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.

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.

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.

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study / Influência da duração da amamentação na incidência de cárie dentária em pré-escolares: um estudo de coorte

Abstract Objectives: investigate the association between breastfeeding duration and the incidence of severe caries in preschoolers. Methods: a cohort study was conducted with 132 pairs of mothers and children in the city of Diamantina, Brazil. Data collection was performed in 2 moments: when the children were between two and three years of age (baseline- 2013/2014) and after three years (T1-2016/2017). In both moments, children were evaluated for dental caries (International Caries Detection and Assessment System - ICDAS) and a questionnaire was administered to the mothers addressing socioeconomic aspects and thee habits of children. The outcome evaluated was the incidence of severe caries (Dentin caries - ICDAS Codes 5 and 6). Data analysis involved descriptive statistics, chi-squared test and Poisson hierarchical regression with robust variance. Results: children who breastfed for more than 24 months (RR = 2.24 CI95%= 1.23-4.08), those whose parents were separated (RR = 1.73 CI95%= 1.11-2.69), and those with estab-lished/severe caries (RR = 2.74 CI95%= 1.37-5.49) at baseline were at greater risk of incidence of severe caries after three years. Conclusion: breastfeeding for more than 24 months is a risk factor for incidence of severe caries. In addition, family structure and established or severe baseline caries were associated.

Resumo Objetivos: investigar a associação entre a duração da amamentação e a incidência de cárie grave em pré-escolares. Métodos: foi realizado um estudo de coorte com 132 pares de mães e crianças de Diamantina, Minas Gerais, Brasil. As crianças foram avaliadas em dois momentos: dois e três anos de idade (baseline-2013/2014) e após três anos (T1- 2016/2017). Dados socioeconómicos e relativos aos hábitos das criançasforam obtidos por meio de entrevistas com as mães e a presença de cárie dentária foi diagnosticada segundo o protocolo "International Caries Detection and Assessment System - ICDAS". O desfecho foi a incidência de cárie grave (cárie em dentina - códigos ICDAS 5 e 6). Para análise dos dados empregou-se regressão hierárquica de Poisson com variância robusta. Resultados: crianças que amamentaram por mais de 24 meses (RR = 2,24 IC95%= 1,234,08), cujos pais viviam separados no baseline (RR = 1,73 IC95%= 1,11-2,69) e aquelas com cárie estabelecida ou grave no baseline (RR = 2, 74 IC950%= 1,37-5,49) estavam em maior risco de incidência de cárie grave após 3 anos. Conclusão: a amamentação por mais de 24 meses foi um fator de risco para a incidência de cárie dentária grave em pré-escolares. Além disso, estrutura familiar e cárie estabelecida ou grave no baseline estiveram associados.

The influence of malocclusion, sucking habits and dental caries in the masticatory function of preschool children

Abstract The aim of this study was to evaluate the association of malocclusion, nutritive and non-nutritive sucking habits and dental caries in the masticatory function of preschool children. A cross-sectional study was conducted with a sample of 384 children aged 3-5 years. A single examiner calibrated for oral clinical examinations performed all the evaluations (kappa > 0.82). Presence of malocclusion was recorded using Foster and Hamilton criteria. The number of masticatory units and of posterior teeth cavitated by dental caries was also recorded. The parents answered a questionnaire in the form of an interview, addressing questions about the child's nutritive and non-nutritive sucking habits. The masticatory function was evaluated using Optocal test material, and was based on the median particle size in the masticatory performance, on the swallowing threshold, and on the number of masticatory cycles during the swallowing threshold. Data analysis involved simple and multiple linear regression analyses, and the confidence level adopted was 95%. The sample consisted of 206 children in the malocclusion group and 178 in the non-malocclusion group. In the multiple regression analysis, the masticatory performance was associated with age (p = 0.025), bottle feeding (p = 0.004), presence of malocclusion (p = 0.048) and number of cavitated posterior teeth (p = 0.030). The swallowing threshold was associated with age (p = 0.025), bottle feeding (p = 0.001) and posterior malocclusion (p = 0.017). The number of masticatory cycles during the swallowing threshold was associated with the number of cavitated posterior teeth (p = 0.001). In conclusion, posterior malocclusion, bottle feeding and dental caries may interfere in the masticatory function of preschool children.

One-year clinical evaluation of the retention of resin and glass ionomer sealants on permanent first molars in children

Abstract Aim : To compare the retention of glass ionomer cement (GIC) used as fissure sealant with a resinbased sealant. Methods: Six- to nine-year-old children (n=96) with all permanent first molars in occlusion were examined and assigned to two groups: GIC sealant or resin-based sealant. The sealants were applied according to the manufacturers' recommendations. The assessment of sealant retention was performed at two-month interval sessions (n=6), when each sample was scored according to the following criteria: complete retention, partial retention or complete loss. The visual and tactile examinations were carried out with a WHO probe, mouth mirror, air syringe and artificial light. The data were submitted to descriptive statistics and survival analysis. Results: A total of 384 occlusal surfaces were analyzed. Independent of the tooth and evaluation time, slightly better results were achieved by the resin-based sealant, but the difference was not statistically significant. Conclusions: GIC and resin-based sealants achieved similar results with regards to retention during a one-year follow-up period.

Societal perceptions of dentofacial appearances of patients with malocclusion: a systematic review / Percepção da sociedade sobre a aparência dento-facial de pacientes com má oclusão: revisão sistemática

Aim: This systematic review aimed to evaluate whether or not there is evidence enough to support the hypothesis that society promotes judgments on the facial aesthetics of individuals with malocclusion. Methods: Searches were conducted in the PubMed, Bireme, BBO, LILACS, Web of Science, EMBASE, Cochrane Library, and SciELO databases, supplemented by an additional manual search. Results: The present study included all articles that appeared in each of these databases between January 1965 and February 2015. Inclusion criteria were based on the articles whose primary focus was the societal perception of dentofacial appearances, written in English; observational and experimental epidemiological studies (Cross-sectional, Longitudinal, Cohort, Randomized Clinical Trial, Case-Control); and systematic reviews. Review articles, clinical case reports, laboratorial experiment studies, and abstracts were excluded. This search identified 2,530 articles, of which four fulfilled the inclusion criteria. Of these, only one study showed a high level of scientific evidence. The main flaws found included blind assessment of the measurement, validity of the measurement methods, error analysis of the method, and confounding factors not reported in all articles. Conclusion: According to this systematic review, it could be concluded that there is a need for further studies with more efficient methodological qualities.(AU)

Objetivo: Avaliar se existem evidências que suportam a hipótese de que a sociedade promove julgamentos considerando a estética facial de indivíduos com má oclusão. Material e Métodos: Foram realizadas buscas nas bases de dados PubMed, Bireme, BBO, LILACS, Web of Science, EMBASE, Cochrane Library e Scielo, complementando por uma busca manual. Resultados: Foram incluídos todos os artigos que apareceram em cada uma destas bases de dados de janeiro de 1965 a fevereiro de 2015. Critérios de inclusão foram os artigos cujo foco principal era a percepção da sociedade em relação à aparência dento-facial, publicados em inglês, estudos epidemiológicos observacionais e experimentais (Transversal, Longitudinal, Coorte, Ensaio Clínico Randomizado e Caso-Controle) e revisão sistemática. Artigos de revisão, relatos de caso clínico, estudos laboratoriais e resumos foram excluídos. A busca bibliográfica identificou 2530 artigos e 4 preencheram os critérios de inclusão. Destes somente um estudo apresentou elevado grau de evidência científica. A avaliação cega da medição, a validade dos métodos de medição, a análise de erro de método e os fatores de confusão não declarados em todos os artigos, foram as principais falhas encontradas. Conclusão: De acordo com esta revisão sistemática, concluiu-se que há a necessidade de estudos com qualidades metodológicas mais eficientes.(AU)

Association between anterior open bite and impact on quality of life of preschool children

The aim of this study was to evaluate the association between different types of malocclusion and the impact on quality of life among preschoolers and their families. A cross-sectional study was carried out involving 451 children 3-5 years of age. A clinical exam was performed to evaluate the malocclusions according to criteria proposed by Foster and Hamilton. This examination was conducted by a calibrated dentist. Parents/caregivers answered the Early Childhood Oral Health Impact Scale (ECOHIS) for the assessment of Oral Health-Related Quality of Life (OHRQoL) and the questionnaire on socioeconomic and demographic characteristics. Data analysis involved descriptive statistics, chi-square, Mann-Whitney and hierarchically adjusted Poisson regression. The prevalence of malocclusion was 28.4%. The most frequent conditions were posterior crossbite (20.4%), anterior open bite (9.5%) and increased overjet (8.4%). A significant association was found between anterior open bite and OHRQoL (p< 0.001). The adjusted analysis confirmed the association between anterior open bite and a negative impact on quality of life (PR = 2.55; 95%CI: 1.87 to 3.47; p< 0.001). Anterior open bite was associated with a negative impact on the quality of life of preschoolers.

Validations of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) / Validação da versão brasileira do Early Childhood Oral Health Impact Scale (ECOHIS)

This study aimed to evaluate the psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A total of 247 children aged 2 to 5 years and their parents/guardians participated in this study. A clinical oral examination was performed and the parents/guardians completed the ECOHIS questionnaire. Within a period of four-weeks, 20 percent of the participants repeated the ECOHIS questionnaire. Construct validity was determined using Spearman's rank correlation. Discriminant validity, internal consistency and test-retest reliability were also evaluated. The children were divided into 2 groups: group 1 (with dental caries) and group 2 (caries-free). Children with caries showed higher mean ECOHIS scores than the caries-free children. The child impact section (p < 0.01), family impact section (p < 0.01) and total ECOHIS scores (p < 0.01) were significantly correlated with tooth decay. Cronbach's alpha coefficients demonstrated satisfactory internal consistency. The Brazilian version of the ECOHIS is a valid instrument for assessing oral health-related quality of life in preschool children with Brazilian Portuguese-speaking primary caregivers.

O objetivo deste estudo foi avaliar as propriedades psicométricas da versão brasileira do Early Childhood Oral Health Impact Scale (ECOHIS). Duzentas e quarenta e sete crianças de 2 a 5 anos e seus pais/cuidadores foram convidados a participar. Foi realizado exame clínico bucal e os pais completaram o ECOHIS. Após quatro semanas, 20 por cento dos participantes responderam ao ECOHIS pela segunda vez. A validade de construto foi determinada através da correlação de Spearman. A validade discriminante, consistência interna e confiabilidade teste-reteste foram avaliadas. As crianças foram divididas em dois grupos: grupo 1 (com cárie) e grupo 2 (sem cárie). As crianças com cárie tinham maiores escores médios do ECOHIS do que as crianças sem cárie. Os domínios impacto na criança (p < 0,01), impacto na família (p < 0,01) e escores totais ECOHIS (p < 0,01) foram significativamente correlacionados com dentes cariados. Coeficientes alfa de Cronbach demonstraram consistência interna satisfatória. A versão brasileira do ECOHIS é apropriada para a avaliação da qualidade de vida relacionada à saúde bucal em crianças pré-escolares de pais cuja língua primária seja o português.

Sialolitíase em glândula submandibular: relato de caso clínico / Sialolithiasis in the submandibular gland: a clinical report

Os sialolitos são formações calcificadas que ocorrem no parênquima das glândulas salivares ou em seus ductos. Dentre as glândulas salivares, as submandibulares são as mais acometidas, e isso se deve, em 80 por cento dos casos, à anatomia da glândula e de seu ducto, sendo que a presença do sialolito é mais comum no ducto. Os sialolitos maiores do que 15mm são considerados raros e poucos casos foram descritos. Essas mineralizações necessitam de remoção cirúrgica, muitas vezes por via extrabucal, sob anestesia geral. Foram relatados casos da coexistência de sialolitíase e patologias malignas; por isso, um diagnóstico precose é de extrema importância bem como a proservação, por um longo período. Este estudo apresenta um caso de sialolito maior que 15mm, supostamente situado no parênquima da glândula submandibular e que foi removido cirurgicamente por via intrabucal.