Parturientes adolescentes em Cruzeiro do Sul, Acre, Brasil: características socioeconômicas e obstétricas / Adolescent pregnancy in Cruzeiro do Sul, Acre, Brazil: socioeconomic characteristics, prenatal and obstetric care

Resumo O objetivo do estudo foi investigar as características socioeconômicas e obstétricas de parturientes adolescentes e suas complicações sobre a saúde materna e neonatal. Trata-se de uma análise de dados da linha de base da coorte de nascimentos MINA-Brasil conduzida no município de Cruzeiro do Sul, estado do Acre. Utilizou-se teste qui-quadrado para comparar características das puérperas adolescentes com as adultas e modelos múltiplos de regressão de Poisson com variância robusta para avaliar fatores associados. Entre as puérperas estudadas, 26,2% (IC95%: 24,0-28,4) eram adolescentes. Os fatores associados ao parto na adolescência foram ter nove anos ou menos de estudo (RPaj:1,36; IC95%: 1,14-1,61), pertencer aos menores quartis do índice de riqueza (1° quartil: RPaj:1,40; IC95%: 1,08-1,80) (2° quartil: RPaj:1,37; IC95%: 1,08-1,74), ser primigesta (RPaj:3,69; IC95%: 2,98-4,57), baixo IMC pré-gestacional (RPaj:1,28; IC95%: 1,04-1,57), infecção urinária na gravidez (RPaj:1,25; IC95%: 1,07-1,46) e menos de seis consultas de pré-natal (RPaj:1,42; IC95%: 1,21-1,66). Pobreza, baixa escolaridade, primigestação, baixo IMC pré-gestacional, infecção urinária na gestação e menor número de consultas de pré-natal foram associados ao parto na adolescência em município da região Norte do Brasil.

Abstract The present study aimed to investigate the socioeconomic and obstetric characteristics of adolescent mothers and the complications they cause to maternal and neonatal health. This baseline data analysis of the MINA-Brazil birth cohort was conducted in the municipality of Cruzeiro do Sul, state of Acre, Brazil. The chi-square test was used to compare characteristics of adolescent and adult postpartum women, and multiple Poisson regression models with robust variance were used to assess associated factors. Among the postpartum women, 26.2% (95%CI: 24.0-28.4) were adolescents. Factors associated with childbirth in adolescence included: nine years or less of schooling (adjPR:1.36; 95%CI: 1.14-1.61), belongs to the lowest quartiles of the wealth index (1st quartile: adjPR:1.40; 95%CI: 1.08-1.80) (2nd quartile: adjPR:1.37; 95%CI: 1.08-1.74), primigravidae (adjPR:3.69; 95%CI: 2.98-4.57), low pre-pregnancy BMI (adjPR:1.28; CI95%: 1.04-1.57), urinary tract infection during pregnancy (adjPR:1.25; CI95%: 1.07-1.46) and less than six prenatal consultations (adjPR:1.42; 95%CI: 1.21-1.66). Poverty, little schooling, primigravidae, low pre-pregnancy BMI, urinary tract infection during pregnancy and few prenatal consultations were associated with childbirth during adolescence in a municipality in the Northern region of Brazil.

Adverse oral conditions associated with worse emotional and social well-being of Brazilian teenagers: a population-based study in a deprived rural-urban boundary / Condições bucais adversas associadas a pior bem-estar emocional e social de adolescentes brasileiros: um estudo de base populacional em uma periferia rural-urbana negligenciada

Abstract Background The relationship between dental appearance and emotional/social well-being in underprivileged areas undergoing rapid urbanization is unknown. Objective To assess if the emotional and social well-being of teenagers living in urban areas might be more affected by unfavorable dental appearance determined by oral conditions. Method A population-based cross-sectional exploratory study with 12-year-old Brazilian schoolchildren was carried out in two poor, underserviced districts of Sao Paulo City, Brazil. Outcome was severity of oral health-related quality of life (QHRQoL) due to the emotional and social well-being and exposures were oral conditions and residence district (rural or urban). Results The impact on severity of QHRQoL due to emotional well-being and due to social well-being, respectively, were 14% and 16% higher for those presenting at least one untreated decayed tooth; 36% and 54% higher for those with unfavorable dental appearance and 25% and 39% higher for those from the urban district. No association between malocclusion and district was observed. Conclusion Despite higher prevalence of untreated dental caries in the rural district, teenagers from the urban district felt that their OHRQoL, adjusted by oral conditions investigated, was more negatively affected. This suggests that urban environmental influences can lead to stressful social pressures stemming from dental appearance, leading to diminished emotional and social well-being.

Resumo Introdução A relação entre aparência dentária e bem-estar emocional/social em áreas carentes com urbanização acelerada é desconhecida. Objetivo Avaliar se o bem-estar emocional e social de adolescentes residentes em área urbana pode ser mais impactado pela aparência dentária desfavorável controlada pelas condições bucais. Método Um estudo exploratório transversal de base populacional envolvendo escolares brasileiros de 12 anos foi realizado em dois bairros carentes foi realizado, na cidade de São Paulo, Brasil. O desfecho foi a gravidade da qualidade de vida relacionada à saúde bucal (QVRSB) devido ao bem-estar emocional e social, e as exposições foram condições bucais e distrito de residência (rural e urbano). Resultados O impacto sobre a gravidade da QVRSB em decorrência do bem-estar emocional e do bem-estar social, respectivamente, foi 14% e 16% maior para aqueles que apresentavam pelo menos um dente cariado não tratado; 36% e 54% maior para aqueles com aparência dentária desfavorável e 25% e 39% maior para aqueles moradores em distrito urbano. Nenhuma associação entre má oclusão e distrito foi observada. Conclusão Apesar da maior prevalência de cárie dentária não tratada no distrito rural, os adolescentes do distrito urbano sentiram-se mais afetados negativamente em sua qualidade de vida relacionada à saúde bucal ajustada pelas condições bucais, sugerindo que as possíveis influências do ambiente urbano podem trazer experiências sociais estressantes devido à aparência dentária impactando no bem-estar emocional e social.

Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach

Abstract This review aimed to describe the importance of the first 1000 days of a child's life as a golden period for interventions and actions to prevent dental caries and other chronic non-communicable diseases (NCDs) throughout the life course and highlight that the first 450 days of life could be even more important for oral health. During the first 1000 days of life (pregnancy and first two years of life), health care providers can identify unhealthy lifestyles, behaviors, and their determinants. Bearing in mind contextual factors like socioeconomic conditions and cultural aspects, this is a unique period to work together with the family and identify opportunities for adopting healthy habits that might last throughout the life of the expected or newborn child. This is a "window of opportunity" for the prevention of chronic NCDs of both systemic and oral origin, such as overweight, obesity, diabetes, cardiovascular diseases, and dental caries. In fact, to effectively prevent dental caries, pregnancy and the first 6 months of a child's life (first 450 days) should be considered the critical period to work together with families to facilitate the adoption of healthy habits. Knowledge about the first thousand days of life is essential and represents a crucial period for the implementation of actions and interventions that will guarantee good oral and general health development that can persist throughout life.

How oral health literacy and parental behavior during the meals relate to dental caries in children

Abstract This cross-sectional study aimed to verify the influence of parental behavior on the development of dental caries in children by assessing parents' behavior during their children's meals and their parental level of oral health literacy. This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred and thirty children were examined to assess the prevalence of dental caries (dmft index). Parents answered a questionnaire related to socio-demographic conditions, oral health literacy (OHL), and the parents' behavior during the meal - Parent Mealtime Action Scale - (PMAS). The analysis fitted zero-inflated negative binomial regression (ZINB) models to assess unadjusted and adjusted associations between the study outcome and covariates. In the unadjusted analysis, the child's age, the number of siblings, household crowding, family income, socioeconomic status and OHL were associated with the outcome (p <0.05). In the adjusted model, dental caries was more prevalent among 3- (PR: 1.85, 95%CI: 1.19-2.87) and 4-year-old children (PR: 2.43, 95%CI: 1.60-3.71), those with at least one sibling (PR: 1.66, 95%CI:1.18-2.33). Poor children were more likely to have dental caries (PR: 0.66, 95%CI: 0.48-0.91); the Use of Rewards dimension of the PMAS was associated positively with dental caries severity (RR: 0.90, 95%CI: 0.84-0.97). Although OHL was not associated with caries, parents' mealtime behaviors were related to dental caries. This suggested that communication between parents and children related to good eating practices could play a protective role against dental caries in children.

Survival rate of pulpectomy in primary teeth using Feapex® paste: a clinical study in infants / Sobrevida de pulpectomia em dentes decíduos utilizando pasta Feapex®: um estudo clínico em bebês

Objective: The aim of this clinical study was to evaluate the survival rate of a new pulpectomy protocol using 2% chlorhexidine digluconate gel and Feapex® paste for endodontic treatment in primary teeth. Material and Methods: A total of 105 pulpectomies were performed in anterior and posterior teeth of 48 infants (1-3 years old) with high caries experience with irreversible pulpitis or pulp necrosis. All treatments were performed by dental surgeons with no specialization in Pediatric Dentistry, under local anesthesia and rubberdam isolation. Manual files were used in conjunction with 2% chlorherixidine gel for root canal instrumentation, and Feapex® paste was used as a obturation material. The clinical and radiographic outcomes were collected by one trained independent evaluator with a follow-up period of 24months. Success was determined by the absence of pain, pathological mobility, pathologic bone rarefaction, pathological root resorption and soft tissue pathology around the affected tooth Survival of the endodontic treatment was evaluated by estimating survival rates through Kaplan-Meier curves. Cox Regression analysis with shared fragility were performed to evaluate the association between the independent variables to endodontic treatment failure (α=5%). Results: After 24 months, the treatment survival was 86% (SE=0.03). Root resorption at baseline was associated with a higher risk of failure (HR=2.81; CI=1.12-7.08; p=0.027). The survival rate of the endodontic treated teeth due to dental trauma was 100%, while teeth with dental caries had lower survival rate (85.05%; p<0.001*). Other variables analyzed included gender, age of the child, tooth position (incisor/molar), restoration type, obturation quality, and caries experience were not associated with treatment failure (p>0.05). Conclusion: The new protocol using 2% chlorhexidine digluconate and Feapex® presented a high survival rate and can be considered as a suitable protocol for pulpectomy in primary teeth.Trial Registration: REBEC (RBR-282s2f) (AU)

Objetivo: Avaliar a sobrevida de um novo protocolo para tratamento endodôntico (pulpectomia) em dentes decíduos utilizando gel de digluconato de clorexidina 2% e pasta Feapex®. Material e Métodos: Um total de 105 pulpectomias foram realizadas em dentes anteriores e posteriores diagnosticados com pulpite irreversível ou necrose pulpar em 48 crianças (1-3 anos de idade) com alta experiência de cárie. Todos os tratamentos foram realizados por cirurgiões-dentistas clínicos gerais, sob anestesia local e isolamento absoluto. Limas manuais foram utilizadas em conjunto com cloroherixidina 2% gel para instrumentação dos canais radiculares e pasta Feapex® foi utilizada como material de obturação. Os resultados clínicos e radiográficos foram coletados por um avaliador independente treinado com um período de acompanhamento de 24 meses. O sucesso foi determinado pela ausência de dor, mobilidade patológica, rarefação óssea patológica, reabsorção radicular patológica e ausência de fístula/abscesso ao redor do dente tratado. A sobrevida do tratamento endodôntico foi estimativa utilizando curvas de Kaplan-Meier. Análise de regressão de Cox com fragilidade compartilhada foi realizada para avaliar a associação entre as variáveis independentes com a falha do tratamento endodôntico (α = 5%). Resultados: Após 24 meses, a sobrevida do tratamento foi de 86% (EP = 0,03). A reabsorção radicular no início do estudo foi associada a um maior risco de falha (HR= 2,81; IC= 1,12-7,08; p= 0,027). Dentes tratados endodonticamente devido ao traumatismo dentário na dentição decídua apresentaram taxa de sobrevida de 100%, enquanto dentes com comprometimento pulpar devido à cárie dentária tiveram menor sobrevida (85,05%; p<0,001 *). Todas as outras variáveis analisadas como sexo, idade da criança, dente (incisivo/molar), tipo de restauração, qualidade da obturação e experiência de cárie não foram associadas à falha do tratamento (p> 0,05). Conclusão: O novo protocolo utilizando digluconato de clorexidina 2% e Feapex® apresentou alta sobrevida e pode ser considerado um protocolo adequado para pulpectomia em dentes decíduos.Registro do estudo clínico: REBEC (RBR-282s2f). (AU)

Follow-up interval for dental appointments: a randomized clinical trial with children with low caries risk

Abstract The objective of this study was to evaluate the effect of different follow-up consultation intervals on caries incidence in children with low caries risk. The study was composed of 224 children aged between 3 and 5 years and with low risk of caries. The children were randomly allocated into two groups, according to two different follow-up consultation intervals: Group 1 (G1) - 12-month follow-up interval; Group 2 (G2) - 18-month follow-up interval. All oral clinical examinations were performed by a single examiner who was previously calibrated and blinded in relation to the study groups. An external dentist provided the advice on oral hygiene and diet and evaluated the children's socioeconomic conditions. The Chi-square and Mann-Whitney tests were used to evaluate the differences between groups. Poisson regression analyses were performed to assess the association of caries incidence with the other variables. At the end of the study there was a significant difference between the groups regarding initial active lesions (p = 0.012), and children in G2 were at a higher risk of developing initial active lesions than those in G1 (p = 0.047). Children who had a higher number of teeth with initial active lesions in the follow-up consultations were at a higher risk of developing cavitated dentin caries (p = 0.001). Both follow-up intervals are justifiable. Although significant results have been observed for initial active caries lesions within the 18-month follow-up interval, it should be noted that these lesions can be treated using just preventive measures. Besides, different return interval had no effect in cavitated dentin lesions.

Does fluorosis have an impact on Peruvian children's oral health related quality of life? / Fluorose dentária tem impacto na qualidade de vida relacionada à saúde bucal de crianças peruanas?

ABSTRACT Objectives The aims of this study were to evaluate the prevalence and severity of dental fluorosis and to assess the impact of dental fluorosis on oral health related quality of life (OHRQoL) of children living in two Peruvian towns with different water fluoride levels. Methods A sample of 292 children between 11 and 14 years of age and both genders were selected among public and private primary schools in the 2 towns. Clinical oral examination was carried out using Dean's index to assess the prevalence and severity of dental fluorosis and the Child Perceptions Questionnaire 11-14 (CPQ 11-14) was used to evaluate the association between dental fluorosis and OHRQoL. Results Dental fluorosis prevalence was 75% and the moderate score was the most frequent (36%). The two towns have a low socioeconomic level and children from public schools predominate (74%). There was no impact of fluorosis on OHRQoL. It is possible that adolescents living in a context with very similar dental appearance of their peers build a sense of identity different than other populations, which can influence in their OHRQoL perception. Conclusions Even though dental fluorosis prevalence was very high it did not have impact on OHRQoL.

RESUMO Objetivos Os objetivos deste estudo foram avaliar a prevalência e a gravidade da fluorose dentária e avaliar o impacto da fluorose dentária na qualidade de vida relacionada à saúde bucal (QVRSB) de crianças residentes em duas cidades peruanas com diferentes níveis de flúor de água. Métodos Uma amostra de 292 crianças entre 11 e 14 anos de idade e ambos os sexos foram selecionada nas escolas públicas e privadas de ensino fundamental nas duas cidades. O exame oral clínico foi realizado utilizando-se o índice de Dean para avaliar a prevalência e a gravidade da fluorose dentária e o Questionário de Percepção Infantil 11-14 (CPQ 11-14) para avaliar a associação entre fluorose dentária e QVRSB. Resultados A prevalência de fluorose dentária foi de 75% e o escore moderado foi o mais frequente (36%). As duas cidades têm baixo nível socioeconômico e predominam as crianças de escolas públicas (74%). Não houve impacto da fluorose na QVRSB. É possível que os adolescentes que vivem em um contexto social em que a aparência dentária seja muito semelhante entre as pessoas tenham um senso de identidade diferente de outras sociedades, o que pode influenciar em sua percepção de QVRSB. Conclusão Embora a prevalência de fluorose dentária tenha sido muito alta, não teve impacto na QVRSB.

Oral health-related quality of life among pediatric liver transplant candidates

Abstract To assess the impact of oral conditions on the oral health-related quality of life (OHRQoL) of pediatric liver transplant candidates. This cross-sectional study included 60 children aged 13 to 48 months who were liver transplant candidates that attended the AC Camargo Cancer Center, São Paulo, Brazil. On the day of oral examinations, the children's mothers were invited to answer two questionnaires; one related to children's OHRQoL using the B-ECOHIS and another related to socioeconomic/demographic characteristics. Thereafter, a single, adequately trained dentist carried out children's oral examinations for gingival inflammation (Silness-Löe index), dental plaque (Green-Vermillion Simplified index), dental caries (dmft index), developmental defects of enamel (DDE index), tooth discoloration, oral mucosal/lip alterations. The data collected also included socioeconomic/demographic characteristics and liver disease. The adjusted Poisson regression model was used to associate children's socioeconomic/demographic characteristics and clinical conditions to the outcome. The adjusted regression model showed that children with untreated caries lesions (RR = 3.35, p < 0.0001) and tooth discoloration (RR = 1.74, p = 0.04) had poorer total B-ECOHIS scores. Dental discoloration and untreated caries lesions had a negative impact on the OHRQoL in pediatric liver transplant candidates.

Parental perceptions of impact of oral disorders on Colombian schoolchildren´s oral health-related quality of life

There is no study assessing the impact of dental caries (DC), dental fluorosis (DF) and traumatic dental injuries (TDI) on oral healthrelated quality of life (OHRQoL) in school children from Colombia. The purpose of this study was to assess the impact of DC, DF and TDI on Colombian schoolchildren´s OHRQoL using their parents as proxies. The parents of 338 children aged 6 to 14 years from public and private schools of Cartagena, Colombia answered the ParentalCaregiver Perception Questionnaire (PCPQ) on child's OHRQoL adapted to Colombian Spanish language and a socioeconomic questionnaire. Three calibrated examiners performed the clinical assessment for DC, DF and TDI. Poisson regression associated clinical and socioeconomic conditions to the outcome. Overall, 90.24% of parents reported children's oral impact (total PCPQ score ≥ 1). The mean (standard deviation) PCPQ scores were 12.49 (14.04). The multivariate adjusted model showed that children from public schools and who have dental caries experience (RR= 1.28; p=0.04 and RR= 1.37; p= 0.018, respectively) were more likely to experience negative impact on total PCPQ scores. DC was found to be associated to parentalcaregiver perception of impact on their children's oral healthrelated quality of life, but DF and TDI were not (AU)

No existen estudios que evalúen el impacto de la caries dental (CD), la fluorosis dental (FD) y el trauma dentoalveolar (TDA) sobre la calidad de vida relacionada con la salud bucal (CVRSB) de escolares de Colombia que pertenece a países de habla hispana. El propósito de este estudio fue evaluar el impacto de la caries dental (CD), la fluorosis dental (FD) y el trauma dentoalveolar (TDA) sobre la calidad de vida relacionada con la salud bucal de escolares colombianos usando sus padres como proxies. Los padres de 338 niños y niñas de 6 a 14 años de escuelas públicas y privadas de Cartagena, Colombia, contestaron el ParentalCaregivers Perception Questionnaire (PCPQ) on child's OHRQoL adaptado al español colombiano y un cuestionario socioeconómico. Tres examinadores calibra dos realizaron la evaluación clínica para CD, FD y TDA. La regresión de Poisson asoció las condiciones clínicas y socioeconómicas al puntaje total del PCPQ y sus dominios. En general, el 90,24% de los padres reportaron el impacto oral de los niños sobre la calidad de vida (puntaje PCPQ total ≥ 1). La media (DE) del PCPQ fue de 12,49 (14,04). El modelo multivariado ajustado mostró que los niños de escuelas públicas que tenían experiencia de caries dental (RR = 1,28, p = 0,04 y RR = 1,37, p = 0,018, respectivamente) tuvieron mayor probabi lidad de experimentar un impacto negativo en las puntuaciones totales del PCPQ. La CD mostró asociación con la percepción del impacto de los padrescuidadores sobre la salud oral de sus hijos en relación con la calidad de vida. Sin embargo, FD y TDA no se encontraron asociados (AU)

Parental perceptions of impact of oral disorders on Colombian preschoolers´oral health-related quality of life / Percepción de padres del impacto de desórdenes orales de preescolares Colombianos sobre calidad de vida relacionada con la salud oral

There is no study assessing the impact of dental caries (DC), traumatic dental injuries (TDI) and dental malocclusions (DM) on the oral healthrelated quality of life (OHRQoL) of preschool children from Spanishspeaking countries in populationbased samples. The purpose of this study was to assess the impact of DC, TDI and DM, on Colombian preschool children's OHRQoL through a crosssectional study. The clinical setting included private and public preschools in Cartagena,Colombia. The sample included 643 preschool children aged 15 years and their parents, who answered the Colombian version of the Early Childhood Oral Health Impact Scale (CECOHIS) and socioeconomic questionnaire. Three calibrated examiners performed clinical assessment of severity of DC according to decayed, missing and filled primary teeth index, TDI and DM. Poisson regression associated clinical and socio economic conditions to the outcome. Overall, 48.2% of parents reported children's oral impacts (total CECOHIS score ≥1). The mean (standard deviation) CECOHIS scores were 2.20 (0.15). The multivariate adjusted model showed that children from nonnuclear families (RR=1.51; p=0.003),with low and high DC severity (RR=1.51, p=0.003; RR=1.53, p=0.009) and TDI (RR=1.56, p=0.003), were more likely to experience negative impact on total CECOHIS scores. DC and TDI have negative impact on Colombian preschool children's OHRQoL. Children from nonnuclear families have worse OHRQoL at this age, independently of the presence of oral conditions (AU)

No existen estudios que evalúen el impacto de la caries dental (CD), el trauma dentoalveolar (TDA) y las maloclusiones dentales (MD) sobre la calidad de vida relacionada con la salud bucal (CVRSB) en niños preescolares en muestras de poblaciones de países hispanohablantes. El propósito de este estudio fue evaluar el impacto de CD, TDA y MD sobre la CVRSB en niños colombianos en edad preescolar a través de un estudio transversal. Las evaluaciones clínicas se realizaron en colegios privados y públicos de Cartagena, Colombia, en una muestra de 643 niños en edad de 15 años y sus padres quienes respondieron la versión colombiana de la Escala Early Childhood Oral Health Impact Scale (CECOHIS) y un cuestionario socioeconómico. Tres examinadores calibrados realizaron la evaluación clínica de la severidad de CD acorde con el Indice ceod para dentición decidua, TDA y MD. La regresión de Poisson asoció las condiciones clínicas y socioeconómicas al puntaje total del CECOHIS y sus dominios. En general, el 48,2% de los padres reportaron impactos orales de los niños (puntuación CECOHIS total ≥1). La media (DE) del CECOHIS fué de 2,20 (0,15). El modelo multivariado ajustado mostró que los niños de familias no nucleares (RR = 1,51; p = 0,003), que tienen baja y alta severidad de CD (RR = 1,51, p = 0,003; RR = 1,53, p = 0,009) y TDA(RR = 1,56, p = 0,003) tuvieron mayor probabilidad de experimentar un impacto negativo en las puntuaciones totales de CECOHIS. La CD y la TDA tienen un impacto negativo sobre la CVRSB en niños preescolares colombianos. Los niños de familias no nucleares tienen peor CVRSB a esta edad, independientemente de la presencia de las condiciones orales (AU)

Does erosive tooth wear affect the oral health-related quality of life of preschool children? / Os desgastes dentários erosivos afetam a qualidade de vida relacionada à saúde bucal em pré-escolares?

ABSTRACT Objective: The aim of this study was to investigate the impact of erosive tooth wear on the Oral Health-Related Quality of life (OHRQoL) of preschool children. Methods: Dental examinations were conducted on 815 children aged 3-4 years during the Children's Vaccination National Day when their parents were also invited to answer the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). ETW prevalence and severity were measured using a modified version of the O'Brien index (1994). Data collected included socioeconomic factors and child's variables. OHRQoL was measured through B-ECOHIS domains and total score. Poisson regression was used to associate ETW to the outcome and this association was adjusted for dental caries and dental trauma. Results: The proportion of children who had at least 1 ETW tooth was 51.2%. Most erosive lesions were confined to enamel (42.7%). The multivariate adjusted model showed that child's age (children aged 4year-old) was associated to a negative impact on the symptom domain (RR=1.70; p=0.010), functional limitation domain (RR=1.85; p=0.005) and total B-ECOHIS score (RR= 1.63; p=0.006). Families with 2 or more children in the house have a negative impact on the self-image/social interaction domain (RR=5.41; p=0.043). ETW was not associated to total B-ECOHIS scores (RR= 0.79; p=0.163) and individual domains. Conclusion: Erosive tooth wear does not affect the OHRQoL in this sample of preschool children.

RESUMO Objetivo: O objetivo deste estudo foi investigar o impacto das lesões de desgaste dentário erosivo na qualidade de vida relacionada à saúde bucal (QVRSB) de pré-escolares. Métodos: Exames clínicos foram conduzidos em 815 crianças de 3 e 4 anos de idade durante a Campanha Nacional de Multivacinação Infantil. Os pais ou responsáveis foram convidados a responderam a versão brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS). A prevalência e a gravidade das lesões de desgastes dentários erosivos foram avaliadas de acordo com o índice de O'Brien (1994). Também foram coletados dados socioeconômicos e variáveis da criança. A QVRSB foi mensurada por meio dos domínios e escore total do B-ECOHIS. A análise de regressão de Poisson foi adotada para associar as lesões de desgaste dentário erosivo ao desfecho e ajustada para cárie dentária e lesões dentárias traumáticas. Resultados: A proporção de crianças que apresentavam pelo menos 1 dente apresentando desgaste dentário erosivo foi 51,2%. A maioria das lesões de desgaste dentário erosivo estava confinada ao esmalte (42,7%). A análise ajustada multivariada revelou que apenas que a idade (crianças de 4 anos) foi associada a um impacto negativo nos domínios de sintomas (RR=1,70; p=0,010), limitação funcional (RR=1,85; p=0,005) e escore total do B-ECOHIS (RR= 1,63; p=0,006). Famílias com 2 ou mais filhos tiveram um impacto negativo nos dominíos de autoestima e interação social (RR=5,41; p=0,043). As lesões de desgaste dentário erosivo não foram associadas ao escore total de B-ECOHIS (RR= 0,79; p=0,163) e domínios individuais. Conclusão: As lesões de desgaste dentário erosivo não afetaram a qualidade de vida de pré-escolares da amostra estudada.

Factors for determining dental anxiety in preschool children with severe dental caries

Abstract The aim of this study was to assess the clinical and socioeconomic indicators associated with dental anxiety in preschool children with severe dental caries. A total of 100 children between 3 and 5 years of age were selected during a dental screening procedure. The selection criteria were having at least one tooth with dental caries and a visible pulpal involvement, ulceration, fistula, and abscess (PUFA) index of ≥1 in primary teeth. Before the clinical examination or any treatment procedure was performed, we evaluated the children’s dental anxiety using the Facial Image Scale (FIS). Parents completed a questionnaire on socioeconomic conditions, which included the family structure, number of siblings, parental level of education, and family income. A dentist blinded to FIS and socioeconomic data performed the clinical examination. Poisson regressions associate clinical and socioeconomic conditions with the outcome. Most of the children (53%) experienced extensive dental caries (dmf-t ≥ 6), and all children had severe caries lesions, with a PUFA index of ≥1 in 41% and that of ≥2 in 59%. The multivariate adjusted model showed that older children (4–5-year old) experienced lower dental anxiety levels compared with younger children (3-year old) (RR = 0.35; 95%CI: 0.17–0.72 and RR = 0.18; 95%CI: 0.04–0.76, respectively), and children with three or more siblings were associated with higher levels of dental anxiety (RR = 2.27; 95%CI: 1.06–4.87). Older age is associated with low dental anxiety, and more number of siblings is associated with high dental anxiety in preschool children, whereas the severity or extent of dental caries is not associated with dental anxiety.

A saúde bucal de crianças menores de 5 anos de idade no município de Diadema / Oral health status of children under 5 years-old in Diadema

O objetivo desse trabalho foi avaliar a prevalência, gravidade e os fatores associados à cárie dentária(CD), lesão dentária traumática (LDT) e desgaste dentário erosivo (DDEr) em crianças menores de 5 anos de idade no município de Diadema, São Paulo. Cirurgiões-Dentistas treinados e calibrados examinaram o total de 1215 crianças de 1, 2, 3 e 4 anos de idade para CD e LDT e 839 crianças de 3 e 4 anos de idade para DDEr nas 19 Unidades Básicas de Saúde, durante a campanha de Multivacinação Infantil, em 2012. Utilizou-se os índices de Knutson, ceo-d e ceo-s para CD, os critérios modificados de Andreas en para LDT e o índice de O´Brien modificado para DDEr. Foram realizadas análises descritivas e regressões de Poisson (IC 95%). As prevalências encontradas levando em consideração o totalda amostra examinada foram: CD (20,3%), LDT (20,1%) e DDEr (51,3%). Os fatores associados para CDforam a idade da criança e ter dois ou mais filhos na família; para LDT a idade e a presença de mordida aberta anterior e/ou sobressaliência acentuada; para DDEr consumir refrigerante e suco mais de 3 vezes ao dia, deixar a bebida na boca ou beber na mamadeira e relato de refluxo gastroesofágico. No município de Diadema, a prevalência de CD é baixa; LDT é moderada, sendo fratura de esmalte a mais frequente; DDEr é alta, no entanto a maioria das lesões acometem somente o esmalte.

This study aimed to assess the prevalence, severity and associated factors of Dental Caries (DC),Traumatic Dental Injury (TDI) and Erosive Tooth Wear (ETW) in children under 5 years-old in the municipality of Diadema, São Paulo. Trained and calibrated dentists examined a total of 1215 children aged 1-4years-old for DC and TDI, and 839 children aged 3 and 4 years-old for ETW in 19 Primary Health Centres during the National Children’s Vaccination in 2012. For the assessment of DC the Knutson, dmf-t and dmf-s indexes were used, a modified And reasen criteria was used for TDI and a modified version of theO’Brien index for ETW. Descriptive analysis and Poisson regression (CI 95%) were used. The prevalence of DC, TDI, ETW was 20.3%, 20.1% and 51.3% respectively. The Factors associated with DC were age and having more than one child in the family, for TDI the factors were age and presence of anterior openbite and/or increased overjet and for ETW, the factors were drinking soft drink or juice more than 3 timesa day, keeping it in the mouth without swallowing or using baby’s bottle, report of gastroesophageal reflux. In Diadema, the prevalence and severity of DC lesions is low; LDT is moderate enamel fracture being the most common; DDEr is high, however most lesions only affect the enamel.

Monitoring of caries disease by risk assessments and activity

ABSTRACT Dental caries is a non-communicable disease and is considered a public health problem. For diagnosis and correct treatment, the study of risk assessment and caries activity is necessary. The caries risk assessment is a way to formalize the balance and imbalance of predictably disease to diagnose dental caries. Therefore, the caries risk assessment is performed through different evaluation systems. Another parameter of great importance to be studied is the activity of caries, because through it is done the correct treatment decision for the patient. The objective of this article is to inform the reader about: the concepts and caries risk factors; the different caries risk assessment systems described in the literature; and which systems are validated. In addition, this literature review provides for identification and evaluation of risk factors and activity of caries lesions in order to enable greater objectivity in the diagnosis and facilitate the decisions of a successful treatment.

RESUMO A cárie dentária é uma doença não infecciosa e é considerada um problema de saúde pública. Para seu diagnóstico e correto tratamento é necessário a avaliação do risco e da atividade da doença cárie. A avaliação do risco de cárie é uma maneira de formalizar o equilíbrio e desequilíbrio da doença de modo previsível para realizar o diagnóstico da doença presente. Para tanto, a avaliação do risco de cárie é realizada através de diferentes sistemas. Outro parâmetro de grande importância a ser estudado é a atividade da doença cárie, pois através dela é realizada a correta decisão de tratamento para o paciente. Assim, o objetivo do presente artigo foi informar ao leitor: os conceitos e fatores de risco de cárie; os diferentes sistemas de avaliação de risco de cárie descritos na literatura; e quais sistemas são validados. Contudo, esta revisão de literatura proporciona a identificação e avaliação dos fatores de risco e atividade das lesões de cárie afim de possibilitar uma maior objetividade no diagnóstico e facilitar as decisões de um tratamento bem-sucedido.

Concordância entre os relatos do núcleo familiar em relação à qualidade de vida da criança / Agreement between the nucleus family reports regarding child's quality of life

Objetivos: Avaliar a concordância entre os relatos de pai, mãe e filhos em relação a qualidade de vida relacionada a saúde bucal (OVRSB) da criança. Métodos: Um total de 80 tríades pai-mãe-criança responderam a versão brasileira do Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) validado para crianças de 5 e 6 anos de idade e seus respectivos pais O preenchimento do SOHO-5 foi realizado por meio de entrevistas independentes face-a-face. A concordância entre os escores totais e de itens foi avaliada usando a comparação de médias e a análise de correlação calculada pelo coeficiente de correlaçâo intraclasse (CCI). Resultados: Houve diferença significativa entre as médias dos relatos pai-criança nos escores totais (p<0.001) e itens relacionados a não sorrir devido à dor e à aparência (p<0,01). O CCI para o escore total dos relatos mãe-criança foi de 0,83 (IC 95% 0,74- 0,89) e de 0,41 (IC 95% 0,09- 0,63) para os relatos pai-criança, indicando uma concordância excelente e moderada, respectivamente. Conclusões: As mães relatam a QVRSB de seus filhos de forma semelhante às crianças enquanto que os pais subestimam os impactos. As mães podem ser consideradas respondentes secundárias preferíveis aos pais.

Objective: To assess the agreement between father, mother and children regarding child'l oral health-related quality of life (OHROoL). Methods: A total of 80 mother-father-child triads answered the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-51, validated for children aged 5-6 years and their parents. The SOHO-5 was completed through face-to-face independent interviews. Agreement between total and items scores was assessed using mean comparisons and correlation analyses by computing the Intraclass Correlation Coefficient (ICC). Results: There were significant differences between the mean total scores for father-child pairs (p<0.001) and items related to avoid smiling due to pain and avoid smiling due to appearance (p<0,01). The ICC for total score was 0.83 (CI 95% 0.74; 0.89) for mother-child pairs and 0.41 (CI 95% 0.09; 0.63) for father-child pairs indicating an excellent and moderate agreement, respectively. Conclusions: Mothers do rate their children's OHRQol similarly to children's self-reports, while fathers underreport the impact. Mothers may be considered preferable proxies than fathers.

Evidências científicas atuais sobre a terapia pulpar de dentes decíduos / Current situation and scientific evidences on pulp therapy for primary teeth

A terapia pulpar conservadora nos dentes decíduos visa manter a integridade, a vitalidade e a saúde dos dentes e estruturas de suporte, reduzir a necessidade de tratamento endodôntico e mantê-Ios até o período de esfoliação. O presente artigo tem o objetivo de apresentar as evi­dências científicas atuais sobre a terapia pulpar em dentes decíduos, após analisar resultados de estudos clínicos randomizados e revisões sistemáticas com metanálises recentes sobre o tema.

The aim of conservative pulp therapy for primary teeth is to maintain the integrity and health of the teeth and their supporting tissues, pulp vitality, reduce the need for a nonvital pulp treatment and retain these teeth until the appropriate time for exfoliation. This paper presents the findings of recent clinical trials, systematic reviews and meta-analysis about vital pulp terapy in primary teeth.

Association between parental guilt and oral health problems in preschool children

Parents may feel guilty about their children's oral problems, which can affect their quality of life. The aim of this study was to assess the presence of parental guilt and its association with early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusion (AMT) in preschool children. All 2 to 5 year-old children (N = 305), and their parents, seeking dental care at the University of São Paulo Dental School one-week Screening Programme, were asked to participate in the study, and 260 agreed. Children were examined by two calibrated dentists, and their parents answered a socioeconomic and ECOHIS questionnaire; the question on guilt was used as the dependent variable. Regression analyses examined the association between parental guilt and ECC, TDI, AMT and socioeconomic factors. A total of 35.8% of parents felt guilty. This was only associated with caries severity. No association was found between guilt and TDI, AMT or socioeconomic factors. ECC was present in 63.8% of the children; the mean (± sd) dmf-t score was 7.29 (± 2.78). Thus, the number of parents feeling guilty increases with the increase of their children's dental caries severity. Parental guilt is related to caries but is not associated with TDI or AMT.

Anomalías dentarias de impacto estético en odontopediatría: características y tratamiento / Dental anomalies of esthetic impact in pediatric dentistry: characteristicsand treatment

El desarrollo dentario es un proceso que comienza en la vida intrauterina. Los disturbios de desarrollo en este proceso se presentan como anomalías y pueden afectar ambas denticiones, temporal y permanente, teniendo carácter sistémico, local y/o hereditario. Los profesionales que atienden niños deben reconocer y diferenciar características normales de eventuales anomalías de la cavidad bucal que necesitan ser tratadas. Este artículo ofrece a los profesionales del área odontológica una revisión sobre las principales anomalías dentarias directamente relacionadas con la estética del niño y su respectivo tratamiento, con el objetivo de promover una mejor calidad de vida en estos pacientes.

Tooth development is a process that begins in the intrauterine life. The developmental disorders in this process are presented as anomalies and can affect both dentitions, deciduous and permanent, having a systemic, local and/or hereditary character. Professionals who treat children must recognize and differentiate normal characteristics of possible abnormalities in the oral cavity that need to be treated This article provides to dental professionals a review of the major dental abnormalities directly related to the aesthetic of children and their respective treatment, with the aim to promote a better quality of life in these patients.

Impact of dental caries on preschool children's quality of life: an update

The literature reports that dental caries can cause functional, physical and aesthetic impairment, often with repercussions on children's general health at an early age. Moreover, recent studies have investigated how caries lesions can compromise children's quality of life. This paper aims to describe the current situation of dental caries prevalence in children and how this oral health disease can impact their quality of life.

Tipo de aleitamento e presença de açúcar nas bebidas das mamadeiras dos bebês / Type of breastfeeding and presence of sugar in the content of baby bottles

This study aims at analyzing the feeding of babies, either by breastfeeding or using a baby bottle, time until weaning, as well as the presence of sugar in the content of baby bottles. Data from 305 babies, aged 0 to 36 months, were collected using questionnaires answered by their mothers. Information on age, gender, feeding habits and the presence of sugar containing substances in the baby bottles was collected. Most mothers used baby bottles (70.2%), and this rate increased with the babies? age. During the babies' first six months of life, 46.2% of mothers fed their babies exclusively on breast, whereas 38.5% of the babies were fed from baby bottles since birth, together with breastfeeding, and 15.3% of the babies at this age range were exclusively fed from baby bottles. Weaning occurred in 20.0%. 82.6% of the babies fed from baby bottles received sugar in their diet. Feeding from a baby bottle was found to be present since the first month of a baby's life, and its use was predominant until the age of 3 years. Sugar is present in the diet of the majority of the babies fed from bottles.

El estudio se propone analizar el tipo de leche utilizada, materno y/o artificial, sus periodos de uso y la presencia de azúcar en los biberones. Participaron 305 infantes de 0 a 36 meses, cuyos datos fueron obtenidos por medio de un cuestionario aplicado a las madres. Éste contenía informaciones sobre edad y sexo de los niños, tipo de alimentación que recibían y presencia o no de azúcar en los biberones. El tipo de alimentación más utilizada era artificial (70,2%), porcentaje que aumentó junto con la edad de los niños. La lactancia materna exclusiva durante los primeros seis meses de vida correspondía a 46,2% del grupo. Para 38,5% el biberón fue introducido conjuntamente con la lactancia materna desde el nacimiento y para 15,3% la lactancia artificial fue exclusiva (biberón). El desmame ocurrió en 20,0%. La dieta de 82,6% de los bebés presentaba azúcar en las bebidas del biberón. La leche artificial está presente desde el primer mes de vida y su uso predomina hasta los 3 años de edad.El azúcar está presente en la dieta de la mayoría de los bebés alimentados con biberón

O estudo propõe analisar o tipo de aleitamento utilizado, seja materno e/ou artificial, o seu tempo de uso, assim como a presença de açúcar na mamadeira dos bebês. Participaram 305 bebês de 0 a 36 meses, cujos dados foram obtidos através de um questionário junto às mães. Este continha informações sobre idade e gênero dos bebês, tipo de aleitamento e substâncias açucaradas introduzidas nas mamadeiras destes. O tipo de aleitamento mais utilizado foi o artificial (70,2%), sendo que aumentou com o decorrer da idade. Nos seis primeiros meses de vida, o aleitamento materno exclusivo foi realizado por 46,2% das mães, sendo que a mamadeira foi introduzida conjuntamente ao aleitamento materno desde o nascimento em 38,5% dos bebês e 15,3% destes receberam aleitamento artificial exclusivo (mamadeira). O desmame ocorreu em 20,0%. A dieta de 82,6% dos bebês continha açúcar nas bebidas da mamadeira. O aleitamento artificial está presente desde o primeiro mês de vida e seu uso é predominante até os três anos de idade. O açúcar está presente na dieta da maioria dos bebês amamentados com mamadeira.