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RESUMEN Objetivo: Analizar oportunidades y situaciones problemáticas para la adopción del paradigma actual de caries dental, desde las reflexiones de docentes, acerca de aspectos curriculares y de los planes de estudio de los programas de odontología pertenecientes a la Asociación Colombiana de Facultades de Odontología. Metodología: Construcción participativa (n=44 docentes). Se realizaron grupos de discusión y entrevistas semiestructuradas con profesores del área de cariología e integrantes del comité de currículo, para acercarse al contenido de los planes de estudio, entendidos como expresión de la orientación curricular. Resultados: Se consideraron para el análisis 2 categorías: la primera, relacionada con las oportunidades identificando una tendencia que mostró la presencia de la temática de caries dental a lo largo de todo el plan de estudios. En la segunda se identificaron 4 tendencias relacionadas con situaciones problemáticas, y una de ellas reportó que la enseñanza de la caries dental continúa anclada en el enfoque de riesgo, con un escaso acercamiento a la dimensión social de la enfermedad, la otra planteó que en los aspectos teóricos hay una aproximación al paradigma actual, pero en la clínica predomina la concepción tradicional de la enfermedad; y el énfasis restaurativo. La tercera tendencia deja ver que se relacionan las teorías actuales de cariología con la adopción de algunos criterios diagnósticos. Por último, un manejo predominante respecto al paradigma actual de caries por parte de los Odontopediatras. Conclusión: Persisten concepciones reduccionistas de salud y de educación en los enfoques curriculares, que se reflejan en planes de estudio fragmentarios, poco posibilitadores de la incorporación del paradigma actual de caries dental.

ABSTRACT The Global Alliance-for-a-Cavity-Free-Future Colombian Chapter has embraced since 2010 to achieve by 2015 a national-wide cariology-teaching consensus on the new- caries paradigm as a disease continuum, with a series of stages from early to cavitated lesions. Aim: To analyse the opportunities and problematic situations around dental education in the new-caries paradigm from the curriculum perspective in the Colombian Dental Schools Association. Methodology: Two teachers from each school (n=23) were invited to participate: the responsible of most-caries teaching and the representative of curricular design (n=46). Discussion groups were conducted to analyse within the curriculum, facilitanting or limiting aspects, the new-caries paradigm incorporation process. These were complemented with a caries-management-guideline questionnaire answered by each school. Results: 44 teachers of 22 schools participated. Within the opportunity category, a relevant trend was found related with the presence of cariology as a transversal axis of the curriculum. In the problematic situations category, four trends were observed: 1. Cariology teaching continues being linked to the risk approach, without embracing the social dimension of the patology; 2. In the theoretical aspects related with cariology, there is an approximation to the new paradigm, but in the clinical practice the traditional patology conception and the restorative emphasis predominate; 3. The current evidence of cariology is related to the adoption of the diagnostic criteria; and 4. There is a predominant caries-new paradigm management within the paediatric dentists. Conclusion: Caries cirricula delivered in University dental schools in Colombia are fragmented and require the incorporation of the new caries paradigm.

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Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists' awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar's tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.

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Resumen Introducción y objetivo: la ortodoncia se considera una especialidad clínica ejercida tradicionalmente en el marco de la práctica liberal independiente, sin embargo, los cambios en las dinámicas del mundo laboral, ameritan realizar monitoreo permanente de condiciones laborales de graduados de especialidades odontológicas. Describir las condiciones laborales y la satisfacción con el ejercicio profesional de los graduados del programa de ortodoncia, Universidad Cooperativa de Colombia, Sede Medellín. Materiales y métodos: estudio descriptivo transversal sobre el total de la población de graduados del programa. La información se recolectó a través de una encuesta. Se realizó análisis univariado para la descripción de la información y análisis bivariado para explorar asociaciones. Resultados: la frecuencia de respuesta fue del 65% y la totalidad de los participantes reportó un tiempo menor a 6 meses para su inserción laboral. Se estableció con mayor frecuencia contratación por prestación de servicios. En general, la satisfacción con el ejercicio profesional fue alta, sin embargo, un 39,4% reportó mediana o baja satisfacción con el tipo de contrato. El sexo se encontró asociado al número de horas laboradas semanalmente. Conclusiones: las condiciones de los graduados son favorables en ciertos aspectos, entre ellos, la inserción al mercado laboral en corto tiempo. Asimismo, los ingresos están en rango alto frente a los promedios del país, sin embargo, se requieren estudios que amplíen el análisis acerca de aspectos como el tipo de contratación, las horas laboradas y elementos de flexibilización laboral que pueden llevar a un deterioro progresivo del ejercicio profesional de los especialistas.

Abstract Introduction and objective: orthodontics is considered a clinical specialization that has been traditionally practiced in an independent fashion. However, working conditions for graduates from dental specialties need to be monitored due to dynamic changes of the working world. To describe the working conditions and level of satisfaction of graduates from the Orthodontics program at Universidad Cooperativa de Colombia, Medellin campus. Materials and methods: transversal descriptive study that considered the total population of graduates from the program. Information was collected by the use of a previously validated survey. A univariate analysis for description of information and a bivariate analysis to explore possible associations were carried out. Results: frequency of response was 65% and the whole population reported finding a job within the first six months after graduation. Provision of services was the most frequent form of contract. In general, the level of satisfaction was high, but 39.4% of the population reported average or low satisfaction, especially regarding the type of contract. Gender was associated with number of weekly worked hours. Conclusions: conditions for graduates are favorable in some areas, including the fact that occupation was readily found. Likewise, income is high when compared to average salaries in the country. However, further studies are required to expand the analyses of different aspects, such as type of contract, working hours and elements of working flexibilization that might lead to a deterioration in the professional services provided by these specialists.

Resumo Introdução e objetivo: A ortodontia é considerada uma especialidade clínica exercida tradicionalmente no âmbito da prática liberal independente. Porém, as mudanças na dinâmica do mundo do trabalho merecem acompanhamento permanente das condições de trabalho dos graduados das especialidades odontológicas. Descrever as condições de trabalho e o grau de satisfação com a prática profissional dos graduados do programa de ortodontia da Universidad Cooperativa de Colombia, campus de Medellín. Materiais e métodos: Estudo transversal descritivo sobre a população total de formados do programa. A informação foi recolhida através de um inquérito previamente validado. Foi realizada uma análise univariada para descrever a informação e uma análise bivariada para explorar associações. Resultados: A frequência de resposta foi de 65% com todos os participantes a relataram um tempo inferior de 6 meses para a sua inserção laboral. Foi determinada com maior frequência a contratação para prestação. Em geral, a satisfação com a prática profissional foi elevada, porém 39,4% relataram uma satisfação média ou baixa, especificamente com o tipo de contrato. O número de horas trabalhadas por semana foi associado ao sexo. Conclusões: As condições dos graduados são favoráveis em certos aspetos, entre os quais, a inserção no mercado de trabalho num curto espaço de tempo. Similarmente, os rendimentos estão num nível alto em comparação com as médias do país; contudo, são necessários mais estudos a fim de alargar a análise a aspectos como o tipo de contratação, as horas trabalhadas e os elementos de flexibilidade laboral que podem levar a uma deterioração progressiva na actividade profissional dos especialistas.

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OBJECTIVES: Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS: In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS: The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION: The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.

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ABSTRACT Introduction: in Colombia, educational and preventive strategies to improve oral health in early childhood have been developed, but few evaluative studies have been conducted to assess their results. The aim of this study was to assess the knowledge on early childhood oral care acquired by education agents after participating in an educational strategy, and to evaluate the results of the implementation of the Ministry of Health's preventive protocol "I am a more smiling generation" (Soy una generación más sonriente). Methods: this was a mixed-focus study. The qualitative component was a participatory assessment of learning. It involved 45 education agents registered in a state program, who participated in workshops and focus groups. The quantitative component was a longitudinal study with the participation of 54 mother-child pairs belonging to the same program. The preventive protocol was applied three times over a twelve-month period. It included educational reinforcement and application of fluoride varnish to the children, using oral examination and assessment of their dental caries risk, as well as a survey to identify the families' social conditions. Results: after applying the preventive protocol, the average carious teeth in children decreased from 3.1 teeth in the first examination to 2.2 in the third one. Prior to application of the preventive protocol, 49% of children had a high risk of developing cavities and in the last visit 63% were at low risk while 5.6% were at high risk. A number of positive aspects result from this learning assessment, including the adoption of new pedagogical strategies to accompany children during oral care practices; there are also some aspects to improve in relation to the persistence of conflicting knowledge concerning children's rights to oral health. Conclusion: following the application of the preventive protocol, the children's average carious teeth decreased, as well as their risk for dental caries. Educational agents acquired new knowledge, but uniform knowledge in terms of children's health rights is still lacking.

RESUMEN Introducción: en Colombia se han desarrollado estrategias educativas y preventivas orientadas a mejorar la salud bucal de la primera infancia, pero son pocos los estudios evaluativos para valorar sus resultados. El objetivo de este estudio consistió en evaluar los aprendizajes en cuidado bucal durante la primera infancia, adquiridos por agentes educativos luego de su participación en una estrategia educativa, y valorar los resultados de la implementación del protocolo preventivo "Soy generación más sonriente" del Ministerio de Salud. Métodos: estudio con enfoque mixto. El componente cualitativo fue una evaluación participativa de aprendizajes con 45 agentes educativos pertenecientes a un programa estatal, quienes participaron en talleres y grupos focales. El componente cuantitativo fue un estudio longitudinal. En este participaron 54 binomios madre-hijo pertenecientes al mismo programa. Se aplicó el protocolo preventivo en tres momentos por un periodo de doce meses, el cual consistió en refuerzo educativo y aplicación de barniz de flúor al niño. Se utilizaron como herramientas el examen bucal y la valoración del riesgo de caries dental del niño, y se aplicó una encuesta para identificar la posición social de las familias. Resultados: luego de la aplicación del protocol preventivo disminuyó el promedio de dientes cariados en el niño, pasando de 3,1 dientes en el primer examen a 2,2 en el tercero. Antes de la aplicación del protocolo preventivo, el 49% de los niños presentó riesgo alto de caries, y en la última visita el 63% pasó a bajo riesgo y el 5.6% quedó en alto riesgo. Como resultados de la evaluación de aprendizajes se destacan aspectos positivos, entre ellos la adopción de nuevas estrategias pedagógicas para el acompañamiento al niño durante la realización de las prácticas de cuidado bucal, y aspectos a mejorar, en relación con la persistencia de saberes contradictorios frente a los derechos en salud bucal de la niñez. Conclusión: luego de la aplicación del protocolo preventivo disminuyó el promedio de dientes cariados y el riesgo de la caries dental en los niños. Los agentes educativos incorporaron nuevos aprendizajes, pero aún no hay conocimientos unificados en el tema de derechos en salud de la niñez.

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Background: Early tooth loss is recognized as a public health problem not only in Colombia but also worldwide. This phenomenon has been approached by positive research, but the approach hasn't been enough from social outlooks. Aim: to understand tooth loss related experiences and reveal the implications of social and emotional interactions of children and teenagers. Methods: Qualitative cross sectional study, this study collects elements of phenomenological approach and method. In data construction, ten children and teenagers with tooth loss were deeply interviewed. Data condensation in significance units was made for the analysis. several trends emerged around those units. Results: among the highlight trends, shame and acquiescence appeared after tooth loss, also dental pain were a key factor to choose dental extraction as a choice. To be afraid of the dentist and the dental attention process were related to the problem. Conclusion: this study contributed to the comprehensive setting extension, revealing shame and fear as emerged emotions through tooth loss suffering. Besides transforming actions in the macro-social level, it is required to build educational process that helps to overcome the imaginary relationship between dental practice and painful experiences and to generate skills that provide a humanized dental practice over an instrumental dental practice in order to change these realities.

Antecedentes: La pérdida dental temprana es reconocida como una problemática de salud pública en Colombia y en otros países del mundo. El fenómeno ha sido abordado por la investigación de enfoque positivo, pero es insuficiente la aproximación desde perspectivas sociales. Objetivo: Comprender las experiencias relacionadas con la pérdida dental y develar implicaciones para la interacción social y emocional de niños y jóvenes. Materiales y Métodos: Estudio cualitativo que retoma elementos del enfoque y método fenomenológico. En la construcción de los datos participaron veinte niños y jóvenes con antecedentes de perdida dental. Se realizó entrevista en profundidad a los participantes. El análisis consistió en un proceso de condensación de los datos en unidades de significado, alrededor de las cuales emergieron varias categorías de análisis. Resultados: Entre las categorías emergentes, se destaca la aparición de emociones como la vergüenza y la resignación luego de perder los dientes. Así mismo la experiencia de dolor fue significativa y guio la decisión de optar por la extracción dental. El miedo al odontólogo y al proceso de atención odontológica fueron reconocidos como aspectos relacionados con la problemática. Conclusión: El estudio contribuyó a la ampliación de los marcos comprensivos, develando que la pérdida dental es un padecimiento atravesado por emociones como la vergüenza y el miedo. Transformar estas realidades, requiere además de la implementación de acciones en lo macro social, construir procesos educativos orientados a superar el imaginario que asocia la práctica odontológica con experiencias dolorosas, y generar capacidades que posibiliten el ejercicio de una práctica profesional más humana que instrumental.

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ABSTRACT. Introduction: identifying inequalities in health is a step towards inequity analysis, a topic that concerns various oral health stakeholders. The aim of the present study was to identify the distribution of indicators of early childhood caries experience. Methods: descriptive study based on data obtained from the baseline study on health indicators in 623 children under six years of age from the municipality of Andes (Antioquia) in 2015. The presence and severity of dental caries lesions were recorded following the International Caries Detection and Assessment System (ICDAS), calculating the indexes of decayed, missing, and filled surfaces surface due to caries (dICDAS5-6 dICDAS6 mfs and dICDAS1-6 mfs), as well as Lorenz curves and Gini coefficients for the accumulated frequencies of both indicators. Results: an average dICDAS5-6 mfs of 3.3 ± 7.4 was found as follows: 3.5 ± 8.0 in the rural area and 2.7 ± 5.7 in the urban area. The average dICDAS1-6 mfs was 14.3 ± 15.1, with statistically significant differences by area of residence: 15.7 ± 15.8 in the rural area and 11.3 ± 12.8 in the urban area. The analysis with Lorenz curves showed inequality in distribution of caries experience. The Gini coefficients were 0.412 for dICDAS5-6 mfs and 0.284 for dICDAS1-6 mfs. Conclusion: the analyses show a skewed distribution of dental caries in children under the age of six, and a greater inequality in terms of indicators of dental caries experience in its severe form in the municipality of Andes.

RESUMEN Introducción: la identificación de desigualdades en salud es un paso hacia el análisis de inequidades, tema que preocupa a diversos actores relacionados con la salud bucal. El objetivo del presente estudio consistió en identificar la distribución de los indicadores de experiencia de caries dental por superficies en la primera infancia. Métodos: estudio descriptivo a partir de los datos obtenidos en el estudio de línea de base de indicadores de salud en 623 niños y niñas menores de seis años de edad del municipio de Andes (Antioquia) en 2015. La presencia y severidad de las lesiones de caries dental se registró según el Sistema Internacional para la Detección y Evaluación de Caries (ICDAS). Se calcularon los índices de superficies cariadas, obturadas y perdidas por caries dental (c ICDAS5-6 ops y c ICDAS1-6 ops), las curvas de Lorenz y los coeficientes de Gini para las frecuencias acumuladas de ambos indicadores. Resultados: se encontró un c ICDAS5-6 ops promedio de 3,3 ± 7,4, así: 3,5 ± 8,0 en la zona rural y 2,7 ± 5,7 en la urbana. El promedio del c ICDAS1-6 ops fue 14,3 ± 15,1, con diferencias estadísticamente significativas por zona de residencia: 15,7 ± 15,8 en la rural y 11,3 ± 12,8 en la urbana. El análisis de la curva de Lorenz mostró desigualdad en la distribución de la experiencia de caries. Los coeficientes de Gini fueron 0,412 para el cops y 0,284 para el c ICDAS1-6 ops. Conclusión: los análisis evidencian una distribución sesgada de la caries dental en los niños y niñas menores de seis años, y una mayor desigualdad en los indicadores de experiencia de caries dental en su forma severa en el municipio de Andes.

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Resumen (descriptivo): A partir de la revisión de fuentes primarias y secundarias, procedimos a develar algunas de las formas de enunciación de la niñez indígena, saberes y prácticas en salud. Intentamos reconocer este lugar de la niñez indígena en el marco de diversas formas de vivir, de concebir la salud y de enfrentar la enfermedad, opacadas históricamente. En este recorrido se analizan, desde una perspectiva crítica, múltiples relaciones en las que se tejen significados en torno a ser niño o niña indígena, vivir, morir, ser un sujeto cuidado y valorado o en muchas ocasiones invisibilizado. Estos significados son difíciles de establecer por la historia de exclusión a la que han estado sometidos los pueblos originarios; sin embargo, ofrecemos elementos que pueden ser de utilidad como punto de partida para realizar futuras investigaciones.

Abstract (descriptive): After reviewing numerous primary and secondary sources, this article examines different studies that have explored knowledge and practices in health related to indigenous childhood. The authors seek to acknowledge the place of indigenous childhood within different ways of life, the concept of health and dealing with diseases that have historically been concealed. The complicated network of relations that leads to a vast amount of meanings on how to be an indigenous boy or girl, how to live or die, how to be looked after and valued, and on many occasions and how to become invisible are all analyzed. These meanings are difficult to establish due to the long history of exclusion suffered by the indigenous population in Colombia. Nevertheless, they provide elements that may be useful as a starting point for future research.

Resumo (descritivo): A partir da revisão de fontes primárias e secundárias, procedeu-se a desvendar algumas das formas de enunciação das crianças indígenas, de conhecimentos e de práticas de saúde. Tentou-se reconhecer o lugar das crianças indígenas no contexto de várias formas de vida, de conceber a saúde e de enfrentar as doenças historicamente ofuscadas. Neste percurso, se analisam múltiplas relações das quais tem importância ser menino ou menina indígena, viver, morrer, ser cuidado e valorizado ou muitas vezes invisível. Esses significados são difíceis de estabelecer devido a exclusão que têm sido submetidos os povos indígenas; No entanto, são fornecidos itens que podem ser úteis como um ponto de partida para a investigação futura.

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Resumen La falta de información de la situación de caries dental en la primera infancia en Andes, limita las acciones en el marco de la Alianza por un Futuro libre de Caries. Objetivo: establecer la situación de caries dental de los niños y niñas de 0 a 5 años del Municipio de Andes (Colombia). Metodología: fueron examinados 623 niños y niñas para evaluar la presencia y severidad de las lesiones de caries, con base en criterios del Sistema Internacional para la detección y evaluación de caries - ICDAS. Se calcularon las proporciones de experiencia y prevalencia de caries dental, y los índices cICDAS 5-6 opd y cICDAS 1-6 opd. Resultados: el 38,2% tenía experiencia de caries dental severa, cuando se incluyen las lesiones iniciales y moderadas de caries dental la experiencia fue 88,4%. Al año de edad, el 4,9% tenía lesiones severas de caries dental, y a los 5 años el 53,6% presentó este tipo de lesiones. El índice cICDAS 5-6 opd fue 0,15±0,8 al año de edad y 2,79±3,6 a los 5 años; el valor del indicador aumenta a 1,97±2,9 y 9,61±4,6 respectivamente, cuando se incluyen lesiones iniciales y moderadas de caries dental, cICDAS 1-6 opd . Discusión: la enfermedad está presente desde el primer año en el 58,8%, el doble de lo reportado en el país a esta edad (29,3%). Conclusión: los hallazgos resaltan la necesidad de diseñar estrategias integrales para el control de la enfermedad, que involucren la salud bucal en políticas y programas de primera infancia.

Abstract The lack of information on dental caries limits the actions of the program called "Alliance for a Cavity Free Future" in the Andes municipality, Colombia. Objective: to establish a baseline for dental caries in primary dentition among children aged 0 to 5. Methods: a total of 623 children were examined in order to detect the presence of dental caries and its severity. This analysis was conducted using the criteria of the International Caries Detection and Assessment System, ICDAS. In addition, the experience and prevalence ratios were calculated along with the cICDAS 5-6, mft and cICDAS 1-6 mft indices. Results: 38.2% of the children had experienced severe caries (dICDAS 5-6 mft>0); the percentage of caries experienced increased to 88.4% when initial and moderate dental caries lesions were included (dICDAS 1-6 mft>0). The data showed that 4.9% of the one-year-olds had untreated severe carious lesions, and this percentage increased to 53.6% for five-year-olds. The dICDAS 5-6 mft index was 0.15±0.8 for one-year-olds and 2.79±3.6 for five-year-olds, increasing to 1.97±2.9 and 9.61±4.6, respectively when initial and moderate dental caries lesions were included - dICDAS 1-6 mft. Discussion: dental caries is present from the first year in 58.8% of children, this is twice the amount reported for Colombia and for the same age (29.3%). Conclusion: the findings highlight the need to design comprehensive strategies for controlling the disease. Such strategies should include oral health in the early policies and programs dealing with early childhood.

Resumo A falta de informação sobre a situação de cáries dentárias na primeira infância no município Andes limita as ações no âmbito da Aliança para um Futuro Livre de Cáries. Objetivo: estabelecer a situação das cáries dentárias nas crianças entre 0-5 anos do Município Andes, Colômbia. Metodologia: foram examinadas 623 crianças visando avaliar a presencia e severidade das lesões de cáries, com base nos critérios do Sistema Internacional de Avaliação e Detecção de Cáries -ICDAS. Calcularam-se as proporções de experiência e prevalência de cáries dentarias, e os índices cICDAS 5-6 opd e cICDAS 1-6 opd. Resultados: 38,2% tinha experiência de cárie dentária severa. Incluindo as lesões iniciais e moderadas de cárie dentária, a experiência foi de 88,4%. Com um ano de idade, 4,9% tinha lesões severas de cárie dentária, e com 5 anos 53,6% tinha este tipo de lesões. O índice de cICDAS 5-6 opd foi 0,15±0,8 com um ano de idade, e de 2,79±3,6 com 5 anos. O valor do indicador aumenta a 1,97±2,9 e 9,61±4,6 respectivamente, incluindo as lesões iniciais e moderadas de cárie dentária, cICDAS 1-6 opd. Discussão: a doença está presente desde o primeiro ano de idade em 58,8%, que é duas vezes o que se notifica no país para esta idade (29,3%). Conclusão: os resultados ressaltam a necessidade de conceber estratégias para controlar esta doença, incluindo a saúde bucal nas políticas e programas de primeira infância.