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Aim: To evaluate the association between functional literacy and the recognition of the word “bruxism” among adolescentes. Method: This was a cross-sectional study carried out in a mid-sized city in Brazil. The sample consisted of 375 schoolchildren, age 12, and 368, aged 15 to 19 years, selected at random. Two calibrated examiners (Kappa > 0.80) applied the oral health literacy instrument, validated for adolescents, the “Rapid Estimate of Adult Literacy in Dentistry” (BREALD-30) and the recognition of the word “bruxism” was used as a dependent variable, in addition to a questionnaire on functional literacy (Functional Literacy Index – INAF). Parents/caregivers answered a sociodemographic questionnaire. Unadjusted analysis and logistic regression were performed for complex samples (p < 0.05). Results: In the final model, the 12-year-old adolescents who were most likely not to recognize the word “bruxism” were those from public schools (OR = 2.83; 95% CI: 1.79-4.46; p = 0.001), without health insurance (OR = 2.02; 95% CI: 1.21-3.37; p = 0.007), and with a lower level of functional literacy (OR = 2.66; 95% CI: 1, 66-4.26; p < 0.001). Adolescents, aged 15 to 19, who had a greater chance of not recognizing the word “bruxism” were those with the lowest level of functional literacy (OR = 3.29; 95% CI: 1.93-5.60; p < 0.001), who lived with more people at home (OR = 2.04; 95% CI: 1.02-4.11; p = 0.040), who had parents/guardians with a low level of education (OR = 1.97; 95% CI: 1.15-3.36; p = 0.013). and who had never been to the dentist (OR = 3.08; 95% CI: 1.26-7.52; p = 0.03). Conclusion: The recognition of the term “bruxism” among 12-year-olds was influenced by the presence of a health plan and a higher level of functional literacy. In the older age group, the higher level of functional literacy, the smaller number of people at home, the higher level of education of the person in charge, and the individual’s visit to the dentist influenced the recognition of the term. Uniterms: Health literacy. Bruxism. Oral health. Pediatric dentistry.

The aim of this study was to evaluate associations between oral health literacy and family, sociodemographic and dental service characteristics in early adolescents. A cross-sectional study was conducted with 740 schoolchildren. The following variables were investigated using validated questionnaires: oral health literary (BREALD-30), sociodemographic characteristics, type of dental service and family functioning (FACES III). Associations were tested using robust Poisson regression analysis (α=5%). Higher oral health literacy was associated with the female sex (RR=1.09; 95%CI: 1.03-1.14), connected type of family cohesion (RR=1.12; 95%CI: 1.05-1.20), rigid (RR=1.14; 95%CI: 1.04-1.25) and structured (RR=1.11; 95%CI: 1.04-1.20) types of family adaptability, more than eight years of mother’s schooling (RR=1.16; 95%CI: 1.10-1.22), age of caregiver more than 38 years (RR=1.07; 95%CI: 1.02-1.13) and the use of private dental services (RR=1.06; 95%CI: 1.01-1.12). The level of oral health literacy in early adolescents was associated with sex, family structure, mother’s schooling, caregiver’s age and type of dental service used. Resumo Este estudo avaliou a associação de fatores sociodemográficos, familiares e do tipo de serviço odontológico utilizado ao alfabetismo em saúde bucal em pré-adolescentes. Trata-se de um estudo transversal com 740 escolares. Foram avaliados o alfabetismo em saúde bucal (BREALD-30), fatores sociodemográficos, tipo de serviço odontológico e funcionalidade familiar (FACES III) por meio de questionários validados. A associação entre as variáveis foi avaliada por meio de regressão de Poisson robusta (α=5%). Um maior alfabetismo em saúde bucal foi associado ao sexo feminino (RR=1.09; IC95%: 1.03-1.14), coesão familiar do tipo conectada (RR=1.12; IC95%: 1.05-1.20), adaptabilidade familiar dos tipos rígida (RR=1.14; IC95%: 1.04-1.25) e estruturada (RR=1.11; IC95%: 1.04-1.20), escolaridade materna superior a oito anos de estudo (RR=1.16; IC95%: 1.10-1.22), idade do responsável superior a 38 anos (RR=1.07; IC95%: 1.02-1.13) e uso de serviços odontológicos privados (RR=1.06; IC95%: 1.01-1.12). O nível de alfabetismo em pré-adolescentes foi associado ao sexo, estrutura familiar, idade e escolaridade do responsável e tipo de serviço odontológico utilizado.

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents’ level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples ( α = 5 % ). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries ( OR = 2.10 ; IC 95%: 1.22–3.61), tooth loss ( OR = 15.81 ; IC 95%: 2.14–116.56), dental pain in the last six months ( OR = 1.87 ; IC 95%: 1.06–3.31), and enmeshed family cohesion type ( OR = 10.23 ; IC 95%: 3.96–26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

Background Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors AIM: The aim of this study was to investigate associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8-10 years of age. Design A school-based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples. Results Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self-reported PAB. Conclusions Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self-reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB.

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Background The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments. Aim To evaluate the influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents. Design A cross-sectional study was conducted with 740 12-year-old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD-30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed. Results A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01-1.03), high social class (PR = 1.28; 95% CI: 1.09-1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37-1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19-2.02) and connected (PR = 1.22; 95% CI: 1.02-1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01-1.38) remained associated with having visited a dentist. Conclusions Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents.

Objective: To investigate the influence de two instruments for evaluation of cariogenic foods consumption by schoolchildren . Material and Methods: The convenience sample comprised of 30 active-caries children (7-10 years old) attended in a public dental clinic and their mothers, who have not received dietary orientation before study. A trained evaluator administered the Previous Day Food Questionnaire (PDFQ) to children and other examiner applied the 24-hour dietary recall with mothers. Internal consistency between PDFQ and 24-hour dietary recall regarding frequency of sugar intake was calculated using intraclass correlation coefficient. Bivariate analyses (Mann-Whitney test) were performed to investigate the factors associated with frequency of sugar intake when using both instruments ( α =0.05). Results: A moderate correlation (ICC = 0.51; 95%CI: -0.04–0.77; p=0.03) was found between instruments. Mean frequency of sugar intake reported by mothers and children was 3.5 (± 1.8) and 3.7 (± 1.5) times a day, respectively. When using the PDFQ, the frequency of cariogenic foods consumption varied depending on frequency of toothbrushing, i.e., children that had higher frequency of sugar intake brushed their teeth at least two times a day (p=0.016). Conclusion: Previous Day Food Questionnaire applied with schoolchildren could substitute the mothers’ reports of cariogenic foods consumption when dietary interventions for controlling dental caries are necessary. If doubts remain regarding the children’s response, mothers should be consulted.

This study aimed to evaluate the association of contextual and individual factors with Oral Health literacy (OHL) in early adolescence. This is a population-based cross-sectional study carried out with 740 12-year-old adolescents randomly selected by a two-stage probabilistic cluster sampling process from schools in Campina Grande, Brazil. The guardians provided sociodemographic information. Adolescents answered the Brazilian version of the Family Adaptability and Cohesion Scales (FACES III) to measure family functioning, and the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30) to measure OHL. Descriptive analysis was conducted, followed by robust Poisson’s regression analysis for complex samples with a multilevel approach (p

Traumatic dental injuries are highly prevalent among preschool children. When occurring at a very young age (prior to the eruption of the primary teeth), such trauma can disturb the normal development of the permanent dentition and, more rarely, affect the primary dentition. This report describes a case of a patient who suffered dentoalveolar trauma at six months of age that caused rare developmental problems in the primary dentition, such as impaction, dilacerations, hypoplasia, and odontoma. Imaging revealed that alterations also occurred in the permanent dentition. This report demonstrates that dentoalveolar trauma prior to complete development of the dentition and even before the eruption of the primary teeth can lead to highly uncommon abnormalities in the primary dentition. Moreover, there may be repercussions in the permanent dentition when the germs of these teeth are injured by the intraosseous displacement of primary teeth.

Background Oral health literacy (OHL) is associated with oral health outcomes. Aim To validate the Brazilian Portuguese version of the Hong Kong OHL Assessment Task for Paediatric Dentistry (HKOHLAT-P). Design We performed cross-cultural adaptation of the HKOHLAT-P. A sample of 200 pre-schoolers and caregivers from Campina Grande, Brazil completed the Brazilian HKOHLAT-P (BOHLAT-P), sociodemographic questionnaire, the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Child dental caries was assessed. Instrument reliability was measured by internal consistency (Cronbach's alpha) and test-retest (ICC). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) evaluated dimensionality. Regression models tested associations between BOHLAT-P and exploratory variables (P Results BOHLAT-P demonstrated excellent reliability (Cronbach's alpha = 0.92; ICC = 0.95). BOHLAT-P and BREALD-30 scores (r = .71), number of schooling years (r = .60), and reading hours (r = .34) were positively correlated. BOHLAT-P and B-ECOHIS scores (r = -.22), and BOHLAT-P scores and number of cavitated teeth (r = -.15) were negatively correlated. After controlling for confounding variables, BOHLAT-P scores were not associated with caries or number of teeth with cavitated caries. Conclusion BOHLAT-P is a valid and reliable instrument to assess the OHL of Brazilian parents.

The aim of this study was to evaluate the relationship between oral health literacy (OHL) among caregivers and untreated dental caries among preschoolers. A cross-sectional study was conducted involving 415 preschool children and their caregivers from Curitiba, Brazil. The children were examined for dental caries and dental plaque. The caregivers’ OHL was evaluated using an instrument translated and validated for Brazilian Portuguese: the Brazilian Rapid Estimate of Adult Literacy in Dentistry-30. The prevalence of children with untreated caries was 42.9% (95%CI: 38.1-47.7%). A low degree of OHL was found among 15.7% (95%CI: 12.2-19.2) of caregivers. The multivariable Poisson regression analysis indicated a higher prevalence of untreated caries among children whose caregivers had a low OHL (PR = 1.35; 95% CI: 1.01-1.79), those with visible plaque (PR = 1.28; 95% CI: 1.01-1.62) and those who never or only occasionally had their teeth brushed by their caregivers (PR = 1.48; 95% CI: 1.16-1.91) in comparison to those without these conditions. In conclusion, a higher prevalence of untreated dental caries was found among preschool children whose caregivers had a low degree of OHL. Resumo O objetivo deste estudo foi avaliar a relação entre a alfabetização em saúde bucal (ASB) entre os cuidadores e a cárie dentária não tratada entre pré-escolares. Um estudo transversal foi realizado envolvendo 415 crianças pré-escolares e seus cuidadores de Curitiba-Brasil. As crianças foram examinadas para cárie dentária e placa dental. O ASB dos cuidadores foi avaliado usando um instrumento traduzido e validado para o idioma português do Brasil, o Brazilian Rapid Estimate of Adult Literacy in Dentistry-30. A prevalência de crianças com cárie não tratada foi de 42,9% (IC 95%: 38,1-47,7%). Um baixo grau de ASB foi encontrado entre 15,7% (IC 95%: 12,2-19,2) de cuidadores. A análise de regressão de Poisson multivariada indicou uma maior prevalência de cárie não tratada entre crianças cujos cuidadores apresentaram baixo ASB (PR = 1,35; IC 95%: 1,01-1,79), aqueles com placa visível (PR = 1,28; IC 95%: 1,01-1,62) e aqueles que nunca ou apenas ocasionalmente tiveram seus dentes escovados por seus cuidadores (PR = 1,48; IC 95%: 1,16-1,91) em comparação com aqueles sem essas condições. Pode-se concluir que uma maior prevalência de cárie dentária não tratada foi encontrada entre os pré-escolares cujos cuidadores tinham um baixo grau de ASB.

Background The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear. Aim To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI). Design A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PRc ) for dental caries and this measure adjusted by HFI (PRa ). Results The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI. Conclusions Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families.

Objective Investigate the association between sleep disorders and probable sleep bruxism (SB) in children eight to ten years of age. Methods A cross-sectional study was conducted with 739 schoolchildren in Brazil. Parents/guardians answered a sociodemographic questionnaire, the sleep disturbance scale for children, and the Circadian Energy Scale. Parafunctional habits were evaluated using the Nordic Orofacial Test-Screening. Multivariate logistic regression was performed (α = 5%), and a directed acyclic graph was used in the statistical model. Results The prevalence of probable SB was 9.1% and 58.6% of the children had sleep disorders. In the final model, having unmarried parents/guardians (OR = 1.98; 95% CI: 1.07-3.65), exhibiting parafunctional habits (OR = 2.02; CI: 1.01-4.06), not practicing sports (OR = 1.92; CI: 1.04-3.54), sleep-wake transition disorders (SWTD) (OR = 2.01; 95%CI: 1.12-3.62), and excessive daytime sleepiness (EDS) (OR = 2.17; 95%CI: 1.11-4.29) were significant associated with probable SB. Conclusion The occurrence of probable sleep bruxism was influenced by the marital status of the parents/guardians, parafunctional habits, the non-practice of sports, and sleep disturbance (SWTD and EDS). This research contributes to the planning of public policies that include educational regimens at school to prevent sleep disorders and favor the reduction in sleep bruxism prevalence.

OBJECTIVES To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents. METHODS A school-based cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP-IV) questionnaire for the detection of signs of ADHD. Multiple Poisson regression with robust variance was used for data analysis (α = 5%). RESULTS The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01-1.15) and connected (PR = 1.06; 95% CI: 1.01-1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04-1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01-1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01-1.11) were also associated with the outcome. CONCLUSION Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.

Objective: To investigate the correlation between human development and dental caries in 12-year-old schoolchildren from the twenty-seven Brazilian states and to analyze the spatial distribution of these variables. Material and Methods: This was an ecological study using secondary data from the National Epidemiological Oral Health Survey 2010 and from the United Nations Development Program. Human development was measured by the Human Development Index (HDI) and dental caries by the Decayed, Missing and Filled Teeth index (DMFT). Dental caries prevalence and experience at the age of 12, and state HDI were entered into Google Sheets ® and Google My Maps ® for map creation. Data were analyzed by Pearson’s correlation (HDI and DMFT, DMFT individual components, prevalence of dental caries and prevalence of dental pain) (p

Resumo Este trabalho estudou a descontinuidade do cuidado (DC) em saúde bucal entre crianças e adolescentes que acessaram os serviços de urgência nas unidades básicas de saúde (UBS) e de pronto atendimento (UPA). Foram avaliados prontuários de indivíduos de 0 a 17 anos vinculados ao Sistema Único de Saúde de Curitiba. Considerou-se DC quando não houve o registro de consulta eletiva na UBS nos 6 meses subsequentes ao atendimento de urgência. A amostra foi estratificada pelo Índice de Desenvolvimento Humano Municipal (IDHM) da Unidade de Desenvolvimento Humano em que o paciente residia em ≤0,799 ou ≥0,800. A associação entre DC e demais covariáveis foi analisada através de regressão de Poisson com variância robusta uni e multivariada (α=0,05). A incidência de DC foi de 42,2%. No estrato de IDHM≤0,799, o risco de DC foi maior para as crianças com menos de 5 anos de idade e aqueles que não visitaram o dentista no último ano. Nos dois estratos, o risco de DC foi maior para aquelas que utilizaram a UPA para o atendimento de urgência quando comparadas com as que receberam atendimento na UBS. A DC em saúde bucal apresentou alta incidência, sendo que entre os residentes em regiões com menor IDHM, sofreu uma maior influência das características de uso dos serviços. Abstract The aim of the present study was to investigate the discontinuity of oral health care among children and adolescents who accessed emergency services at primary care units and urgent care units. Records were reviewed of patients aged 0 to 17 years treated in the public healthcare system in city of Curitiba, Brazil. Discontinuity was considered when elective treatment was not registered at the primary care unit within six months after urgent care. The sample was stratified based on the Municipal Human Development Index (MHDI) (≤0.799 or ≥0.800). The association between discontinuity and covariables was assessed using univariate and multivariate Poisson regression models with robust variance (α=0.05). The incidence of discontinuity was 42.2%. In the MHDI≤0.799 stratum, the risk of discontinuity was greater among children younger than five years of age and individuals who had not had a dental appointment in the previous year. In both MHDI strata, the risk of discontinuity was higher in patients who received urgent care at an urgent care unit than those treated at a primary care unit. The incidence of the discontinuity of oral health care was high and was strongly influenced by the characteristics of dental service utilization among individuals living in regions with a lower MHDI.

The risk of dental caries seems to be greater in the presence of developmental defects of enamel (DDE). The aim was to determine whether the presence of DDE in the primary teeth of preschool children increases the risk of dental caries in the primary dentition after a period of approximately 2 years. This study was conducted in two stages: baseline (T0) and follow-up (T1). At T0, examinations were conducted for the diagnosis of enamel defects using the DDE index (FDI, 1992), dental caries, and oral hygiene. The participants were allocated to two groups according to the presence (affected) or absence (unaffected) of DDE. At the second evaluation (T1), examinations were performed for the diagnosis of dental caries. Poisson regression analysis with a multilevel approach was used to determine the association between DDE and dental caries. The two levels of the analysis were tooth and child. Among the 339 children (113 affected and 226 unaffected) examined at baseline (T0), 325 were re-examined at follow-up (T1). According to the multilevel analysis, teeth with enamel hypoplasia had a greater risk of having dental caries (RR: 1.99; 95% CI: 1.19–3.33). The risk of caries was greater on posterior teeth (RR: 2.59; 95% CI: 2.18–3.07) and maxillary teeth (RR: 1.48; 95% CI: 1.26–1.75) that had DDE at T0. On the child level, dental caries at T1 was associated with having dental caries at T0 (RR: 1.38; 95% CI: 1.32–1.46). In conclusion, enamel hypoplasia and previous dental caries are risk factors for carious lesions in the primary dentition.

Objective: To evaluate the relationship between excess body weight (EBW) and the prevalence of dental caries in preschoolers considering parental control regarding snack consumption. Material and Methods: An observational, population-based, cross-sectional study was conducted at Municipal Child Education Centers in the city of Curitiba, Brazil, involving a representative sample of 686 preschool children aged four to five years and eleven months and their parents/caregivers. Dental caries was analyzed using the dmft index. Weight and height were measured for the determination of the body mass index, which was categorized for each z-score range considering age and sex. Children with overweight or obesity were considered to have EBW. The assessment of nutritional status was performed with the aid of the WHO Anthro and WHO Anthro Plus programs. The data were analyzed using univariate and multivariate Poisson regression analysis with robust variance ( α = 0.05). Results: The children with EBW had a lower prevalence rate of caries, but this association lost its significance when adjusted by the other variables included in the multivariate model. In the multivariate regression analysis, household income per capita (PR=0.804; 95%CI: 0.665-0.972), child's age (PR=1.015; 95%CI: 1.001-1.029) and snack limits (PR=0.839; 95%IC: 0.732-0.962) were associated with a greater prevalence rate of dental caries. Conclusion: Excess body weight was not significantly associated with dental caries, whereas a lower parental limit regarding snack consumption by the children was independently associated with a higher prevalence rate of dental caries.

Dental caries are a global health problem that affects all age groups and must be considered a public health priority due to its significant financial costs and impact on the quality of life. This study evaluated the association between oral health literacy (OHL), school factors, and untreated dental caries in 12-year-old Brazilian adolescents using a multilevel approach. A population-based cross-sectional study was carried out with 740 adolescents randomly selected from private and public schools in Campina Grande, Brazil. Two dentists were trained and calibrated to diagnose dental caries using the Nyvad index and OHL using the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30). The caregivers of the adolescents reported demographic data (sex, skin color, and socioeconomic status). Data of school factors such as the type of school and the school grade retention rate were classified through a 2-step hierarchical cluster analysis to obtain the school environment. A robust multilevel log-linear negative binomial regression for complex samples was performed (p < 0.05). In the analysis, adjusted by individual determinants, nonwhite skin color (RR = 2.20; 95% CI 1.56–3.12), a low socioeconomic status (RR = 1.60; 95% CI 1.09–2.34), a low OHL score (RR = 0.94; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.25; 95% CI 1.67–3.04) were associated with untreated dental caries. The following factors remained associated with untreated dental caries in the final model: students from an unfavorable learning environment (RR = 2.20; 95% CI 1.27–3.80), nonwhite skin color (RR = 1.92; 95% CI 1.27–2.91), a low socioeconomic status (RR = 1.82; 95% CI 1.12–2.94), a low OHL score (RR = 0.95; 95% CI 0.91–0.98), and low satisfaction with the last dental appointment (RR = 2.07; 95% CI 1.47–2.91). Untreated dental caries in early adolescence were impacted by the school environment, the socioeconomic status, OHL, and the adolescent’s satisfaction with the last dental appointment.

BACKGROUND/AIM Sleep quality exerts an influence on attention level and motor skills and is associated with accidental injuries in children. The aim of this study was to evaluate the association between traumatic dental injury and sleep behaviour in children. MATERIAL AND METHODS A cross-sectional study was conducted in a small city in southern Brazil with a representative sample of schoolchildren aged 8-10 years (n = 537). Weight and height were measured, and examinations were performed for the determination of clinical occlusion and traumatic dental injury. The parents answered the Sleep Behaviour Questionnaire and questions addressing socio-demographic characteristics. RESULTS The prevalence of traumatic dental injury was 22% (95% CI: 19-26) and was higher among children who woke three to four times per night (PR = 3.30; 95% CI: 2.47-4.39), those who fell asleep in the parental bed (PR = 1.41; 95% CI: 1.09-1.83), those who were not in a good mood on waking up in the morning (PR = 1.30; 95% CI: 1.02-1.65), those who became sleepy while sitting and/or studying (PR = 1.57; 95% CI: 1.09-2.24) and while watching TV (PR = 1.41; 95% CI: 1.0005-1.97) and those who had bad dreams (PR = 1.35; 95% CI: 1.04-1.76). The Poisson multiple regression model with a multilevel approach revealed that the prevalence of traumatic dental injury was 1.51-fold higher among children with daytime drowsiness (PR = 1.51; 95% CI: 1.11-2.04) after adjusting for socio-demographic, occlusal and anthropometric variables. CONCLUSION Sleep problems were associated with a higher prevalence of traumatic dental injury among the children analysed.

OBJECTIVES To investigate whether oral health literacy (OHL) impacts missing data obtained through self-reporting in oral health epidemiological research. METHODS A cross-sectional study was conducted with parents (n = 344) of 4- to 5-year-old children randomly selected from public schools within the city of Curitiba, Brazil. Parental OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Parents answered a set of questionnaires comprising 88 items concerning sociodemographic and economic data, children's access to dental services, oral hygiene behaviour, diet and mealtime behaviour. The total number of unanswered items (TUI) and the number of unanswered items in each type of question (open-ended, dichotomous, multiple choice with up to 4 options and with 5-9 options) for each participant was compared across different levels of OHL (chi-squared, Mann-Whitney, Kruskal-Wallis and Spearman's correlation test). Multiple Poisson regression was used to estimate rate ratios (RR) of TUI between OHL scores and their respective 95% confidence interval (95% CI). RESULTS Approximately one-third of studied parents (37%) exhibited low OHL (BREALD-30 ≤ 21). The prevalence of missing data in at least one item was 85.5%. Low OHL was associated with failing to respond open-ended items (P = 0.003) and multiple-choice items with up to 4 (P = 0.003) and between 5 and 9 options (P = 0.030). There was a negative correlation between OHL scores and TUI (r = -0.195; P

Objective To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. Materials and methods A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. Results The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p = 0.05), whereas the latter maintained an association with lower caries rates (p = 0.01). Conclusion A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.

Background Dental caries have a high prevalence in children and need to evaluate their individual and contextual determinants. Aim To evaluate the importance of individual and contextual determinants on the occurrence of cavitated lesions in 5-year-old children. Design A cross-sectional study was conducted with 769 preschoolers in a city in northeastern Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, socio-demographic characteristics and the child's oral health. The diagnosis of dental caries (cavitated lesion) was performed using the ICDAS-II. Variables related to the context were collected at the preschools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models with robust variance correction were used. Results The prevalence of cavitated lesions was 58.8%. In the analysis adjusted by individual determinants, low household income (PR = 1.61; 95%CI:1.27-2.05), lower parent's/caregiver's schooling (PR = 1.57; 95%CI:1.20-2.05), not visited to the dentist (PR = 0.77; 95%CI:0.62-0.94), brushing frequency under 2 times per day (PR = 2.17; 95%CI:1.35-3.51) and weak parent's/caregiver's SOC (PR = 1.30; 95%CI:1.09-1.56) were associated with cavitated lesions. However, after the incorporation of the contextual determinants, parent's/caregiver's schooling and SOC lost their association. Considering contextual factors, children attending public preschools (PR = 1.66; 95%CI:1.34-2.05) and/or smaller preschools (PR = 1.001; 95%CI:1.001-1.002) had a greater probability of exhibiting cavitated lesions. Conclusion Contextual variables were more important to the occurrence cavitated lesions than individual socioeconomic variables.

Objectives To conduct a systematic review and meta-analysis regarding the association of oral health literacy (OHL) with oral health behaviors, perception, knowledge, and dental treatment related outcomes. Methods Eight electronic databases were searched up until June 2017. Studies regarding the aforementioned outcomes measuring OHL through a validated instrument and in which OHL was an explanatory variable were included. Two independent reviewers selected studies, extracted data, and analyzed the risk of bias of the studies. Meta-analysis using random effect modeling was undertaken. Pooled estimates were calculated with 95 percent confidence interval (CI) and odds ratios (OR). Results Twenty-five studies were included in the systematic review and three in the meta-analysis. Most studies were cross-sectional (n = 21) and had a high risk of bias (n = 17). The meta-analysis showed no association between OHL and frequency of visit to the dentist for adults, either through bivariate analysis (OR = 1.25; 95 percent CI: 0.95-1.63) or multivariate analysis (OR = 1.90; 95 percent CI: 0.77-4.84). Dental anxiety and night bottle-feeding were associated with low OHL (P

To test the correlation among dental caries, dental fluorosis, and the percentage of municipalities with optimal fluoridated water among Brazilian 12-year-old schoolchildren. An ecological study was performed using primary data from the latest Brazilian Oral Health Survey. The units of analysis were the 26 states plus the Federal District of Brazil (n = 7328 schoolchildren). Dental caries was diagnosed according to the DMFT criteria and dental fluorosis according to Dean’s Index. Descriptive and analytical statistics (p

The aim of this cross-sectional study was to assess the impact of temporomandibular disorder (TMD) on oral health-related quality of life (OHRQoL) of adolescents. The OHRQoL of adolescents undergoing dental treatment at a University clinic in 2019 was measured using the Brazilian version of the Oral Heath Impact Profile – 14 (OHIP-14). The diagnosis of TMD was performed using Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). The patients were examined for other oral conditions and the parents/guardians answered questions addressing socioeconomic/demographic characteristics and the general health of the adolescents. Statistical analysis involves simple and multiple logistic regression models. Ninety male and female adolescents between 13 and 18 years of age participated in the study. The prevalence of negative impact on OHRQoL was 34%. In the unadjusted analysis, negative impact on OHRQoL was associated with a poorer self- perception of general and oral health of the adolescent, nonspecific symptoms including pain, and generalized anxiety disorder, caries, reports of dental pain, muscle disorders and disc displacement, and chronic pain related to TMD. In the adjusted model, negative impact on OHRQoL was associated with all diagnoses related to TMD on the RDC/TMD, except signs of depression. Adolescents with at least one diagnosis related to TMD were 4.13-fold more likely (95% CI:1.08-15.80) to have negative impact on OHRQoL than adolescents without a diagnosis of TMD. The different diagnostic categories of TMD had a negative impact on the OHRQoL of the adolescents analyzed in the present study. El objetivo de este estudio transversal fue evaluar el impacto de los trastornos temporomandibulares (TTM) en la calidad de vida relacionada con la salud bucal (QARSO) de los adolescentes. La OHRQoL de adolescentes sometidos a tratamiento dental en una clínica universitaria en 2019 se midió utilizando la versión brasileña del Oral Health Impact Profile - 14 (OHIP-14). El diagnóstico de TMD se realizó utilizando los Criterios de diagnóstico de investigación para trastornos temporomandibulares (RDC / TMD). Los pacientes fueron examinados en busca de otras afecciones bucales y los padres / tutores respondieron preguntas sobre las características socioeconómicas / demográficas y la salud general de los adolescentes. El análisis estadístico implica modelos de regresión logística simple y múltiple. Participaron del estudio 90 adolescentes, hombres y mujeres, entre 13 y 18 años. La prevalencia de impacto negativo en la OHRQoL fue del 34%. En el análisis no ajustado, el impacto negativo en la OHRQoL se asoció con una peor autopercepción de la salud general y bucal del adolescente, síntomas inespecíficos como dolor y trastorno de ansiedad generalizada, caries, informes de dolor dental, trastornos musculares y desplazamiento del disco, y dolor crónico relacionado con TMD. En el modelo ajustado, el impacto negativo en OHRQoL se asoció con todos los diagnósticos relacionados con TMD en el RDC / TMD, excepto los signos de depresión. Los adolescentes con al menos un diagnóstico relacionado con TMD tenían 4,13 veces más probabilidades (IC 95%: 1,08-15,80) de tener un impacto negativo en la OHRQoL que los adolescentes sin un diagnóstico de TMD. Las diferentes categorías diagnósticas de TTM tuvieron un impacto negativo en la OHRQoL de los adolescentes analizados en el presente estudio. Esse estudo transversal objetivou avaliar o impacto da disfunção temporomandibular (DTM) na qualidade de vida relacionada à saúde bucal (QVRSB) de adolescentes. Pacientes entre 13-18 anos, em tratamento odontológico em uma clínica universitária no ano de 2019 tiveram sua QVRSB mensurada atraves da versão brasileira do Oral Heath Impact Profile – 14 (OHIP-14). O diagnóstico de DTM foi realizado atraves dos eixos I e II do RDC/TMD. Os pacientes foram examinados para outras condições bucais e seus pais/responsáveis responderam questões sociecônomicas, demográficas e de saúde geral dos adolescentes. A análise estátistica usou modelos simples e múltiplos de regressão logística. Noventa adolescentes, de ambos os sexos, participaram do estudo. A prevalência do impacto negativo na QVRSB foi de 34%, sendo os domínios de maior impacto “Desconforto Psicológicos” (28%) e “Incapacidade Psicológica” (19%). O impacto negativo na QVRSB esteve associado, nas análises não ajustadas, a uma pior autopercepção de saúde geral e bucal do adolescente, depressão, sintomas inespecíficos incluindo dor e transtorno de ansiedade generalizada, cárie, relato de dor de dente, DTM, desordem muscular e articular e de dor crônica relacionada à DTM. No modelo ajustado, o impacto negativo na QVRSB foi associado a todos os diagnósticos relacionados à DTM no RDC/TMD, exceto sinais de depressão. Adolescentes com pelo menos um diagnóstico relacionado à DTM tinham chance 4,13 (IC95%%: 1,08-15,80) maior de apresentar impacto negativo na QVRSB do que adolescentes sem diagnóstico de DTM. DTM em suas diferentes categorias diagnósticas tiveram impacto negativo na QVRSB de adolescentes.

Background The authors systematically reviewed the scientific evidence regarding an association between oral health literacy (OHL) and oral conditions. Types of Studies Reviewed The authors performed an electronic search of 8 databases up through October 2016, as well as a manual search. The authors included studies in which the investigators evaluated oral conditions and measured OHL through a validated tool and studies in which OHL was an explanatory variable. The authors assessed risk of bias by using the Newcastle-Ottawa Scale. Results The authors included 10 cross-sectional studies. Risk of bias was high in most studies (n = 6). Dental caries and periodontal status were the most common oral conditions reported (each outcome was reported in 5 studies). Investigators in 4 studies found a statistically significant association between dental caries and lower levels of OHL ( P P Conclusions and Practical Implications There seems to be a weak association between lower levels of OHL and dental caries in primary teeth. Similar findings for adults and between OHL and other oral conditions remain unsubstantiated because the results are controversial, with considerable clinical and statistical heterogeneity between studies.

The aim of this study was to evaluate the association between number of cavitated dental caries in adolescents and family cohesion, drug use, sociodemographic factors and visits to the dentist. A cross-sectional study was conducted with 746 adolescents aged 15 to 19 years from Campina Grande, Brazil. The parents answered a questionnaire addressing sociodemographic data, and the adolescents answered questionnaires on drug use, type of family cohesion and visits to the dentist. Two examiners underwent training and calibration exercises (K > 0.80) to diagnose dental caries using the Nyvad criteria. A directed acyclic graph was created to select the variables to be controlled in the statistical model. Associations between the independent variables and the outcome were determined using robust Poisson Regression analysis for complex samples (α = 5%). Rate ratios (RR) and 95% confidence intervals (CI) were calculated. The prevalence of dental caries and cavitated lesions among the adolescents was 92.8% and 41.6%, respectively. The following variables remained associated with the number of cavitated lesions in the multivariate analysis: disengaged (RR: 6.30; 95%CI: 1.24–31.88; p = 0.028 ), separated (RR: 4.80; 95%CI: 1.03–22.35; p = 0.046) and connected (RR: 5.23; 95%CI: 1.27–21.59; p = 0.024) levels of family cohesion, and high social class (RR: 0.55; 95%CI: 0.39–0.76; p = 0.001). In conclusion, this paper posits that adolescents with a lower socioeconomic status, and those whose family cohesion was classified as disengaged, separated or connected, had a larger number of cavitated lesions.

OBJECTIVE: Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS: Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87–0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS: The following variables remained associated with better OHL: high mother’s schooling level (RR = 1.07; 95%CI: 1.03–1.12), high income (RR = 1.04; 95%CI: 1.01–1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01–1.10), married parents (RR = 1.04; 95%CI: 1.01–1.09), “enmeshed” family cohesion (RR = 1.21; 95%CI: 1.12–1.30), “structured” (RR = 1.06; 95%CI: 1.01–1.12) or “rigid” (RR = 1.11; 95%CI: 1.04–1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01–1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03–1.13). CONCLUSION: Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

Objective: To measure the influence of oral health literacy (OHL) level in the improvement of knowledge about traumatic dental injuries (TDI) after an educational intervention. Material and Methods: A total of 257 parents of children aged 0–12 years had their OHL level evaluated (BREALD-30). A leaflet with information about how to respond to TDI Emergency was developed and delivered to the parents. A questionnaire about attitudes towards TDI was administered before (TDIQ1) and after (TDIQ2) parents read the educational leaflet. The hypotheses were evaluated by non-parametric tests, correlation analysis and logistic regression . Results: The mean OHL score was 21.6. The means of correct answers in TDIQ1 were 5.5 and 5.9 (p = 0.066) and in TDIQ2 were 6.6 and 7.7 (p=0.003) between the groups with inadequate and marginal/adequate OHL, respectively. In the logistic regression, the total score of BREALD-30 and the maximum number of correct answers in TDIQ2 maintained statistical association when adjusted for schooling, gender, age of the parents, family income and the number of correct answers in the first application of the questionnaire . Conclusion: The level of OHL influenced the improvement of parents’ knowledge about emergency care in cases of TDI in children from an educational intervention using a leaflet, and this intervention was more effective for parents with adequate OHL.

Objective: To Determine whether possible sleep bruxism (PSB) is associated with daytime oral habits and sleep behavior in schoolchildren.Methods: A cross-sectional study was conducted with a representative sample of 8-to-10-year-old children (n = 544). The Sleep Behavior Questionnaire (SBQ) was administered to evaluate sleep behavior. Daytime oral habits were evaluated using the Nordic Orofacial Test-Screening.Results: The prevalence of PSB was 21% and was significantly higher in children with reports of awake bruxism (p < .001; PR = 2.76; 95% CI: 2.01-3.79), snoring (p < .001; PR = 1.93; 95% CI: 1.41-2.65), and sucking/biting the lips daily (p = .034; PR = 1.73; 95% CI: 1.08-2.78). No socioeconomic characteristics were associated with PSB in the final model.Conclusion: Possible sleep bruxism in schoolchildren is associated with possible awake bruxism, snoring, sleep fragmentation, and daytime sleepiness.

Objective: To evaluate the factors related to the dental emergency care of children and adolescents in Basic Health Units (UBS) and Emergency Care Units (UPA) affiliated with the public dental network of Curitiba, Brazil. Material and Methods: Cross-sectional study that evaluated 1,012 emergency cases in individuals aged up to 17 years old and with a permanent record in the Unified Health System of Curitiba. Demographic data of individuals and of services were taken from electronic medical records. Statistical analysis was performed using the chi-square test and chi-square test for linear trend (α = 0.05), estimating the prevalence ratio (PR) (95%CI). Results: Of the total of emergency cases, 68.2% and 31.8% were of children and adolescents, respectively. UBS accounted for 89.7% of the cases while UPA represented 10.3%, and 12.2% of the treatments were characterized as first access to the system. Adolescents used UPAs for emergency care more often than children (PR = 1.84; 95%CI: 1.28-2.64). Among children, those with more than 1 year since the last appointment used UPAs for emergency care more often (PR = 1.86; 95%CI: 1.09-3.17). Adolescents for whom emergency care was characterized as first access to the system used UPAs more often (PR = 2.16; 95%CI: 1.04-4.46). The proximity between the UBS of origin and the UPA was associated with greater UPA utilization by both groups. Conclusion: UBSs accounted for most of the dental emergency treatments. Children and adolescents with a poorer connection with UBSs and those who lived near an UPA had a higher prevalence of UPA utilization for emergency care.

Background: Infective endocarditis (IE) is a serious disease that affects the surface of the endocardium. The spread of microorganisms from the oral cavity has been associated with the occurrence of IE. Objective: To analyze whether dental treatment before cardiac valve surgery (CVS) influenced the occurrence of IE. Methods: We performed a retrospective analysis of the medical and dental histories of patients undergoing CVS from 2004 to 2014. The sample consisted of 481 patients who underwent CVS divided into two groups: patients submitted to dental treatment prior to CVS (n = 110) and patients undergoing CVS without dental treatment (n = 371). Results: Of the total sample, 38 patients (8%) were diagnosed with IE. No significant difference was detected (p = 0.496) in comparing the occurrence of IE in the group with dental preparation (6.4%) and without dental preparation (8.4%). The logistic regression model confirmed that dental treatment did not change the IE risk (p = 0.504) and indicated that age (p

The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families. Resumo O objetivo deste estudo foi avaliar a associação entre cárie dentária não tratada (CDNT) e insegurança alimentar (IA) em escolares de diferentes estratos de renda. Foi realizado um estudo de base populacional com uma amostra de 584 escolares de 12 anos de idade. Exames clínicos bucais foram realizados e IA foi determinada por meio de uma escala validada. Outras variáveis foram analisadas por serem de interesse para a estratificação dos resultados (renda domiciliar per capita) ou como variáveis de confusão. A prevalência de CDNT e IA foi de 45% e 39%, respectivamente. Os modelos multivariados demonstraram que a CDNT foi significativamente mais prevalente entre as crianças com IA alimentar e renda per capita de até US$ 70,71 do que entre aqueles no mesmo estrato de renda que estavam livres de IA [RP = 1,52 (IC 95% = 1,01 -2,29)]. A IA foi associada com uma maior frequência de CDNT em escolares de baixa renda, porém não teve impacto significativo sobre esta variável entre crianças de diferentes estratos de renda. Diante disso, garantir o acesso a uma alimentação de qualidade pode representar uma boa estratégia para minimizar as iniquidades em saúde bucal e reduzir a experiência de cárie dentária em escolares de baixa renda.

Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists.To investigate parents' knowledge about SB among their children.A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P 0.05).Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P 0.05).There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

O objetivo deste estudo foi avaliar o uso de álcool e tabaco entre os acadêmicos de odontologia. Foi realizado um estudo transversal censitário com 300 acadêmicos de odontologia da Universidade Federal do Paraná (UFPR). As informações sobre o perfil socioeconômico, assim como acerca do uso de álcool e tabaco foram coletadas por meio de um questionário especificamente desenvolvido para essa pesquisa. A população estudada era na maioria do sexo feminino e com idade média de 21±2,5 anos, sendo que 51,3% e 8,4% usavam álcool e tabaco, respectivamente. Estudantes do sexo masculino apresentaram maior prevalência de uso de álcool (RP=1,58; IC 95%: 1,09-2,28) e tabaco (RP=1,72; IC 95%: 1,10-2,70). Maior prevalência de uso de álcool (RP=1,70; IC 95%: 1,30-2,21) e tabaco (RP=1,50; IC 95%: 1,10-2,05) foi observada entre os estudantes de classes econômicas mais altas, quando comparados aos menos favorecidos economicamente. Os estudantes que não moravam com a família apresentaram prevalência de consumo de álcool 70% maior do que os que residiam com a família (RP=1,70; IC 95%: 1,10-2,65). O uso de tabaco não diferiu em função da moradia. Conclui-se que os estudantes de odontologia da UFPR que são usuários de álcool e tabaco apresentam especificidade social e econômica, assim esforços devem ser direcionados para a conscientização e proteção desse grupo.

Introduction The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at Sao Bernardo Hospital. Methods A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data. Background The Apgar score (at 1 min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning. Results The mean water immersion time was 1 h and 46 min and had an influence on the duration of labour (mean 5 h and 37 min), with a statistically significant difference (P = 0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9). Conclusion These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women.

Telehealth has been considered a practical and potentially cost-effective method of providing healthcare to the underprivileged population. The aim of this study was to determine whether a teledentistry system is a valid tool to screen for the presence of dental caries in a cohort of 102 Brazilian juvenile offenders.Clinical examinations were performed to evaluate the decayed, missing, and filled teeth (DMFT) index and oral conditions of each adolescent, documented using a digital camera. For distant diagnosis, two methods of image transmission were tested. In the first, images were uploaded on a file-sharing service, and the link was sent via e-mail to one distant consultant. The other consultant received the images recorded on a compact disc. Both assessed the files and calculated the DMFT index for each case. The degree of agreement between the traditional examination and distant consultant assessments was measured by the kappa coefficient of agreement. Sensitivity and specificity were also calculated.According to the traditional clinical examination, 93.1% of the adolescents had at least one instance of dental caries with a mean DMFT index of 5.9. Kappa statistics ranged from "strong" to "almost perfect." Sensitivity ranged from 48% to 73%, and specificity was either 97% or 98%.Adolescent inmates could benefit from oral health screening using digital photography. Teledentistry appears to be a reliable alternative to the traditional oral examination for dental caries assessment.

The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families. O objetivo do presente estudo foi avaliar o impacto da maloclusão na OHRQoL de crianças e suas famílias. Um estudo transversal de base populacional foi conduzido em Belo Horizonte, Brasil. Uma amostra representativa contendo 1069 crianças dos gêneros masculino e feminino foi randomicamente selecionada, em creches e pré-escolas públicas e privadas. Os dados foram coletados através do questionário B-ECOHIS. Ademais, um questionário contendo dados socioeconômicos e demográficos foi respondido pelos pais/responsáveis das crianças. Os critérios utilizados para o diagnóstico de maloclusão foram baseados nos estudos de Foster e Hamilton (1969), Graboswki et al. (2007) e Oliveira et al. (2008). Análises descritivas, univariadas e regressão logística múltipla de Poisson foram realizadas. A prevalência de maloclusão foi observada em 46,2% das crianças, sendo a mordida profunda o tipo de maloclusão mais frequente (19,7%), seguido de mordida cruzada posterior (13,1%), sobressaliência acentuada (10,5%), mordida aberta anterior (7,9%) e mordida cruzada anterior (6,7%). A prevalência do impacto da maloclusão na OHRQoL foi de 32,7% nas crianças e 27,1% nas famílias. No modelo de regressão múltipla ajustado para o status socioeconômico, não se observou associação significante entre maloclusão e OHRQoL das crianças (PR=1.09, 95% CI: 0,96-1,24) e de suas famílias (PR=1,11, 95% CI: 0,94-1,31). Conclui-se que as crianças que apresentaram maloclusão nesta amostra, não apresentaram impacto negativo na sua OHRQoL e nem de suas famílias.

Objective: The aim of the present study was to assess the impact of orofacial dysfunction on oral health-related quality of life (OHRQoL) among Brazilian schoolchildren.Material and methods: A population-based study was conducted with 531 children aged eight to 10 years at schools in the city of Campo Magro, Brazil. The Brazilian version of the Child Perceptions Questionnaire (CPQ8–10) was the outcome variable used to measure the impact on OHRQoL. The main independent variable was orofacial function, which was diagnosed using the Nordic Orofacial Test-Screening (NOT-S). Descriptive, bivariate and multiple Poisson regression analyses were performed using a multilevel approach, with the significance level set to 5%.Results: The mean (±SD) total CPQ8–10 score was 13.95 ± 0.5. The multilevel Poisson regression model revealed that the mean CPQ8-10 score was higher among girls (RR: 1.38, 95% CI: 1.17–1.63; p

Objetivo: Este estudio evaluó los cambios en el patrón de lactancia materna, alimentación artificial y en la introducción de azúcar en la dieta de niños de 0 a 36 meses, a través de dos estudios, con un intervalo de 13 años en la ciudad de Curitiba, Paraná, Brasil. Material y métodos: Poblaciones semejantes de una misma región geográfica fueron evaluadas a través de un cuestionario, en los años de 1993 y 2006, envolviendo, respectivamente, las madres de 180 y 94 niños. Introducción de azúcar en la dieta fue considerada precoz cuando ocurrió antes del 6º mes completo de vida. Los datos fueron analizados estadísticamente a través del test de qui-cuadrado y test exacto de Fisher (?= 0,05). Resultados: Hubo diferencias en la frecuencia del primer contacto con azúcar (p

La displasia cleidocraneal (CCD) es un trastorno oseo, autosomico dominante, causado por un defecto en el gen CBFA1 y se caracteriza por anomalias esqueleticas, craneofaciales y bucodentales. En este trabajo se describen los principales aspectos de un caso de CCD, desde el diagnostico y la planificacion para la primera etapa de las intervenciones. Un paciente varon de 11 anos de edad, concurrio a la Clinica de Odontologia Pediatrica de la Universidad Federal de Parana (Brasil) con un problema de retencion prolongada de casi todos sus dientes de leche. Se describen los examenes clinicos y de imagen dirigidos al diagnostico de la CCD y el plan de tratamiento. La primera etapa consistio en la extraccion de cuatro dientes primarios, dos dientes permanentes y dos dientes supernumerarios del maxilar, seguido de separacion del paladar, traccion de los dientes afectados y traccion inversa del maxilar. El paciente permanece en tratamiento. El seguimiento clinico, asi como la concientizacion y motivacion de la familia son factores importantes en este tipo de casos.

Eating behavior of parents exerts an influence on eating practices among their children, including the consumption of cariogenic products. The aim of this study was to determine the relationship between the snack limits established by parents/caregivers and the prevalence of untreated dental caries (UDC) among their children. A cross-sectional study was conducted with a representative sample of 686 children aged four and five years enrolled at public schools in the city of Curitiba, Brazil, and their parents/caregivers. The children were examined for dental caries and visible plaque. Parents/caregivers answered the Brazilian version of the Parent Mealtime Action Scale (PMAS). Data were analyzed using nonparametric tests and Poison regression analysis. The prevalence of UDC was 45.6%. The Snack Limits subscale of the PMAS was associated with a lower prevalence rate of UDC (PR: 0.83; 95%CI: 0.72–0.96), independently of the other variables. UDC was also associated with a greater prevalence of visible plaque (PR: 1.29; 95%CI: 1.08–1.54), a lower tooth brushing frequency (PR: 1.46; 95%CI: 1.22–1.77) and greater age of the child (PR: 1.31; 95%CI: 1.08–1.59). Snack limits established by parents/caregivers were associated to a lower prevalence rate of UDC among preschool children.

Objectives The purpose of this study was to evaluate the impact of oral health conditions on oral health-related quality of life (OHRQoL) in population-based sample of Brazilian preschool children. A further aim was to identify the influence of socio-demographic profile and perceptions regarding general health and oral health status on OHRQoL. Methods An epidemiological survey was carried out at public and private preschools in the city of Belo Horizonte, Brazil. The sample consisted of 1632 5-year-old male and female preschoolers randomly selected using a multi-stage sampling technique and their parents/caregivers. Oral examinations of the children were performed by a single, previously calibrated examiner for the assessment of dental caries experience, malocclusion, traumatic dental injury and developmental defects of enamel. Caregivers were asked to complete the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) and a form on socio-demographic data. Descriptive, bivariate and adjusted Poisson regression model analyses were carried out. Results In the child section of the B-ECOHIS, OHRQoL was negatively impacted by decayed, missing and filled teeth [prevalence ratios (PR) = 2.18; 95% CI, 1.88–2.52], position of the child among siblings in the family (PR = 1.20; 95% CI, 1.04–1.39), type of preschool (PR = 1.36; 95% CI, 1.10–1.69), age of parents/caregivers (PR = 1.18; 95% CI, 1.04–1.34), monthly household income (PR = 1.48; 95% CI, 1.18–1.85) and perception of the child's general health status (PR = 1.26; 95% CI, 1.06–1.51). In the family section, the adjusted results demonstrated a negative impact on OHRQoL associated with dental caries experience (PR = 3.40; 95% CI, 2.83–4.08), age of parents/caregivers (PR = 1.16; 95% CI, 1.01–1.33) and monthly household income (PR = 1.41; 95% CI, 1.16–1.72). Conclusions Dental caries experience was the only normative criteria with a negative impact on OHRQoL. Families with low income and younger parents reported a greater impact on quality of life. According to parents' perceptions, a poor general health status rating was related to poorer quality of life among the children.

The aim of the present study was to analyze dental research trends in Brazil over the past nine years. All abstracts presented at the 26th Annual Meeting of the Brazilian Society for Dental Research in 2009 (n = 2648) were classified based on field of knowledge, home institution and geographic region. Data were compared with those previously published based on abstracts presented at various meetings. Between 2001 and 2006, five fields of knowledge had a greater than 10% representation among the total number of studies. These fields included restorative dentistry/dental materials (RD/DM), periodontics, endodontics, pediatric dentistry and population-based oral health. In 2009, only RD/DM maintained a greater than 10% proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8%). The majority of research studies were performed at public institutions, and the number of abstracts per state increased significantly in 2009 (Wilcoxon test, p < 0.001). The southeastern region of Brazil submitted the greatest number of abstracts; however, other regions also demonstrated increased participation in research (11%). The percentage distribution of abstracts between states remained constant (Wilcoxon test, p = 0.255; r s = 0.873). The results of the present study suggest a slight shift in the scientific research profile in Brazilian dentistry: fields related to professional disciplines have declined in relative research participation, while increasing interest has been observed in basic fields and new specialties.

The objective of this study was to describe an interviewer training and calibration method to evaluate oral health literacy using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) in epidemiological studies. An experienced researcher (gold standard) conducted all training sessions. The interviewer training and calibration sessions included three different phases: theoretical training, practical training, and calibration. In the calibration phase, six interviewers (dentists) independently assessed 15 videos of individuals who had different levels of oral health literacy. Accuracy and reproducibility were evaluated using the kappa coefficient and the intraclass correlation coefficient (ICC). The percentage of agreement for each word in the instrument was also calculated. After training, the kappa values were higher than 0.911 and 0.893 for intra- and inter-rater agreement, respectively. When the results were analyzed separately for the different levels of literacy, the lowest agreement rate was found when evaluating the videos of individuals with low literacy (K = 0.871), but still within the range considered to be near-perfect agreement. The ICC values were higher than 0.990 and 0.975 for intra- and inter-rater agreement, respectively. The lowest percentage of agreement was 86.6% for the word “hipoplasia” (hypoplasia). This interviewer training and calibration method proved to be feasible and effective. Therefore, it can be used as a methodological tool in studies assessing oral health literacy using the BREALD-30.

Aiming to assess the effect of mixing process on microleakage, 40 primary molars were filled with encapsulated glass ionomer cements (GICs) (Vidrion,RCaps and Fuji,IXGPFAST) or with GICs stored in bottles (Vidrion,R and Fuji,IX). Dye penetration was assessed using scores. Encapsulation and mechanical mixing have reduced significantly marginal microleakage levels in class II restorations performed with conventional GICs if compared to the values obtained by their bottled correspondents (p=0,000).

Objective To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40

Background In the present state of knowledge regarding the etiology of dental caries, it is unacceptable for studies addressing factors associated with this outcome to disregard oral hygiene. Simple, valid methods are needed for the assessment of oral hygiene in adolescents to allow this condition to be properly investigated in epidemiological studies on caries and assist in the establishment of health promotion measures. The aim of the present study was to test the hypothesis that the self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices in epidemiological studies on dental caries in adolescents. Methods A cross-sectional study was conducted with a representative sample (n = 589) of 12-year-old school children in a medium-sized city in southern Brazil. A detailed questionnaire addressing socio-demographic and economic characteristics was sent to primary caregivers. Adolescents answered a brief self-administered questionnaire on behavioral characteristics, including toothbrushing frequency and sugar intake. Samples of stimulated saliva were collected from the adolescents and evaluated for levels of mutans streptococci and lactobacilli using Dentacult kits I and II, respectively. Examiners who had undergone a training and calibration exercise (kappa > 0.81) performed the clinical examination of the adolescents. Caries experience was assessed using the decayed, missing and filled teeth index. Oral hygiene was determined using the Simplified Oral Hygiene Index and the Visible Plaque Index. Results When the oral hygiene variables were used alone in the multiple models, significant associations with dental caries were found. When Simplified Oral Hygiene Index and/or Plaque Index were used together with toothbrushing frequency in the same model, only the latter was significantly associated with dental caries. A significant association was also found between self-reported toothbrushing frequency and the clinical indices. Conclusion Based on the present findings, self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices, which facilitates data collection in epidemiological studies addressing dental caries in adolescents.