
This study is aimed at determining whether a commercially available varnish, containing 40% chlorhexidine, is able to reduce the numbers of mutans streptococci and lactobacilli in saliva, in a moderately caries-active population in Surinam. 238 children, ages 13-14 years, were selected from different schools in Paramaribo, Surinam. From these children, total dental status was recorded and saliva samples were taken. At baseline and every 6 months, a 40% chlorhexidine varnish (EC40) was applied. The control group received a neutral gel that did not contain chlorhexidine. The numbers of salivary mutans streptococci and lactobacilli were calculated by standard methods, and the caries status was recorded every 12 months. The study lasted 30 months. The results indicate that chlorhexidine varnish did not decrease the numbers of cariogenic bacteria, nor did it decrease caries progression. Moreover, in this population with a low dental health care, children with lactobacilli present in the saliva above our detection level, the chlorhexidine varnish even tended to increase caries progression, possibly due to selection of aciduric and acidogenic oral bacterial species. We therefore conclude that 40% chlorhexidine varnish is not likely to decrease caries in children in a high-treatment-need population without treatment of the sources of infection.