Caries dental y calidad de vida de escolares de 6 a 8 años / Dental caries and quality life of schoolchildren aged 6 to 8 years

Introducción: la caries dental ocasiona dolor y alteración de la salud. La calidad de vida se refiere a la percepción de uno con base en su situación física, emocional y social. Objetivo: analizar la percepción de la calidad de vida en un grupo de escolares con caries. Metodología: 270 escolares de 6-8 años de edad con y sin experiencia de lesiones cariosas contestaron con sus padres un cuestionario basado en la Scale of Oral Health Outcomes (SOHO). Las respuestas se registraron con escala de tipo Likert. Se obtuvieron frecuencias, porcentajes, promedios y desviación estandar. Se compararon los grupos con chi cuadrada y t de Student, y se calculó la razón de momios (RM). Resultados: el 58% presentó experiencia de caries. El 64% de los escolares con caries informó que tenía antecedentes de dolor dentario y la media en los dominios sobre funciones bucales y relación familiar fue mayor para los escolares con caries (p = 0.001). Tener caries fue determinante para presentar dificultades para comer: RM 8.7 (intervalo de confianza del 95% [IC 95%] 4.7-16); beber: RM 5.9 (IC 95% 3.4-10); dormir: RM 5.3 (IC 95% 3.1-9); jugar: 5.2 (IC 95% 2.7-10), p < 0.001. Desde la autopercepción del escolar, el 87% manifestó no sentirse contento por la presencia de caries. Conclusiones: la percepción de los escolares y padres del grupo con experiencia de caries dental mostró deterioro en la calidad de vida.

Background: Dental caries causes pain and alteration of integral health. Quality of life refers to oneself's perception of their physical, emotional and social situation. Objective: To analyze the perception of quality of life in a group of schoolchildren with caries. Methodology: 270 schoolchildren aged 6-8 years with and without experience of carious lesions, with their parents, answered a questionnaire based on the Scale of Oral Health Outcomes (SOHO). The answers were recorded with a Likert-type scale. Frequencies, percentages, averages and standard deviation were obtained. The groups were compared with chi squared and Student's t test, and odds ratios (OR) were calculated. Results: 58% presented caries experience. 64% of schoolchildren with caries reported antecedents of dental pain, and the mean in the domains on oral functions and family relationship was higher for schoolchildren with caries (p = 0.001). Having caries was determinant for eating difficulties: OR 8.7 (95% CI 4.7-16); drink: OR 5.9 (95% CI 3.4-10); sleeping: OR 5.3 (95% CI 3.1-9); play: OR 5.2 (95% CI 2.7-10), p < 0.001. From schoolchildren auto-perception 87% said they did not feel happy about their decayed teeth. Conclusions: The perception of the schoolchildren and parents belonging to the group with experience of dental caries showed deterioration in the quality of life.

Does dental trauma in early childhood have the potential to affect the quality of life of children and families? / Os traumatismos dentários na primeira infância têm potencial para afetar a qualidade de vida das crianças e das famílias?

ABSTRACT Objective: To evaluate the influence of dental trauma on oral health-related quality of life (OHRQoL) of children and their families. Methods: A total of 571 children aged five years were randomly selected at public schools. Trauma was clinically evaluated in accordance with the Andreasen classification. Caries experience in the anterior region and increased overjet were determined according to the World Health Organization criteria. The Early Childhood Oral Health Impact Scale (ECOHIS) was answered by the parents and used to evaluate OHRQoL. In addition, this questionnaire has aspects related to socioeconomic status. Simple logistic regression was performed, and the raw Odds Ratios with the respective 95% confidence intervals (95%CI) were estimated. The variables with p<0.20 were tested in multiple logistic regression models, and those with p≤0.05 remained in the model and the adjusted odds ratio with respective 95%CI was estimated. Results: Income showed a magnitude of association of 1.56 and 2.70 with the OHRQoL of children and families, respectively. The avulsion variable showed 9.65- and 8.25-times greater chance of influencing the OHRQoL of children and families, respectively. The experience of caries showed 3.80- and 2.42-times greater chance of influencing the OHRQoL of children and families, respectively. Conclusions: Dental trauma did not influence OHRQoL of children and their families negatively. However, avulsion and caries experience in low-income families was associated with a negative perception of OHRQoL.

RESUMO Objetivo: Avaliar a influência do traumatismo dentário na qualidade de vida relacionada à saúde bucal (QVRSB) de crianças e suas famílias. Métodos: 571 crianças de 5 anos de idade foram aleatoriamente selecionadas de escolas públicas. O trauma foi avaliado clinicamente de acordo com a classificação de Andreasen. A experiência de cárie na região anterior e a presença de overjet foram determinadas com base nos critérios da Organização Mundial da Saúde. A versão brasileira do questionário ECOHIS (Escala de Impacto na Saúde Oral na Primeira Infância) avaliou a QVRSB e foi respondida pelos pais; além disso, foram avaliados aspectos socioeconômicos. Realizou-se uma regressão logística simples, bem como as razões de chances brutas com os respectivos intervalos de confiança de 95%. As variáveis ​​com p <0,20 foram testadas nos modelos de regressão logística múltipla, e aquelas com p≤0,05 permaneceram no modelo. Resultados: A renda mostrou uma magnitude de associação de 1,56 e 2,70 com a QVRSB das crianças e famílias, respectivamente. A variável avulsão apresentou chance 9,65 e 8,25 vezes maior de influenciar a QVRSB de crianças e famílias, respectivamente. A experiência de cárie mostrou chance 3,80 e 2,42 vezes maior de influenciar a QVRSB de crianças e famílias, respectivamente. Conclusões: O trauma dental não influenciou negativamente a QVRSB das crianças e suas famílias. Entretanto, especificamente a avulsão, e a experiência de cárie nos dentes anteriores em famílias de baixa renda estiveram associadas a uma percepção negativa da QVRSB.

Reabilitação estética e funcional em paciente com cárie na primeira infância: relato de caso / Aesthetic and functional rehabilitation in a patient with caries in early childhood: case report

Introdução: Cárie na Primeira Infância (CPI) é o termo utilizado para descrever a cárie dentária em crianças menores de 6 anos de idade. Objetivo: Relatar o tratamento reabilitador estético e funcional de uma criança com CPI. Relato do caso: Paciente do sexo masculino, 5 anos de idade, compareceu à clínica de Odontopediatria da Faculdade de Odontologia de Araçatuba (FOA/UNESP), acompanhado pela mãe, que relatou como queixa principal dor e presença de cárie. Ao exame clínico intrabucal, constatou-se na arcada superior lesões de cárie em todos os dentes, exceto nos dentes 55, já restaurado, e dente 65, hígido. Na arcada inferior, lesões de cárie foram observadas nos dentes 74 e 84. Após diagnóstico clínico e radiográfico, optou-se por realizar a confecção de coroa de aço para os dentes 74 e 84, exodontia dos dentes 51, 52, 61 e 64, instalação de aparelho mantenedor de espaço funcional removível e restaurações dos demais dentes afetados com compósito resinoso. Conclusão: Foi possível recuperar as funções estéticas, fonéticas e mastigatórias do paciente, colaborando para a melhora da autoestima da criança, o que gerou satisfação dos familiares. A educação em saúde bucal realizada com a criança e os responsáveis foi essencial para o sucesso do tratamento e a manutenção da saúde bucal.

Introduction: Early Childhood Caries (ECC) is the term used to describe dental caries in children under 6 years of age. Objective: Report the aesthetic and functional rehabilitation treatment of a child with ECC. Case report: A 5-year-old male patient was attended at the to the Pediatric Dentistry Clinic of the Araçatuba Dental School (FOA/UNESP), accompanied by his mother, who reported pain and dental caries as the main complaint. On intraoral clinical examination, caries lesions were found in all upper teeth, except for tooth 55, already restored, and tooth 65, healthy. In the lower arch, caries lesions were observed in teeth 74 and 84. After clinical and radiographic diagnosis, it was decided for the manufacture of steel crown for teeth 74 and 84, extraction of teeth 51, 52, 61 and 64, installation of removable functional space maintenance device and restorations of the other affected teeth with composite resin. Conclusion: In view of the treatment performed, it was possible to recover the aesthetic, phonetic and masticatory functions, contributing to the improvement of the child's self-esteem as well assatisfaction of family members. Oral health education carried out with the child and his parents was essential for the success of the treatment and the maintenance of oral health.

Impact of untreated dental caries and malocclusion in brazilian adolescents on the quality of life of their families

Objective: The aim of the present study was to evaluate the impact of dentalcaries and malocclusion in Brazilian adolescents on the oral health-related qualityof life (OHRQoL) of their families. Methods: A representative cross-sectional studywas conducted with 1168 adolescents from Belo Horizonte, Minas Gerais, Brazil,and their families. Parents/caregivers answered the Brazilian version of the FamilyImpact Scale (B-FIS) to assess the impact of oral conditions on the OHRQoL of thefamilies. Malocclusion was diagnosed using the Dental Aesthetic Index. Dentalcaries was diagnosed using the DMFT index. Three examiners who had undergonetraining and calibration exercises performed the clinical examinations. Sex, ageand social vulnerability of the adolescents were considered confounding variables.Data analysis was performed using bivariate and multivariate Poisson regressionanalysis with robust variance (p<0.05). Results: The analysis adjusted by sex, ageand social vulnerability demonstrated that families of adolescents with untreateddental caries had 29% more impact on Parental/Family Activity (95% CI: 1.11-1.50), 28% on Parental Emotions (95% CI: 1.09-1.51) and 34% on Family Conflict(95% CI: 1.09-1.65) than those without caries. When adjusted for sex and age,malocclusion was associated with Financial Burden (PR=1.39; 95%CI=1.01-1.65),but this variable lost its significance when social vulnerability was included in themultivariate model (PR=1.27; 95% CI: 0.99-1.64). Conclusion: Untreated dentalcaries in adolescents exerted a negative impact on the OHRQoL of their families.Social vulnerability exerted an influence on the impact of malocclusion on theOHRQoL of the families.

Objetivo: O objetivo do presente estudo foi avaliar o impacto da cárie dentária e damá oclusão em adolescentes brasileiros na qualidade de vida relacionada à saúdebucal (QVRSB) de suas famílias. Métodos: Foi realizado um estudo transversalrepresentativo com 1168 adolescentes de Belo Horizonte, Minas Gerais, Brasil, e suasfamílias. Os pais/responsáveis responderam à versão brasileira da Family ImpactScale (B-FIS) para avaliar o impacto das condições bucais na QVRSB das famílias. Amá oclusão foi diagnosticada pelo Índice de Estética Dental e a cárie dentária peloíndice CPOD. Três examinadores calibrados realizaram exames clínicos. Sexo, idadee vulnerabilidade social dos adolescentes foram coletadas como variáveis de confusão.A análise dos dados foi realizada por meio de análise de regressão de Poisson bivariadae multivariada com variância robusta (p<0,05). Resultados: Resultados ajustados porsexo, idade e vulnerabilidade social demonstraram que famílias de adolescentes comcárie dentária não tratada tiveram 29% mais impacto na Atividade Parental/Familiar(IC95% = 1,11-1,50), 28% nas Emoções Parentais (IC95% = 1,09-1,51) e 34% em ConflitoFamiliar (IC 95% = 1,09-1,65) do que aqueles sem cárie. Quando ajustada para sexo eidade, a má oclusão foi associada ao Encargo Financeiro (RP = 1,39; IC95% = 1,01-1,65); entretanto, perdeu significância quando a vulnerabilidade social foi incluída nomodelo multivariado (RP = 1,27; IC95% = 0,99-1,64). Conclusão: A cárie dentária nãotratada em adolescentes exerceu impacto negativo na QVRSB de suas famílias. Avulnerabilidade social influenciou a ausência de impacto da má oclusão na QVRSBdas famílias.

Odontogenic Infection and dental Pain negatively impact Schoolchildrens Quality of Life / Infecção odontogênica e odontalgia impactam negativamente a qualidade de vida de crianças escolares

ABSTRACT The aim of this study is to assess the prevalence of odontogenic infection in lowincome Brazilian schoolchildren and evaluate its association with the subjective variables of oral healthrelated quality of life and dental pain. In this crosssectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ810) and selfreports of dental pain were collected. Data were statistically analyzed using MannWhitney or KruskalWallis test with a posttest by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional wellbeing (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among lowincome Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's selfperception of quality of life.

RESUMO O objetivo deste estudo foi avaliar a prevalência de infecção odontogênica em crianças escolares brasileiras de baixa renda e analisar a sua associação com as variáveis subjetivas da autopercepção de qualidade de vida relacionada à saúde bucal e dor dentária. Neste estudo transversal, 230 crianças escolares com 8 a 10 anos de idade realizaram exame clínico bucal no qual os índices CPOD/ ceod e PUFA/pufa foram mensurados. Com isso, as crianças responderam individualmente ao Child Perceptions Questionnaire (CPQ810) e relatos de dor dentária foram coletados. Os dados foram estatisticamente analisados utilizandose o teste MannWhitney ou KruskalWallis, com posterior teste da correlação de Dunn e Pearson. Dentre as crianças examinadas, 42,6% apresentavam infecção odontogênica e 80% reportou experiência de dor dentária. A idade (p=0,034) e experiência de dor dentária (p<0,002) das crianças foram associadas à infecção odontogênica, bem como o seu bemestar emocional (p=0,008) e social (p=0,009) e impacto geral na qualidade de vida (p=0,019). Além disso, a intensidade (p<0,001), frequência (p<0,001) e duração (p<0,001) da odontalgia foram correlacionadas com o impacto geral na qualidade de vida da criança. A prevalência de infecção odontogênica permanece elevada em crianças escolares brasileiras. Infecção pediátrica e sua dor relacionada induzem não apenas diversas desordens biológicas, mas também afetam negativamente a autopercepção de qualidade de vida das crianças.

Assessment of the impact of toothache, untreated caries and its consequences on the quality of life among poor Brazilian children / Avaliação do impacto da dor de dente, da cárie não tratada e suas consequências na qualidade de vida de crianças brasileiras

Purpose: to evaluate the impact of dental pain and the consequences of untreated dental caries on the quality of life in children of low social-economic status aged from 8 to 10 years old. Materials and Methods: in this cross-sectional study, 230 children were submitted to a clinical examination in which the caries-pufa ratio was measured, afterward, they answered to two questionnaires: one about their quality of life (CPQ8-10) and the other about dental pain. Data were statistically analyzed through Chi-square, Mann-Whitney or Kruskal-Wallis tests to evaluate the association between the variables with impact on children's OHRQoL. To establish the existence of risk factors among variables and impact on OHRQoL a Poisson Regression model was applied. Results: dental caries (p = 0.003; PR 2.39; 95% CI 1.04­1.56), severity of untreated caries (p = 0.008; PR 2.86; 95% CI 1.13­2.00), toothache (p < 0.001; PR 2.31; 95% CI 1.64­3.27) and PUFA + pufa index (p < 0.023; PR 2.68; 95% CI 1.10­1.87) were associated with and were a predictor factor for impact on overall OHRQoL. All of these variables also had an effect over the social welfare subscale (p ≤ 0.001), whereas caries presence was also statistically linked with the emotional wellbeing subscale (p = 0.008) and dental pain with all four subscales (p ≤ 0.001). Conclusion: untreated dental caries' clinical consequences and dental pain exerted a negative influence on the quality of life of schoolchildren analyzed.(AU)

Objetivo: avaliar o impacto da dor de dente e das consequências da cárie não tratada na qualidade de vida de crianças entre 8 e 10 anos com baixos indicadores socioeconômicos. Métodos: neste estudo transversal, 230 crianças escolares foram submetidas a um exame clínico, no qual foram avaliados seus CPO/ceo (Dentes cariados, perdidos e obturados) e PUFA/pufa (Envolvimento pulpar, ulceração, fístula e abscesso). Em um segundo momento, elas responderam a dois questionários: um sobre a qualidade de vida (CPQ8-10) e outro sobre odontalgia. Os dados foram analisados estatisticamente por meio dos testes de Chi-quadrado, Mann-Whitney ou Kruskal-Wallis, para avaliar a associação entre as variáveis e o impacto na qualidade de vida relacionada à saúde oral (QdVRSO) da criança. Para estabelecer a existência de fatores de risco para impacto na QdVRSO entre as variáveis, um modelo de regressão de Poisson foi aplicado. Resultados: a presença de cárie (p = 0,003; RP 2,39; 95% IC 1,04-1,56), a severidade da cárie não tratada (p = 0,008; RP 2,86; 95% IC 1,13-2,00), dor de dente (p < 0,001; RP 2,31; 95% IC 1,64-3,27) e PUFA/pufa (p < 0,023; RP 2,68; 95% IC 1,10- 1,87) foram associados com impacto na QdVRSO, assim como também foram fatores preditores para o impacto na qualidade de vida relacionada à saúde oral. Todas as então citadas variáveis também exerceram efeito sobre a subescala do bem-estar social (p ≤ 0,001), enquanto a presença de cárie esteve estatisticamente conectada com a subescala do bem-estar emocional (p = 0,008) e a dor dentária com todas as subescalas da QdVRSO (p ≤ 0,001). Conclusão: as consequências clínicas da cárie não tratada e a dor dentária exercem uma influência negativa na qualidade de vida das crianças analisadas.(AU)

Associations of socioeconomic status and lifestyle factors with dental neglect of elementary school children: the MEXT Super Shokuiku School Project

BACKGROUND@#Despite the fact that there are parents who do not take children with untreated dental caries to a dental clinic, few studies have been conducted to identify the responsible underlying social and family factors. The aim of this study was to investigate whether socioeconomic status and lifestyle factors are associated with dental neglect in elementary school children.@*METHODS@#This study was conducted in 2016 with 1655 children from the Super Shokuiku School Project in Toyama. Using Breslow's seven health behaviors, the survey assessed: the grade, sex, and lifestyle of the children; parental internet and game use and lifestyle; socioeconomic status. The odds ratios (OR) and 95% confidence intervals (CIs) for having untreated dental caries were calculated using logistic regression analysis.@*RESULTS@#Among the children participating, 152 (3.2%) had untreated dental caries. Among them, 53 (34.9%) had not been taken to a dental clinic despite the school dentist's advice. Dental neglect was significantly associated with children in higher grades (OR, 2.08; 95% CI, 1.14-3.78), father's Internet and game use ≥ 2 h/day (OR, 1.99; 95% CI, 1.02-3.88), not being affluent (OR, 2.78; 95% CI, 1.14-6.81), and non-engagement in afterschool activities (OR, 1.99; 95% CI, 1.10-3.62).@*CONCLUSIONS@#Socioeconomic status was the strongest factor associated with dental neglect despite the fact that the children's medical expenses are paid in full by the National Health Insurance in Toyama, Japan. Future studies should investigate what factors prevent parents of non-affluent families from taking their children to dental clinics and how they can be socially supported to access adequate medical care.

Gingivitis influences oral health-related quality of life in adolescents: findings from a cohort study / A gengivite influencia a qualidade de vida relacionada à saúde bucal de adolescentes: achados de um estudo de coorte

ABSTRACT: Introduction: Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents. Methodology: This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up. Results: Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables. Conclusions: The findings indicate that gingivitis negatively impacts the adolescents' OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.

RESUMO: Introdução: Qualidade de vida relacionada à saúde bucal (QVRSB) é afetada por diferentes condições clínicas. O objetivo deste estudo foi avaliar o impacto da gengivite na QVRSB de adolescentes. Metodologia: Este estudo de coorte consistiu em uma amostra aleatória de 1.134 escolares iniciado em 2012, na cidade de Santa Maria, Brasil. Após dois anos, 743 adolescentes foram acompanhados (taxa de resposta: 65,5%). Dados clínicos, socioeconômicos e de QVRSB foram coletados. A QVRSB foi avaliada pela versão brasileira curta do Child Perceptions Questionnaire 11-14 (CPQ11-14) e o sangramento gengival foi coletado através do Índice Periodontal Comunitário. Gengivite foi considerada com o indivíduo apresentando 15% ou mais locais de sangramento. Os modelos de regressão de Poisson foram utilizados para avaliar a associação entre gengivite e os escores total e específico do domínio do CPQ11-14. A prevalência de gengivite na primeira avaliação foi considerada o preditor principal para a QVRSB no acompanhamento. Resultados: A gengivite no baseline foi associada à maior pontuação geral do CPQ 11-14 (RR = 1,07; IC95% 1,01 - 1,14) e ao domínio de bem-estar emocional (RR = 1,17; IC95% 1,04 - 1,31), independentemente das outras condições orais e variáveis socioeconômicas. Conclusão: Os achados indicam que a gengivite impacta negativamente a QVRSB de adolescentes. Além disso, sexo, escolaridade materna e renda familiar mensal também foram associados à QVRSB.

Impact of sense of coherence on oral health-related quality of life among Brazilian adults

Abstract It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24-4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67-5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07-3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29-3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Abstract Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures. Results: A total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ±1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects. Conclusion: Our findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.

Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions

Abstract Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.

Individuals with special needs and their families' oral health-related quality of life

Abstract To evaluate the impact of dental caries among Brazilian individuals with special health care needs (SHCN) on their families' oral health-related quality of life (OHRQoL). A cross-sectional study was carried out with a population-based sample of 227 subjects who were enrolled from the ACOLHER-PNE project conducted at the Fluminense Federal University. Parents/caregivers answered the Brazilian version of the 14-item Family Impact Scale (B-FIS) to assess the impact on family's quality of life (QoL). The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The DMFT/dmft score was categorized into 0 = caries free; 1-2 = low; 3-4 = moderate; and ≥ 5 = high experience. Mother's schooling, age, sex, SHCN conditions, and socioeconomic factors were the other independent variables. QoL was measured through FIS domains and total score. Statistical analyses was performed using the Kruskal Wallis and Mann Whitney U tests and Poisson regression (p<0.05). The impact values observed in moderate and high caries experience were significantly higher than those found in subjects without caries and low level of parental emotions. Parents' years of schooling showed more impact on total score and on parental emotions. Older subjects showed significantly higher impact on total score and in all domains. The multivariate model demonstrated that families of older subjects (> 8 years old) experience a higher impact level compared to younger subjects (PR: 2.43; 95%CI: 1.80-3.29, p = 0.001). High caries experience and other socioeconomic factors were not associated with a greater negative impact on parents' QoL.

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.

Impacto da cárie dentária, maloclusão e hábitos orais na qualidade de vida relacionada à saúde oral em crianças pré-escolares / Impact of dental caries, malocclusion and oral habits on the oral health-related quality of life of preschool children

RESUMO Introdução As doenças e desordens bucais, bem como hábitos orais, podem causar impacto na qualidade de vida das crianças. Objetivo Associar a cárie dentária, maloclusão e hábitos orais com a qualidade de vida de crianças pré-escolares. Métodos Estudo transversal com 93 crianças de 3 a 5 anos de idade, acometidas, ou não, por lesões de cárie não tratadas. Os responsáveis responderam ao questionário sobre hábitos orais e ao Questionário sobre a Qualidade de Vida Relacionada à Saúde Bucal de Crianças na Idade Pré-escolar (B-ECOHIS). Um odontopediatra avaliou a gravidade das lesões de cárie e a presença de alterações oclusais. O nível de significância utilizado foi de 5%. Resultados O B-ECOHIS evidenciou impacto na qualidade de vida, conforme o aumento da idade, nos domínios dos sintomas, aspectos psicológicos, autoimagem e interação social e de função familiar. A cárie dentária apresentou impacto sobre a qualidade de vida das crianças e de seus familiares, especialmente em relação aos domínios dos sintomas e limitações. Hábitos de respiração oronasal e chupeta também evidenciaram efeitos negativos na qualidade de vida das crianças e de seus familiares. Não foi observada associação entre maloclusão e qualidade de vida relacionada à saúde oral. Conclusão A cárie dentária, os hábitos de sução de chupeta e de respiração oronasal demonstraram impacto negativo na qualidade de vida relacionada à saúde oral das crianças.

ABSTRACT Introduction Oral diseases and disorders as well as oral habits can impact the quality of life of children. Purpose To associate the dental caries, malocclusion and oral habits with the quality of life of preschool children. Methods Cross-sectional study with 93 children from three to five years of age who have or have not been affected by untreated carious lesions. Parents answered the questionnaire on oral habits and quality of life instrument related to oral health denominated Early Childhood Oral Health Impact Scale (B-ECOHIS). A pediatric dentist assessed the severity of the carious lesions and the presence of occlusal disorders. The level of significance used was 5%. Results The B-ECOHIS demonstrated impact on quality of life with increasing age in the fields of symptoms, psychological aspects, self-image and social interaction and family function. Dental caries were shown to have an impact on the quality of life of children and their families, especially in relation the domains of symptoms and limitations. Oronasal breathing and pacifier habits negatively impacted the quality of life of children and their families. There was no association between malocclusion and quality of life related to oral health. Conclusion The dental caries, the pacifier suction habits and oronasal breathing demonstrated negative impact on quality of life related to oral health of children.

Factors for determining dental anxiety in preschool children with severe dental caries

Abstract The aim of this study was to assess the clinical and socioeconomic indicators associated with dental anxiety in preschool children with severe dental caries. A total of 100 children between 3 and 5 years of age were selected during a dental screening procedure. The selection criteria were having at least one tooth with dental caries and a visible pulpal involvement, ulceration, fistula, and abscess (PUFA) index of ≥1 in primary teeth. Before the clinical examination or any treatment procedure was performed, we evaluated the children’s dental anxiety using the Facial Image Scale (FIS). Parents completed a questionnaire on socioeconomic conditions, which included the family structure, number of siblings, parental level of education, and family income. A dentist blinded to FIS and socioeconomic data performed the clinical examination. Poisson regressions associate clinical and socioeconomic conditions with the outcome. Most of the children (53%) experienced extensive dental caries (dmf-t ≥ 6), and all children had severe caries lesions, with a PUFA index of ≥1 in 41% and that of ≥2 in 59%. The multivariate adjusted model showed that older children (4–5-year old) experienced lower dental anxiety levels compared with younger children (3-year old) (RR = 0.35; 95%CI: 0.17–0.72 and RR = 0.18; 95%CI: 0.04–0.76, respectively), and children with three or more siblings were associated with higher levels of dental anxiety (RR = 2.27; 95%CI: 1.06–4.87). Older age is associated with low dental anxiety, and more number of siblings is associated with high dental anxiety in preschool children, whereas the severity or extent of dental caries is not associated with dental anxiety.

Dental caries and quality of life of preschool children: discriminant validity of the ECOHIS

Abstract The aim of the present study was to confirm the discriminant validity (obtained using traditional statistical methods) of the Early Childhood Oral Health Impact Scale (ECOHIS) between preschool children with and without caries (mean score) through an evaluation of the effect size. A systematic search of electronic databases and a manual search were performed for studies published up to December 2015 involving the use of the ECOHIS for the evaluation of the impact of dental caries on oral health–related quality of life (OHRQoL) among preschool children. Two independent raters performed the selection of the studies and data extraction. Only papers published in English and Spanish were selected. No restrictions were imposed regarding the year of publication. Twelve studies were included, and the magnitude of standardized differences between the means of the “without caries” and “with caries” groups was calculated using Cohen’s d. Most studies demonstrated a large magnitude in the difference between the groups evaluated. The estimate of the effect size confirmed the discriminant validity of the ECOHIS obtained through traditional statistics. Thus, the magnitude of the difference should be considered an important analytical tool for the confirmation of statistical findings regarding null hypotheses and demonstrates the clinical significance of these research results.

Psychological factors and his influence in the oral health of older people: a narrative review / Factores psicológicos y su influencia en la salud oral en el adulto mayor: una revisión narrativa

Abstract: there has been a significant growth in the elderly population of developing countries. This growth leads health systems in those countries to face an increase in consultations for oral diseases for this age group. Therefore, the biopsychosocial approach is essential for healthy aging in the elderly. The objectives of this review article are to identify the psychological factors that have a relationship with most prevalent oral diseases in elderly people (dental caries and periodontal disease), and then describe how tooth loss, the principal consequence of caries and periodontal disease, impacts the mental health of older people. Finally, some proposals for dental work in the elderly are discussed, considering the psychological factors related to oral health.

Resumen: este último tiempo, ha existido un aumento significativo de los adultos mayores en los países en desarrollo. Este aumento lleva a estas naciones a enfrentar un crecimiento en las consultas dentales para este grupo etáreo. Bajo este contexto, es que la aproximación biopsicosocial es esencial para el envejecimiento saludable en la tercera edad. El objetivo de este artículo de revisión sería, en primer lugar, dentificar los factores psicológicos que tienen relación con las enfermedades más prevalentes en el adulto mayor (caries dental y enfermedad periodontal), para luego describir como la pérdida de dientes, principal consecuencia de la caries y enfermedad periodontal, impacta en la salud mental del adulto mayor. Finalmente, se discuten algunas propuestas para el trabajo dental en el adulto mayor, considerando los factores psicológicos relacionados a la salud oral.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

Abstract This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

The impact of the oral condition of children with sickle cell disease on family quality of life

Abstract The aim of this study was to assess the impact of oral conditions of children with sickle cell disease (SCD) on their parents' quality of life (QoL). A cross-sectional study was performed with parents of outpatients suffering from SCD at a hematology referral center in Belo Horizonte, MG. A qualified dentist performed an intraoral exam. The Family Impact Scale (FIS) was used to assess the parents' perception of QoL. The parents answered some questions regarding sociodemographic and medical information about their children. The dmft/DMFT score, DAI, gum bleeding and SCD severity were evaluated in terms of their impacts on the overall mean FIS scores and subscale scores. The chance of more frequent impacts was greater in parents of adolescents (OR = 2.04; 95%CI = 1.2, 3.4) than of younger children. Dental caries (dmft/DMFT ≥ 1) had a negative impact on the QoL of parents of younger children and adolescents (p < 0.05 and p < 0.01, respectively). Among the parents of younger children, dental caries and SCD severity significantly affected the subscales for parental activities (PA) and parental emotions (PE) (p < 0.01, p < 0.05, respectively). Among parents of adolescents, dental caries (DMFT) and severe malocclusion adversely affected the PE and PA subscales (p < 0.01, p < 0.05, respectively). SCD severity affected the overall FIS score among young children's parents (p < 0.05). In conclusion, dental caries, age and SCD severity were associated with a negative impact on the QoL of parents of children with SCD

Parental influence on children's answers to an oral-health-related quality of life questionnaire

Abstract The aim of the study was to evaluate parental influence on children's answers to an oral health-related quality of life (OHRQoL) questionnaire. A cross-sectional study was conducted with a non-probabilistic sample of 84 pairs of 5-year-olds and parents/guardians. The participants were selected from a primary family healthcare center in Campina Grande, Brazil. First, the children and parents answered respective versions of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Seven days later, the children answered their version of the SOHO-5, without the presence of their parents/guardians, and underwent a clinical exam of dental caries, traumatic dental injury and malocclusion, by a previously calibrated researcher. Statistical analysis involved a comparison of mean scores and the calculation of the intraclass correlation coefficient (ICC). Poisson regression models were used to associate the variables (α = 5%). No significant differences were found between the mean SOHO-5 scores of the children when alone or accompanied by parents/guardians (p > 0.05). The ICC between the answers of the children alone or accompanied was 0.84. White spot (PR = 6.32; 95%CI: 1.36 - 29.40) and cavitated lesions (PR = 9.81; 95%CI: 3.22 - 29.85) had an impact on OHRQoL, according to the children's self-report, whereas cavitated lesions (PR = 90.52; 95%CI: 13.26 - 617.74) and anterior open bite (PR = 1.95; 95%IC: 1.07 - 3.53) remained on the final model, according to the parents' version of the SOHO-5. In conclusion, parents did not influence the children's responses, and dental caries are the oral health problem exerting the greatest impact on the children's OHRQoL.