Orthodontic treatment during pregnancy, lactation, and postmenopausal period: a questionnaire development

Abstract This study aimed to develop and validate a self-administered questionnaire in Brazilian Portuguese to verify the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women, named "Considerations on Orthodontic Treatment during Pregnancy, Lactation, and Postmenopausal Periods." The development and validation of the questionnaire consisted of the following steps: a) item generation; b) item reduction; c) questionnaire design; and d) validity and reliability tests in a cross-sectional study with 258 orthodontists working in the field from different Brazilian states. A total of 60 orthodontists participated in test-retest over a mean period of 45 days. The preliminary questionnaire consisted of a total of 60 questions. After item reduction, 40 questions were selected for the final version of the questionnaire, with eight questions about pregnant women; six about lactating women; 18 about postmenopausal women, and eight about general knowledge in dentistry. Each item had three response options in the Likert scale format. Face and content validity analysis, reliability assessment through internal consistency (Cronbach's alpha and McDonald's omega), and test-retest reliability through the intraclass correlation coefficient (ICC) and Spearman's correlation coefficient were performed. Face and content validity indicated that the questionnaire was considered valid, objective, and easily understandable. The questionnaire had good internal consistency (Cronbach's alpha = 0.77; McDonald's omega = 0.78) and good test-retest reliability (ICC = 0.71; Spearman's correlation coefficient = 0.51). The questionnaire was considered valid and reliable to assess the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women.

Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil

Abstract The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.

Leadership through a gender lens: Disparities in Dental Research

Abstract This study aimed to analyze the 100 most-cited papers in Dentistry, with a focus on female leadership in dental research. Papers were retrieved from the Web of Science Core Collection (WoS- CC) in the category 'Dentistry, Oral Surgery & Medicine'. Gender was assessed through WoS-CC, Scopus, ResearchGate, social media, institutional websites, and software that assigns gender according to first names (https://genderapi.io). Characteristics of authors in leadership roles were retrieved, such as affiliation, publication history, citations, H factor, and i500. The 100 most-cited papers in Dentistry were authored by 394 researchers, 326 (82.7%) men, and 68 (17.3%) women - there were 4.8 male authors for each female. Among the lead authors, there were 11.3 males for each female. Among female senior authors, there were 7 males for each female. Among lead/senior authors of the 100 most-cited papers (first and last authors, respectively), 18 were women. There was an increase in the participation of women in the top cited papers regardless of authorship role across the six decades, with a peak of two female authors in the first decade of the 21st century. For female authors in leadership roles, their publication history shows the time between their first and last papers in WoS-CC ranged from 4 to 42 years for lead authors and 1 to 39 years for senior authors. Women were found to be largely underrepresented as leaders of the 100 most-cited papers, highlighting pervasive gender inequalities in dental research publications.

Resumo Objetivou-se analisar os 100 artigos mais citados em Odontologia, com foco na liderança feminina na pesquisa odontológica. Os artigos foram identificados utilizando-se a base de dados Web of Science Core Collection (WoS-CC) na categoria 'Dentistry, Oral Surgery & Medicine'. O gênero dos autores foi avaliado por meio do WoS-CC, Scopus, ResearchGate, mídias sociais, sites institucionais e um software que atribui gênero de acordo com o primeiro nome (https://genderapi.io). As características dos autores em papéis de liderança foram identificadas, como afiliação, histórico de publicação, número de citações, fator H e i500. Os 100 trabalhos mais citados em Odontologia foram de autoria de 394 pesquisadores, sendo 326 (82,7%) homens e 68 (17,3%) mulheres - foram 4,8 autores homens para cada mulher. Entre os primeiros autores, havia 11,3 homens para cada mulher. Entre os últimos autores, havia 7 homens para cada mulher. Entre os primeiros/últimos autores dos 100 artigos mais citados, 18 eram mulheres. Houve um aumento na participação de mulheres nos artigos mais citados, independentemente do papel da autoria ao longo das seis décadas, com um pico de duas autoras na primeira década do século XXI. Para autoras em papéis de liderança, seu histórico de publicação mostra que o tempo entre o primeiro e o último artigo no WoS-CC variou de 4 a 42 anos para primeiro autor principais e de 1 a 39 anos para último autor. Verificou-se que as mulheres estão sub-representadas como líderes dos 100 artigos mais citados, destacando-se desigualdades de gênero generalizadas nas publicações em pesquisa odontológica.

Situational diagnosis of policies in Latin American and Caribbean countries for the use of fluoride and reduction of sugar consumption

Abstract Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.

Profile of brazilian research productivity grant holders with a background in pediatric dentistry

Abstract This study outlines the profile of research productivity grant holders of the Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq (National Council for Scientific and Technological Development)] in the field of pediatric dentistry. A cross-sectional study with data collected from the Brazilian academic curriculum vitae database. The eligibility criterion was being a research productivity grant holder in pediatric dentistry from 2018 to 2020. In the period of interest, 215 individuals were research productivity grant holders in the field of dentistry, 33 of whom had graduate degrees (specialization, master's or doctorate) in pediatric dentistry. The period of scientific production and work concluded of advising of scientific initiation, master, doctoral and post-doctoral degrees was 2010 to 2020. Descriptive analysis was performed and the Kruskal-Wallis test was used to analyze associations (5% significance level) between productivity grant level (2, 1D, 1C, 1B or 1A) and year of obtainment of the doctoral degree. The VOSviewer (version 1.6.17) was used to present graphically the interinstitutional collaborations. The sample was composed of Level 2 researchers (66.7%), women (66.7%), researchers linked to institutions in the southeastern region of Brazil (81.8%), with a doctoral degree concluded prior to 2002 (51.5%), began working as a professor at a higher education institution prior to 2007 (78.8%) and the title of full professor (45.5%). No significant association was found between productivity grant level and year of conclusion of the doctoral degree (p = 0.10). Median (interquartile range) of scientific articles was 119 (37-312). The prevalence of citations (57.52%) and JCR articles (62.76%) was higher among female researchers. In conclusion, CNPq research productivity grant holders in pediatric dentistry are essentially represented by females from the southeast region of the country (UFMG and USP). However, males have proportionally greater productivity.

Resumo Este estudo traça o perfil dos pesquisadores bolsistas de produtividade do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) da área de odontopediatria. Pesquisa transversal com dados coletados na base de currículos acadêmicos brasileiros. Os critérios de elegibilidade abrangeram os pesquisadores bolsistas de produtividade de 2018 a 2020. Foram identificados 215 pesquisadores bolsistas de produtividade na área de odontologia, dos quais 33 com pós-graduação (especialização, mestrado ou doutorado) em odontopediatria. O período de produção científica e trabalho de orientação concluído de iniciação científica, mestrado, doutorado e pós-doutorado foi de 2010 a 2020. Foi realizada análise descritiva e o teste de Kruskall-Wallis foi utilizado para verificar associações (nível de significância de 5%) entre nível da bolsa de produtividade (2, 1D, 1C, 1B ou 1A) e ano de obtenção do grau de doutor. O programa VOSviewer (versão 1.6.17) foi utilizado para identificar colaborações interinstitucionais. A amostra foi composta por pesquisadores de Nível 2 (66,7%), mulheres (66,7%), pesquisadores vinculados a instituições da região sudeste do Brasil (81,8%), com doutorado concluído antes de 2002 (51,5%), começaram a atuar como professor em instituição de ensino superior anterior a 2007 (78,8%) e o título de professor titular (45,5%). Não foi encontrada associação significativa entre nível de bolsa de produtividade e ano de conclusão do doutorado (p = 0,10). A mediana (intervalo interquartil) de artigos científicos foi de 119 (37-312). A prevalência de citações (57,52%) e artigos do JCR (62,76%) foi maior entre as pesquisadoras. Em conclusão, os pesquisadores bolsistas de produtividade em Odontopediatria do CNPq são representados essencialmente por mulheres da região sudeste do país. No entanto, os homens apresentaram produtividade proporcionalmente maior.

Brazilian version of Positive Oral Health and Well-Being: cross-cultural adaptation and psychometric analysis

Abstract: Specific measures to evaluate positive oral health have been in a nascent stage in Dentistry, especially in developing countries. The present study aimed to translate, cross-culturally adapt and evaluate the psychometric properties of the Brazilian version of Positive Oral Health and Well-Being (B-POHW). After forward-backwards translation to Brazilian Portuguese language, the cross-cultural adaptation of B-POHW was pretested, followed by the main study to perform psychometric analysis. We tested the model fit by Confirmatory Factor Analysis with categorical factor indicators in bifactor and simple structure models on a sample of 209 participants (mean age: 39.36 ± 12.26. Questionnaires about sociodemographic status, self-reported oral health-related outcomes, and general well-being were administered and used as external validation measures. Moreover, dental caries experience was clinically diagnosed. For test-retest reliability, 53 participants completed the B-POHW a fortnight later. The following results were found: a) the bifactor model presented the best model fit; b) the B-POHW demonstrated satisfactory internal consistency (Cronbach's α and McDonald's ω > 0.8); c) the intraclass correlation coefficient suggested good reliability for the Global Factor of B-POHW in the test-retest (ICC = 0.84); d) evidence based on other variables and construct representation was in line with the positive oral health framework. The B-POHW is psychometrically sound to be used in a Brazilian context, and evidence of its internal structure confirmed its theoretical framework for measuring positive oral health. These findings advance in holistic approaches, enabling to assess positive oral health in Dental practice in Brazil.

Validation of the Brazilian Version of the RMS Tactile Scale (B-RMS-TS)

Abstract This study aimed to validate the Brazilian version of the RMS Tactile Scale (B-RMS-TS) in children and adolescents with visual impairment. Ten visually impaired children and adolescents between 10 and 17 years old of an Educational Center for Visually Impaired People answered the verbalized Dental Anxiety Scale (DAS), and the DAS in Braille to evaluate their dental anxiety levels. B-RMS-TS construct validity was assessed by convergent and discriminant validity. Convergent validity was tested in two ways: Pearson's correlation between the B-RMS-TS and the overall anxiety question; Pearson's correlation between B-RMS-TS and verbalized DAS and DAS in Braille. B-RMS-TS reliability was measured by internal consistency (Cronbach's alfa and McDonald's omega) and test-retest reliability (ICC). B-RMS-TS was moderately correlated to the overall anxiety question (r=0.493;p=0.147). B-RMS-TS showed excellent correlation with verbalized DAS (r=0.971;p<0.001) and DAS in Braille (r=0.934;p<0.011). B-RMS-TS was able to discriminate dental anxiety levels between male and female (p=0.008). The B-RMS-TS demonstrated excellent reliability (Cronbach's alpha=0.661, McDonald's omega=0.700 and ICC=0.987; 95%CI=0.817-0.999). B-RMS-TS is valid and reliable to measure dental anxiety levels in Brazilian children and adolescents with visual impairment.

Resumo Este estudo objetivou validar a versão brasileira da escala tátil RMS (B-RMS-TS) em crianças e adolescentes com deficiência visual. Dez crianças e adolescentes deficientes visuais entre 10 e 17 anos de idade de um Centro Educacional para Pessoas Deficientes Visuais responderam a Dental Anxiety Scale (DAS) verbalizada, e a DAS em Braille para avaliar seus níveis de ansiedade odontológica. A validade de construto da B-RMS-TS foi avaliada pela validade convergente e discriminante. A validade convergente foi testada em duas maneiras: correlação de Pearson entre a B-RMS-TS e a questão geral de ansiedade; correlação de Pearson entre a B-RMS-TS e a DAS verbalizada e a DAS em Braille. A confiabilidade da B-RMS-TS foi mensurada pela consistência interna (alfa de Cronbach e ômega de McDonald).) e confiabilidade teste-reteste (CCI). A B-RMS-TS foi correlacionada moderadamente à questão geral de ansiedade (r=0,493;p=0,147). A B-RMS-TS mostrou correlação excelente com a DAS verbalizada (r=0,971;p<0,001) e com a DAS em Braille (r=0,934;p<0,011). A B-RMS-TS foi capaz de discriminar níveis de ansiedade odontológica entre meninos e meninas (p=0,008). A B-RMS-TS demonstrou confiabilidade excelente (alfa de Cronbach=0,661, ômega de McDonald=0,700 e CCI=0,987; 95%IC=0,817-0,999). A B-RMS-TS é válida e confiável para mensurar níveis de ansiedade odontológica em crianças e adolescentes brasileiros com deficiência visual.

Internet and decision-making regarding health among pregnant woman: cross-cultural adaptation of a questionnaire for use in Brazil / A Internet e tomada de decisões sobre saúde entre gestantes: uma adaptação transcultural de um questionário para uso no Brasil / Internet y toma de decisiones respecto a la salud entre mujeres embarazadas: adaptación transcultural de un cuestionario para su uso en Brasil

The aim of this study was to translate and cross-culturally adapt the Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) to Brazilian Portuguese and analyze the psychometric properties of the Preparation for Decision Making Scale (PDMS). This study consisted of the following steps: translation, synthesis, back-translation, evaluation by the author of the original questionnaire, review by the panel of experts, and pretest of the WUIPQ. For such, Brazilian pregnant women and mothers who were members of Facebook groups participated in the study. We measured test-retest reliability as well as internal consistency and performed confirmatory factor analysis (CFA) of the B-PDMS. In the pretest, 88.14% of the participants considered the items of the B-WUIPQ to be clear and pertinent, and 84.09% rated the sequence and organization of the questionnaire as excellent/good. The intraclass correlation coefficient and Cronbach's alpha coefficient for the B-PDMS were 0.850 (95%CI: 0.791-0.899) and 0.91, respectively. CFA revealed factor loadings higher than 0.70 for most items, with a comparative fit index of 0.989, Tucker-Lewis index of 0.984, and root mean square error of approximation of 0.08 (95%CI: 0.06-0.09). The B-WUIPQ presented cross-cultural adapted, and the B-PDMS demonstrated satisfactory psychometric proprieties to Brazilian pregnant women.

O estudo teve como objetivos, traduzir e realizar a adaptação transcultural do Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) para português do Brasil e analisar as propriedades psicométricas da Preparation for Decision Making Scale (PDMS). O estudo consistiu nas seguintes etapas: tradução, síntese, retrotradução, avaliação pelo autor do questionário original, revisão pelo painel de especialistas e pré-teste do WUIPQ. Gestantes e mães brasileiras que pertenciam a grupos de Facebook participaram no estudo. Medimos a confiabilidade teste-reteste e a consistência interna e realizamos análise fatorial confirmatória (AFC) do B-PDMS. No pré-teste, 88,14% das participantes consideraram os itens do B-WUIPQ claros e pertinentes, e 84,09% avaliaram a sequência e organização do questionário como excelentes ou boas. Os coeficientes de correlação intraclasse e alfa de Cronbach para o B-PDMS foram 0,850 (IC95%: 0,791-0,899) e 0,91, respectivamente. A AFC revelou cargas fatoriais acima de 0,70 para a maioria dos itens, com um índice de ajuste comparativo de 0,989, índice de Tucker-Lewis de 0,984 e raiz da média dos quadrados dos erros de aproximação de 0,08 (IC95%: 0,06-0,09). O B-WUIPQ apresentou boa adaptação transcultural, e o B-PDMS demonstrou propriedades satisfatórias para gestantes brasileiras.

El objetivo de este estudio fue traducir y adaptar transculturalmente el Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) al portugués de Brasil y analizar las propiedades psicométricas de la Preparation for Decision Making Scale (PDMS). Este estudio consistió en los siguientes pasos: traducción, síntesis, traducción inversa, evaluación por parte del autor del cuestionario original, revisión de un panel de expertos, y pretest del WUIPQ. Para ello, mujeres embarazadas brasileñas, y madres que eran miembros de grupos de Facebook, participaron en el estudio. Se midió la fiabilidad del test-retest y la consistencia interna, y se realizó un análisis factorial confirmatorio (AFC) de la B-PDMS. En los pretest, 88,14% de las participantes consideraron los ítems del B-WUIPQ claros y pertinentes, y un 84,09% calificaron la secuencia y organización del cuestionario como excelente/buena. El coeficiente de correlación intraclase y el coeficiente alfa de Cronbach para la B-PDMS fueron 0,850 (IC95%: 0,791-0,899) y 0,91, respectivamente. El AFC reveló cargas factoriales superiores a 0,70 para la mayoría de los ítems, con un índice de ajuste comparativo de 0,989, índice de Tucker-Lewis de 0,984 y raíz de la media de los cuadrados de los errores de aproximación de 0,08 (IC95%: 0,06-0,09). El B-WUIPQ demostró estar transculturalmente adaptado, y la B-PDMS mostró propiedades psicométricas satisfactorias para las mujeres brasileñas embarazadas.

Oral health-related quality of life of pre-school children: review and perspectives for new instruments

Abstract This study aimed to describe different approaches for the evaluation of the Oral health-related quality of life (OHRQoL) of preschool children and to discuss perspectives for future instruments. The OHRQoL is a concept that surpasses an exclusively clinical perception and includes functional, social, emotional, and environmental issues. The measure of OHRQoL represents a holistic approach for researchers and clinicians extending their visions beyond the mouth and understanding the entire context of the patient. Negative impacts of oral conditions on OHRQoL in childhood can reflect on health development, especially in a life stage marked by social and cognitive maturation. Instruments have been developed and cross-culturally adapted to evaluate the impact of oral conditions on the OHRQoL of preschool children and their families. Some features distinguish these instruments and influence their selection, such as: self- or proxy-report; generic- or specific-condition; long- or short-form, and less or more established used in literature. Moreover, theoretical framework, construct validation and availability should also be considered. Nine OHRQoL instruments for preschool children were included in the present literature review. They were created between 2003 and 2017 by developed countries in most cases. The shorter instrument has five items, and the larger has 31 items. Most of them are proxy-reported, generic-condition, and have been relatively well established in the literature. The diversity of instruments indicates the evolution of OHRQoL studies, but there are methodological issues still in need to be improved in future developments or cross-cultural adaptations, according to current psychometric evidence.

Resumo Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) é um conceito que extrapola uma percepção exclusivamente clínica ao incluir questões funcionais, sociais, emocionais e ambientais. A avaliação da QVRSB representa uma abordagem holística para a pesquisa e prática clínica. O impacto negativo das condições bucais na QVRSB durante a infância pode refletir no desenvolvimento saudável, especialmente em um estágio da vida marcado pela maturação social e cognitiva. Instrumentos vêm sendo desenvolvidos e adaptados transculturalmente para avaliar o impacto das condições bucais na QVRSB de pré-escolares e seus familiares. Algumas características distinguem esses instrumentos e influenciam na seleção, tais como: autorrelato ou relato proxy; condição genérica ou específica; formas longas ou curtas, mais ou menos estabelecidos na literatura. Além disso, a base teórica, a avaliação do construto e a disponibilidade do instrumento também devem ser consideradas. A diversidade de instrumentos indica a evolução dos estudos em QVRSB, mas ainda há questões metodológicas que precisam ser avançadas em futuros desenvolvimentos ou adaptações desses instrumentos, seguindo as atuais evidências psicométricas. O presente estudo objetiva descrever as diferentes abordagens para avaliar a QVRSB de pré-escolares e discutir as perspectivas para futuros instrumentos.

Patient-centered assessments: how can they be used in dental clinical trials?

Abstract Recently, there has been greater interest in adopting a more holistic approach to healthcare. However, this trend should not limit itself merely to the notion that a human being lies behind the mouth being treated. Rather, it should embrace the understanding that this human can actively participate in and contribute to the treatment process. Patient Report Outcome Measures (PROMs) and Patient Report Experience Measures (PREMs) provide means for measuring data from the patient's perspective, and enable health-related feelings and functions to be evaluated. Accordingly, this critical review aims to provide definitions, rationales and applications of patient-centered approaches in dental clinical research. Some patient-centered constructs are especially relevant to dental clinical trials, such as oral health-related quality of life, pain/discomfort, aesthetics and satisfaction concerning treatment and services. The selection and application of patient-reported measures can vary according to condition (generic, disease-specific or treatment-specific) and to the specific population evaluated (age and cognitive impairment). These measures can help weigh risks and benefits, as well as assess the cost effectiveness of treatments, thus influencing treatment recommendations and health policies. The incorporation of these measures into a professional's daily life not only represents an improvement in professional performance, but also addresses a humanitarian concern.

Fluoride content in children's dentifrices marketed in Lima, Peru

Abstract The aim of the present study was to determine the concentration of total fluoride (TF) and total soluble fluoride (TSF) in children's dentifrices marketed in the city of Lima, Peru. Three samples of 23 dentifrices (4 without fluoride and 19 with fluoride) were purchased in different pharmacies in Lima, Peru. The TF and TSF concentrations found in the dentifrices were determined by ion-selective electrode, expressed in ppm F (μg F/g of dentifrice). The TF concentration in the majority of the fluoride toothpastes matched that shown on the label, except for one declared as 1450 ppm F by the manufacturer, whereas only 515.1 ppm F was found. The concentration of TSF found in the fluoride toothpastes ranged from 457.5 to 1134.8 ppm F. All the dentifrices were formulated with silica, but one also presented calcium carbonate. In conclusion, 83% of the children's dentifrices marketed in Lima, Peru, were fluoridated, but only 53% contained a TSF concentration greater than 1000 ppm F, the minimum concentration required to provide an anticaries effect.

Toothache and non-clinical individual and school factors in five-year-old children: multilevel analysis

Abstract The objective of the present study was to evaluate the influence of individual and contextual factors on the occurrence of toothache in five-year-old children. A cross-sectional study was conducted with 756 five-year-old children from public and private preschools in a city in the countryside of the northeast of Brazil. The sample was determined through probabilistic sampling in two stages (preschools and children). The children included could not have systematic diseases, permanent tooth or orthodontic treatment. Parents/caregivers were required to spend at least 12 hours per day with their children. The history of toothache during the life of the child was reported by parents/guardians. Socioeconomic and psychological questionnaires were completed by parents/guardians. Variables related to social context were obtained from the preschools in which the children studied and the official publications of the municipal region. Unadjusted and adjusted multilevel Poisson regression models were used to investigate the association between individual and contextual characteristics and history of toothache. The history of toothache was found for 23.8% of the children. Among the individual determinants, gender of the child, order of birth, and schooling of parent/guardian were associated with toothache in children. The individual variables remained associated with the outcome after the addition of the contextual variables to the model. The type of preschool was the contextual determinant associated with toothache in the final model. Both individual (gender, order of birth and schooling of parents/guardians) and contextual (type of preschool) determinants were associated with history of toothache in five-year-old children.

Resumo O objetivo do presente estudo foi avaliar a influência de fatores individuais e contextuais na ocorrência de dor de dente em crianças de cinco anos de idade. Um estudo transversal foi realizado com 756 crianças de cinco anos de idade de pré-escolas públicas e privadas em uma cidade no interior do Nordeste do Brasil. A seleção da amostra foi realizada por meio de amostragem probabilística em duas etapas (pré-escolas e crianças). As crianças incluídas não poderiam ter doenças sistêmicas, dentes permanentes ou tratamento ortodôntico. Foram incluídos apenas pais/responsáveis que passavam pelo menos 12 horas por dia com seus filhos. O histórico de dor de dente durante a vida da criança foi relatado pelos pais/responsáveis. Os questionários socioeconômicos e psicológicos foram preenchidos pelos pais/responsáveis. As variáveis relacionadas ao contexto social foram obtidas na pré-escola em que as crianças estudaram e nas publicações oficiais da região municipal. Os modelos de regressão de Poisson multinível não ajustados e ajustados foram utilizados para investigar a associação entre características individuais e contextuais e histórico de dor de dente. O histórico de dor de dente foi encontrado em 23,8% das crianças. Entre os determinantes individuais, gênero da criança, ordem de nascimento e escolaridade dos pais/responsáveis ​​foram associados com dor de dente em crianças. As variáveis ​​individuais permaneceram associadas ao resultado após a adição das variáveis ​​contextuais ao modelo. O tipo de pré-escola foi o determinante contextual associado ao histórico de dor de dente no modelo final. Tanto o indivíduo (gênero, ordem de nascimento e escolaridade dos pais/responsáveis) quanto os determinantes contextuais (tipo de pré-escolar) foram associados com o histórico de dor de dente em crianças de cinco anos de idade.

Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers

Abstract The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent's/caregiver's sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52-5.65) and tooth wear (OR = 2.34; 95%CI: 1.39-3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.

Oral Problems and Self-Confidence in Preschool Children

Abstract The aim of the present study was to evaluate the impact of clinical oral factors, socioeconomic factors and parental sense of coherence on affected self-confidence in preschool children due to oral problems. A cross-sectional study with probabilistic sampling was conducted at public and private preschools with 769 five-year-old children and their parents/caretakers. A questionnaire addressing socio-demographic characteristics as well as the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Sense of Coherence Scale (SOC-13) were administered. The dependent variable was self-confidence and was determined using the SOHO-5 tool. Dental caries (ICDAS II), malocclusion and traumatic dental injury (TDI) were recorded during the clinical exam. Clinical examinations were performed by examiners who had undergone training and calibration exercises (intra-examiner agreement: 0.82-1.00 and inter-examiner agreement: 0.80-1.00). Descriptive statistics and Poisson regression analysis were performed (a=5%). Among the children, 91.3% had dental caries, 57.7% had malocclusion, 52.8% had signs of traumatic dental injury and 26.9% had bruxism. The following variables exerted a greater negative impact on the self-confidence of the preschool children due to oral problems: attending public school (PR=2.26; 95% CI: 1.09-4.68), a history of toothache (PR=4.45; 95% CI: 2.00-9.91) and weak parental sense of coherence (PR=2.27; 95% CI: 1.03-5.01). Based on the present findings, clinical variables (dental pain), socio-demographic characteristics and parental sense of coherence can exert a negative impact on self-confidence in preschool children due to oral problems.

Resumo O presente estudo teve como objetivo avaliar a interferência de fatores clínicos bucais, socioeconômicos e senso de coerência (dos pais) no prejuízo de autoconfiança devido alterações de saúde bucal em pré-escolares. Um estudo transversal com amostra probabilística foi realizado em pré-escolas públicas e privadas com 769 crianças de 5 anos de idade e seus responsáveis. Questionários de variáveis sociodemográficas, o Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) e Sense of Coherence Scale (SOC-13) foram aplicados na amostra. A variável dependente foi autoconfiança e coletada a partir do questionário SOHO-5. Cárie dentária (ICDAS II), má oclusão e traumatismo dentário foram registrados durante o exame clínico. Exames clínicos foram realizados nos pré-escolares por examinadores previamente calibrados (acordo intra-examinador: 0,82-1,00 e acordo inter-examinador: 0,80-1,00). Análise descritiva e Regressão de Poisson foram aplicadas (a=5%). Entre as crianças avaliadas, 91,3% apresentaram cárie dentária, 57,7% maloclusão, 52,8% traumatismo dentário e 26,9% bruxismo. As seguintes variáveis mostraram uma maior média de prejuízo na autoconfiança dos pré-escolares devido alterações de saúde bucal: frequentar pré-escola pública (PR=2,26; 95% CI: 1,09-4,68), histórico de dor de dente (PR=4,45; 95% CI: 2,00-9,91) e fraco senso de coerência dos pais (PR=2,27; 95% CI: 1,03-5,01). Com base nos resultados, pode-se concluir que variáveis clínicas, como a dor de dente, sociodemográfica e senso de coerência dos pais podem interferir na autoconfiança devido a alterações de saúde bucal em pré-escolares.