Diagnosis and prevalence of probable awake and sleep bruxism in adolescents: an exploratory analysis

Abstract The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status. Adolescents answered a questionnaire evaluating AB (e.g., grinding and clenching) and SB (e.g., grinding, bracing, and thrusting) activities and frequent headaches. A clinical examination was performed on adolescents to evaluate bruxism clinical signs/symptoms (pain upon palpation on masseter and temporal, linea alba, indentation on the tongue and attrition wear severity). Descriptive statistics and Pearson's Qui-square test were performed (P≤0.05). Adolescents mean age was 14.3±1.5 years, and 58.1% were female. Self-report of SB was identified in 31% of participants and self-report of AB in 51.6%. Almost all adolescents (99%) presented at least one tooth with attrition wear (98.5% on enamel and 0.5% on dentin), with a mean number of 12.4±5.7 teeth. Depending on the diagnosis criteria, the prevalence of probable SB and AB varied from 0- 99% and 0.2- 99%, respectively. A high inconsistency was found for the prevalence of probable AB and SB in adolescents, which were influenced by the different clinical sings/symptoms used as diagnosis criteria. Frequent headaches and pain upon palpation on masseter and temporal muscle were associated to self-report of AB and SB among adolescents.

Resumo Os objetivos deste estudo foram realizar uma análise exploratória da prevalência de provável bruxismo em vigília (BV)e do sono (BS) utilizando diferentes critérios de diagnóstico baseados no Consenso Internacional; avaliar a associação entre o autorrelato e os sinais/sintomas clínicos em adolescentes. Participaram deste estudo transversal 403 adolescentes de 12 a 19 anos de idade matriculados em escolas públicas e privadas de Belo Horizonte, Brasil. Os pais/responsáveis responderam um questionário sobre dados sociodemográficos e estado de saúde dos adolescentes. Os adolescentes relataram atividades do BV (ranger e apertar) e BS (ranger, bracing e thrusting) e dores de cabeça frequentes. Um exame clínico foi realizado nos adolescentes para avaliar os sinais/sintomas clínicos do bruxismo (dor à palpação nos músculos masseter e temporal, marcas de endentação na língua e linha alba, desgaste dentário por atrição). Análises descritiva e teste Qui-quadrado de Pearson foram realizados (P≤0,05). A média de idade dos adolescentes foi de 14,3±1,5 anos e 58,1% eram do sexo feminino. O autorrelato de BS foi identificado em 31% dos participantes e o autorrelato do BV em 51,6%. Quase a totalidade dos adolescentes (99%) apresentaram pelo menos um dente com desgaste dentário (98,5% em esmalte; 0,5% em dentina), com média de 12,4±5,7 dentes acometidos. Dependendo do critério de diagnóstico, a prevalência do provável BS e BV variou de 0- 99% e 0,2- 99%, respectivamente. Uma grande inconsistência foi identificada na prevalência de provável BV e BS em adolescentes, que foram influenciadas pelos diferentes sinais/sintomas usados como critério de diagnóstico. Dores de cabeça frequentes e dor à palpação no masseter e temporal foram associados ao autorrelato de bruxismo em crianças e adolescentes.

Describing the Oral Health of Warfarin Users. A Short Report

Aim: To describe the burden of oral diseases and of self-reported periodontal disease of patients under Oral Anticoagulation Therapy (OAT) with warfarin. Methods: A cross-sectional study was conducted. Validated questionnaires assessed self-reported periodontal disease and demographic variables. After calibration (Kappa > 0.80), an examiner evaluated dental caries and the need for dental prostheses. Statistical analysis involved proportions and measures of central tendency. Results: The sample consisted of 158 individuals, with a mean age of 58.8 years (SD = 12.1), of which 62.7% of the participants were women. The average DMFT (Decayed, Missing, and Filled Teeth) index was 22.9 (SD = 7.6), with the missing component being the highest (Mean = 16.23). The use of maxillary prosthesis (53.2%) was higher than mandibular (32.3%). The need for mandibular prosthesis reached 66.5%. The percentage of participants that referred gum disease, tooth migration, and tooth mobility was 29.6%, 37.4%, and 30.4%, respectively. Conclusions: The burden of oral diseases among individuals undergoing OAT is worrisome.

Objetivo: Describir la carga de enfermedades bucales y la enfermedad periodontal autorreportada de pacientes en tratamiento con anticoagulación oral con warfarina. Métodos: Se realizó un estudio transversal. Los cuestionarios validados evaluaron la enfermedad periodontal autoinformada y las variables demográficas. Después de la calibración (Kappa> 0.80), un examinador evaluó la caries dental y la necesidad de prótesis dentales. El análisis estadístico involucró proporciones y medidas de tendencia central. Resultados: La muestra estuvo formada por 158 individuos, con una edad media de 58.8 años (DE = 12.1), de los cuales el 62.7% de los participantes eran mujeres. El índice CPOD promedio fue de 22.9 (DE = 7.6), siendo el componente perdido el que más contribuyó al índice (Media = 16.23). El uso de prótesis maxilar (53.2%) fue mayor que el de prótesis mandibular (32.3%). La necesidad de prótesis mandibular alcanzó el 66.5%. El porcentaje de participantes que informaron enfermedad de las encías, migración de los dientes y movilidad de los dientes fue del 29.6%, 37.4% y 30.4%, respectivamente. Conclusiones: Las enfermedades bucales y la necesidad de rehabilitación oral entre los individuos sometidos a anticoagulación oral con warfarina fue motivo de preocupación.

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.

Mothers' sense of coherence and oral health-related quality of life of preschoolers: a 3-year cohort study

Abstract The aim of the present study was to assess whether mothers' sense of coherence (SOC) was a predictor of decline in oral health-related quality of life (OHRQoL) of preschoolers. A 3-year cohort study was conducted in Diamantina, Brazil. At baseline, 162 preschoolers aged one to three years were randomly selected from among children registered in local Primary Healthcare Units. In the first stage, mothers completed a sociodemographic questionnaire, the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian short version of the Sense of Coherence Scale (SOC-13). The total score obtained from the SOC-13 was used to select exposed and unexposed children. Clinical examinations were performed to detect the presence of dental caries, traumatic dental injury, and malocclusion. At follow-up, mothers completed the sociodemographic questionnaire and the B-ECOHIS again. The incidence of severe dental caries and adherence to the proposed treatment at baseline were evaluated. A decline in OHRQoL was considered if there was an increase in the B-ECOHIS score of at least one unit. The chi-square test and Poisson regression were performed. A total of 151 preschoolers participated in the study, among whom 37.7% showed a decline in OHRQoL. Mothers' SOC was not associated with a negative impact on OHRQoL (RR = 1.24; 95%CI = 0.81-1.88), while the incidence of severe dental caries had a greater impact on the decline in OHRQoL (RR = 2.02; 95%CI = 1.29-3.16). Mothers' low SOC was not a predictor of decline in the OHRQoL of preschoolers after a 3-year follow-up period.

Factors associated with dentists' search for oral health information during the COVID-19 pandemic

Abstract: The aim of this cross-sectional study was to evaluate the factors associated with the search by Brazilian and Portuguese dentists for oral health information on social networks during the COVID-19 pandemic. A total of 597 Brazilian and Portuguese dentists answered an online questionnaire between January 17 and 31, 2021. Respondents were asked about sociodemographic data, weight and height, hours of sleep per night, screen time for work and leisure, and where they sought information about general and/or oral health for themselves and for their loved ones and information about COVID-19. Descriptive statistics and binary regression were used for the statistical analysis. Most participants were Brazilian (62.8%) and 451 (75.5%) were female. Mean age was 42.1 years (± 12.5 years). For every lost hour of sleep, the chances of participants frequently or always searching for information about self-perceived oral health problems on lay websites increased by 1.33 times. For every additional hour spent on social networks or on the Internet, the likelihood of participants frequently searching for self-perceived oral health problems on lay websites increased by 17% (OR = 1.17; 95% CI: 1.06-1.30). Individuals who searched the Internet for information about COVID-19 symptoms before consulting their doctors were 3.85 times more likely (95% CI: 2.22-6.67) to frequently or always search for information about self-perceived oral health problems on lay websites. Dentists used lay websites to search for general and oral health knowledge during the COVID-19 pandemic, and shorter sleep duration favored screen use.

Risk indicators of untreated dental caries incidence among preschoolers: a prospective longitudinal study

Abstract: The aim of the present study was to evaluate the influence of socioeconomic factors, oral conditions and the impact of OHRQoL as possible risk indicators related to the incidence of untreated dental caries in preschool children two years after an initial examination. A prospective longitudinal study was performed with a sample of 288 preschool children allocated to two groups at baseline (T0): caries free (n = 144) and with untreated dental caries (n = 144). Untreated dental caries was determined through clinical examinations performed by a calibrated dentist at T0 (Kappa > 0,89) and T1 (two years after the baseline) (Kappa > 0,91) using the dmft criteria. Parents/caregivers answered a socioeconomic questionnaire and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) at T0 and T1. Mann-Whitney test and hierarchically adjusted Poisson regression models were used (95%CI, p < 0,05). The incidence of untreated dental caries was 41.3%. Low (RR = 1.63; 95%CI:1.18-2.26; p < 0.001) and high severity of untreated dental caries (RR = 1.92; 95%CI:1.36-2.72; p < 0.001), monthly household income less than two times the Brazilian minimum salary (RR = 1.79; 95%CI:1.04-3.25; p = 0.042) and overall B-ECOHIS score (RR = 1.03; 95%CI:1.02-1.05; p < 0.001) at T0 were risk indicators for the incidence of untreated dental caries among the preschool children. In conclusion, the incidence of untreated dental caries was high and the higher severity of untreated dental caries, the lower monthly income and the higher the B-ECOHIS score (indicating a negative impact on quality of life) were risk indicators to the developing of new lesions of untreated dental caries after 2 years.

The importance of full text screening when judging eligibility criteria in a systematic review: a systematic survey / A importância da avaliação do texto completo ao julgar os critérios de elegibilidade em uma revisão sistemática: uma revisão de métodos

Aim: To evaluate if statistically significant results are more likely to be reported in title/abstracts compared to non-significant outcomes. Methods: In this methodological survey, we reanalyzed 59 observational studies from a previous systematic review. The PECO question was: Patient (P): children with primary teeth; Exposure (E): low birth weight and/or preterm; Comparison (C): normal birth weight and/or full-term; Outcome (O): dental caries. We analyzed the presence of key terms in the titles and abstracts, such as gestational age, preterm, full-term, birth weight, low/normal birth weight. Full texts were analyzed for "positive outcomes" (statistically significant association, p < 0.05 or 95% CI not crossing the null effect line) related to the association between the outcome and the exposure; and "negative outcomes" (when the outcome had statistically similar occurrence between the exposure and the comparison group). The odds ratio (OR) was calculated between the presence of key terms in titles/abstracts and the type of outcome (positive or negative). Results: Of 59 studies, 66% cited the key terms in titles/abstracts, and 75% reported negative outcomes. Studies with positive outcomes were more likely to report key terms in the titles/abstracts compared to studies with negative outcomes (OR: 4.5; 95% CI: 0.9-22.4; Chi-square test: p = 0.06). Studies with statistically significant outcomes, favoring the exposure or the comparison, were more likely to report these data in the titles/abstracts. Conclusion: When conducting a systematic review, the final decision related to the inclusion of a study must be based on a full-text level.

Objetivo: Avaliar se os resultados estatisticamente significativos são mais prováveis de serem relatados nos títulos/resumos dos artigos do que os resultados não significativos. Métodos: Neste levantamento metodológico, foram reanalisados 59 estudos observacionais de uma revisão sistemática anterior. A questão PECO foi: Paciente (P): crianças com dentes decíduos; Exposição (E): baixo peso ao nascer e/ou pré-termo; Comparação (C): peso normal ao nascer e/ou a termo; Resultado (O): cárie dentária. Foi analisada a presença de termos-chave nos títulos/resumos, como idade gestacional, pré-termo, a termo, peso ao nascer, baixo/peso normal ao nascer. Textos completos foram analisados para "desfechos positivos" (associação estatisticamente significativa, p < 0,05 ou IC 95% não cruzando a linha de efeito nulo) relacionados à associação entre o desfecho e a exposição; e "desfechos negativos" (quando o desfecho teve ocorrência estatisticamente semelhante entre a exposição e o grupo de comparação). Foi calculada a odds ratio (OR) entre a presença de termos-chave nos títulos/resumos e o tipo de resultado (positivo ou negativo). Resultados: Dos 59 estudos, 66% citaram os termos-chave nos títulos/resumos e 75% relataram resultados negativos. Estudos com resultados positivos foram mais propensos a relatar os termos-chave nos títulos/resumos em comparação com estudos com resultados negativos (OR: 4,5; IC 95%: 0,9-22,4; teste do qui-quadrado: p = 0,06). Estudos com significância estatística os desfechos, favorecendo a exposição ou a comparação, foram mais propensos a relatar esses dados nos títulos/resumos. Conclusão: Ao realizar uma revisão sistemática, a decisão final quanto à inclusão de um estudo deve ser baseada por meio da análise do texto completo.

Association between different stages of dental caries in preschoolers and familial socioeconomic factors

Abstract: This study evaluated the association between socioeconomic factors and stages of dental caries in children one to five years of age. A cross-sectional study was conducted involving 759 children enrolled in preschools in Diamantina, Brazil. The parents/caregivers filled out a form addressing socioeconomic factors. Add to the end of this sentence: and categorized in caries free (code 0 and 1), no obvious decay (code 2 and 3) and obvious decay (code 4, 5 and 6). Statistical analysis was performed using the Mann-Whitney test and multinomial regression. The prevalence of "no obvious decay" was higher among children from families with a larger number of income-dependent individuals (OR: 2.47; 95%CI: 1.41-4.31). The higher prevalence of "obvious decay" was associated with the child's age (OR: 1.36; 95%CI: 1.16-1.58), attending a public preschool (OR: 2.38; 95%CI: 1.31-4.34), a larger number of income-dependent individuals (four to five individuals: OR: 1.71; 95%CI: 1.09-2.74; more than five individuals: OR: 3.41; 95%CI: 1.95-5.94), no access to a dentist (OR: 2.14; 95%CI: 1.48-3.09), and lower income (OR: 1.72; 95%CI: 1.19--2.49). It was concluded that the variable of a larger number of income-dependent individuals was associated with both no obvious decay and obvious decay. Child's age, type of preschool, access to a dentist, and income were associated with obvious decay.

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.

Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: a cross-sectional study

Abstract Mucopolysaccharidosis (MPS) is a group of rare and inherited metabolic disorders caused by the accumulation of macromolecule glycosaminoglycans inside lysosomes. Affected individuals may have dental and craniofacial tissue alterations, facilitating the development of several oral diseases. Objectives To assess, with panoramic radiographic images, the frequency of dental and maxillomandibular incidental findings among MPS individuals and compare them with non-MPS individuals. Methodology A cross-sectional study evaluating a sample of 14 MPS individuals and 28 non-MPS individuals aged from 5 to 26 years was carried out. They were matched for sex and age on a 2:1 proportion. Panoramic radiographs were assessed for the presence/absence of the following dental and maxillomandibular alterations: dental anomalies of number (hypodontia/dental agenesis, supernumerary teeth); anomalies of form (microdontia, macrodontia, conoid teeth, taurodontism, and root dilaceration); anomalies of position (impacted tooth, inverted tooth, tooth migration, partially bony teeth, complete bony teeth); periapical alterations (furcation lesion, circumscribed bone rarefaction); other alterations (radiolucent bone lesions, radiopaque bone lesions, radiopacity in the maxillary sinus, condylar hypoplasia). Differences between groups were tested by the Fisher's exact test and chi-square test (p<0.05). Results For intrarater agreement, Kappa values were 0.76 to 0.85. The presence of supernumerary teeth (p=0.003); conoid teeth (p=0.009); taurodontism (p<0.001); impacted teeth (p<0.001); partial bony teeth (p=0.040); complete bony teeth (p=0.013); and root dilaceration (p=0.047) were statistically more frequent in MPS individuals compared to non-MPS individuals. Bone rarefaction/furcation lesions (p=0.032), condylar hypoplasia (p<0.001), radiolucent bone lesions (p=0.001), and dentigerous cysts (p=0.002) were also more frequent in MPS individuals. Conclusion The presence of specific oral manifestations is more common in MPS individuals than non-MPS individuals.

Malocclusion Impact Scale for Early Childhood (MIS-EC): development and validation

Abstract: This study aimed to develop and validate the Malocclusion Impact Scale for Early Childhood (MIS-EC), a malocclusion-specific measure of oral health-related quality of life (OHRQoL) of children aged 3-5 years and their parents/caregivers. A pool of items was analysed to identify those relevant to the assessment of the impact of malocclusion on OHRQoL. Dental professionals and mothers of children with and without malocclusion rated the importance of these items. The final version of the MIS-EC was evaluated in a cross-sectional study comprising 381 parents of children aged 3-5 years to assess construct validity, internal consistency and test-retest reliability. Twenty-two items were identified from item pooling. After item reduction, eight items were chosen to constitute the MIS-EC, in addition to two general questions. The MIS-EC demonstrated good internal consistency (Cronbach's alpha = 0.79 for the Child Impact section and 0.53 for the Family Impact section), and excellent test-retest reliability (ICC = 0.94), floor effect was 55.7% and ceiling effect 0%. MIS-EC scores indicating worse OHRQoL were significantly associated with the presence of malocclusion (p < 0.05). The MIS-EC is reliable and valid for assessing the impact of malocclusion on the OHRQoL of preschool children and their parents/caregivers.

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.

Medo de Covid-19 e fatores associados ao possível bruxismo do sono e/ou em vigília entre universitários da região sudeste do Brasil durante a pandemia Covid-19 / Fear of Covid-19 and factors associated with sleep and/or wakefulness bruxism among university students in southeastern Brazil during the Covid-19 pandemic

Introdução: O possível bruxismo é um comportamento autorrelatado, caracterizado pelo ranger e/ou apertar dos dentes, estando associado a fatores psicológicos. A pandemia da COVID-19 tem afetado o emocional das pessoas, podendo ser associada a este comportamento. Objetivo: Analisar a associação entre o nível de medo da COVID-19, assim como outros fatores associados à prevalência de possível bruxismo entre universitários. Materiais e métodos: Participaram deste estudo transversal 311 universitários de graduação e pós-graduação de faculdades odontológicas públicas e privadas da região sudeste do Brasil. Os participantes foram contatados via WhatsApp e redes sociais através de amostragem em bola de neve para responder um questionário com avaliação sociodemográfica, presença, frequência e severidade de possível bruxismo do sono (PBS) e/ou em vigília (PBV) e a versão brasileira da fear scale of COVID-19. Análises descritivas e bivariadas foram realizadas através dos testes estatísticos de Mann-Whitney e Kruskall-Wallis (p<0,05). Resultados: A prevalência de PBS grave foi de 12,5% e PBV 23,8%. Não houve associação entre escores de medo COVID-19 nem com PBS (p=0,342) nem com PBV (p=0,912). Quando analisado o PBV, observou-se maior prevalência dentre os participantes que não trabalhavam (p=0,008), sendo maior percentual entre os universitários na segunda metade do curso (p=0,021) e, dentre os participantes da pós-graduação, o bruxismo foi mais prevalente entre alunos matriculados em programas stricto sensu comparados àqueles de programas lato sensu (p=0,036). Conclusão: Estar fora do mercado de trabalho, a fase final da graduação e a inserção em uma pós-graduação stricto sensu influenciaram na prevalência de PBV.

Introduction: The possible bruxism is a self-reported behavior characterized by grinding and/or clenching teeth and is associated with psychological factors. The COVID-19 pandemic has affected people's emotions and can be associated with this behavior. Objective: Analyze the association between level of fear of COVID-19, as well as other factors associated to the prevalence of possible bruxism among university students. Materials and methods: A total of 311 undergraduate and graduate students from public and private dental schools in Southeastern Brazil participated in this cross-sectional study. Participants were contacted via WhatsApp and social networks through snowball sampling to answer an online questionnaire with sociodemographic assessment, presence, frequency and severity of possible sleep bruxism (PSB) and/or awake bruxism (PAB) and Brazilian version of the fear scale of COVID-19. Descriptive and bivariate analyzes were performed using the Mann-Whitney and Kruskall-Wallis statistical tests (p<0.05). Results: The prevalence of severe PSB was 12.5% and PAB 23.8%. There was no association between COVID-19 fear scores or with PSB (p=0.342) or with PAB (p=0.912). When analyzing the PAB, there was a higher prevalence among participants who didn't work (p=0.008), with a higher percentage among university students in the second half of the course (p=0.021). Among graduate participants, possible bruxism was more prevalent among students enrolled in stricto sensu programs compared to those in lato sensu programs (p=0.036). There wasn't association between COVID-19 fear score and possible bruxism. Conclusion: Being out of the job market, final stage of graduation and entry into a stricto sensu graduate program influenced the prevalence of PAB.

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.

Binge drinking, alcohol outlet density and associated factors: a multilevel analysis among adolescents in Belo Horizonte, Minas Gerais State, Brazil / Consumo excessivo episódico de álcool, densidade de locais de venda de bebidas alcoólicas e fatores associados: uma análise multinível entre adolescentes em Belo Horizonte, Minas Gerais, Brasil / Consumo de alcohol compulsivo, densidad de locales de venta de alcohol y factores asociados: un análisis multinivel entre adolescentes procedentes de Belo Horizonte, estado de Minas Gerais, Brasil

Our study sought to evaluate the prevalence of binge drinking in adolescents and its association with density of alcohol outlets around schools. This cross-sectional study was conducted in Belo Horizonte, Minas Gerais State, Brazil, with 436 high-school students aged between 17 and 19 and enrolled in 18 public and private schools. The students completed the Alcohol Use Disorder Identification Test (AUDIT-C), consisting of questions about alcohol consumption by parents and siblings, and socioeconomic status (type of school, mother's education level). Data from geographic information systems were used to estimate the density of alcohol outlets around schools participating. The association between exploratory variables and binge drinking was investigated using multilevel logistic regression analysis (p < 0.05) with random intercepts and fixed slopes. A three-step sequential modeling strategy was adopted. The prevalence of binge drinking was 39.9%. The alcohol consumption among adolescents was lower for those studying in areas with low density of alcohol outlets around schools (OR = 0.32; 95%CI: 0.14; 0.73) and the consumption of alcohol by mothers was associated with binge drinking among adolescents (OR = 1.94; 95%CI: 1.14; 3.30). Our study concluded that binge drinking among adolescents was associated with density of alcohol outlets around the schools and mother's alcohol consumption.

O estudo teve como objetivo avaliar a prevalência de consumo excessivo episódico de álcool entre adolescentes e a associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas. Um estudo transversal foi realizado em Belo Horizonte, Minas Gerais, Brasil, com 436 estudantes de segundo grau entre 17 e 19 anos de idade matriculados em 18 escolas públicas e privadas. Os estudantes responderam perguntas do Alcohol Use Disorder Identification Test (AUDIT-C) sobre consumo de álcool pelos pais e irmãos, além de características socioeconômicas (tipo de escola, escolaridade materna). Foram utilizados dados de sistemas de informações geográficas para calcular a densidade de locais de venda de bebidas alcoólicas em torno das escolas participantes. A associação entre variáveis independentes e consumo excessivo episódico de álcool foi investigada por análise de regressão logística multivariada (p < 0,05) com interceptos randômicos e inclinações fixas. Foi adotada uma estratégia de modelagem sequencial em três passos. A prevalência de consumo excessivo episódico de álcool foi de 39,9%. O consumo de álcool entre adolescentes foi mais baixo naqueles que estudavam em áreas com baixa densidade de locais de venda de bebidas alcoólicas em torno das escolas (OR = 0,32; IC95%: 0,14; 0,73), e o consumo de álcool pelas mães esteve associado ao consumo excessivo episódico de álcool pelos adolescentes (OR = 1,94; IC95%: 1,14; 3,30), Em conclusão, consumo excessivo episódico de álcool por adolescentes mostrou associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas e com o consumo materno de álcool.

El objetivo de este estudio fue evaluar la prevalencia del consumo compulsivo de alcohol por parte de adolescentes y su asociación con la densidad de establecimientos de venta de alcohol próximos a escuelas. Este estudio transversal se realizó en Belo Horizonte, Minas Gerais, Brasil, con 436 estudiantes de escuelas secundarias con edades comprendidas entre los 17-19 años, inscritos en 18 escuelas públicas y privadas. Los estudiantes completaron con Alcohol Use Disorder Identification Test (AUDIT-C) preguntas sobre el consumo de alcohol por parte de padres y hermanos, así como de su estatus socioeconómico (tipo de escuela, nivel de escolarización de la madre). Los datos del sistema de informaciones geográficas se usaron para calcular la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas participantes. La asociación entre las variables exploratorias y el consumo compulsivo de alcohol fue investigado usando un análisis de regresión logística multinivel (p < 0,05) con intersecciones aleatorias y curvas fijas. Se adoptó una estrategia de modelado secuencial en tres pasos. La prevalencia de consumo compulsivo de alcohol fue de 39,9%. El consumo de alcohol entre adolescentes fue más bajo entre quienes estudiaban en áreas con baja densidad de establecimientos de venta de alcohol alrededor de las escuelas (OR = 0,32; IC95%: 0,14; 0,73), además el consumo de alcohol en madres estuvo asociado con el consumo de alcohol en adolescentes (OR = 1,94; IC95%: 1,14; 3,30). La conclusión fue que el consumo compulsivo de alcohol en adolescentes estaba asociado con la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas y el consumo de alcohol por parte de la madre.

COVID-19: a new turning point for dental practice

Abstract Recent new zoonotic respiratory viruses have infected humans and led to severe acute respiratory syndrome: severe acute respiratory syndrome coronavirus (SARS-CoV), influenza A H5N1, influenza A H1N1 and Middle East respiratory syndrome coronavirus (MERS-CoV). The first SARS-CoV outbreak took place in 2003, in Guangdong, China. A decade later, another pathogenic coronavirus, MERS-CoV caused an endemic in Middle Eastern countries. The latest pandemic coronavirus infectious disease (COVID-19) has been related to the newly isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For the first time since the acquired immunodeficiency syndrome (AIDS) in the 1980s. Dentistry is facing a new turning point. This critical review aims to discuss the impact of COVID-19 infection on oral health care. In dental practice COVID-19 patients are the main source of infection and symptomatic patients are more contagious. Dentists can be first line of diagnosis of the disease, as they work in close contact with patients and are at the risk of being affected by COVID-19 and all respiratory infections. Several guidelines for dental practice environments have been published by dental associations and regulatory boards. It is already evident that biological, psychological and social effects of the COVID-19 pandemic have present and future impacts on dental practice. Dental schools, regulatory boards, scientific associations, government authorities, and public and private health care services must join efforts to design enduring answers for severe and long-standing viral challenges.

Oral health-related quality of life of young people with mucopolysaccharidosis: a paired cross-sectional study

Abstract The purpose of the present study was to compare the perceptions of the parents/ caregivers of young people with and without Mucopolysaccharidosis (MPS) with regards to their oral health-related quality of life (OHRQoL). A cross-sectional study was conducted with 29 individuals with MPS and 29 normotypic individuals aged three to 21 years and their parents/caregivers. All parents/caregivers of young people with MPS in follow-up at two reference hospitals in the city of Belo Horizonte, southeastern Brazil, were invited to participate in the study. Individuals without MPS were recruited from the pediatric clinics of both hospitals. Parents/caregivers answered a structured questionnaire addressing the sociodemographic characteristics, behavioral habits and medical and dental history of the children as well as the Brazilian short-form version of the Parental-Caregiver (P-CPQ). The individuals with and without MPS were examined for malocclusion, dental caries and oral hygiene by an examiner who had undergone training and calibration exercises. Mean age of the subjects was 12.1 years (± 4.2). Comparing total P-CPQ scores and scores on the oral symptoms, functional limitations and wellbeing domains, the parents/caregivers individuos with MPS reported a statistically significant greater negative impact on OS domain than their counterparts. Regarding the clinical variables, malocclusion was also associated a greater negative impact on OHRQoL of young people with MPS when compared to those of young people without MPS. Our findings show the great negative impact caused by the malocclusion of young people with MPS.

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.

Difference of Socioeconomic Factors among Mothers of Preterm and Full-Term Infant

Abstract Objective: To analyze the difference of socioeconomic factors among mothers of preterm and full-term infants. Material and Methods: A cross-sectional retrospective study was developed with 250 mothers of children aged three to five years. The sample was divided into two groups: 125 mothers of preterm infants from the referral center of a public hospital in the city of Belo Horizonte, Brazil and 125 mothers of children born full-term at a daycare center within the same city. A pre-tested questionnaire was used to collect socioeconomic data and type of breastfeeding. To verify if there was association between the dependent variable gestational age at birth and the independent variables, the chi-square test was used. A final model with multiple Poisson regression estimated prevalence ratio values for each independent variable was developed. Results: The final multiple regression model showed that mothers that have a low monthly income of up to USD 450.28 (PR = 1.979, 95% CI = 1.082-3.620), used drugs, cigarettes, or alcohol during their pregnancy (PR = 4.095, 95% CI = 2.422-6.921), and did not breastfeed (PR = 2.294, 95% CI = 1.205-4.369) were more likely to give birth to preterm infants. Conclusion: Low monthly family income, use of drugs, alcohol, or smoking during pregnancy and absence of breastfeeding were more frequent on mothers of preterm infants.

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.