Improvement on oral health related quality of life after orthosurgical treatment: a mixed methods study

Abstract The aim of this study was to understand the influence of orthosurgical treatment on oral health-related quality of life (OHRQoL) in patients with Class II and III skeletal malocclusion by conducting a mixed method case series study. Nineteen patients submitted to orthosurgical treatment in a private practice in Brazil were included in the sample. Data were collected retrospectively and interviews were held from March 2020 to July 2021. Patients answered to the Oral Health Impact Profile (OHIP-14) in the first part of the interview and subsequently answered the qualitative questions. The overall mean of OHIP-14 after treatment was 4.21 (SD 4.68). The qualitative data were analyzed according to thematic analysis and four themes emerged from the interviews: a) concept of quality of life, b) pre-treatment life, c) post-treatment life, and d) positive and negative aspects of treatment. Quality of Life was reported by the patients as the absence of feeling pain, having emotional and physical health, having a satisfactory esthetic appearance and self-esteem. Before treatment, most Class II patients used to complain about breathing and sleeping problems, while Class III patients complained more intensely about esthetics. Pain was a common problem reported by both Class II and Class III patients. In general, improvement was perceived in self-esteem, esthetics, function and pain. Complaints about negative aspects of the treatment were restricted to the postoperative period. The orthosurgical treatment was important for improving the OHRQoL of patients in terms of esthetic, functional and psychosocial aspects.

Do untreated caries influence the school leaving of adolescents? A cohort study

Abstract The objective was assess the influence of untreated caries and socioeconomic status (SES) on school dropout among adolescents. A six-year cohort study was conducted with random sample of adolescents (12 years-old) who had been evaluated initially in 2012 from Santa Maria, Brazil. Sex, socioeconomic status (mother's education and household income), and untreated caries were collected at the baseline. The outcome variable was collected at the follow-up through self-report and was divided into three categories: adolescents who only studied, who studied and employed, and who school dropouts. A multinomial regression model was performed to assess the influence of oral disease and SES on school leaving, through relative risk ratio (RRR) and 95% confidence interval (95% CI). From of 1,134 adolescents evaluated at the baseline, 768 participants with a mean age of 17.5 years were re-evaluated at follow-up (67.8% response rate). Male (RRR: 2.31; 95%CI: 1.19-4.48) and adolescents with untreated caries at the baseline had an increment in school-leaving (RRR: 2.26; 95%CI: 1.12-4.56). Mothers with low education (RRR: 2.24; 95%CI: 1.09-4.61) had a higher probability of having children who leave school. Untreated caries and low SES in early adolescence can influence the tendency to school dropouts.

Resumo O objetivo foi avaliar a influência da cárie dentária não tratada e do status socioeconômico (SES) sobre o abandono escolar dos adolescentes. Foi realizado um estudo de coorte de seis anos de acompanhamento com uma amostra aleatória de adolescentes (12 anos de idade) avaliados inicialmente em 2012 em Santa Maria, Brasil. Sexo, status socioeconômico (educação da mãe e renda familiar) e cárie não tratada foram coletados no início do estudo. A variável de desfecho foi coletada no acompanhamento por meio do autorrelato e foi dividida em três categorias: adolescentes que apenas estudavam, aqueles que estudavam e trabalhavam e quem tinha abandonado a escola. Um modelo de regressão multinomial foi realizado para avaliar a influência da doença bucal e do SES sobre o abandono escolar, por meio da razão de risco relativo (RRR) e intervalo de confiança de 95% (IC95%). Dos 1.134 adolescentes avaliados no início do estudo, 768 participantes com idade média de 17,5 anos foram reavaliados no acompanhamento (taxa de resposta de 67,8%). Meninos (RRR: 2,31; IC 95%: 1,19- 4,48) e adolescentes com cárie não tratada no início do estudo tiveram um incremento no abandono escolar (RRR: 2,26; IC 95%: 1,12-4,56). Mães com baixa escolaridade (RRR: 2,24; IC95%: 1,09-4,61) tiveram maior probabilidade de ter filhos que abandonaram a escola. Cárie dentária não tratada e baixo SES no início da adolescência pode influenciar a tendência de evasão escolar.

Impact of Oral Conditions and Subjective Factors on Academic Performance

ABSTRACT Objective: To evaluate the influence of oral health clinical and non-clinical indicators on adolescents' academic performance. Material and Methods: A longitudinal design was performed with a random sample of 1,134 12-year-old Brazilian adolescents. In 2012, the adolescents were clinically assessed by calibrated dentists and investigated about demographics, socioeconomic factors, dental service use, toothache, and verbal bullying related to oral condition via structured questionnaires. The contextual variable was obtained from the city's official database. After two years, 771 adolescents were reassessed. The outcome adolescent's academic performance (good or poor) was collected through official school's register. Multilevel logistic regression analyses were performed to assess associated factors for adolescents' academic performance. Results: Adolescents with toothache (OR 1.74; CI 95%: 1.05-2.89), who have been a victim of bullying (OR 2.23; CI 95%: 1.21-4.09), and were male (OR 1.92; CI 95%: 1.19-3.09) had a lower academic performance. On the other hand, adolescents whose mothers had higher educational levels (OR 1.79; CI 95%: 1.08-2.97) and belonged to higher-income households (OR 1.95; CI 95%: 1.18-3.23) had higher academic performance when compared to their peers. Conclusion: Adverse oral conditions, as well as subjective and socioeconomic factors, impacted on adolescents' academic performance.

Nível socioeconômico, saúde bucal e fatores associados no suporte social de gestantes: estudo transversal / Socioeconomic level, oral health, and associated factors in the social support of pregnant women: a cross-sectional study

Avaliar a associação entre variáveis socioeconômicas e relacionadas a saúde bucal no suporte social percebido por gestantes. Esse estudo transversal incluiu uma amostra obtida em conglomerados de gestantes atendidas no serviço público de saúde no sul do Brasil. As gestantes responderam questionários acerca de características demográficas, socioeconômicas e relacionadas à saúde bucal. O suporte social foi avaliado através da escala Medical Outcomes Study. As variáveis clínicas incluíram cárie dentária não tratada e sangramento gengival. Análise de Regressão de Poisson em multinível foram utilizados para avaliar a influência dos preditores no suporte social. A amostra foi composta por254 gestantes. Gestantes com pior autopercepção de saúde bucal, níveis extensivos de sangramento gengival e com menor nível socioeconômico apresentaram um pior suporte social. Fatores socioeconômicos e relacionados à saúde bucal exerceram impacto no suporte social percebido por gestantes.

To evaluate the association between socioeconomic and oral health-related variables in the social support perceived by pregnant women. This cross-sectional study included a sample obtained from clusters of pregnant women who attended public health services in southern Brazil. The pregnant women answered questionnaires about demographic, socioeconomic, and oral health characteristics. Social support was assessed using the Medical Outcomes Study scale. Clinical variables included untreated dental caries and gingival bleeding. Multilevel Poisson regression analysis was used to assess the influence of predictors on social support. The sample consisted of 254 pregnant women. Those with poorer self-perceived oral health, extensive levels of gingival bleeding, and lower socioeconomic status, presented poor social support. Socioeconomic factors and factors related to oral health had an impact on the social support perceived by pregnant women.

Effect of dental caries and socioeconomic status on social capital throughout adolescence: a 6-year follow-up

Abstract The aim of the study was to investigate the influence of clinical and socioeconomic factors on social capital throughout adolescence. A cohort study was performed in 2012 (T1) with a random sample of 1,134 12-year-old adolescents from Santa Maria, Brazil. Questions on socioeconomic factors (maternal education, household income, household crowding) were answered by the parents. Clinicians evaluated their dental caries (decayed, missing, and filled status of permanent teeth) and gingival bleeding (using the Community Periodontal Index). Contextual variables including the mean income of the neighborhood in which the school was located were used (T1). The adolescents were revaluated in 2018 (T2) and answered questions regarding social capital (social trust, social control, empowerment, neighborhood security, and political effectiveness). A path analysis was used to test the relationship between the predictor variables (T1) and social capital (T2). A total of 768 adolescents were reevaluated at a 6-year follow-up (cohort retention rate of 67.7%). Most of the adolescents were girls, with a low household income, about 40% had caries experience (T1), and about 64% had high social capital (T2). The highest neighborhood's mean income was related to a lower household income in T1 (p < 0.01), and this was directly related to a low social capital in T2 (p = 0.04). Furthermore, caries experience at T1 was directly associated with low social capital at T2 (p = 0.03). Socioeconomic factors were also related to caries experience. Individuals who lived in neighborhoods with greater inequality such as families with a low household income and those with untreated dental caries in early adolescence, had a low social capital after follow-up.

Factors associated with the number of filled teeth in adolescents from public schools: a cohort study

Abstract This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.

Oral and oropharyngeal cancer: epidemiology and survival analysis / Câncer de boca e orofaringe: epidemiologia e análise da sobrevida

ABSTRACT Objective To evaluate the epidemiological profile and survival rate of oral and oropharyngeal cancer patients seen at a university hospital. Methods A cross-sectional study was carried out by means of the pathological reports of patients with oral and oropharyngeal cancer, seen at a university hospital of the Southern Region, between January 2004 and December 2014. Information was collected on patients and tumors. The mortality rate was gathered from the patient death registry in the Mortality Information System. Data were analyzed using the Kaplan-Meier survival curve and the log-rank test to compare variables. Results The 5- and 10-year survival rates were 42% and 38%, respectively. The anatomical location had a significant association with survival rate (p=0.001), with the rates were better in the lips (p=0.04), and worse in the oropharynx (p=0.03). There were no statistically significant differences between survival rates according to age, sex, ethnicity, schooling level and histologic grade. Conclusion The survival rates of oral and oropharyngeal cancer were and associated with the anatomical site of the tumor.

RESUMO Objetivo Avaliar o perfil epidemiológico e a taxa de sobrevida do câncer de boca e orofaringe de pacientes atendidos em um hospital universitário. Métodos Foi realizado um estudo transversal por meio dos laudos anatomopatológicos dos pacientes com câncer de boca e orofaringe atendidos em um hospital universitário, na Região Sul, entre janeiro de 2004 a dezembro de 2014. A partir destes laudos, foram coletadas informações sobre o paciente e o tumor. A taxa de mortalidade foi obtida do registro de óbitos dos pacientes no Sistema de Informações sobre Mortalidade. Os dados foram analisados utilizando a curva de sobrevida pelo método de Kaplan-Meier e o teste de log-rank para a comparação das variáveis. Resultados As taxas de sobrevida em 5 e 10 anos foram 42% e 38%, respectivamente. A localização anatômica apresentou associação significativa com a taxa de sobrevida (p=0,001), sendo que, em lábio, os índices foram melhores (p=0,04) e, em orofaringe, piores (p=0,03). Não houve diferenças estatisticamente significantes entre as taxas de sobrevida de acordo com idade, sexo, etnia, nível educacional e grau histológico. Conclusão As taxas de sobrevida do câncer de boca e orofaringe foram baixas e associadas à localização anatômica do tumor.

Edema and gingival bleeding in anterior region have a negative influence on quality of life of adolescents

Abstract The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.

Practice of physical activities is related to fine motor skills in elderly / Prática de atividades físicas estão relacionadas a motricidade fina de idosos

Objective: Evaluating the fine motor skills (M1) degree in a group of independent elders, checking its possible association with the weekly practice of physical activities. Methods: 139 independent elders of both genders, aged 60 and older, who responded to a survey about their weekly practice of physical activities and then, later on were subjected to M1 tests according to EMTI, which final scores determine each individual's M1. The elderly were categorized into two groups: 60­70 years­old and above 70 years­old. Results: the female gender was predominant in the sample. Most of the elders (46.56%) showed a M¹ Mean Normal, followed by Inferior levels (29.50%) and Superior levels (23.74%). About 6.5% of the elders do not practice any physical activity, 5% practice it once a week, 53% twice a week and 35.5% more than two times per week. It could be observed that those practicing physical activity at least three times a week have better score on the M1 test (Mann­Whitney Test; p = 0.039). On the other hand, the group older than 70 years had a worse performance (Mann­Whitney Test, p = 0.001). Conclusion: The M1 Normal Medium was the score achieved with the highest percentage in the two age groups analyzed, being the group older than 70 years the one that presented worse performance. In addition, sedentary elderly or those who report having physical activity only once a week also had the worst test results.

Objetivo: Avaliar o grau de Motricidade fina (M1) de um grupo de idosos independentes verificando a possível associação com a frequência semanal de atividade física. Métodos: 139 idosos independentes, de ambos os gêneros, com idade igual ou superior a 60 anos, que responderam um questionário relacionado a sua frequência semanal de atividade física, e, posteriormente, realizaram testes de M1 de acordo com a EMTI, cuja pontuação final determina a M1 de cada um. Os idosos foram categorizados em dois grupos: 60 a 70 anos e acima de 70 anos. Resultados: O gênero feminino foi predominante (88%) na amostra. A maioria dos idosos (46,56%) apresentaram M1 Normal Médio, seguido de níveis inferiores (29,50%) e superiores (23,74%). Em torno de 6,5% dos idosos da amostra não realizam atividade física, 5% praticam uma vez por semana, 53% duas vezes por semana e 35,5% acima de duas vezes. Foi observado que aqueles que praticam atividade física no mínimo três vezes por semana obtêm melhores pontos pelo teste de M1 (Teste Mann­Whitney; p = 0,039), já o grupo acima de 70 anos teve pior desempenho (Teste Mann­Whitney; p = 0,001). Conclusão: A M1 Normal Médio foi a classificação alcançada com maior percentual nos dois grupos etários analisados, sendo no grupo acima de 70 anos aquele que apresentou pior desempenho. Além disso, idosos sedentários ou que afirmam realizar atividade física apenas uma vez por semana também tiveram os piores resultados nos testes.