The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.
Use of the DLT after the ICDAS e-learning program tended to increase the sensitivity of ICDAS used by undergraduate dental students. The DLT appeared to improve dental students' ability to use ICDAS.
The progression of caries lesions could negative impact on OHRQoL in Brazilian preschoolers.
Early childhood caries (ECC) affects children all over the world and has high prevalence and severity in preschool children. Different social, biological and behavioral factors compose a network of causal factors for ECC. The aim was to evaluate the association between socioeconomic variables and caries at baseline, and the presence of Streptococcus mutans and Lactobacillus spp. microorganisms with the progression of caries lesions after two years of follow-up in a group of children. At baseline, 163 children (3-4 years old) living in the areas of 12 primary care services of the Hospital Group Conceição (GHC, Porto Alegre, RS, Brazil) were evaluated. After two years, 119 children were re-evaluated. Clinical examinations were conducted by calibrated examiners using the ICDAS criteria. A sociodemographic questionnaire was applied to the children's parents and saliva samples were collected from the children for microbiological analysis. Descriptive statistics and multivariate Poisson regression analysis were performed in the statistical analysis. The factors associated with the caries progression were marital status of mothers (p=0.040), higher S. mutans counts (p=0.031) and the presence of cavitated lesions at baseline (p<0.001). The caries lesions progression in preschool children enrolled in primary health care was directly associated with marital status, presence of cavitated lesions at baseline and higher S. mutans counts at two-year follow-up.
ResumoObjetivo: comparar a aceitabilidade da ART e de restaurações convencionais em crianças. Material e métodos: A amostra do presente ensaio clínico randomizado foi composta por 30 crianças de 4 a 7 aanos de idade que tinham pelo menos uma cavidade ativa classe II em um primeiro molar que era acessível a instrumentos manuais. Os grupos de tratamento foram: grupo controle -tratamento com anestesia local, isolamento absoluto, instrumentos rotatórios e resina composta; grupo teste -tratamento de acordo com ART utilizando instrumentos manuais somente, sem anestesia e ionômero de vidro. Em ambos os grupos, somente tecido cariado desmineralizado e esmalte sem suporte foram removidos. A aceitabilidade dos dois grupos foi acessada por mensuração das sensações emocionais usando a Escala de Imagem Facial (EIF) antes e depois do procedimento. Resultados: Não houve diferenças significativas entre os grupos na mudanças dos escores da EIF. 50% das crianças do grupo teste ficaram mais satisfeitas, enquanto 64% das crianças do controle não mudaram seus sentimentos. Conclusão: ART não demonstrou ter melhor aceitabilidade do que o tratamento convencional. Entretanto, o menor tempo utilizado para completar o procedimento parece ser um aspecto válido em crianças muito jovens ou pacientes com problemas de comportamento. AbstractAim: to compare the acceptability of the ART and the conventional restoration approaches in children. Material and methods: The sample of the current randomized clinical trial was 30 children 4 to 7 years old who had at least one class II active cavity in a primary molar that was accessible to hand instruments. The treatment groups were: Control Group-treatment with local anesthesia, rubber dam, rotary instruments and composite resin. Test Group-treatment according to ART approach using only hand instruments, no anesthesia and glass ionomer. In both groups, only the demineralized carious tissue and unsupported enamel were removed. The acceptability of the two groups was assessed by measuring the emotional feelings represented by Face Image Scale (FIS) before and after the procedure. Results: There was no significant difference between the two groups regarding changes in FIS scores. Fifty percent of the children from the Test Group got more satisfied after the procedure, while 64% of the participants from Control Group did not change their feelings. Conclusion: The ART approach had not demonstrated to have a best acceptability then the conventional approach. However the short time taken to complete the procedure seems to be worthy aspects when dealing with very young children or patients with behaviors problems.
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