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ABSTRACT Objective: The aim of this study was to assess dental caries and associated factors in children with Down syndrome (DS). Methods: The sample consisted of children between 6 and 12 years old being 67 with DS and 46 without DS. Caries experience and gingival bleeding index were recorded. Questionnaire with socio-demographic questions was applied to children's caregivers. Crude and adjusted prevalence ratios for caries in primary and permanent teeth were calculated by means of Poisson regression with robust variance. Results: Children with DS and without DS showed similar results for caries experience. Only age was associated with caries at permanent teeth. None of the variables were associated with caries at primary teeth in both groups of children. Conclusion: It can be concluded that social factors and access to dental services analyzed in this study were not associated with dental caries in children with DS syndrome. Furthermore, caries experience for children with DS and those without the syndrome were not different based on this study.

RESUMO Objetivos: O objetivo deste estudo foi avaliar a experiência de cárie dentária e os fatores associados em crianças com síndrome de Down (SD). Métodos: A amostra consistiu de crianças de 6 a 12 anos de idade, sendo 67 crianças com SD e em 46 sem SD. A experiência de cárie e o índice de sangramento gengival foram registrados. Um questionário sociodemográfico foi aplicado aos cuidadores das crianças. Os valores brutos e ajustados das razões de prevalência para cárie dentária foram calculados através das médias da regressão de Poisson com variável robusta. Resultados: As crianças com SD e sem SD mostraram resultados similares para experiência de cárie. Somente a idade foi associada com cárie em dentes permanentes, nenhuma das variáveis foi associada com cárie em dentes decíduos para ambos os grupos de crianças. Conclusão: Pode ser concluído que os fatores sociais e o acesso a serviços odontológicos analisados neste estudo não foram associados com cárie dentária em crianças com SD. Além disso, a experiência de cárie não diferiu entre as crianças com SD e sem SD neste estudo.

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AIMS: To evaluate the genotypic diversity and acidogenicity of Streptococcus mutans (S. mutans) and the potential association of these factors with dental caries experience in children with DS compared to non-DS children (controls). METHODS AND RESULTS: Seventeen children (age 6-12 years) with high salivary S. mutans counts (> 2.5 × 105 CFU/mL) were selected and divided into two groups: DS and non-DS. Five children in each group were caries-free, while the remainder had elevated caries experience. S. mutans isolates were obtained from each participant. The genotypic profile of the isolates was analyzed with the AP-PCR methodology. The acidogenicity of a representative strain from each genotype of S. mutans was also evaluated. DS children had 16 different S. mutans genotypes, while the control group had 21. Twelve genotypes were present in both groups and one of them was associated with caries-free status (P < .05). Although the acidogenicity of the genotypes found in DS children was significantly lower (P < .05) compared to controls, this fact was not associated with caries experience in both groups. CONCLUSIONS: DS children have a lower S. mutans genotypic diversity and genotypes with lower acidogenicity than those of non-DS children. However these findings were not associated with their caries experience.

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PURPOSE: To evaluate the relationship between salivary secretory immunoglobulin A (sIgA) concentration and dental caries in children with Down syndrome (DS) and compare it with findings in non-DS children. METHODS: The sample comprised 61 DS children and 52 non-DS children, aged 6 to 14 years. Caries experience, plaque index (PI), and gingival bleeding index (GBI) were recorded. Saliva samples were collected from all children. Total salivary sIgA concentrations were determined using an enzymatic assay method. RESULTS: Caries experience in primary and permanent dentitions were similar in DS and non-DS children. However, PI and GBI values were significantly lower in DS compared to non-DS children. DS children had higher salivary sIgA concentrations compared to non-DS children. No difference in sIgA concentration was observed between children with and without caries experience in either group. CONCLUSIONS: DS children have higher salivary sIgA concentrations than non-DS children. However, this finding did not correlate with caries experience in the study population.

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Down syndrome (DS) is the most common genetic disorder in humans, but its incidence in monozygotic twins is extremely rare. The aim of this study was to determine the factors associated with dental caries in a pair of monozygotic twin girls with DS, where one had caries experience and the other did not. Clinical examination, salivary Streptococcus mutans (S. mutans) levels and their genotypic diversity, the biochemical composition of the dental biofilm, the frequency of sucrose consumption, and toothbrushing habits were assessed from the twin girls. Twin with caries experience showed higher levels of S. mutans in the saliva and lower concentrations of calcium, phosphate, and fluoride and higher concentrations of extracellular polysaccharides in the biofilm compared to her sister. Genotypic diversity of S. mutans was also higher in the twin with caries experience. Dental biofilm composition showed different patterns of cariogenicity between the two sisters, which may also by itself explain the difference in the dental caries between them.

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BACKGROUND: Many studies have shown a lower experience of caries in people with Down syndrome compared to individuals without Down syndrome, but this issue has not been critically evaluated. AIM: To conduct a systematic review of the international literature on dental caries experience in people with Down syndrome. DESIGN: Three online databases (PubMed, LILACS, and Cochrane) were used to identify relevant studies on caries experience in people with Down syndrome published until May 2015. PICO (Patient/Population, Intervention, Comparison group, and Outcome) criteria were used to screen studies by title and abstract. An assessment of the methodological study quality was performed according to the modified Newcastle-Ottawa Scale. RESULTS: The search resulted in 226 studies. Thirteen publications were included in the systematic review. Ten studies reported results of lower caries experience in individuals with Down syndrome in at least one age group studied. Three studies reported no differences in caries experience among the groups. All studies, however, included in this systematic review had limitations that increased the likelihood of bias in the study results. CONCLUSION: There is no scientific evidence to support the hypothesis that people with Down syndrome have a lower experience of caries than non-syndromic individuals.

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BACKGROUND: The biochemical composition of the saliva and biofilm of children with Down syndrome (DS) may be associated with the incidence of caries in this population. AIM: To evaluate the biochemical composition of the saliva and dental biofilm of children with DS in the city of Porto Alegre, RS. DESIGN: The sample comprised 144 children between 6 and 14 years of age, of whom 61 had DS and 83 did not. Stimulated saliva samples were collected from all participants, as were samples of 48-h biofilm. Fluoride (F), calcium (Ca), and phosphorus (Pi ) concentrations in saliva and biofilm were determined by colorimetric method (Ca and Pi ) or selective electrode (F). The level of insoluble extracellular polysaccharide (EPS) in dental biofilm was measured using sulphuric acid method. RESULTS: Salivary concentration of F, Ca, and Pi did not differ between children with and without DS. The dental biofilm of children with DS, however, showed higher Pi and EPS levels than that of children without the syndrome (P < 0.05). CONCLUSIONS: The present results suggest that despite the salivary composition being similar between groups, the dental biofilm of children with DS has higher cariogenic potential than that of children without this condition.

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Objective: To evaluate the effect of different low-cost disinfectant solutions on Candida albicans (C. albicans) adhered to acrylic resin used in dental prosthesis.Methods: Sixty acrylic resin specimens were divided into four experimental groups according to the disinfecting agent tested (2% chlorhexidine, 1% sodium hypochlorite, vinegar and 10v hydrogen peroxide) and two control groups. Fifty specimens were incubated with C. albicans and after immersed in the disinfecting solutions or saline (negative control). Specimens without contamination constituted the positive control group. After disinfection procedures, all specimens were immersed in a culture medium and incubated for 24 hours at 37°C. Culture media turbidity was evaluated.Results: The disinfectants 2% chlorhexidine and 1% sodium hypochlorite performed a maximal reduction of C. albicans. Vinegar showed intermediate antifungal effect and 10v hydrogen peroxide showed a lower effect.Conclusions: Among the disinfecting solutions tested in the present study, 2% chlorhexidine and 1% sodium hypochlorite are the most effective in the reduction of C. albicans adhered to acrylic resin. However, vinegar may represent a viable and low-cost alternative to prosthesis disinfection.

Objetivo: Avaliar o efeito de diferentes soluções desinfetantes de baixo custo sobre Candida albicans (C. albicans) aderida a resina acrílica usada em prótese dentária.Métodos: Sessenta espécimes de resina acrílica foram divididos em 4 grupos experimentais de acordo com o agente desinfetante testado (clorexidina a 2%, hipoclorito de sódio a 1%, vinagre e peróxido de hidrogênio 10v) e 2 grupos controle. Cinquenta espécimes foram incubados com C. albicans e após imersos nas soluções desinfetantes ou salina (controle negativo). Espécimes sem contaminação constituíram o grupo controle positivo. Após os procedimentos de desinfecção, todos os espécimes foram imersos em um meio de cultura e incubados por 24 horas a 37°C. A turbidez do meio de cultura foi avaliada.Resultados: Os desinfetantes clorexidina a 2% e hipoclorito de sódio a 1% apresentaram a redução máxima de C. albicans. O vinagre mostrou efeito antifúngico intermediário e o peróxido de hidrogênio 10v apresentou o menor efeito dentre eles.Conclusões: Baseado nos resultados do presente estudo, clorexidina a 2% e hipoclorito de sódio a 1% são mais efetivas em reduzir C. albicans aderida à resina acrílica. Entretanto, o vinagre pode representar uma alternativa viável e de baixo custo para a desinfecção de próteses.

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PURPOSE: The literature on the oral health status of Down syndrome (DS) patients is controversial. Therefore, the purpose of this study was to assess the oral health status and levels of mutans streptococci (MS) in the saliva of DS children. METHODS: This study was performed with 60 DS children and 71 non-DS children aged six to 12 years old. Caries experience, plaque index (PI), and gingival bleeding index (GBI) were recorded. Information about oral hygiene habits was obtained. Saliva samples were collected to determine MS levels. RESULTS: The prevalence of dental caries was similar in children with and without DS. DS children had lower PI and GBI values and a higher toothbrushing frequency. Supervised toothbrushing by parents or guardians was more frequent in DS children and associated with lower PI and GBI. High counts of MS in saliva were associated with caries experience in DS children. CONCLUSIONS: Down syndrome children had a similar caries experience, lower plaque index, and lower gingival bleeding index values compared to children without Down syndrome. However, DS children who had caries were more likely to display high counts of mutans streptococci in saliva than non-DS children with caries.

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Objetivo: Avaliar a atividade antimicrobiana in vitro dos componentes (tirotricina, quinosol e tintura de malva) de um enxaguatório bucal contendo malva (Malvatricin®) sobre Streptococcus mutans, Lactobacillus spp. e um pool de micro-organismos da cavidade bucal. Método: Para a verificação do potencial antimicrobiano do enxaguatório bucal contendo malva (Malvatricin®) e de seus diferentes componentes, a metodologia utilizada foi a da difusão em ágar-cilindro em placas. Utilizaram-se dez placas com ágar Brain Heart Infusion para cada micro-organismo e foram testadas as seguintes soluções: Malvatricin®, tirotricina, quinosol e tintura de malva. Como controle positivo foi utilizada uma solução de clorexidina 0,12%. As placas foram incubadas por 24 horas a 37°C em anaerobiose. Após 24 horas, mensuraram-se os diâmetros das zonas de inibição. Utilizou-se o teste de Kruskal-Wallis, seguido pelo teste de comparações múltiplas, quando indicado, para comparar o efeito de cada substância sobre os micro-organismos testados. O nível de significância adotado foi de 5%. Resultados: Sobre Streptococcus mutans, Lactobacillus e um pool de micro-organismos da cavidade bucal, Malvatricin® apresentou valores de medianas 23,47; 8,61 e 11,23, respectivamente. O quinosol apresentou resultado semelhante ao de Malvatricin®, mostrando-se efetivo para inibir o crescimento microbiano de todos os micro-organismos (27,17; 9,33; 12,53). A tirotricina (0; 5,66; 0) e a tintura de malva (0; 0; 4,29) apresentaram pouca ou nenhuma atividade antimicrobiana. A clorexidina apresentou as maiores zonas de inibição frente a todos os micro-organismos testados (30,06; 15,54; 20,89). Conclusão: Os resultados do presente estudo sugerem que, dentre os componentes presentes na composição do produto comercial Malvatricin®, a substância quinosol apresenta a maior atividade antimicrobiana frente aos micro-organismos testados. E que a atividade antimicrobiana verificada para o produto comercial provavelmente deva-se à ação da substância quinosol, presente em sua composição.

Objective: To evaluate the in vitro antimicrobial activity of the components (tyrothricin, hydroxyquinoline and Malva sylvestris tincture) of a mouthwash containing Malva sylvestris (Malvatricin®) against Streptococcus mutans, Lactobacillus spp. and a pool of oral microorganisms. Method: In order to verify the antimicrobial potential of the Malva sylvestris-containing mouthwash (Malvatricin®) and its different components, was used the cylinder-agar diffusion plate methodology. Ten plates with Brain Heart Infusion agar were used for each microorganism and the following solutions were tested: Malvatricin®, tyrothricin, hydroxyquinoline and Malva sylvestris tincture. The positive control was a 0.12% chlorhexidine solution. The plates were incubated for 24 hours at 37°C in anaerobiosis. After 24 hours, the diameters of bacterial growth inhibition zones were measured. The Kruskal-Wallis test and the multiple-comparisons test (when required) were used to compare the effect of each substance against the test microorganisms. The significance level was set at 5%. Results: Malvatricin® presented medians of 23.47, 8.61 and 11.23, respectively, against Streptococcus mutans, Lactobacillus spp. and a pool of oral microorganisms. Hydroxyquinoline showed similar result to Malvatricin®, being effective to inhibit the growth of all microorganisms (27.17, 9.33 and 12.53, respectively). Tyrothricin (0, 5.66, 0, respectively) and Malva sylvestris tincture (0, 0, 4.29, respectively) showed little or no antimicrobial activity. Chlorhexidine produced the largest inhibition zones against the tested microorganisms (30.06, 15.54, 20.89, respectively). Conclusion: The results from this study suggest that among all components of Malvatricin®, hydroxyquinoline presented the greatest antimicrobial activity against the tested microorganisms, and that the antimicrobial activity of the commercial product is likely due to the action of the hydroxyquinoline present in its composition

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