RESUMEN
BACKGROUND: Early childhood caries (ECC) has a profound impact on a child's quality of life, and its management remains a challenge for the paediatric dentist, mainly because it depends on radical changes in the child/carers' daily behaviour and any dental treatment must be provided to very young child. CASE REPORT: This case report describes the on-going care of a 2-year-old child presenting with ECC and management until permanent dentition is complete. All patient-focused, teamdelivered care was delivered using the minimum intervention oral care framework, implementing non-invasive and minimally invasive preventive procedures. Throughout the care provided, oral and dental health education was reinforced in all visits. The child's mother was trained to perform effective biofilm control and dietary habits were adjusted, especially baby-bottle removal during sleep. The child was initially anxious and resistant towards any dental examination and clinical procedures. However, with effort from the oral healthcare team members, the patient became compliant, allowing the mother to perform suitable oral hygiene measures, as well as accepting the clinical procedures carried out by the paediatric dentist. The clinical procedures consisted of atraumatic restorations and fluoride varnish applications. During the subsequent years after the baseline treatment, follow-up visits included continued dietary and oral hygiene instruction with positive behavior reinforcement, fluoride topical applications and tooth-restoration complex maintenance with glass-ionomer cement where needed. Currently, the patient is 19 years old and has a stable, healthy permanent dentition. CONCLUSION: Understanding of the causes of oral diseases by the patients' caregivers, alongside with pragmatic practical guidance to maintain good oral health, can reduce the risk for acquiring future disease, since caries activity control is the basis for successful caries management.
Asunto(s)
Susceptibilidad a Caries Dentarias , Caries Dental , Preescolar , Lactante , Niño , Humanos , Adulto Joven , Adulto , Estudios de Seguimiento , Calidad de Vida , Caries Dental/prevención & control , Salud BucalRESUMEN
AIM: The aim of this single-blind cross-over study was to compare the performance of three different toothbrush models in the control of dental biofilm and maintaining a healthy gingival condition. METHODS: Twenty-seven schoolchildren (aged 9-10 years) participated in the study. Three toothbrushes with different bristle arrangements were used: T1 - bristles on the same plane, straight arrangement; T2 - bristles on different planes, straight arrangement; T3 - bristles on different planes, straight and circular arrangement. The participants were then randomly divided into three groups for brushing with one of the three toothbrushes. Each experimental period lasted 15 days each, with three daily brushings and a 7-day washout interval was used between periods. The oral hygiene and gingival bleeding indices were recorded by a single, calibrated examiner blind to the brush used. Bristle wear was measured with a digital calliper at the end of each period. The data were analysed using parametric (anova and Student's t-test) and non-parametric (Cochran's Q and McNemar) tests. RESULTS: The toothbrushes achieved similar results (P>0.05) for the clinical parameters investigated. The three models exhibited a similar degree of bristle wear (P>0.05). CONCLUSION: The arrangement of the bristles had little influence over the removal of biofilm and gingival conditions. Thus, there is no clinical justification for replacing conventional toothbrushes with more expensive models.
Asunto(s)
Placa Dental/prevención & control , Higiene Bucal/instrumentación , Cepillado Dental/instrumentación , Análisis de Varianza , Biopelículas , Niño , Estudios Cruzados , Dispositivos para el Autocuidado Bucal , Diseño de Equipo , Humanos , Índice Periodontal , Valores de Referencia , Método Simple Ciego , Estadísticas no ParamétricasRESUMEN
AIM: The purpose of this research was to evaluate molar furcation entrances and the width of periodontal curette blades used in periodontal instrumentation. MATERIALS AND METHODS: One hundred extracted molars (50 upper and 50 lower) were analysed. The furcation entrances were measured using orthodontic wires of different predetermined diameters: 0.4, 0.5, 0.6, 0.7, 0.8 and 0.9 mm. McCall 17-18, Gracey 5-6 and Gracey 5-6 mini-five curette blades were measured at their anterior (AT), middle (MT) and posterior (PT) thirds by a single trained investigator, through the use of a digital caliper. RESULTS: The results showed significant differences (P < 0.0001) in relation to furcation entrances. The buccal upper molar furcations showed the narrowest dimensions. In relation to the blade diameter, significant differences among the instruments were found for their MT and PT (P < 0.0001), but not for the AT (P = 0.183). Significant differences were found among curette manufacturers. Nineteen per cent of evaluated furcations presented entrances <0.60 mm and 75% of the blades at their AT presented width >0.60 mm. CONCLUSIONS: These findings demonstrated that some molar furcation entrances could not be adequately instrumented with the tested curettes. The use of other hand instruments, such as periodontal files, rotating instruments and ultrasonic devices should be taken into consideration during periodontal therapy.