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

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

The perception of caregivers of poor oral health of their children and its related clinical conditions / Percepção de cuidadores sobre a má saúde bucal das crianças e sua relação com condições clínicas

ABSTRACT Objective: To determine the association between the perception of caregivers regarding the oral health of their children and socio-demographic characteristics, report of dental pain, and clinical oral conditions. Methods: A cross-sectional study was conducted with 570 children aged two to five years old, enrolled at public preschools, and with their caregivers. Data regarding perceptions of oral health status in children, socio-demographic characteristics, and dental pain were collected from a questionnaire. Three examiners (Kappa>0.7) evaluated children's oral health status using the dmft index, pufa index, and the Andreasen classification for traumatic dental injury (TDI). The occurrence of open bite and overjet was also investigated. Descriptive analyses, and unadjusted and adjusted logistic regression were used, considering a 5% significance level. Results: A total of 24.7% of children had poor oral health status, which increased 4.92-fold (95% confidence interval [95%CI] 3.05-7.93) when children had dental caries, and 3.78-fold (95%CI 1.63-8.76) when there were consequences from dental caries. The perception of poor oral health was also associated to open bite (Odds Ratio [OR] 1.98; 95%CI 1.16-3.38) and TDI (OR 1.68; 95%CI 1.06-2.68). No associations were found between the perception of caregivers and socio-demographic variables or overjet. Conclusions: The perception of caregivers of poor oral health in their children was associated to dental caries, its consequences, TDI, and open bite.

RESUMO Objetivo: Determinar a associação entre a percepção dos cuidadores sobre a saúde bucal das crianças e características sociodemográficas, relato de dor dentária e condições clínicas bucais. Métodos: Foi realizado um estudo transversal com 570 crianças de dois a cinco anos matriculadas em pré-escolas públicas e seus cuidadores. Os dados referentes à percepção do estado de saúde bucal nas crianças, características sociodemográficas e dor dentária foram coletados por meio de um questionário. Três examinadores (Kappa>0,7) avaliaram o estado de saúde bucal das crianças usando o índice ceo-d, o índice PUFA e a classificação de Andreasen para traumatismo dentário (TD). A ocorrência de mordida aberta e overjet também foi investigada. Análise descritiva e regressão logística não ajustada e ajustada foram realizadas, considerando um nível de significância de 5%. Resultados: A percepção da má condição de saúde bucal nas crianças foi de 24,7%, a qual aumentou 4,92 vezes (IC95% ­3,05-7,93) quando as crianças apresentaram cárie dentária e 3,78 vezes (intervalo de confiança de 95% [IC95%] 1,63-8,76) quando houve consequências de cárie dentária. A percepção de saúde bucal ruim também foi associada a mordida aberta (Odds Ratio [OR] 1,98; IC95% 1,16-3,38) e TD (OR 1,68; IC95% 1,06-2,68). Não foram encontradas associações entre as percepções dos cuidadores e variáveis sociodemográficas ou overjet. Conclusões: As percepções dos cuidadores sobre a má condição de saúde bucal das crianças foram associadas à cárie dentária, suas consequências, TD e mordida aberta.

Is the perception of anxiety in dental care by children and their parents concordant? / A percepção da ansiedade no atendimento odontológico pelas crianças e por seus pais são concordantes?

ABSTRACT Objectives: This research evaluated the caregivers' perception on dental anxiety of their children and verified its association with independent variables: caregivers' dental anxiety and the reason for their last dental appointment, socioeconomic factors, caregivers and children's last dental visit, children's oral health status, dental anxiety and kind of dental appointment. Methods: Fifty-eight children aged 6 to 9 years old and their caregivers participated in the study. For this cross-sectional study the participants were selected from a clinical study where half of the children received fluortherapy and the other half tooth extraction. The caregivers answered questions about socioeconomic status and to evaluate their dental anxiety and the perception on children's dental anxiety they answered the Dental Anxiety Scale and Dental Anxiety Question, respectively. To evaluate children's dental anxiety the Modified Venham Picture Test was applied and their oral health status was verified with the DMFT index. Data were analyzed with Chi-square, Fisher's Exact and Mann-Whitney's test. Results: The frequency of the caregivers' perception on dental anxiety of their children were 50.9%. However, 41.4% of children reported dental anxiety. There was a significant difference between Dental Anxiety Question and Modified Venham Picture Test (p=0.002). There was no relationship between caregivers' perception on dental anxiety of their children and other independent variables. Conclusion: There was a significant difference between children's dental anxiety and the perception of it by those caregivers.

RESUMO Objetivos: Este trabalho avaliou a percepção dos responsáveis sobre a ansiedade odontológica das crianças e sua associação com as variáveis independentes: ansiedade odontológica dos responsáveis e o motivo para sua última consulta odontológica, fatores socioeconômicos, última visita ao dentista dos responsáveis e da criança, condição bucal da criança e tipo de procedimento odontológico realizado na consulta. Métodos: Neste estudo transversal a amostra contou com 58 crianças entre 6 e 9 anos e seus responsáveis. Os participantes foram selecionados a partir de um estudo clínico em que metade das crianças receberam fluorterapia e as outras exodontia. Os responsáveis responderam ao questionário socioeconômico e para avaliar a ansiedade odontológica e a percepção sobre a ansiedade odontológica das crianças eles responderam a Dental Anxiety Scale e a Dental Anxiety Question, respectivamente. Para avaliar a ansiedade odontológica das crianças foi aplicado o Venham Picture Test Modificado e a sua condição bucal foi verificada pelo índice CPO-D/ceo-d. A análise dos dados foi realizada pelo teste Qui-quadrado, Exato de Fisher e Mann-Whitney. Resultados: A frequência de responsáveis que perceberam a ansiedade odontológica das crianças foi de 50,9%. Entretanto, 41,4% das crianças relataram a ansiedade odontológica. Houve uma diferença significativa entre o Dental Anxiety Question e o Venham Picture Test Modificado (p = 0,002). Não houve relação entre a percepção dos responsáveis sobre a ansiedade odontológica das crianças com as demais variáveis independentes. Conclusão: Existiu uma diferença significativa entre a ansiedade odontológica das crianças e a percepção desta pelos responsáveis.

Avaliação do comportamento odontológico infantil durante procedimentos de profilaxia e exodontia / Evaluation of children's dental behavior during prophylaxis and extraction procedures

Objetivo: Avaliar o comportamento infantil durante os tratamentos odontológicos de profilaxia e de exodontia. Métodos: Este estudo transversal contou com 58 crianças, entre 6 e 9 anos de idade. Dentre essas, 29 crianças foram submetidas ao procedimento de exodontia e 29 ao procedimento de profilaxia. O comportamento infantil frente ao tratamento odontológico proposto foi avaliado por um cirurgião-dentista treinado através da versão brasileira e validada da Escala Comportamental de Venham (Venham's Behavior Rating Scale (BvVBRS). Avaliou-se também a ansiedade infantil prévia ao tratamento odontológico através da Venham Picture Test modificada (VPTm). A condição bucal foi avaliada pelo índice CPO-D e ceo-d, por pesquisador previamente calibrado (Kappa > 0,7). Os pais/responsáveis responderam a um questionário socioeconômico e questões relacionadas a experiência odontológica prévia das crianças. Realizou-se análise descritiva e teste Qui-quadrado com nível de significância de 5%. Resultados: Em relação ao comportamento o grupo submetido à profilaxia apresentou 100% das crianças com um comportamento positivo, enquanto no grupo submetido à exodontia houve 75,9% das crianças com comportamento positivo (p = 0,010). Idade, gênero e presença de ansiedade prévia aos procedimentos não tiveram relação estatisticamente significante com o comportamento infantil. A presença de cárie na dentição decídua esteve associada ao comportamento negativo durante os procedimentos odontológicos (p = 0,013). Conclusão: Foi observado que durante o procedimento de profilaxia os pacientes demonstraram um comportamento mais colaborador quando comparado ao procedimento de exodontia.

Aim:To investigate the behavior of children during dental treatments of prophylaxis and dental extraction. Methods: Fifty-eight children, 6 to 9 years of age, and their caregivers participated of this cross-sectional study. Of these, 29 children underwent prophylaxis and 29 dental extraction. Child behavior was assessed through the Brazilian version of the Venham's Behavior Rating Scale (BvVBRS), and dental anxiety was measured by the Venham Picture Test modified (VPTm). Clinical examination was performed by a calibrated examiner (Kappa > 0.7), using the decay, missing, filled index for primary and permanent dentition dmft/DMFT index. The caregivers answered a socioeconomic questionnaire and questions related to the previous dental experience of the children. Descriptive data analysis and Chi-square test were performed, with a significance level of 5%. Results:Regarding behavior, the prophylaxis group presented 100% of children with a positive behavior, while the extraction group contained 75.9% of children with positive behavior, and this difference was statistically significant (p = 0.010). Age, gender, and presence of anxiety prior to the procedures had no statistically significant relationship to the presented child behavior. The presence of caries in the deciduous dentition was associated with child behavior during dental procedures (p = 0.013). Conclusion: It was observed that the type of procedure interfered directly in the negative behavior of the children, with a difference in cooperation with invasive (dental extraction) and non-invasive (prophylaxis) procedures.

Association of gender, oral habits, and poor sleep quality with possible sleep bruxism in schoolchildren

Abstract The aim of this study was to verify the oral habits, symptoms, and characteristics of some children aged 8 to 10 years that could be associated with possible sleep bruxism. A cross-sectional study was performed. Questionnaires were sent to parents to obtain information on sex, age, school shift, sleep quality, parents' perception of children's behavior, and children's oral habits (nail biting, object biting, and lip biting), and symptoms such as headache or earache. In addition, parents reported the frequency of sleep bruxism (no day to 7 days a week). Descriptive analysis and multinomial logistic regression were performed and the level of significance was set at 5%. A total of 1,554 parents of children aged 8 to 10 years participated in this study. Possible sleep bruxism was reported as mild for 65.7%, moderate for 25.3%, and severe for 9% of the children. In the adjusted multinomial logistic regression, boys were 79% more likely to have sleep bruxism (OR: 1.79; 95%CI 1.23-2.60) and were 2.06 more times at risk of being in the habit of lip biting (OR: 2.06; 95%CI 1.26-3.37). Children with possible severe sleep bruxism were 61% more likely to develop object biting (OR: 1.61; 95%CI 1.09-2.39), 52% more likely to have headaches (OR: 1.52; 95%CI 1.01-2.28), and 3.29 more times at risk of poor sleep quality (OR: 3.29; 95%CI 2.25-4.82). Based on the report, boys with lip and object biting habits, headaches, and poor sleep quality presented a higher chance of possible severe sleep bruxism.

Mouth Breathing and Prevalence of Sleep Bruxism among Preschoolers aged 2 to 5 years

Objective: To determine the prevalence of bruxism, associating it with mouth breathing in preschool children in Florianopolis, Brazil. Material and Methods: Clinical examination and questions to parents/guardians of 429 children aged 2-5 were conducted. The clinical examination was performed by three calibrated examiners to register the presence of tooth wear on incisors and molars. The questions were related to sleep bruxism (teeth grinding) and mouth breathing. For determinate diagnosis, were "possible" bruxism by the American Academy of Sleep Medicine and "probable" bruxism, whereas the Item Response Theory was employed for mouth breathing. To determine the associations, a Chi-square test and Fisher exact test with a standard error of 5% and 95% interval confidence were applied. Results: The clinical examination revealed bruxism in 8.2%, whereas the parental report revealed bruxism in 17.2%. When clinical examination was associated with the parent's report, bruxism was present in 2.1%. Among the non-clinical variables, the most prevalent changes included: child presenting a regular stuffy nose (19.6%), followed by child is always open-mouthed (16.1%). A significant statistical association between bruxism and age was obtained (p<0.05), the age group with prevalence of 4 and 5 years old with 68.9%. There was no mouth breathing association with the presence of bruxism (p>0.05). Conclusion: Bruxism was prevalent for children aged 4-5 and bruxism had no association with mouth breathing.