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OBJECTIVES: Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. METHODS: A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24-month follow-up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention-to-treat (ITT) approach was used for the primary analysis. RESULTS: We included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow-up showed a between-group prevention fraction of 18.9% (-2.9%-36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported. CONCLUSIONS: In conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries.

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Introduction: early Childhood Caries (ECC) is a serious public health concern worldwide, especially in communities without water fluoridation. Objective: To determine the prevalence of ECC in 2 and 3 year old children attending rural daycare centers without access to water fluoridation. Methods: A cross-sectional study at community level was performed during 2012. The eligible population was composed of 2 and 3 year-old children from rural daycare centers located in nonfluoridated areas in regions La Araucania, Los Rios, and Los Lagos, Chile. Four calibrated examiners (ICC=0.83) measured the prevalence of dental caries based on criteria proposed by the WHO. Data were analyzed using chi-square test, t-test and logistic regression models. Results: The study sample consisted of 587 children; two-year-olds accounted for 53.32 percent, and 52.47 percent were female. Prevalence of ECC was 51.62 percent with a mean dmft index of 2.53. Region de la Araucania had the highest ECC prevalence (52.79 percent). Variables that showed association were age, OHI-S and type of health insurance coverage (p<0.05). Conclusion: A high prevalence of ECC was found in areas with a non-fluoridated water supply.

Introducción: la Caries temprana de la infancia (CTI) constituye un serio problema de salud pública a nivel mundial, sobre todo en zonas rurales sin acceso a agua florada. Objetivo: Determinar la prevalencia de CTI en niños de 2 y 3 años que asisten a jardines infantiles sin acceso agua potable florada. Métodos: Se realizó un estudio de corte transversal a nivel comunitario durante el 2012. La población elegible fueron niños de 2 y 3 años asistentes a Jardines rurales de zonas no fluoradas de las regiones de La Araucanía, Los Ríos y Los Lagos. Cuatro examinadores calibrados (ICC= 0,83) determinaron la prevalencia de caries usando los criterios propuestos por la OMS. La información fue analizada utilizando el test chi cuadrado, la prueba t-test y modelos de regresión logística. Resultados: La muestra quedo constituida por 587 niños de los cuales el 53,32% tenían 2 años y el 52,47 por ciento eran mujeres. La prevalencia de CTI fue de 51,62 por ciento con un índice ceod promedio de 2,53. La región con más alta prevalencia fue la Araucanía con un 52,79 por ciento. La variables que mostraron asociación fueron edad, IHO-S y previsión (p<0,05). Conclusión: La prevalencia de CTI en las zonas rurales sin agua florada es alta.

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Se realizó un estudio de tipo descriptivo, a través del análisis de contenido, con la finalidad de conocer las percepciones de los estudiantes de odontología sobre la enseñanza de la bioética en el currículo de la carrera de Odontología de la Universidad de la Frontera. La recolección de los datos se realizó mediante la técnica de grupos focales, en dos sesiones de doce alumnos cada uno, representados por dos alumnos de los diferentes niveles de la carrera. La interrelación entre los participantes se estimuló a través de una pauta de conducción previamente diseñada. Los datos, registrados a través de grabaciones, fueron transcritos para el análisis de contenido, efectuado manualmente mediante triangulación entre los investigadores. A partir del análisis de contenido de los datos primarios, se estableció una serie de categorías, agrupadas en cuatro grandes dimensiones: concepto de bioética, importancia de la bioética en el ejercicio profesional, enseñanza-aprendizaje de la bioética y modalidad de enseñanza de la bioética. Los estudiantes de odontología de la Universidad de la Frontera transitan de manera muy asertiva por los tópicos que componen la compleja dimensión de la enseñanza de la bioética y reconocen la importancia de la bioética en su formación.

A descriptive study was carried out through content analysis, with the goal of knowing the perceptions of dentistry students about bioethics training in Dentistry curriculum of Frontera University. Data collected was carried out through focal group technique in two sessions of 12 students each, represented by two students from de different levels of the career. The interrelation among participants was stimulated through a guide for conduction previously designed. Data registered through tape recording were transcribed for content analysis, carried out manually by triangulation among researchers. Several categories were established by content analysis of primary data, grouped in four big dimensions: concept of bioethics, importance of bioethics in professional exercise, teaching-learning of bioethics and modality of teaching of bioethics. Dentistry students of Frontera University walked in assertive way through issues belonging to the complex dimension of bioethics training and recognize the importance of bioethics in their training.

Foi realizado um estudo de tipo descritivo, através da análise de conteúdo, com a finalidade de conhecer as percepções dos estudantes de odontologia sobre o ensino da bioética no currículo do curso de Odontologia da Universidad de laFrontera. A coleta dos dados foi realizada mediante a técnica de grupos focais, nas seções de doze alunos cada uma, representados por dois alunos dos diferentes níveis do curso. A inter-relação entre os participantes foi estimulada por meio de uma pauta de condução previamente projetada. Os dados, registrados através de gravações, foram transcritos para a análise de conteúdo, efetuado manualmente mediante triangulação entre os investigadores. A partir da análise de conteúdo dos dados primários, se estabeleceu uma série de categorias, agrupadas em quatro grandes dimensões: conceito de bioética, importância da bioética no exercício profissional, ensino-aprendizagem da bioética e modalidade de ensino da bioética. Os estudantes de odontologia da Universidad de laFrontera transitam de maneira muito assertiva pelos tópicos que compõem a complexa dimensão do ensino da bioética e reconhecem a importância da bioética em sua formação.

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El pediatra sostiene una estrecha relación con el niño y sus padres durante sus primeros años de vida, teniendo periódicamente la oportunidadde detectar problemas orales y educar en su prevención. El objetivo de este estudio fue evaluar los conocimientos, actitudes y experiencia profesional de pediatras chilenos en relación a la salud oral infantil. Se aplicó una encuesta a 164 pediatras asistentes al 50 Congreso Chileno de Pediatría. El instrumento fue traducido y adaptado de la encuesta nacional para pediatras de la Universidad de Washington. La validez de fachada y contenido fue evaluada mediante un grupo focal compuesto por pediatras. La encuesta incluyó datos demográficos, aspectos relacionados con su conocimiento sobre terapias preventivas en salud oral, su opinión sobre su rol en promoción de salud oral, su experiencia para detectar problemas orales y barreras existentes al referir pacientes al odontólogo. Los resultados mostraron que el 64% de los encuestados reportaron diagnosticar caries en preescolares al menos una vez al mes. El 51,53% estaba de acuerdo con derivar al odontólogo al niño al año de edad, sin embargo, 55,82% reportó dificultad al referir pacientes menores de 2 años. Sólo 3% respondió correctamente todas las preguntas sobre conocimiento. 66,87% nunca recibió instrucción en salud oral durante su formación como especialista. A pesar que los pediatras asumen que la salud oral es un aspecto importante de la salud general y que se enfrentan frecuentemente a patologías orales, reconocen que no cuentan con los conocimientos y estrategias de derivación oportuna, para participar de la prevención de ellas.

The pediatrician holds a close relationship with children and their parents during the first years of life. As such, this professional has regular opportunities to perform screening dental examination in young children and to educate families on preventive oral health. The aim of this study was to assess Chilean pediatricians' knowledge, attitudes and professional experience regarding children's oral health. A survey was responded by 164 pediatricians attending the 50th Chilean Pediatrics Convention. The survey questionnaire was translated and adapted from a national survey for pediatricians designed by the Department of Pediatrics, University of Washington. The face and content validity of the instrument was evaluated through a focus group with Chilean pediatricians. The survey included demographic data, elements related to knowledge about oral preventive therapies, their own role in oral health promotion, their experience to screen oral problems and the barriers to refer patients to the dentist. The results showed that 64% of the respondent pediatricians reported to diagnose dental cavities in preschool children at least once a month. 51.53% agreed with referring children to the dentist from the age of 1, however 55.82% found difficulties to successfully refer children under 2 years old. Only 3% of the respondents answered all knowledge questions correctly. 66.87% never received training in oral health during their pediatrics specialization studies. In spite of the general consensus about the relevance of oral health and the frequent encounter with oral pathologies, pediatricians acknowledge that they do not possess enough knowledge nor referral strategies to participate in their prevention.

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La Hipomineralización Molar Incisal (MIH) es una alteración del desarrollo dentario, que estaría asociada a causas de origen sistémico, e involucra al menos uno o más primeros molares permanentes, pudiendo estar comprometidos los incisivos. La prevalencia de este síndrome varía en la literatura entre 2,5 a 40 por ciento en la población infantil mundial. El objetivo de este estudio fue determinar la frecuencia y grado de severidad de MIH entre los pacientes atendidos en la Clínica de Odontopediatría de pregrado y postgrado de la Universidad de La Frontera y los posibles factores asociados. Se realizó un estudio descriptivo en 334 niños entre 6 y 13 años de edad. El examen fue realizado por 2 examinadores en las clínicas de la Universidad de la Frontera. Se estableció el diagnóstico, de acuerdo a los criterios establecidos por Weerheijm et al. (2003) y la severidad según a los criterios propuestos por Mathu-Muju & Wright (2006). La prevalencia encontrada correspondió a 16,8 por ciento. De estos, el 57 por ciento mostró signos severos de MIH, el 20 por ciento signos moderados y 23 por ciento signos leves. No hubo diferencias significativas por sexo y edad respecto a la presencia de MIH o su severidad. El 87 por ciento de los afectados reportó antecedentes mórbidos en el período comprendido desde el preparto hasta la primera infancia. Esta patología presenta alta prevalencia en los pacientes muestreados, comparable a la establecida en estudios realizados a nivel mundial.

Molar incisor hypomineralization (MIH) is a tooth development disorder, which would be associated with systemic causes, and involves at least one or more first permanent molars, incisors may be compromised. The prevalence of this syndrome varies in literature between 2.5 to 40 percent of the world's children. The aim of this study was to determine the frequency and severity of MIH between patients attended at the Graduate Pediatric Dentistry Clinic of the Universidad de La Frontera and the possible associated factors. We conducted a descriptive study of 334 children between 6 and 13 years of age. The review was conducted by 2 examiners at the Universidad de La Frontera. The diagnosis, according to the criteria established by Weerheijm et al (2003) and severity according to the criteria proposed by Mathu-Muju & Wright (2006). The prevalence found corresponded to 16.8 percent. Of these, 57 percent showed severe signs of MIH, 20 percent and 23 percent moderate and mild signs respectively. No significant differences by sex and age for the presence of MIH or its severity. 87 percent of those affected reported morbid history in the period from pre-early childhood. This disorder has high prevalence in patients sampled, comparable to that established in studies worldwide.

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En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.

In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.

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Se realizó una revisión bibliográfica sobre la incorporación de la ética en el currículo de la carrera de odontología. La información recopilada se sistematizó para configurar un planteamiento general en torno a este tema, poniendo énfasis en su importancia dentro del currículo, así como en los objetivos, contenidos y estrategias involucrados en la enseñanza de esta disciplina.

A bibliographical review was performed related to the incorporation of ethics in the curriculum of an odontology career. The information compiled was processed in order to create a general suggestion around this theme, placing emphasis on its importance inside the curriculum, as well as in the objectives, content, and strategies involved in the instruction of this discipline.

Realizou-se uma revisão bibliográfica sobre a incorporação da ética no currículo do curso de odontologia. A informação recopilada foi sistematizada para configurar um questionamento geral em torno deste tema, pondo-se ênfase em sua importância dentro do currículo, assim como nos objetivos, conteúdos e estratégias envolvidos no ensino desta disciplina.

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