Parental acceptance toward behavior guidance techniques for pediatric dental visits: a meta-analysis

Abstract This study aimed to answer the following question: What is the proportion of acceptance reported by parents toward pediatric behavior guidance techniques (BGTs)? Observational studies that evaluated parental acceptance of BGTs during pediatric dental visits among parents of non-special health care need (non-SHCN) and SHCN children were included. A search of the Cochrane Library, Latin American and Caribbean Health Sciences (LILACS), MedLine/PubMed, PsycINFO, Scopus, and Web of Science databases, in addition to gray literature, was performed until October 2021. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for quality assessment. The certainty of evidence was assessed using the Recommendation, Assessment, Development, and Evaluation (Grade). Fifty-three studies with 4868 participants were included, and 42 were retained for the random-effects proportion meta-analysis. The methodological quality varied from low to high. The agreement with the BGTs varied from 85.6% (95%CI: 77.5-92.1; p < 0.001; I 2 = 93.6%; 16 studies; n = 1399) for tell-show-do to 25.7% (95%CI: 17.8-34.4; p < 0.001; I 2 = 90.4%; 12 studies; n = 1129) for passive protective stabilization among non-SHCN children's parents; meanwhile, among the parents of SHCN children, it varied from 89.1% (95%CI: 56.1-99.7; p < 0.001; I 2 = 95.7%; 3 studies; n = 454) for tell-show-do to 29.1% (95%CI: 11.8-50.0; p = 0.001; I 2 = 84.8%; 3 studies; n = 263) for general anesthesia. The effect estimates varied greatly, as substantial heterogeneity across studies was observed, thus limiting the confidence in the results. Parents were more likely to agree with basic BGTs over advanced BGTs, with very low certainty of evidence. Dentists should discuss BGT options with parents. Protocol registration: PROSPERO CRD42018103834.

Children's and parents' perceptions concerning surgical attire: a systematic review / Percepções de crianças e pais sobre trajes médicos: uma revisão sistemática

ABSTRACT Objective: To review the literature about children's and parent's perceptions on surgical attire. Data source: A systematic search was conducted in the databases EMBASE, Latin American and Caribbean Health Sciences (LILACS), PubMed, PsycINFO, Scopus and Web of Science. Grey literature was searched on Google Scholar, Open Grey and ProQuest Dissertations, and Theses Database. Data synthesis: A total of 2,567 papers were identified. After a two-phase selection, 15 studies were included in narrative synthesis. Children favored wearing white coats in five of the nine included studies (55.5% [95%CI 48.3-62.7]; p=1.00). With respect to parents' preferences, results of vote counting showed that in 11 of 15 included studies, they favored physicians wearing white coats (73.3% [95%CI 67.9-78.6]; p=0.11). Conclusions: Children and parents have preferred physicians to wear a white coat with a very low certainty of evidence.

RESUMO Objetivo: Revisar a literatura sobre as percepções de crianças e seus pais a respeito de trajes médicos. Fontes de dados: Buscas sistemáticas foram conduzidas nas bases de dados EMBASE, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), PubMed, PsycINFO, Scopus e Web of Science. A literatura cinzenta foi pesquisada no Google Scholar, Open Grey e ProQuest Dissertations e Theses Database. Síntese dos dados: Foram identificadas 2.567 publicações e, após uma seleção de duas fases, foram incluídos 15 estudos na síntese qualitativa. As crianças tinham preferência pelo uso de jaleco branco em cinco dos nove estudos incluídos (55,5% [IC95% 48,3-62,7]; p=1,00). Em 11 dos 15 estudos incluídos, os pais tinham preferência pelos médicos que utilizavam jaleco (73,3% [IC95% 67,9-78,6]; p=0,11). Conclusões: Com uma qualidade baixa de evidência, crianças e pais preferem os médicos que usam jaleco branco.

Socioeconomic Disparities in Oral Health Related Quality of Life of Schoolchildren: A Cross-Sectional Study

Abstract Objective: To analyze whether demographic and socioeconomic factors can influence the OHRQoL in schoolchildren. Material and Methods: A cross-sectional study using a representative sample of 1137 children aged 8-10 years, enrolled in public schools in Florianópolis, Brazil, was conducted. Children answered the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) quality of life questionnaire and their parents responded to socioeconomic and demographic questions. Logistic regression models were used to analyze the data. Results: Higher probability of presenting a negative impact on the OHRQoL was observed in children whose skin color was non-white (OR 1.46, 95% CI 1.04-1.69) and female (OR 1.33, 95% CI 1.04-1.69). Children in whom the head of the family had years of schooling 9-11 (p=0.001), 5-8 (p=0.005) and ≤4 (p=0.000) were more likely to have a negative impact on the OHRQoL. CPQ8-10 domains evaluation showed that variables education, gender, skin color, and age were associated with a negative impact on OHRQoL (p≤0.05). Conclusion: The educational level of the head of the family and the demographic characteristics of the children are associated with a negative impact on the OHRQoL.

Conhecimento de responsáveis sobre traumatismo dentário em crianças / Knowledge of parents regarding dental trauma in children

Objetivo: identificar o conhecimento de pais/responsáveis sobre como proceder em caso de traumatismo dentário. Método: pesquisa com desenho observacional descritivo realizada por meio de questionários impressos entregues a 80 pais/responsáveis por crianças atendidas nas disciplinas de Clínica Infantil e Ortodontia I e II da Faculdade Avantis. A análise dos dados foi realizada de forma descritiva e com os testes Qui-Quadrado e Exato de Fisher. Resultados: a prevalência de pais que nunca receberam orientações sobre como porceder perante um traumatismo dentário foi de 75%, associando-se às respostas das perguntas: se saberiam como acondicionar o dente (p=0,001) e se já presenciaram alguma situação de trauma dental (p=0,047). As variáveis socioeconômicas escolaridade e renda e a autopercepção sobre o que fazer em uma situação de traumatismo dentário não se associaram a ter recebido informação sobre como proceder perante um traumatismo dentário, segundo o autorrelato dos responsáveis. A maioria dos pais das crianças nunca receberam informações e não sabem como proceder em caso de um possível traumatismo dentário. Conclusão: ter recebido informação sobre como proceder diante de um traumatismo dentário está associado a já ter presenciado situação de traumatismo dentário e a saber como acondicionar o dente para levar no dentista. (AU)

Objective: to identify the knowledge of parents/ guardians on how to proceed in the event of dental trauma. Method: observational descriptive study performed using printed questionnaires applied to 80 parents/guardians of children assisted in the classes of Children's Clinic and Orthodontics I and II at Faculdade Avantis. The data were analyzed descriptively and with chi-square and Fisher's exact tests. Results: the prevalence of parents who had never received instructions on how to deal with dental trauma was 75%, which was associated with the answers to the questions: "Would you know how to prepare the tooth?" (p = 0.001) and "Have you ever experienced any dental trauma situation?" (p = 0.047). Socioeconomic variables including education and income, and the self-perception on the procedures in case of dental trauma were not associated with having received information about how to proceed in a dental trauma situation according to the self-report of parents/guardians. Most parents had never received information and did not know how to deal with a potential dental trauma. Conclusion:having received information on how to deal with dental trauma is associated with having experienced a dental trauma situation and with how to prepare the tooth to take it to the dentist. (AU)

Malocclusion traits and sucking habits in preschool children: a cross-sectional study

Objective: The aim was to evaluate the prevalence of malocclusion traits altogether and separate in anterior open bite, accentuated overjet and posterior cross-bite, and the possible association between them and sucking habits and breastfeeding. Methods : A preschool-based cross-sectional study was conducted with 472 children aged 24-60 months and their parents (response rate 86.6%). Three trained dentists (Kappa > 0.70) examine children for anterior open bite, accentuated overjet and posterior cross-bite and parents answered a questionnaire indicating the presence of breastfeeding, bottle usage, pacifier usage, finger sucking and the length of usage of all these habits. Results : The prevalence of malocclusion traits was 38.8%, Accentuated overjet was the most prevalent (30.3%) followed by posterior cross-bite (8.9%) and anterior open bite (7.4%). The unadjusted Poisson regression showed that children who were not breastfed had 63.0% more prevalent malocclusion traits when compared with those who were breastfed (RP 1.63, 95%CI 1.06-2.50). Length of pacifier usage in months was the only habit remained in the adjusted model associated with anterior open bite (RP 1.10, 95%CI 1.05-1.14, p < 0.000) and accentuated overjet (RP 1.03, 95%CI 1.01- .05, p = 0.004). For posterior cross-bite none habit showed association in the adjusted model. All models were adjusted for age and sex. Conclusion : Accentuated overjet is the most prevalent malocclusion trait. Length of pacifier usage is associated with the presence of malocclusion traits, anterior open bite and accentuated overjet. None of the investigated habits is associated with posterior cross-bite.

Objetivo: O objetivo foi estimar a prevalência de maloclusões avaliadas em conjunto e separadamente em mordida aberta anterior, sobressaliência acentuada e mordida cruzada posterior, e a possível associação entre elas e os hábitos de sucção e amamentação. Métodos : Estudo transversal foi realizado com 472 pré- escolares de 24 a 60 meses e seus pais (taxa de resposta de 86,6%). Três dentistas treinados (Kappa > 0,70) examinaram as crianças para mordida aberta anterior, sobressaliência acentuada e mordida cruzada posterior e os pais responderam a um questionário indicando a presença de amamentação, uso de mamadeira, uso de chupeta, sucção de dedo e tempo de hábito. Resultados : A prevalência de maloclusões foi de 38,8%. A sobressaliência acentuada foi o mais prevalente (30,3%), seguido da mordida cruzada posterior (8,9%) e da mordida aberta anterior (7,4%). A regressão de Poisson não ajustada mostrou que as crianças que não foram amamentadas apresentaram 63,0% maior prevalência de maloclusão quando comparadas com aquelas que foram amamentadas (RP 1,63, IC95% 1,06-2,50). A duração do uso de chupeta em meses foi o único hábito que permaneceu no modelo ajustado associado à mordida aberta anterior (RP 1,10, IC 95% 1,05-1,14, p < 0,000) e sobressaliência acentuada (RP 1,03, IC 95% 1,01- 1,05, p = 0,004). Para mordida cruzada posterior nenhum hábito mostrou associação no modelo ajustado. Todos os modelos foram ajustados por idade e sexo. Conclusão : A sobressaliência acentuada é a maloclusão mais prevalente. O tempo do uso de chupeta está associado à presença de maloclusão, mordida aberta anterior e sobressaliência acentuada. Nenhum dos hábitos investigados está associado à mordida cruzada posterior.

Conhecimento dos pediatras sobre os efeitos dos medicamentos na cavidade bucal / Pediatricians' knowledge about medicines on the oral health

Objetivo: Avaliar o conhecimento dos médicos pediatras sobre a composição de edulcorante dos medicamentos mais prescritos e seu conhecimento em relação aos fármacos e seus possíveis efeitos na cavidade bucal. Métodos: Nesse estudo transversal foram entregues questionários com 10 perguntas referentes a: medicamento mais prescrito, tipo de fármaco, formas de apresentação, composição e efeitos adversos para 71 médicos dos quais 54 preencheram os critérios de inclusão. Resultados: Para situações clínicas que variaram entre febre, dor, amigdalite, otite, asma, bronquite, rinite alérgica e alergias, os medicamentos mais prescritos foram paracetamol 23%, amoxicilina 17%, dipirona 15% e sulfato de salbutamol 11%. Entre os médicos 39% afirmaram saber a composição dos medicamentos porém somente 26% citaram algum componente além do princípio ativo. Quanto aos efeitos secundários gerais dos medicamentos, 98% dos pediatras afirmaram conhecer mas 54% não souberam citar quais. Dos que citaram, 29% relataram problemas bucais. Com relação aos fatores de risco à cárie, 42% citaram o tipo de edulcorante e 28% o tempo de uso. Mas quanto ao tipo de edulcorante presente na fórmula, 64% não sabiam ou não responderam, apesar de 40% terem afirmado prescrever para casos de diabetes ou obesidade. Das informações repassadas aos pais apenas 3% citaram espontaneamente orientar cuidados bucais. Conclusão: Não houve lembrança, de maneira espontânea, sobre os aspectos relacionados à saúde bucal como a presença de sacarose nas formulações e possíveis efeitos secundários sobre os dentes.

Objectives: To evaluate the knowledge of pediatric doctors regarding the sweetener composition of the prescribed drugs and the knowledge regarding the relationship of these drugs with possible effects in the oral cavity. Methods: Clinicians answered a 10 questions questionnaire related to most prescribed medicine, drug type, presentation forms, composition and adverse effects. Results: From 71 doctors, 54 met the inclusion criteria. For clinical situations ranging from fever, pain, tonsillitis, otitis media, asthma, bronchitis, rhinitis, to allergies, the most prescribed drugs were paracetamol 23%, amoxicillin 17%, dipyrone 15% and salbutamol sulphate 11%. Thirty nine percent of doctors said they knew the composition of medicines but only 26% cited some other active component. Of pediatricians, 98% said they knew the side effects of drugs but 54% could not say which ones. From these, only 29% reported oral problems. Regarding risk factors for dental caries, 42% cited the type of sweetener and 28% usage time. Sixty four percent did not know or did not answer the type of sweetener present in the formula, although 40% stated they prescribe in cases of diabetes or obesity. Only 3% cited spontaneously orient oral care. Conclusion: There was no spontaneous memory on aspects related to oral health as the presence of sucrose in the formulations and possible side effects on teeth.