Seeking treatment for traumatic dental injuries in schoolchildren: A multilevel analysis

ABSTRACT To investigate individual and contextual factors associated with seeking treatment for traumatic dental injuries. A cross-sectional study was conducted with 739 pairs of guardians and children. Guardians answered a questionnaire addressing sociodemographic characteristics, seeking treatment for a tooth injury in the child, and the Oral Health Literacy-Adult Questionnaire. Descriptive analysis and unadjusted and adjusted multilevel Poisson regression analysis (p<0.05). The prevalence of seeking treatment for traumatic dental injury was 44.7%. Sociodemographic variables associated were white skin of the child (PR = 1.30; 95% CI: 1.08-1.76), mother's age older than 35 years (PR = 1.70; 95% CI: 1.50-1.90), married parents (PR = 1.93; 95% CI: 1.70-2.23), guardians with more than eight years of schooling (PR = 2.00; 95% CI: 1.76-2.23), with adequate oral health literacy (PR = 3.33; 95% CI: 3.01-3.62) and the daily use of electronic devices by the child (PR = 1.26; 95% CI: 1.02-1.50). On the contextual level, attending a private school (PR = 1.77; 95% CI: 1.02-3.05) and the number of primary care units with oral health teams in the school district (PR = 1.78; 95% CI: 1.12-2.38) remained associated. Among the children who suffered TDI, adequate oral health literacy on the part of the parents stood out among the factors associated with seeking treatment.

Resumo Investigar fatores individuais e contextuais associados à busca de tratamento para lesões dentárias traumáticas. Foi realizado um estudo transversal com 739 pares de responsáveis e crianças. Os responsáveis responderam a um questionário abordando características sociodemográficas, busca por tratamento para traumatismo dentário na criança e o Questionário de alfabetização em saúde bucal para adulto. Análise descritiva e análise de regressão de Poisson multinível não ajustada e ajustada (p<0,05) foram realizadas. A prevalência de busca de tratamento para lesão dentária traumática foi de 44,7%. As variáveis sociodemográficas associadas foram a pele branca da criança (RP = 1,30; IC 95%: 1,08-1,76), idade da mãe maior que 35 anos (RP = 1,70; IC 95%: 1,50-1,90), os responsáveis casados (RP = 1,93; IC 95%: 1,70-2,23), com mais de oito anos de estudo (RP = 2,00; IC 95%: 1,76-2,23), com alfabetização adequada em saúde bucal (RP = 2,00; IC 95%: 1,76-2,23) e uso diário de dispositivos eletrônicos pela criança (RP = 1,26; IC 95%: 1,02-1,50). No nível contextual, frequentar uma escola particular (PR = 1,77; IC 95%: 1,02-3,05) e a quantidade de unidades básicas de saúde com equipes de saúde bucal no distrito sanitário da escola (PR = 1,78; IC 95%: 1,12-2,38) permaneceram associados. Entre as crianças que sofreram TDI, a alfabetização em saúde bucal adequada dos pais foi um fator que se destacou na busca por tratamento.

Predictors associated with malocclusion in children with and without sleep disorders: a cross-sectional study

Abstract The aim of the present study was to investigate predictors of malocclusion in Brazilian schoolchildren eight to ten years of age based on a causal directed acyclic graph model. A cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians provided information on sleep disorders of the child (Sleep Disturbance Scale for Children) and family characteristics (Family Adaptability and Cohesion Evaluation Scale). The diagnosis of malocclusion was performed by four trained examiners using the Dental Aesthetic Index. Control variables were selected using a directed acyclic graph. Descriptive analysis was performed, followed by robust logistic regression analysis for complex samples (α = 5%). The following variables were associated with malocclusion in the final model: sleep disorders (OR = 2.61; 95%CI: 2.43-2.86), mouth breathing (OR = 1.04; 95%CI: 1.02-1.99), non-nutritive sucking habits (OR = 2.45; 95%CI: 2.37-4.85), and obesity (OR = 1.54; 95%CI: 1.02-2.33). Sociodemographic characteristics, family functioning, and premature tooth loss did not remain associated with malocclusion. Sleep disorders, mouth breathing, sucking habits, and obesity are predictors of malocclusion in schoolchildren eight to ten years of age.

Evaluation of the association between self-reported sleep bruxism and chronotype and sleep quality among dental students / Avaliação da associação entre cronotipo, qualidade do sono e autorrelato de bruxismo do sono entre estudantes universitários de Odontologia

ABSTRACT Background Sleep bruxism (BS) is defined as involuntary jaw movements characterized by grinding and clenching teeth. Objective To verify the association between chronotype, sleep quality, and self-reporting of BS in dental students. Method A cross-sectional study was conducted with 214 undergraduate dental students at a public university in northeast Brazil. The participants answered the Munich Chronotype Questionnaire for the identification of chronotype and another questionnaire regarding daily aspects to collect information about sleep quality, self-reported sleep bruxism, the use of sleeping pills, snoring, concentration during daily activities and energy upon waking. Results The prevalence of self-reported sleep bruxism was 11.0%. In the final model, the eveningness chronotype (OR = 23.00; 95% CI: 2.36-223.84, p = 0.007), habitual snoring (OR = 3.12; 95% CI: 1.31-7.39, p = 0.01) and low energy upon waking in the morning (OR = 2.37; 95% CI: 1.96-5.58, p = 0.040) were associated with self-reported sleep bruxism. Conclusion The evening chronotype, presence of snoring, and low energy when waking up in the morning influenced self-reporting of sleep bruxism among undergraduate dental students.

RESUMO Introdução O bruxismo do sono (BS) é definido como movimentos involuntários da mandíbula caracterizados por ranger e apertar os dentes. Objetivo Verificar se o cronotipo e a qualidade do sono estão associados ao autorrelato de BS em graduandos de Odontologia. Método Um estudo transversal com 214 estudantes de uma universidade pública do Nordeste do Brasil. Os participantes responderam ao Morningness-Eveningness Questionnaire para identificar os cronotipos e outro questionário sobre aspectos diários em que foram coletadas informações sobre qualidade do sono, autorrelato de bruxismo do sono, uso de pílulas para dormir, ronco, concentração nas atividades diárias, energia ao acordar. Resultados A prevalência de autorrelato do bruxismo do sono foi de 11,0%. No modelo final, o cronotipo noturno (OR = 23,00; 95% IC: 2.36-223.84, p = 0,007), o hábito de roncar (OR = 3,12; 95% IC: 1.31-7.39, p = 0,01) e o baixo nível de energia ao acordar pela manhã (OR = 2,37; 95% IC: 1.96-5.58, p = 0,04) estiveram associados com o autorrelato de BS. Conclusão O cronotipo noturno, a presença do ronco e a baixa energia ao se levantar pela manhã influenciaram o autorrelato de bruxismo do sono entre os estudantes de graduação em Odontologia.

Family structure, sociodemographic factors and type of dental service associated with oral health literacy in the early adolescence / Estrutura familiar, fatores sociodemográficos e tipo de serviço odontológico associados ao alfabetismo em saúde bucal no início da adolescência

Abstract 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.

Oral health literacy as a priority to reduce disparities in oral health among adolescents

O alfabetismo em saúde bucal é um determinante social e estrutural de saúde reconhecido por seu papel relevante na saúde bucal e na utilização de serviços odontológicos. Estudos tem abordado esse tema na adolescência porque é uma fase crítica do desenvolvimento humano e requer atenção para mudanças físicas, cognitivas e sociais. Essa abordagem é importante para fortalecer políticas públicas que visem reduzir as disparidades de saúde bucal nessa população por meio de ações promovidas por profissionais da saúde, gestores e pela população em geral. O presente comentário pretende abordar as contribuições do alfabetismo em saúde bucal para a saúde bucal em adolescentes, bem como discutir novas perspectivas de estudos sobre essa temática.

Oral health literacy is a social and structural determinant of health recognized for its important role in oral health and the use of dental services. Research has focused on adolescence because this life period requires attention to physical, cognitive and social changes. This is an important time to focus on youth and we can do this through actions promoted by health providers, managers and the general public. This commentary aims to address how oral health literacy contributes to oral health in adolescents, as well as to discuss new perspectives for studies on this topic.

Contextual and individual factors associated with oral health literacy in adolescents: A multi-level approach

Abstract 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<0.05). Rate ratio (RR) and 95% confidence intervals (CI) were calculated. The two levels of the analysis were students and schools. Adolescents enrolled at schools with higher grade-retention rate had slightly worse OHL scores (RR = 0.99; 95% CI: 0.98 to 0.99). The following individual factors were associated with the level of OHL: the female sex (RR = 1.05; 95% CI: 1.01 to 1.10), mother's schooling more than eight years (RR = 1.13; 95% CI: 1.08 to 1.19), younger guardians (RR = 0.94; 95% CI: 0.90 to 0.97) and a balanced family functioning (RR = 1.08; 95% CI: 1.01 to 1.14). Individual and contextual factors were associated with OHL in early adolescence.

Resumo O objetivo deste estudo foi avaliar o efeito de um nanocomplexo recém-desenvolvido formado entre hidroxipropil-β-ciclodextrina e 1% de tetrafluoreto de titânio (TiF4) após distintos períodos de complexação (12/72 horas) na desmineralização do esmalte bovino in vitro. Blocos de esmalte (n = 60) foram alocados para cada grupo: água Mili-Q, hidroxipropil-β-ciclodextrina, TiF4 a 1%, hidroxipropil-β-ciclodextrina + TiF4 1% após 12 horas de complexação e hidroxipropil-β-ciclodextrina + TiF4 1% após 72 horas de complexação. As amostras foram avaliadas pela microdureza superficial, microdureza transversal e micro-CT. Microscopia eletrônica de varredura / espectrometria de raios X por dispersão de energia (MEV / EDX) foram obtidas. A hidroxipropil-β-ciclodextrina + TiF4 1% após 12h de complexação resultou em um menor percentual de perda de microdureza superficial em comparação com água Mili-Q, hidroxipropil-β-ciclodextrina, TiF4 a 1% e hidroxipropil-β-ciclodextrina + TiF4 1% após 72 horas de complexação com uma ampla magnitude de efeito (de 1,307 a 2,943) e alto poder (84,9 a 99%). Todos os grupos resultaram em similar perda integrada de minerais (ΔZ) obtida por ambas as técnicas de microdureza e micro-CT. O esmalte tratado com os grupos TiF4 e TiF4 + hidroxipropil-β-ciclodextrina apresentou camada de esmalte TiO2, enquanto a avaliação de EDX identificou Ti. A solução contendo o complexo de inclusão de hidroxipropil-β-ciclodextrina + TiF4 com 12 horas de período de complexação demonstrou uma capacidade significativa para reduzir a desmineralização superficial do esmalte hígido sob um desafio cariogênico artificial.

Associação entre o alfabetismo funcional e o reconhecimento da palavra bruxismo em adolescentes / Association between functional literacy and the recognition of the word bruxism in adolescents

Objetivo: Avaliar a associação entre alfabetismo funcional e o reconhecimento da palavra "bruxismo" entre adolescentes. Métodos: Foi um estudo transversal realizado em uma cidade de porte médio no Brasil. A amostra consistiu em 375 escolares de 12 anos e 368 de 15 a 19 anos selecionados aleatoriamente. Dois examinadores calibrados (Kappa > 0,80) aplicaram o instrumento de alfabetismo em saúde bucal validado para adolescentes o Rapid Estimate of Adult Literacy in Dentistry ­ BREALD-30 e o reconhecimento da palavra "bruxismo" foi utilizado como variável dependente, além de um questionário sobre o alfabetismo funcional (Índice de Alfabetismo Funcional ­INAF). Os pais/cuidadores responderam um questionário sociodemográfico. Foi realizada análise não-ajustada e regressão logística para amostras complexas(p < 0,05). Resultados: No modelo final, os adolescentes de 12 anos que tiveram mais chances de não reconhecer a palavra "bruxismo" foram os de escola pública (OR = 2,83; 95% IC: 1,79-4,46; p = 0,001), sem plano de saúde (OR = 2,02; 95% IC: 1,21-3,37; p = 0,007) e com menor nível de alfabetismo funcional (OR = 2,66; 95% IC: 1,66-4,26; p < 0,001). Adolescentes de 15 a 19 anos que tiveram maior chance de não reconhecer a palavra "bruxismo" foram os com menor nível de alfabetismo funcional (OR = 3,29; 95% IC: 1,93-5,60; p < 0,001), que residiam com mais pessoas em casa (OR = 2,04; 95% IC: 1,02-4,11; p = 0,040), que tinham pais/responsáveis com baixo nível de escolaridade (OR = 1,97; 95% IC: 1,15-3,36; p = 0,013) e que nunca foram ao dentista (OR = 3,08;95% IC: 1,26-7,52; p = 0,03). Conclusão:O reconhecimento do termo "bruxismo" entre os adolescentes de 12 anos foi influenciado pela presença deplano de saúde e por um maior nível de alfabetismo funcional. Na faixa etária maior, o maior nível de alfabetismo funcional, o menor número de pessoas em casa, a maior escolaridade do responsável e a ida ao dentista influenciaram no reconhecimento do termo.

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.

Family and contextual factors associated with licit drug use in adolescence

ABSTRACT OBJECTIVE: TO evaluate the family and contextual factors associated with licit drug use among 15 to 19-year-old adolescents in the school context. METHODS: This is a representative, school-based, cross-sectional study conducted with 746 adolescents from 15 to 19 years old enrolled in public and private schools. Parents/guardians reported on the sociodemographic variables, while adolescents answered questionnaires on drug use, family cohesion and adaptability, oral health literacy and visits to the dentist. Information on school context was obtained at the institution and via municipal publications. Associations between variables were analyzed using unadjusted and adjusted multilevel Poisson regression models. RESULTS: Prevalence of licit drug use at least once and a pattern indicative of harmful drug use were 39.8% and 15.1%, respectively. After the adjusted analysis of licit drug use at least once, the variables gender (PR = 1.26; 95%CI: 1.01-1.59), family cohesion (PR = 9.81; 95%CI: 1.23-72.54), and average income of the school district (PR = 0.72; 95%CI: 0.57-0.91) remained in the final model. As for drug abuse, only the detached type (PR = 23.01; 95%CI: 2.46-214.87) and separated type (PR = 13.54; 95%CI: 1.40-130.97) of family cohesion remained in the final model. CONCLUSION: Experience with licit drug use was associated with family and contextual factors among the adolescents, while family cohesion was the main factor related to harmful drug use.

Contributions of school context to caries on anterior teeth: a multilevel analysis

ABSTRACT OBJECTIVE To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents. METHODS A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05). RESULTS The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24-2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13-1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05-3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07-1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78-3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05-0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98-0.99) were associated with the outcome. CONCLUSIONS Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

Socioeconomic status and family functioning influence oral health literacy among adolescents

ABSTRACT 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.

Degree of family cohesion and social class are associated with the number of cavitated dental caries in adolescents

Abstract 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.

Psychometric properties of BREALD-30 for assessing adolescents' oral health literacy

ABSTRACT OBJECTIVE To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents. METHODS The study included 750 adolescents: 375 aged 12 years and 375 aged 15-19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%. RESULTS BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach's alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48-3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24-3.11]. CONCLUSIONS BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.

Odontopediatras e técnicas aversivas no controle do comportamento infantil

Avaliar o perfil dos odontopediatras e o uso das técnicas aversivas para o controle do comportamento no cotidiano clínico. Sujeitos e método: foi realizado um estudo transversal, censitário, realizado com 33 odontopediatras atuantes na cidade de João Pessoa, regularmente inscritos no Conselho Regional de Odontologia da Paraíba. Os dados foram coletados por meio de questionário, objetivando avaliar: dados sociodemográficos; seleção e indicação das técnicas aversivas; ansiedade do odontopediatra e o consentimento e aceitação das técnicas aversivas pelas crianças/responsáveis. A análise dos dados foi realizada por estatística descritiva. Resultados: os odontopediatras foram representados principalmente pelo sexo feminino (93,9%), graduados há mais de 10 anos (84,8%) e com especialização (45,5%). Entre os profissionais, 84,8% utilizavam as técnicas aversivas, destes, 75,0% utilizavam as técnicas em pelo menos dois a cada 10 pacientes. No entanto, apenas 66,6% consideraram a abordagem do assunto suficiente durante a pós/graduação. A técnica aversiva mais escolhida pelos profissionais foi a contenção de braços, pernas e cabeça sem dispositivos específicos (53,6%), a principal indica- ção foi para crianças birrentas e agressivas (39,3%) e os profissionais relataram baixa ansiedade para execução das técnicas (46,4%). A maioria dos odontopediatras (60,7%) não solicitava a assinatura do termo de consentimento. Além disso, 92,9% afirmaram que a estabilização protetora não era rejeitada pelos pais, como também, 92,9% não consideraram que a estabilização protetora prejudicasse a aceitação do tratamento odontológico posterior da família do paciente. Conclusão: foi comum os odontopediatras utilizarem as técnicas aversivas para o controle comportamental, porém poucos solicitavam a autorização pelo termo de consentimento.