Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Brazilian Schoolchildren Aged 8 to 10 Years

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

Prevalence of Dental Fear and its Association with Painful Oral Conditions in Adolescents

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System - ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear.

Estão os estudantes de odontologia com medo do Coronavírus? Um estudo piloto utilizando a escala de medo da COVID-19 / Are dental students afraid of the Coronavirus? A pilot study using the fear of COVID-19 Scale

Introdução: a pandemia da COVID-19 acarretou mudanças em todos os segmentos da sociedade, inclusive com impacto na educação odontológica. Objetivo: avaliar o medo frente à COVID-19 em estudantes de Odontologia. Metodologia: estudo transversal composto por 40 estudantes de Odontologia de uma universidade privada. Foram coletados dados referentes a questões sociodemográficas e aplicada a Escala de Medo da COVID-19 (EMC-19). Os dados foram tabulados utilizando-se o software IBM SPSS e analisados descritivamente (frequências absoluta e percentual, medidas de tendência central e de variabilidade). Resultados: a maioria dos estudantes era do sexo feminino (60,0%), tinha entre 16 e 20 anos (50,0%) e 45,0% possuía renda familiar mensal de mais de um e menos de três salários mínimos. A média do escore total na EMC-19 foi de 18,45 (DP = 6,08), com escore mínimo de 7 e máximo de 30. A maior parte dos estudantes apresentou "pouco medo" da COVID-19 (55,0%). Os itens "Eu tenho muito medo da COVID-19", "Eu tenho medo de morrer por causa da COVID-19", e "Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19" obtiveram os maiores valores médios. Conclusão: a maioria dos estudantes apresentou pouco medo da COVID-19, apesar dos itens "Eu tenho muito medo da COVID-19", "Eu tenho medo de morrer por causa da COVID-19" e "Eu fico nervoso ou ansioso quando vejo notícias nos jornais e nas redes sociais sobre a COVID-19" terem obtido os maiores valores médios.

Introduction: the COVID-19 pandemic brought changes in all segments of society, including with impact on dental education. Objective: to evaluate the fear of COVID-19 in dental students. Methodology: cross-sectional study composed of 40 dental students from a private university. Data were collected regarding sociodemographic issues and the Fear of COVID-19 Scale (FCV-19S) was applied. The data were tabulated using the IBM SPSS software and analyzed descriptively (absolute and percentage frequencies, measures of central tendency and variability). Results: most students were female (60.0%), between 16 and 20 years old (50.0%) and 45.0% had a monthly family income of more than one and less than three minimum wages. The average of the total score on the FCV-19S was 18.45 (SD = 6.08), with a minimum score of 7 and a maximum of 30. Most students showed "little fear" of COVID-19 (55.0 %). The items "I am very afraid of COVID-19", "I am afraid of dying because of COVID-19", and "I get nervous or anxious when I see news in the newspapers and on social media about COVID-19" obtained the highest average values. Conclusion: most students showed little fear of COVID-19, despite the items "I am very afraid of COVID-19", "I am afraid of dying because of COVID-19" and "I get nervous or anxious when I see news in newspapers and social media about COVID-19" having obtained the highest average values.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Avaliação micro e macroscópica de escovas dentais / Micro and macroscopic evaluation of toothbrushes

Introdução: as escovas dentais possuem como principal função a limpeza dos tecidos bucais. Objetivo: analisar as características micro e macroscópicas de escovas dentais de uso infantil e adulto. Metodologia: foram selecionadas 11 escovas dentais (cinco de uso infantil e seis de uso adulto). Dois pesquisadores treinados analisaram aspectos microcoscópicos e macroscópicos, de acordo com os parâmetros da Portaria n° 97/SVS (ANVISA). Os dados foram tabulados e analisados utilizando-se o Microsoft Excel, sendo apresentados por meio de estatística descritiva. Resultados: foram encontradas cerdas arredondadas em 40% das escovas de uso infantil e em 66,7% de uso adulto, com farpas em 60% das escovas de uso infantil e em 50% de uso adulto, com a parte ativa ovalada em 60% das escovas de uso infantil e em 50% de uso adulto e com as cerdas macias em 80% das escovas de uso infantil e em 50% de uso adulto. O comprimento e a largura da parte ativa das de uso infantil variaram de 19,14 a 25,03 mm e de 8,82 a 13,98 mm respectivamente, enquanto, nas de uso adulto, o comprimento variou de 25,77 a 37,02 mm e a largura de 12,57 a 15,40 mm. As escovas de uso infantil possuíam comprimento total entre 137,91 e 163,82 mm e as de uso adulto entre 180,08 mm e 195,42 mm. Conclusão: a maioria das escovas dentais analisadas não estão adequadas aos parâmetros estabelecidos na legislação brasileira, sendo essencial que o cirurgião-dentista oriente individualmente o paciente acerca de qual escova é a mais indicada.

Introduction: toothbrushes have the main function of cleaning the oral tissues. Objective: to analyze the micro and macroscopic characteristics of children's and adult's toothbrushes. Methodology: eleven toothbrushes were selected (five for children and six for adults). Two trained researchers analyzed microscopic aspects and macroscopic aspects of the brushes, according to the parameters of Ordinance Number 97/SVS (ANVISA). Data were tabulated and analyzed by using Microsoft Excel and were presented by using descriptive statistics. Results: rounded bristles were found in 40% of the children's brushes and 66.7% of the adult, with barbs in 60% of the children's brushes and 50% of the adult, with the active part oval in 60% of the children's brushes and 50% adult brushes and soft bristles on 80% of the children's brushes and 50% of the adult. The length and width of the active part of the children's brushes ranged from 19.14 to 25.03 mm and from 8.82 to 13.98 mm respectively, while the adult brushes ranged from 25.77 to 37.02 mm in length and from 12.57 to 15.40 mm in width. The children's brushes had a total length between 137.91 and 163.82 mm and the adult brushes were between 180.08 mm and 195.42 mm. Conclusion: most of the toothbrushes analyzed are not adequate by the parameters established by the Brazilian legislation, so it is essential that the dentist individually guide the patient as to which toothbrush is the most suitable.

Caracterização dos ensaios clínicos sobre cárie dentária desenvolvidos no Brasil e registrados no clinical trials: uma análise de 15 anos (2003-2017) / Characterization of clinical trials about caries developed in Brazil and registered on clinical trials: an analysis of 15 years (2003-2017)

Objetivo: Caracterizar os ensaios clínicos sobre cárie dentária desenvolvidos por pesquisadores brasileiros e registrados na plataforma Clinical Trials. Material e método: Tratou-se de estudo bibliográfico sobre a cárie dentária por meio da análise dos registros feitos na plataforma Clinical Trials. O período de busca compreendeu todos os estudos registrados entre os anos de 2003 a 2017. Para a estratégia de pesquisa foi utilizada a palavra-chave "Dental caries" na seção "Condition or disease" e "Brazil" na seção "Country". Os dados foram apresentados por meio de estatística descritiva. Resultados: Foram obtidos 55 ensaios clínicos, constituindo- se o Estado de São Paulo como principal local de execução (51,8%). A amostra variou de três a 800 indivíduos. Quanto à análise do período de registro, a maioria dos ensaios clínicos foram registrados nos últimos cinco anos (2013-2017) (63,6%). A maioria dos ensaios clínicos analisados recrutou crianças entre 0-12 anos (67,7%). Com relação à alocação dos grupos, apenas um estudo (1,8%) não se caracterizou como randomizado. O modelo de intervenção mais frequente foi o paralelo (70,9%). Quanto ao tipo de mascaramento, o estudo cego (34,5%) foi o mais prevalente e os estudos com finalidade terapêutica foram predominantes (67,3%). A maior parte dos estudos dividiu os participantes em dois grupos (67,3%) e não usou grupo placebo (80,0%). Conclusões: Os ensaios clínicos desenvolvidos por pesquisadores brasileiros voltados à temática da cárie dentária são majoritariamente desenvolvidos em crianças, predominando o desenho paralelo e a finalidade terapêutica. Existe grande variabilidade no número amostral, sendo baixo o uso de grupo placebo.

Objectives: To caracterize the clinical trials about dental caries developed by brazilian resourchers and registered on Clinical Trials Plataform. Methods: A bibliographic study about dental caries theme by means of the analysis of registries made at the Clinical Trials, an international plataform for registration of clinical trials. The search included all the registered studies between the years of 2003 and 2017. The search strategy used "dental caries" as key word on section "Condition or disease" and "Brazil" on section "Country". The data were presented through a descriptive statistics. Results: The search obtained 55 (fifty five) clinical trials, having the state of São Paulo as the principal execution place (51,8%). The sample varied between 3 (three) and 800 (eight hundred) individuals. In relation to the period of registry, most of the clinical trials belong to the last 5 (five) years - 2013-2017 (63,6%). Most of clinical trials analyzed had recruited children between 0-12 years (67,7%). With regard to allocation of groups, only 1 (one) study didn't caracterize as randomized. The most frequent intervation model was the parallel (70,9%). As the type of masking, the blind study prevailed and the studies with therapeutic purpose were predominant (67,3%). The most part of studies divided the participants into 2 (two) groups (67,3%) and didn't use a placebo group. Conclusion: The clinical trials developed by brazilian resourchers toward dental caries theme are mostly developed on children, predominating the parallel design and therapeutic purpose. There is large variability on sample numbers, with low use of placebo groups.

Hipomineralização molar-incisivo: etiologia, características clínicas e tratamento / Molar incisor hypomineralization: etiology, clinical characteristics and treatment

Introdução: a Hipomineralização Molar-Incisivo (HMI) é um defeito de desenvolvimento do esmalte dentário que afeta de um até todos os primeiros molares permanentes, podendo estar presente nos incisivos permanentes. Objetivo: revisar a literatura sobre a HMI objetivando proporcionar informações ao cirurgião-dentista que realiza atendimento infantil sobre o diagnóstico, características clínicas e tratamento. Metodologia: revisão integrativa da literatura, sendo utilizado as bases de dados LILACS, PubMed, Web of Science e Scopus. Foram usadas as palavras-chaves "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" e " Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization". Resultados: fatores etiológicos associados a complicações pré, peri e pós-natais, ambientais e genéticos têm sido evidenciados e a prevalência de HMI mostra-se variada entre as populações. Apresenta-se como manchas opacas bem delimitadas e, com o aumento da gravidade, ocorre a perda do esmalte resultando em fratura, destruição coronária e indicação de exodontia. As fraturas pós-eruptivas atuam como áreas de retenção de biofilme, o que facilita seu acúmulo e aumenta a susceptibilidade à cárie dentária. A Academia Europeia de Odontopediatria (EAPD) estabeleceu critérios que facilitam o diagnóstico deste agravo por meio de pesquisas epidemiológicas. As medidas terapêuticas são direcionadas de acordo com a gravidade da lesão. Conclusão: a HMI deve receber adequada atenção do cirurgião-dentista em função das consequências clínicas e estéticas que acarreta ao paciente, interferindo negativamente na sua qualidade de vida nos casos mais graves. Novas pesquisas são necessárias com a finalidade de expandir o conhecimento acerca da HMI, objetivando ofertar ao paciente o correto diagnóstico e a melhor opção terapêutica.

ntroduction: molar Incisor Hypomineralization (HMI) is a developmental defects of enamel that affects from one to all first permanent molars and also permanent incisors. Aim: to review the literature with the aim of providing information to the pediatric dentist about the diagnosis, clinical characteristics and treatment of HMI. Methodology: integrative literature review, using the LILACS, PubMed, Web of Science and Scopus databases. The keywords "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" and "Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization" were used. Results: etiologic factors are associated with prenatal and postnatal factors, environmental and genetic complications. The prevalence of HMI is varied among the populations. It's clinically characterized as delimited opaque spots. With increasing severity, can occurs enamel loss, fracture, coronary destruction and indication of exodontia. Post-eruptive fractures act as areas of biofilm retention, which facilitates their accumulation and increases susceptibility to dental caries. European Academy of Pediatric Dentistry (EAPD) has established criteria that facilitate diagnosis of HMI in epidemiological research. Therapeutic measures are indicated according to the severity of the lesion. Conclusion: MIH should receive adequate attention from the dentist due to its clinical and aesthetic consequences, interfering negatively in quality of life of patients in the most severe cases.