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.

Cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for use on Brazilian adolescents

Abstract The present study aimed to perform the cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for native Brazilian Portuguese-speaking adolescents (DHLI-BrA). Cross-cultural adaptation consisted of the following steps: translation, assessment, and adjustments by the expert committee to ensure cultural equivalence; back-translation, and synthesis of back-translations. Cognitive testing was then performed in a pretest with adolescents using cognitive interviews with probing questions on the item's understanding interpretation and response options. Cronbach's alpha coefficient and McDonald's omega were used to estimate the instrument's reliability. Forty-two Brazilian adolescents participated in the study (mean age: 16.0 ± 2.0 years; range: 13 to 19 years). Items that were difficult to understand were adapted to the context of Brazilian adolescents. Cronbach's alpha coefficient and McDonald's omega for the 21 items of the DHLI-BrA were, respectively, 0.79 and 0.80. Cronbach's alpha coefficient for the subscales of the self-report instrument was 0.53-0.79 (range), demonstrating good reliability in the total instrument and moderate reliability in the subscales. This study provides the cross-cultural adapted version of the Digital Health Literacy Instrument (DHLI), which is an instrument for measuring digital Health literacy, for use in Brazilian adolescents (DHLI-BrA).

Resumo O estudo teve o objetivo de adaptar transculturalmente o Digital Health Literacy Instrument (DHLI) para adolescentes nativos do idioma português do Brasil (DHLI-BrA). O estudo de adaptação transcultural consistiu nas seguintes etapas: tradução, avaliação e adequação de equivalência cultural da tradução por comitê de especialistas; retrotradução e síntese das retrotraduções. Foi realizada a testagem cognitiva em pré-teste com adolescentes, utilizando-se entrevistas cognitivas com perguntas de sondagem sobre a compreensão e interpretação dos itens e opções de resposta. O alfa de Cronbach e ômega de McDonald's foram utilizados para estimar a confiabilidade do instrumento. Participaram do pré-teste 42 adolescentes brasileiros com média de idade de 16,0 ± 2,0 (variação de 13-19) anos. Os itens com dificuldade de compreensão foram adaptados ao contexto dos adolescentes brasileiros. O coeficiente alfa de Cronbach e o ômega de McDonald's, para os 21 itens do DHLI-BrA foi respectivamente, 0,79 e 0,80. O coeficiente alfa de Cronbach para as subescalas do instrumento de autorrelato foi de 0,53-0,79 (variação), demonstrando boa confiabilidade no instrumento total e confiabilidade moderada nas subescalas. Este estudo fornece a versão adaptada transculturalmente do Digital Health Literacy Instrument (DHLI), um instrumento de mensuração do letramento digital em saúde, para utilização em adolescentes brasileiros (DHLI-BrA).

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

Effects of different toothpaste formulations on erosive tooth wear prevention: systematic review / Efeitos de diferentes dentifrícios na prevenção do desgaste dentário erosivo: revisão sistemática de literatura

Objective: erosive tooth wear is a multifactorial condition that results in loss of dental hard tissue, caused by a chemical and mechanical process. This paper aims to carry out a systematic review presenting the effects of different toothpaste formulations on the loss of dental enamel surface in vitro. Material and Methods: the searches were performed in the databases PubMed, Web of Science, LILACS and Scielo. Articles published from 2010 to 2020 were filtered, without language restriction. Articles that included abrasion and erosion protocols were searched, as they were more similar to clinical reality, since toothpaste is applied through tooth brushing. The searches with descriptors and free terms on the topic resulted in 992 articles, however only 12 were within the search criteria. Results: the selected studies appointed that association of conventional fluorides (NaF) with metallic fluorides can be a promising strategy for the reduction of surface loss by erosive tooth wear. Toothpastes containing sodium fluoride, as well as tin without chitosan, showed a reduction in surface loss, considered sufficient for individuals with medium exposure to acids. In children's toothpastes, the one containing sodium fluoride showed a reduction in surface loss when compared to non-fluoride dentifrices. Conclusion: different protocols may result in less or greater loss of enamel surface, and methodological differences should be considered. To clarify the effects of dentifrices on erosive tooth wear, other properties of dentifrices should be investigated. (AU)

Objetivo: o desgaste erosivo é uma condição multifatorial que resulta em perda de tecido duro dentário, causado por um processo químico e mecânico. Este trabalho tem como objetivo realizar uma revisão sistemática de literatura apresentando os efeitos de diferentes formulações de dentifrícios na perda de superfície de esmalte dentário in vitro. Material e Métodos: a busca foi realizada nas bases de dados PubMed, Web of Science, LILACS e Scielo. Foram filtrados artigos publicados no intervalo de 2010 a 2020, sem restrição de idioma. Buscou-se artigos que incluíssem protocolos de abrasão e erosão, por mais se assemelhar a realidade clínica, uma vez que o dentifrício é aplicado através da escovação dentária. A busca com descritores e termos livres sobre o tema encontrou 992 artigos, entretanto somente 12 estavam dentro dos critérios da pesquisa. Resultados: os estudos selecionados apontaram que associação dos fluoretos convencionais (NaF) com os metálicos pode ser uma estratégia promissora para a redução de perda de superfície pelo desgaste dentário erosivo. Dentifrícios contendo fluoreto de sódio, assim como estanho sem quitosana, apresentaram redução na perda de superfície, sendo considerada suficiente para indivíduos com exposição média aos ácidos. Em dentifrícios infantis, aquele que continha fluoreto de sódio apresentou uma redução de perda de superfície quando comparado com dentifrícios sem fluoreto. Conclusão:diferentes protocolos podem resultar em menor ou maior perda de superfície de esmalte e as diferenças (AU)

Parental oral health literacy influences preschool children's utilization of dental services

Abstract: Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered questionnaire about their perception of their children's oral health and whether their children had already been to a dental visit. Parental OHL level was assessed by the validated version of the Oral Health Literacy Adult Questionnaire (OHL-AQ) translated into Brazilian Portuguese. Univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis (α = 0.05). Most children had already been to a dental visit (73%). Overall, 31.7% of the parents or guardians reported that their children had experienced dental pain or dental caries. Parental OHL level was classified by tercile as low, medium, and high. The final model showed independent associations between children who had already been to a dental visit and higher parental OHL level (PR = 1.16; 95%CI = 1.00-1.35) when compared to the lowest OHL level, higher parental educational level (PR = 1.39; 95%CI = 1.03-1.87) when compared to lower educational level, the report of children's pain and dental caries (PR = 1.22; 95%CI = 1.09-1.36) and married parents or parents in a common-law marriage (PR = 1.17; 95%CI = 1.03-1.93). The prevalence of children who had already been to a dental visit was higher among those parents with a higher OHL level when compared to those with a lower OHL level.

Different dimensions of oral health literacy are associated with social determinants of health in Brazilian adults

Abstract Social determinants of health (SDH) are strongly associated with oral health outcomes, and oral health literacy (OHL) is a potential factor that can modify this association. This study evaluated the association between SDH and OHL, including functional and interactive dimensions of OHL. The cross sectional study was conducted with 354 adults recruited from public dental clinics in southern Brazil. Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14), for the evaluation of interactional OHL. SDH was evaluated through a structured questionnaire, and economic class was determined based on the Brazilian Economic Classification Criteria. The statistical analysis involved bivariate and multivariate Poisson regression with robust variance (α=0.05) to estimate rate ratios (RR) and 95% confidence intervals (CI). Among the 354 participants, 284 (80.2%) were women and the mean age was 22.9 ± 4.9 years. The median BREALD-30 score was 24 (1st/3rd quintile: 20/27) and the median HeLD-14 score was 45 (1st/3rd quintile: 37/50). Most participants had up to eight years of schooling (71.5%) and belonged to the "C" Economic Class or lower (94.1%). The multiple regression analysis showed that schooling and economic class were associated with the BREALD-30 and HeLD-14 scores, income and age were associated with the HeLD-14 score, and marital status and occupation were associated with the BREALD-30 score. Different dimensions of OHL were associated with SDH in Brazilian adults. This aspect should be incorporated into strategies for improving OHL levels in individuals or populations.

Impact of the COVID-19 pandemic on sleep quality and sleep bruxism in children eight to ten years of age

Abstract: This study aimed to determine the impact of the COVID-19 pandemic on sleep quality and possible sleep bruxism (SB) in children eight to ten years of age. The study hypothesis was that sleep disturbances influenced a higher occurrence of bruxism during the COVID-19 pandemic. A longitudinal study was conducted at two time points: in person prior to the COVID-19 pandemic (T1), and online during the pandemic (T2). The sample comprised 105 children. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics, the use of electronic devices, reported (vs. clinical) SB, and the Sleep Disturbance Scale for Children (SDSC) at both T1 and T2. McNemar's and Wilcoxon's tests were used to compare SB and sleep disorders at both time points. Poisson regression analysis determined the relative risk (RR) among the variables, and the incidence of possible SB (p≤0.05). The comparison of the two time points (T1 and T2) revealed a significant increase in possible SB (p<0.01) and sleep disorders (p < 0.04). Children whose parents had a lower schooling level (RR: 2.67; 95%CI: 1.19-6.01), those with their own electronic devices (RR: 1.97; 95%CI: 1.09-2.50), and those with sleep disorders during the pandemic (RR: 1.74; 95%CI: 1.35-2.24) were at greater risk of developing SB during the pandemic. Moreover, the incidence of bruxism and sleep disorders was greater during the pandemic. The factors influencing SB incidence during the pandemic were a lower level of mothers' schooling, greater access to electronic devices, and the occurrence of sleep disorders.

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.

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.

Perfil dos orientadores de bolsistas de Iniciação Científica da Faculdade de Odontologia da Universidade Federal de Minas Gerais / Profile of the advisors of scientific initiation Scholars at the Faculdade de Odontologia at Universidade Federal de Minas Gerais

Objetivo: Traçar o perfil dos orientadores de Iniciação Científica da Faculdade de Odontologia da Universidade Federal de Minas Gerais durante uma década.Métodos: Foi feita uma avaliação retrospectiva da formação, da carreira e daexperiência de orientações na pós-graduação e na graduação dos professores da Instituição que orientaram alunos como bolsistas do Programa de Iniciação Científica de 2006 a 2016. Com base em informações dos currículos cadastrados na plataforma Lattes do CNPq, a produção intelectual dos docentes foi analisada, quanti e qualitativamente, Qualis 2015. Para avaliar a correlação entre o número de orientações de Iniciação Cientifica e as demais variáveis numéricas, foi usado o coeficiente de correlação de Spearman e para verificar se existia diferença entre o número de orientações de Iniciação Cientifica entre as categorias das variáveis categóricas, foram usados os testes de Mann-Whitney e Kruskal-Wallis. Resultados: Pouco mais de 35% (n = 44) do total de professores da Instituição, com formações, tempo de titulação e níveis de carreira diversos, alocados nos 4 departamentos, orientaram bolsistas no período; dos quais 18 tinham orientações em andamento. Quase 90% destes apresentam vínculo com Programa de pós-graduação. As áreas responsáveis pelo maior número de bolsas vigentes são a Odontopediatria e Odontologia social e preventivas. O número de orientações de Iniciação Científica concluídas e em andamento por orientador apresentou correlação positiva e significante (rs, p < 0,05) com a produção científica qualificada (≥ B3) e com o número de orientações de pós-graduação stricto sensu, mas não esteve correlacionada a outras produções e orientações. Conclusão: O perfil de orientadores de Iniciação Científica entre o período de 2006-2016 foi diversificado, com diferentes áreas de atuação, níveis de carreira e titulação. No entanto, observamos que a participação no Programa é pequena diante do total de docentes com titulação, capacidade de orientação e do número de alunos de graduação da Instituição. Isso se deve principalmente ao número de bolsas de Iniciação Científica não conseguir contemplar todos os professores que se inscrevem no programa.

Aim: To outline the profile of the Scientific Initiation advisors of the School of Dentistry at the Federal University of Minas Gerais over a 10-year period. Methods: A retrospective assessment was made regarding the education, career, and experience of postgraduate and undergraduate guidance rendered by the institution's faculty who advised students who were fellows of the Scientific Initiation Program from 2006 to 2016. Based on information from registered curricula in the CNPq Lattes platform, the intellectual production of teachers was analyzed, both quantitatively and qualitatively, according to Qualis 2015. To evaluate the correlation between the amount of Scientific Initiation guidance rendered and the other numerical variables, the Spearman correlation coefficient was used, and to verify if there was a difference between the amount of Scientific Initiation guidance rendered between the categories of categorical variables, the Mann-Whitney and Kruskal-Wallis tests were used. Results: Just over 35% (n = 44) of the total number of teachers of the institution, with different degrees, tenure, and career levels, allocated in the four departments, advised fellows during this period, of which 18 received ongoing guidance, almost 90% of which were linked to the Postgraduate Program. The areas responsible for the largest number of scholarships in effect cane from the fields of Pediatric Dentistry and Social and Preventive Dentistry. The amount of completed and ongoing Scientific Initiation guidance rendered per advisor showed a significant positive correlation (rs, p < 0.05) with qualified scientific output (≥ B3) and with the amount of stricto sensu postgraduate guidance rendered, but was not correlated with other productions and advice. Conclusion: The profile of Scientific Initiation advisors between 2006-2016 was diverse, with different areas of activity, career levels, and titles. However, we observed that participation in the program is minimal, given the total number of professors with a degree, capacity to provide advice, and the number of undergraduate students registered at the institution. This is mainly due to the number of Scientific Initiation scholarships failing to contemplate all teachers who enrolled in the program.

Cárie dentária e presença de placa visível em dentes ântero-superiores em crianças de 0 a 5 anos / Dental caries and presence of visible plaque on anterior teeth on 0 to 5 years old children

Objetivo: Identificar a associação entre cárie dentária e placa dental em função do estágio da primeira infância. Materiais e Métodos: Foram examinadas clinicamente 183 crianças de 8 a 69 meses de idade em dois Centros Municipais de Educação Infantil de Curitiba. As crianças foram divididas em dois grupos, de acordo com o estágio da primeira infância, G1 (até 36 meses)e G2 (37 a 69 meses). Experiência de cárie (ceo-d > 0) e presença de placa visível (em pelo menos um incisivo superior) foram avaliadas por um único pesquisador previamente calibrado (Kappainter e intraexaminador> 0,80). As mães responderam a um questionário sobre condições socioeconômicas, hábitos de higiene e alimentação. Os dados foram submetidos à análise bivariada,por meio dos testes de Qui-quadrado de Pearson e Exato de Fisher. Resultados: No grupo G1houve tendência de associação entre experiência de cárie e placa visível (p = 0,053), enquanto no grupo G2 esta associação apresentou-se significativa (p = 0,006). Houve associações entre o padrão de higienização após a alimentação durante a noite e placa visível (p= 0,026) no grupoG1; e entre estado civil das mães e placa visível no grupo G2 (p= 0,043). Conclusão: Dentro da primeira infância, a relação entre cárie dentária e placa visível em dentes anteriores torna-semais evidente com o aumento da idade.

Objective: To identify the association between dental caries and plaque in the different stages of the early childhood. Materials and Methods: 183 children 8-69 months of age from two Municipal Centers of Children Education, in Curitiba, were clinically examined for cariesand visible plaque. Children were divided in two groups according to the different stages ofthe early childhood, G1 (up to 36 months), G2 (37 to 69 months). Caries experience (ceo-d>0)and visible plaque on at least one upper incisor were evaluated by one previously calibrated examiner (kappa>0,80). Mothers were invited to answer a questionnaire about socioeconomic aspects, dental hygiene and feeding habits. Data were submitted to bivariate analysis using Pearson´s chi-square and Fisher´s exact tests. Results:G1 showed a tendency of association between caries experience and visible plaque (p=0,053), while in G2 a significant association wasfound (p=0,006).Association was found in G1 between dental hygiene after feeding during thenight and visible plaque (p=0,026), and between mother´s marital status and visible plaque onG2 (p=0,043). Conclusion: The association between dental caries and visible plaque on anteriorteeth becomes more evident on the late stages of early childhood.

Training and calibration of interviewers for oral health literacy using the BREALD-30 in epidemiological studies

Abstract 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.

The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1

ABSTRACT 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.

Weaning and associated factors in children from low-income communities / Fatores associados ao desmame em crianças de comunidades de baixa renda

Introduction: The average duration of breastfeeding is still insufficient and differ widely taking in account the location and specific characteristic of local people involved in these studies. Aim: This research aimed at studying factors associated to weaning among South Brazilian children living in a low-income household. Material and method: Cross-sectional study was carried out enrolling 124 mothers of 1 to 12-month-old children, who were interviewed at "Pastoral da Criança" (non-governmental organization) in Almirante Tamandaré, Paraná, Brazil. The risk of weaning considered was the dependent variable and the information collected from the questionnaires, independent variables. The method used to collect information in this study was Kaplan-Meier method and Cox regression model and Spearman's rank correlation (α = 0.05). Result: Actuarial life table presented a higher weaning conditional probability at 12 months of age, followed by first and fourth months of age. Multivariate analysis pointed out that contact with bottle feeding before the sixth month of age [HR=17.16 (2.34-125.86)] and contact with pacifier before the sixth months of age [HR=3.48 (1.90-6.38)] are risk factors associated with weaning. Among children who were not breastfed at the moment of the interview, breastfeeding duration presented a positive correlation with the ages when the children had their first contact with sugar (r s =+0.419, p=0.001) and negative correlation with the use of pacifier (r s =-0.300, p=0.017). Conclusion: Results from this study showed that the use of the feeding bottle and pacifier were related to a shorter breastfeeding time span at these communities. .

Introdução: A duração média do aleitamento materno ainda é insuficiente e apresenta grandes variações em razão do local e das características da população estudada. Objetivo: Analisar os fatores associados ao desmame em crianças sul brasileiras de comunidades de baixa renda. Material e método: Estudo transversal realizado através de entrevista envolvendo 124 mães de crianças com até 12 meses de idade, atendidas pela Pastoral da Criança, em Almirante Tamandaré, Paraná, Brasil. O risco ao desmame foi considerado como variável resposta e os dados do questionário, variáveis preditoras. Os dados foram analisados através do método de Kaplan-Meier, modelo de regressão de Cox e correlação de Spearman (α = 0,05). Resultado: A tábua de vida atuarial revelou uma probabilidade condicional de desmame maior aos 12 meses de idade, seguido do primeiro e quarto meses. A análise multivariada mostrou que o contato com a mamadeira antes do sexto mês de vida [HR=17,16 (2,34-125,86)] e o contato com a chupeta antes do sexto mês de vida [HR=3,48 (1,90-6,38)] foram variáveis de risco associadas ao desmame. Entre as crianças desmamadas, por ocasião da entrevista, a duração da amamentação apresentou correlação positiva com a idade do primeiro contato com açúcar (r s =+0,419; p=0,001) e negativa com a duração do uso de chupeta (r s =-0,300; p=0,017). Conclusão: O uso da mamadeira e da chupeta estiveram relacionados a uma menor duração do aleitamento materno nestas comunidades. .

Folheto educativo melhora o conhecimento de pais frente ao traumatismo alvéolo-dentário? / Do educational leaflets improve the knowledge of parents when faced with traumatic dental injuries?

Objetivo: Este estudo teve como objetivo verificar a eficácia de um folheto educativo para melhoraro nível de conhecimento sobre o pronto-atendimento em casos de traumatismo alvéolo-dentário (TAD) por pais/responsáveis de crianças de até 12 anos. Materiais e Métodos: Uma amostra de 257 pais/responsáveis decrianças de até 12 anos de idade que faziam acompanhamento em Unidades de Saúde do Município de Colombo(PR) entre junho e setembro de 2012 respondeu a questionários com dados demográficos e socioeconômicose sobre atitudes no prontoatendimento de casos de TAD (QTAD). O QTAD é um questionário autoaplicado, composto por 10 perguntas de múltipla escolha referentes a situações de avulsão, intrusão, extrusão e fratura na dentição decídua e permanente e foi aplicado antes (QTAD1) e imediatamente após (QTAD2) a leitura do folheto educativo. O folheto educativo se baseou nas orientações da Sociedade Brasileira de Traumatologia Dentária, continha instruções sobre como proceder diante de casos de TAD e possuía ilustrações coloridas das situações, linguagem simples e direta. Resultados: Após a leitura do folheto, houve aumento no escore total do QTAD (Teste de Wilcoxon, p < 0,001) e na frequência de acertos para a maioria das questões individuais, sendo o aumento mais expressivo para respondentes jovens (rs = -0,127, p = 0,042), com maior escolaridade (Teste de Mann-Whitney, p < 0,001), maior renda (rs = 0,135, p = 0,030) e menor escore em QTAD1 (rs = -0,524, p <0,001). Conclusão: O folheto educativo mostrou-se um instrumento válido para melhorar o conhecimento de pais/responsáveis sobre o pronto-atendimento em casos de TAD em crianças.

Profile of Brazilian scientific research in pediatric dentistry based on the 26th Annual Meeting of the SBPqO / Perfil da produção científica brasileira na Odontopediatria baseado na 26ª Reunião da SBPqO

PURPOSE: To describe the Brazilian scientific research in pediatric dentistry in 2009 based on the 26th Annual Meeting of the SBPqO (Brazilian division of the IADR). METHODS: All studies on pediatric dentistry were selected from the abstracts presented at the 26th Annual Meeting of the SBPqO in 2009. They were assessed in terms of subjects, methodology and sampling units. RESULTS: Of the 2,648 abstracts presented, 7.7% were on pediatric dentistry, thereby representing the field with the 4th greatest participation in the meeting. The Southeast was the most productive region in Brazil, accounting for 70.1% of abstracts. A wide range of subjects were addressed: dental trauma (5.4%), diagnosis of dental caries (4.9%), diet and dental caries (4.4%), endodontic medication (4.4%), developmental enamel defects (3.4%), glass ionomer cement (3.4%), and dental care for pregnant women (3.4%). The cross-sectional design was the most prevalent type of study (52.5%), followed by in vitro studies (23.5%). Only 2.5% of the abstracts were randomized controlled trials. A total of 41.7% of the studies included children aged 0 to 11 years old, while 14.7% used human deciduous teeth. CONCLUSION: Pediatric dentistry played an important role in Brazilian scientific research in 2009, presenting a broad diversity of subjects and methodological approaches.

OBJETIVO: Descrever a produção científica brasileira na Odontopediatria em 2009, baseando-se na 26ª Reunião Anual da SBPqO (divisão brasileira do IADR). METODOLOGIA: Todos os estudos na área de Odontopediatria, selecionados a partir dos resumos apresentados na reunião, foram avaliados em termos de assuntos, desenho metodológico e unidades amostrais. RESULTADOS: Dos 2648 resumos apresentados, 7,7% corresponderam aos de Odontopediatria, representando a área com a quarta maior participação. A região sudeste foi a mais produtiva do país, sendo responsável por 70,1% dos resumos. Foram abordados assuntos bastante variados, sendo os mais prevalentes: traumatismo dentário (5,4%), diagnóstico de cárie dentária (4,9%), dieta e cárie dentária (4,4%), medicações endodônticas (4,4%), defeitos de desenvolvimento de esmalte (3,4%), cimento de ionômero de vidro (3,4%) e atendimento odontológico para gestantes (3,4%). Os estudos transversais foram os mais prevalentes (52,5%), seguidos dos estudos in vitro (23,5%). Apenas 2,5% dos resumos foram estudos clínicos controlados e randomizados. Um total de 41,7% incluíram crianças de 0 a 11 anos de idade e 14,7% utilizaram dentes decíduos humanos. CONCLUSÃO: A Odontopediatria desempenhou um papel importante na produção científica brasileira em 2009, oferecendo uma ampla diversidade de temas e abordagens metodológicas.

A map of Brazilian dental research in the last decade

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 percent 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 percent proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8 percent). 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 percent). 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.

Validade e confiabilidade de kits para detecção dos níveis de estreptococos do grupo mutans e lactobacilos na saliva de crianças e adultos / Validity and reliability of kits for salivary detection of mutans streptococci and lactobacilli in infants and adults

Objetivo: Avaliar a validade e a confiabilidade dos resultados obtidos por meio de kits pré-fabricados disponíveis no mercado brasileiro para a detecção e quantificação dos níveis de estreptococos do grupo mutans e lactobacilos na saliva de crianças e adultos. Método: Amostras salivares de 15 crianças (12-24meses) e 14 adultos (17-35 anos) foram coletadas e analisadas quanto aos níveis salivares de estreptococos do grupo mutans e lactobacilos pelo uso dos kits Dentacult I e II (Laborclin) e por método microbiológico convencional, baseado em cultura em meios seletivos. Os resultados de ambos os métodos foram comparados pelo uso dos coeficientes Kappa ponderado (Kp) e de correlação de Spearman. Para a determinação da concordância inter e intraexaminador da leitura dos resultados obtidos com o uso dos kits, os dados foram comparados por meio do Kp. As análises estatísticas foram realizadas utilizando o software Minitab 15 (versão 15.1.0.0.). Foi adotado o nível de significância de 5%. Resultados: Os resultados apresentados pelo kit Dentalcult I apresentaram concordância regular e correlação não-significante com os obtidos com o método microbiológico convencional (rs=0,53; p maior que 0,05). Por outro lado, os resultados obtidos com o kit Dentalcult II apresentaram boa concordância e correlação estatisticamente significante com os do método convencional (rs=0,77; p menor que 0,05). Os kits Dentalcult I e II tiveram confiabilidade de leitura perfeita (Kp=1) em momentos distintos, independentes do examinador. A concordância interexaminadores foi perfeita para o kit Dentalcult II (Kp=1) e ótima para o Dentalcult I (Kp=0,94). Conclusão: O kit Dentalcult II pode ser indicado para a estimativa dos níveis salivares de estreptococos do grupo mutans em substituição aos métodos convencionais.

Objective: To compare the results of commercially available kits for determination of mutans streptococci (MS) and lactobacilli (LB) salivary levels in infants and adults. Method: Salivary samples of 15 children (aged 12-24 months-old) and 14 adults (aged 17-35 years-old) were collected and evaluated for salivary levels of MS and LB by using the Dentacult I and II kits, respectively (Laborclin) and conventional methods based on culture in selective media. The results of both methods were compared to those obtained by the weighted kappa coefficients (Kp) and Spearman's correlation. Statistical analysis was performed using Minitab software 15 (version 15.1.0.0). It was adopted a significance level of 5%. Results: The data obtained with the Dentalcult I kit showed regular agreement and no significant correlation with the conventional microbiological method (rs=0.53, p greater than 0.05). On the other hand, results provided by the Dentalcult II kit produced good agreement and were statistical significant correlated with those of the conventional method (rs=0.77, p less than 0.05). The kits Dentalcult I and II presented perfect reading reliability (Kp=1) in distinct moments, not -dependent on the examiner. The inter-examiner agreement was considered perfect for the kit Dentalcult II (Kp=1) and satisfactory for Dentalcult I (Kp=0.94). Conclusion: The kit Dentalcult II proved validity and reliability for detecting salivary MS.

Efeito do xilitol em pastilhas na composição do biofilme dental e na desmineralização e remineralização do esmalte / Effect of xylitol mints in the dental biofilm composition and in the enamel demineralization and remineralization

Apesar dos conhecimentos já existentes sobre o xilitol, seu efeito nodesenvolvimento da cárie dentária ainda requer maiores esclarecimentos. Assim,este estudo in situ randomizado, duplo-cego e cruzado teve como objetivodeterminar o efeito de xilitol em pastilhas na composição do biofilme dental e nosprocessos de desmineralização e remineralização do esmalte, comparado a umcontrole com pastilhas contendo sorbitol. Em duas fases de 14 dias, 11 voluntáriosutilizaram dispositivos palatinos com seis blocos de esmalte humano (três hígidospara avaliação da desmineralização + três previamente desmineralizados paraavaliação da remineralização) com dureza de superfície conhecida. Sacarose 20%foi gotejada oito vezes ao dia apenas sobre os blocos hígidos. Cinco minutos apóscada gotejamento, os dispositivos eram recolocados na boca e os voluntárioschupavam pastilha com xilitol 88,3% ou sorbitol 84,5%. A utilização das pastilhasiniciou-se uma semana antes de cada fase experimental. Foi usado dentifrício semflúor. Ao final de cada fase, o biofilme formado sobre os blocos foi coletado edividido para análises microbiológica e bioquímica, e os fragmentos de esmalteforam analisados quanto a variação de dureza de superfície antes e após oexperimento. A porcentagem de perda de dureza de superfície dos blocos deesmalte do grupo do xilitol apresentou uma tendência a ser menor do que aquelaobservada no grupo do sorbitol, embora a diferença não tenha sido significante (p=0,066; ANOVA). Também não houve diferença estatisticamente significante entre osgrupos em relação à porcentagem de ganho de dureza de superfície e à maioria dosparâmetros bioquímicos do biofilme. As médias das concentrações de fósforoinorgânico e de polissacarídeo intracelular no biofilme no experimento de...

In spite of the existing knowledge about xylitol, its effect on the development of dentalcaries is still a subject that requires further clarifications. Thus, this randomized,double-blind, crossover in situ study aimed at assessing the effect of xylitol mints inthe dental biofilm composition and in the processes of enamel demineralization andremineralization, in comparison to a control group using sorbitol mints. During the twophases of 14 days, 11 volunteers wore palatal appliances with six human enamelblocks (three intact ones for evaluation of demineralization and three demineralizedones for the evaluation of remineralization) of known superficial hardness. A solutionof 20% sucrose was dripped only on the intact enamel blocks eight times per day.Five minutes after each dripping, the appliances were placed back inside the mouthand the volunteers took either an 88.3% xylitol mint or an 84.5% sorbitol mint. Bothtypes of mints started being used by the volunteers one week before eachexperimental phase. Non-fluoridated toothpaste was used. At the end of each phase,the biofilm formed over the blocks was collected and divided for microbiological andbiochemical analysis and the enamel fragments were evaluated in relation to surfacehardness variation before and after the experiment. The percentage of surfacehardness loss of the enamel blocks in the xylitol group tended to be lower than inthose of the sorbitol group although this difference was not significant (p= 0.066;ANOVA). Moreover, there were no statistically significant differences between the...

Performance of Brazilian and imported glass ionomer cements used in Atraumatic Restorative Treatment (ART) regarding microleakage in primary molars

With the aim of assessing the performance of Brazilian and imported glass ionomer cements (GIC) with regard to microleakage, 40 primary molars received two standard class II cavity preparations with margins in enamel. Twenty cavities were filled with Brazilian materials (Vidrion® R and Vidrion® R Caps) and the other 20 cavities were filled with imported materials (Fuji® IX and Fuji® IX GPFast capsule). All fillings were performed by a single operator according to the manufacturer's instructions. Teeth were immersed in 0.5 percent methylene blue and half-sectioned. Three independent calibrated examiners assessed microleakage using scores (0-3). Data were submitted to the Kruskal-Wallis statistical test and Wilcoxon analysis. High microleakage indexes were verified for all ionomer cements: 59.5 percent of the samples restored with Vidrion® R or Vidrion® R Caps and 83.4 percent of the samples restored with Fuji® IX or Fuji® IX GPFast capsule obtained the maximum score (3). The Brazilian ionomer cements presented less microleakage than imported cements, although this difference was only significant (p=0.003) among the encapsulated materials.

Buscando comparar o desempenho de 2 cimentos de ionômero de vidro (CIV) restauradores convencionais nacionais, mais acessíveis tanto financeiramente quanto por disponibilidade no mercado, ao desempenho de 2 CIV importados frente à microinfiltração, confeccionou-se preparos classe II com término cervical em esmalte em 40 molares decíduos hígidos. Vinte cavidades foram restauradas com os CIV nacionais (Vidrion® R e Vidrion® R Caps) e as demais com os importados (Fuji® IX e Fuji® IX GPFast), por um único operador. Os dentes foram impermeabilizados, imersos em azul de metileno 0,5 por cento e seccionados mesio-distalmente. A microinfiltração foi avaliada por 3 examinadores calibrados, em microscópio estereoscópico, através de escores (0-3). Foram utilizados os testes estatísticos de Kruskall-Wallis e de Wilcoxon. Verificou-se altos índices de microinfiltração para todos os CIV: 59,5 por cento das amostras restauradas com Vidrion® R ou Vidrion® R Caps e 83,4 por cento das amostras restauradas com Fuji® IX ou Fuji® IX GPFast obtiveram o escore máximo (3). Os CIV nacionais apresentaram menos microinfiltração que os CIV importados, embora essa diferença só tenha sido significativa (p=0,003) entre os materiais encapsulados.