The composition of dental plaque formed in the presence of sucrose or glucose and fructose and its relation to cariogenicity was evaluated. Twelve adult volunteers took part in this crossover study done in three phases of 28 days each. For each phase, an acrylic resin appliance containing four human dental enamel blocks was constructed for the volunteers. Solutions containing 20% sucrose or 10% glucose + 10% fructose were dripped onto the enamel blocks 8 times a day, while in the control group no solution was used. Enamel surface and cross–sectional microhardness results showed that dental plaque formed in the presence of sucrose was more cariogenic than that formed in the presence of glucose + fructose (p<0.05). The concentration of alkali–soluble carbohydrates in dental plaque was higher in the sucrose group than in the control and glucose + fructose groups (p<0.05). Although concentrations of Ca, P and F were lower in plaque formed in the presence of sucrose than glucose + fructose and the control, significant differences (p<0.05) were only observed in relation to control. The electrophoretic profile of the matrix proteins of dental plaque showed distinct patterns when it was formed in the absence or presence of the different carbohydrates. Although the results suggest that the high cariogenicity of dental plaque formed in the presence of sucrose can be mainly explained by the high concentration of insoluble glucans of its matrix, the low inorganic concentration and its protein composition may have some contribution.

Quality of life related to oral health: contribution from social factors

Aim To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents. Design A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants’ school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle‐Ottawa Scale. Meta‐analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance. Results Eighteen studies were included. Of them, fifteen studies were used for the meta‐analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR = 1.44 95%CI: 1.24‐1.64) and poor school attendance (OR = 1.57 95%CI: 1.08‐2.05) than caries‐free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR = 1.51 95%CI: 1.10‐1.92) and poor school attendance (OR = 1.35 95%CI: 1.14‐1.57). Conclusions Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.

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PurposeTo identify demographic, socioeconomic and dental clinical predictors of oral health-related quality of life (OHRQoL) in elderly people.MethodsCross-sectional study involving 613 elderly people aged 65–74 years in Manaus, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and sex) and socioeconomic data (income and education), dental clinical measures (DMFT, need of upper and lower dentures) and OHRQoL (GOHAI questionnaire). Structural equation modelling was used to estimate direct and indirect pathways between the variables.ResultsBeing older predicted lower schooling but higher income. Higher income was linked to better dental status, which was linked to better OHRQoL. There were also indirect pathways. Age and education were linked to OHRQoL, mediated by clinical dental status. Income was associated with dental clinical status via education, and income predicted OHRQoL via education and clinical measures.ConclusionOur findings elucidate the complex pathways between individual, environmental factors and clinical factors that may determine OHRQoL and support the application of public health approaches to improve oral health in older people.

Objective : To compare health-related quality of life and oral health-related quality of life between nonsyndromic individuals with and without cleft lip and/or cleft palate and to identify the most affected quality of life dimensions in individuals with cleft lip and/or palate. Design : Systematic review and meta-analysis were conducted. Of the 314 identified citations, 23 articles were submitted to quality assessment. Data from nine studies on health-related quality of life and six on oral health-related quality of life were extracted for meta-analysis. Main Outcome Measures : Pooled mean differences of health-related quality of life between adults with and without cleft lip and/or palate, pooled means of health-related quality of life dimensions of children and adults with cleft lip and/or palate and oral health-related quality of life dimensions of children and adolescents with cleft lip and/or palate with a 95% confidence interval were calculated. Results : Quality assessment revealed methodological differences between studies. Lack of subgroup stratification and absence of control for confounders were the main limitations. Heterogeneity was detected on the comparison of oral health-related quality of life and health-related quality of life between children with and without cleft lip and/or palate, and oral health-related quality of life between adolescents with and without cleft lip and/or palate. A random-effect model showed a significant difference on health-related quality of life between adults with and without cleft lip and/or palate (mean difference = 0.10; 95% confidence interval, 0.16 to 0.05). Psychological health (mean, 78.9; 95% confidence interval, 70.1 to 87.7) and vitality (mean, 68.1; 95% confidence interval, 48.0 to 88.1) were the most affected health-related quality of life dimensions in children and adults with cleft lip and/or palate, respectively. Means of health-related quality of life dimensions in children and adults with cleft lip and/or palate and oral health-related quality of life in children and adolescents with cleft lip and/or palate varied yet did not differ in indirect comparisons. Conclusion : The presence of cleft lip and/or palate negatively affected the health-related quality of life of adults, mainly on psychosocial dimensions.

ABSTRACT:The minimum requirement for the anti-caries effect of a dentifrice is the presence of available and stable fluoride in the formulation. The concentration of available fluoride in the major dentifrices sold in Brazil has been reported, but few data have been published about its stability, which is temperature-dependent. Thus, the aim of this study was to evaluate the concentration and stability of fluoride in dentifrices sold in Manaus, AM, Brazil, which is a typical tropical city. The concentrations of total fluoride, total soluble fluoride, MFP, and of insoluble fluoride of six Brazilian dentifrices and an imported one were analyzed. The analyses were made when the dentifrices were purchased and during a year of storage at room temperature (28.9 ± 1.16°C) and under refrigeration (26.3 ± 0.88°C). The analyses were performed using an ion specific electrode Orion 96-09. At the time of purchase, all the dentifrices analyzed showed more than 1,000 ppm (mg F -/g; w/w) of soluble fluoride. However, in most of them, this form of fluoride was not shown to be stable. The highest loss of soluble fluoride was found for storage at room temperature, reaching up to 40%. Although all dentifrices comply with the Brazilian guidelines with regard to the concentration of total fluoride (maximum of 0.15%), the instability of soluble fluoride observed in some of them can impair their anti-caries effect and this condition is not contemplated in the Governmental rules. DESCRIPTORS: Dentifrices; Fluorine; Toothpaste; Fluorides. RESUMO:O requisito mínimo para que um dentifrício tenha potencial anticárie é ele ter uma formulação com fluoreto na forma solúvel e estável. A concentração de fluoreto solúvel nos dentifrícios vendidos no Brasil tem sido descrita, mas pouco é conhecido sobre sua estabilidade, a qual é função da temperatura. Assim, o objetivo deste estudo foi avaliar a concentração e estabilidade do fluoreto em dentifrícios vendidos em Manaus, AM, Brasil. As concentrações de fluoreto total, fluoreto solúvel total, MFP, e de fluoreto insolúvel de seis dentifrícios nacionais e um importado foram determinadas quando da aquisição e durante um período de 12 meses de armazenamento à temperatura ambiental (28,9 ± 1,16°C) e sob ar refrigerado (26,3 ± 0,88°C). Para a análise foi utilizado eletrodo específico para íon fluoreto Orion 96-09. Os resultados mostraram que todos os dentifrícios tinham uma expressiva concentração (mg F -/g; p/p) de fluoreto solúvel total quando da aquisição. Entretanto, a maioria deles não se mostrou estável quando do armazenamento. A maior perda ocorreu à temperatura ambiente, atingindo valores de 40%. Embora a concentração de fluoreto total encontrada em todos os dentifrícios esteja de acordo com a portaria da ANVISA, dependendo das condições de armazenamento a perda de fluoreto solúvel pode comprometer o efeito anticárie de alguns dentifrícios e isto não está contemplado pela portaria brasileira em vigor.

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