Correlation of the need for orthodontic treatment between the self-perception of chilean adolescents aged 14 to 18 years and the dentist's diagnosis / Correlación de la necesidad de tratamiento ortodóncico entre la autopercepción de adolescentes chilenos de 14 a 18 años con la observación del odontólogo

Background: To correlate the need for orthodontic treatment between the self-perception of Chilean adolescents from 14 to 18 years old with the observation of a dentist using the same assessment scale, as well as to determine if covariates such as gender, age and type of school influence the self-perception of the adolescent and the examiner. Material and Methods: Cross-sectional descriptive study of adolescents aged 14 to 18 years from public, subsidized and private schools in Temuco, Chile. The probability sample is stratified by course, from first to fourth year, a total of 414 students participated, according to the eligibility criteria. The photographic score of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used. The statistical analysis of the data was performed with the SPSS Statistics program v.23. Results: 94.9% of the adolescents perceived themselves as having good aesthetics. The examiner considered that 77% presented this condition, p<0.00. Males perceived themselves better than females. At age 15, 1.7% of students considered themselves to have poor aesthetics, p<0.01. From the examiner's perspective, aesthetics are related to type of school, p<0.00. Conclusion: Adolescents perceive themselves better aesthetically than do the evaluators. The school type factor, according to the IOTN-AC examiner, shows a higher proportion of students with no need for orthodontic treatment in private schools, and a threshold need in municipal and subsidized institutions.

Correlacionar la necesidad de tratamiento ortodóncico, entre la autopercepción de adolescentes con el diagnóstico de un evaluador odontólogo, utilizando la misma escala de valoración, así también determinar si las variables como el género, la edad y la dependencia educacional influyen en la autopercepción del adolescente y la observación del examinador. Material y Métodos: Estudio descriptivo de corte transversal, en adolescentes de 14 a 18 años de escuelas públicas, subvencionadas y privadas de Temuco-Chile. Muestreo probabilístico estratificado por cursos, de primero a cuarto medio con una muestra de 414 estudiantes, según los criterios de elegibilidad. Se utilizó el score fotográfico del componente estético (AC) del Índice de Necesidad de Tratamiento de Ortodoncia (INTO). El análisis estadístico de los datos fue realizado con el programa SPSS Statistics v.23. Resultados: El 94,9% de los adolescentes se autoperciben con una buena estética, el examinador considera que un 77% presenta esta condición, p<0,00. Los varones se perciben mejor que las damas. Los adolescentes de 15 años un 1,7% considera tener mala estética, p<0,01. Desde la perspectiva del examinador la estética se relaciona con la dependencia educacional, <0,01. Conclusión: Los adolescentes se autoperciben mejor estéticamente que lo diagnosticado por evaluadores odontólogos. El factor dependencia educacional según INTO-AC examinador, muestra mayor proporción de estudiantes sin necesidad de tratamiento ortodóncico en los establecimientos privados, y necesidad límite en los públicos y subvencionados.

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.

Unusual case of prolonged breastfeeding in an orthodontic patient: clinical and psychosocial implications / Amamentação prolongada em paciente ortodôntico: implicações clínicas e psicossociais

Case report: This article presents the case of an 11-year-old patient who sought orthodontic treatment, complaining of crooked teeth. In anamnesis, an emotional and physical dependence was reported regarding the act of breastfeeding. Considerations on the diagnosis, psychological implications, and clinical approach in this rare case were addressed. An orthodontic treatment and myofunctional therapy were performed to resolve the occlusal and functional aspects of the patient. Psychological therapy for the child and her mother was required to handle emotional sequelae. Conclusion: Multidisciplinary treatment was prescribed. Dentists should be aware of this need in cases of patients with special characteristics for treatment beyond oral problems. In orthodontics, this may be the difference between effective treatment outcomes or not.

Relato de caso: Este artigo apresenta o caso de uma paciente de 11 anos que procurou tratamento ortodôntico com queixa de "dentes tortos". Na anamnese, foi relatada dependência emocional e física da criança em relação ao ato de amamentar. Considerações sobre diagnóstico, implicações psicológicas, abordagem clínica neste raro caso foram abordadas. Foi realizado tratamento ortodôntico e terapia miofuncional para resolução dos aspectos oclusais e funcionais do paciente. Um acompanhamento psicológico para crianças e sua mãe foi necessária para abordar sequelas emocionais inerentes. Conclusão: Um tratamento multiprofissional foi instituído e o dentista deve estar atento a essa necessidade nos casos de pacientes com características especiais, visando uma abordagem além dos problemas bucais. Na Ortodontia, essa pode ser a diferença entre os resultados eficazes do tratamento ou não.

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.

Crowding of anterior teeth and bullying in schoolchildren / Apiñamiento de dientes anteriores y bullying en escolares

Objective: To compare the crowding of anterior teeth in schoolchildren with and without experience of bullying. Materials and Methods: A prospective, cross-sectional, comparative and observational study was conducted in two educational institutions, one public and one private; The sample consisted of 218 schoolchildren between 11 and 16 years of age. Dental crowding was evaluated in the upper and lower anterior sector using Little's irregularity index. To diagnose bullying, a previously validated questionnaire was applied, with dichotomized questions. The comparison between crowding in patients with and without experience of bullying was evaluated with the U-Mann Whitney statistical test. Results:Statistically significant differences in the amount of crowding (p<0.05) were found. The average crowding for the group subjected to bullying was 11.6 +/- 9.4 mm and in the group without bullying was 9.1+/- 7.9 mm. Conclusion: There was a higher amount of dental crowding in schoolchildren subjected to bullying compared to schoolchildren with no bullying.

Objetivo: Comparar el apiñamiento de dientes anteriores en escolares con y sin experiencia de acoso escolar (bullying). Material y Métodos: Se realizó un estudio prospectivo, transversal, comparativo y observacional en dos instituciones educativas, una pública y otra privada; La muestra estuvo conformada por en 218 escolares entre 11 y 16 años de edad. El apiñamiento dental se evaluó en el sector anterior superior e inferior utilizando el índice de irregularidad de Little. Para diagnosticar acoso escolar, se aplicó un cuestionario validado previamente, con preguntas dicotomizadas. La comparación entre el apiñamiento en pacientes con y sin experiencia de acoso escolar se evaluó con la prueba estadística U-Mann Whitney. Resultados: Se encontraron diferencias estadísticamente significativas la cantidad de apiñamiento (p<0.05). El apiñamiento promedio para el grupo sometido a acoso escolar fue de 11.6 +/- 9.4 mm y en el grupo sin acoso escolar fue de 9.1 +/- 7.9 mm. Conclusion: Hubo un mayor grado de apiñamiento dental en los escolares sometidos al acoso escolar en comparación con los escolares sin acoso escolar.

Association between malocclusion severity and psychosocial issues among adolescents / Asociación entre gravedad de maloclusión y problemas psicosociales en adolescentes

Aim: To evaluate the association between malocclusion severity and psychosocial issues among Brazilian adolescents. Methods: The study sample consisted of 120 adolescents between 11 and 12 years, patients at the Dental School of the Federal University of Minas Gerais. Psychosocial issues were assessed by means of two questions, through which the adolescents were asked about whether a classmate had teased or called them names due to the condition of their teeth, or whether the adolescents had felt upset due to their teeth. The higher the response scores the greater the psychosocial impact. Malocclusion was evaluated with the Dental Aest-hetic. Index, with assignment of individuals to the following sub-groups: mild malocclusion (DAI≤25), moderate malocclusion (DAI=26­30), definite malocclusion (DAI=31­35) and severe malocclusion (DAI≥36). Results: Adolescents' mean age was 11.50 years. The more severe the malocclusion the greater the frequency of episodes of teasing or name-calling because of the condition of the teeth (p=0.010), and the greater the frequency of episodes when the adolescents had felt upset due to their teeth (p=0.001). Individuals with severe malocclusion had a higher frequency of episodes during which they were teased or called names due to the condition of their teeth when compared to individuals with mild malocclusion (p=0.013). Individuals with severe malocclusion had a higher frequency of episodes in which they felt upset due to their teeth when compared to individuals with mild malocclusion (p<0.001), individuals with moderate malocclusion (p=0.002), and those with defined malocclusion (p=0.001). Conclusion: Severe malocclusion was associated with psychosocial issues among adolescents.

Objetivo: Evaluar la asociación entre la gravedad de la maloclusión y los problemas psicosociales en adolescentes brasileños. Métodos: La muestra de estudio consistió en 120 adolescentes entre 11 y 12 años, pacientes de la Escuela de Odontología de la Universidad Federal de Minas Gerais. Los problemas psicosociales se evaluaron mediante dos preguntas, a través de las cuales se preguntó a los adolescentes si un compañero de clase se había burlado de ellos o les habían insultado debido a la condición de sus dientes, o si los adolescentes se habían sentido molestos debido a sus dientes. Cuanto mayor la puntuación de la respuesta, mayor el impacto psicosocial. La maloclusión se evaluó con el Índice de Estética Dental y se asignó los siguientes subgrupos: maloclusión leve (DAI≤25), maloclusión moderada (DAI=26-30), maloclusión definida (DAI=31-35) y maloclusión grave (DAI≥36). Resultados: la edad media de los adolescentes fue de 11,50 años. Cuanto más grave la maloclusión, mayor la frecuencia de episodios de burlas o insultos debido a la condición de los dientes (p=0.010) y mayor la frecuencia de episodios cuando el adolescente se ha sentido molesto debido a sus dientes (p=0.001). Las personas con maloclusión severa tuvieron una mayor frecuencia de episodios durante los cuales fueron objeto de burlas o se les insultó y les dio nombres debido a la condición de sus dientes en comparación con las personas con maloclusión leve (p=0.013). Los individuos con maloclusión severa tuvieron una mayor frecuencia de episodios en los que se sintieron molestos debido a sus dientes en comparación con individuos con maloclusión leve (p<0,001), individuos con maloclusión moderada (p=0,002) y aquellos con maloclusión definida (p=0.001). Conclusión: la maloclusión grave se asoció con problemas psicosociales en adolescentes.

Malocclusion and dental appearance in underprivileged Brazilian adolescents

Abstract Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components.

Impact of malocclusion on the quality of life of children aged 8 to 10 years

ABSTRACT Objective: The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil. Methods: The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study. Results: Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038). Conclusions: Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.

RESUMO Objetivo: o objetivo do presente estudo transversal foi avaliar o impacto da má oclusão na qualidade de vida de crianças na faixa etária de 8 a 10 anos de idade, estudantes de escolas da rede pública da cidade de Belo Horizonte, estado de Minas Gerais, Brasil. Métodos: o instrumento utilizado para medir a qualidade de vida relacionada à saúde bucal foi a versão brasileira do Child Perceptions Questionnaire 8-10 (CPQ8-10). As crianças foram examinadas para diagnóstico de má oclusão utilizando-se o Dental Aesthetic Index (DAI). A análise dos dados foi realizada por meio de estatística descritiva, bivariada e multivariada por meio da regressão de Poisson, com nível de significância de 5%. Participaram do estudo 270 crianças. Resultados: crianças com oclusão normal ou má oclusão leve (DAI ≤25) apresentaram 56% menos probabilidade (IC 95%: 0,258-0,758; p= 0,003) de impacto na qualidade de vida, comparadas com crianças diagnosticadas com má oclusão muito grave (DAI ≥ 36). Crianças com sobressaliência superior anterior ≥ 3 mm apresentaram maiores escores médios de CPQ8-10 (19,4; DP = 17,1) do que aqueles com sobressaliência < 3 mm (13,6; DP=11,7; p= 0,038). Conclusões: a má oclusão muito grave e a sobressaliência superior anterior aumentada se associaram ao impacto negativo na qualidade de vida.

Concerns about dental aesthetics are associated with oral health related quality of life in Southern Brazilian adults / Preocupações sobre a estética dentária com qualidade de vida relacionada à saúde bucal em adultos no sul do Brasil

Abstract It aims to evaluate the association between dental appearance and Oral Health Related Quality of Life. Fifteen primary care services with dental services were selected in Porto Alegre, Brazil. Individuals were interviewed from a random sampling of households in the catchment area of the health centres. The outcome was having an OHIP14 score > 0 (any impact). The main exposures included self-reported tooth colour and position, perception of oral health and concern with dental aesthetics. Data were analysed with stepwise logistic regression. Of 1943 individuals contacted, 433 used public dental services in the last year. Seventy-three percent had some impact on quality of life, 35.2% and 47.5% reported stained and crowded teeth, respectively. Also, 22.2% had already tried bleaching their teeth. Individuals concerned with colour were 2.56 times (95% CI: 1.34-4.89) more likely to report any impact after adjusting for number of teeth, smoking and education. Concerns about tooth position, reporting stained or crowded teeth, age, sex and income were not significant (p > 0.30). There is a direct and independent association between concerns with tooth colour and quality of life. The effect of tooth colour on quality of life may be mediated by individuals' perceptions of aesthetics.

Resumo O objetivo do presente estudo foi avaliar a associação entre a aparência dos dentes com a qualidade de vida relacionada à saúde bucal. Quinze centros de atenção primária com serviços odontológicos foram selecionados em Porto Alegre, Brasil. Os indivíduos foram entrevistados a partir de uma amostragem aleatória de domicílios. O desfecho avaliado foi ter um escore de OHIP14 > 0. As exposições foram: cor e posição autorreferida dos dentes, percepção da saúde bucal e preocupação com a estética dental. Os dados foram analisados com regressão logística. De 1.943 indivíduos contatados, 433 utilizaram os serviços públicos odontológicos, dos quais 73% tinham algum impacto na qualidade de vida; 35,2% dentes manchados e 47,5% dentes apinhados. Além disso, 22,2% já haviam tentado clarear os dentes. Indivíduos preocupados com a cor tinham 2,56 vezes (IC 95%: 1.34-4.89) mais chances de relatar qualquer impacto após o ajuste para número de dentes, tabagismo e educação. Preocupações com a posição dos dentes, relato de dentes manchados ou apinhados, idade, sexo e renda não foram significativas (p > 0,30). Houve uma associação direta e independente entre as preocupações com a cor do dente e qualidade de vida. O efeito da cor do dente pode ser mediado pela percepção da estética.

Malocclusion impacts the quality of life of Peruvian school children: a cross-sectional study

OBJECTIVE: To assess the impact of malocclusion considering the orthodontic treatment need (IOTN) on the oral health related quality of life evaluated with the Child Perceptions Questionnaire in students aged 11 to 14 years (CPQ 11-14 ) of the Peruvian public schools in the city of Juliaca. MATERIALS AND METHODS: A cross-sectional study was performed. The sample included 354 students. The data were obtained from the tool of self-perception using the aesthetic component (AC) and the oral health component (DHC) from the IOTN, and the CPQ 11-14. For the data analysis the Kruskal Wallis test was used (p<0.05). RESULTS: The value of the impact on the quality of life was higher in the dimension moderate treatment need with 56.08; followed by need for treatment with 55.56 (p<0.001). CONCLUSION: Malocclusion affects the quality of life of students aged 11 to 14 years in Peruvian public schools of the city of Juliaca.

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.

Impact of oral health on the quality of life of young people in confinement, Córdoba, Argentina: a mixed methods study

Introduction: quality of life can be understood as the perception subjects have of their position in life in relation to their goals, expectations and concerns. Measuring and understanding the impact of oral health on the quality of life of people may contribute to the promotion of health and prevention of disease. The aim of this study was to evaluate the impact of oral health on the quality of life of young people in confinement. Methodology: Cross-sectional study with mixed approach. Adolescents between 14 and 18 years of age, confined in socio-educational juvenile detention centers in the Province of Córdoba, Argentina, were included in the study. After signing of informed consent, the OHIP-49 questionnaire was applied to 70 youngsters and 32 semi-structured interviews were conducted. Results: The OHIP-49 had a mean of 53.37 +/- 28.77, the dimensions with more impact were: functional limitation, physical pain and psychological discomfort. Confinement emerges as an amplifier of sensations and as a barrier for accessing palliative care. Regarding aesthetic aspects, subjects reported specific discomfort that does not always interfere with their self-esteem or relationship with peers. Conclusions: Young people perceive the impact of oral health on their quality of life from episodes of suffering, although not only because of pain, but also for aesthetic reasons. Confinement creates a particular context for sensations and resolutions on health-disease-care processes regarding oral health.

AVALIAÇÃO OBJETIVA E SUBJETIVA DA NECESSIDADE DE TRATAMENTO ORTODÔNTICO DO ADOLESCENTE E SEU IMPACTO SOBRE A AUTOESTIMA / OBJECTIVE AND SUBJECTIVE EVALUATION OF ADOLESCENT'S ORTHODONTIC TREATMENT NEEDS AND THEIR IMPACT ON SELF-ESTEEM

RESUMO Objetivo: Verificar a presença de associação entre a avaliação objetiva e subjetiva da necessidade de tratamento ortodôntico em adolescentes e seu impacto na autoestima. Métodos: Estudo transversal com adolescentes de 10 a 17 anos da cidade de Sri Ganganagar, Rajastão, Índia. Foi utilizado o Índice de Ortodontia de Saúde Dental (IOTN) para avaliar de modo objetivo a necessidade de tratamento (DHC) e o componente estético desse índice (AC) para a avaliação subjetiva. Os estudantes selecionados foram também avaliados quanto a traumatismos dentários, perda dentária e cárie dentária. Aplicou-se a escala de autoestima de Rosenberg para determinar o nível de autoestima dos estudantes. Os dados foram analisados por regressão linear múltipla, testando a associação individual das diferentes variáveis clínicas independentemente da autoestima dos adolescentes, de acordo com o escore da escala de Rosenberg. Resultados: Entre 1.140 adolescentes estudados, a prevalência da necessidade de tratamento ortodôntico avaliado de modo objetivo pelo IOTN-DHC ocorreu em 56,9% dos indivíduos. A avaliação subjetiva do adolescente (IOTN-AC) revelou prevalência de necessidade de tratamento de 53,3%. A análise multivariada mostrou que, além de todos os problemas dentários, o componente objetivo (IOTN-DHC), seguido do componente estético subjetivo (IOTN-AC), teve maior impacto na autoestima dos estudantes analisados. Conclusões: A insatisfação com a aparência dental é um forte preditor de baixa autoestima na adolescência.

ABSTRACT Objective: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Methods: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Results: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Conclusions: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence.

Perception of parents and caregivers regarding the impact of malocclusion on adolescents' quality of life: a cross-sectional study

ABSTRACT Objective: The objective of this article was to assess the perception of parents and caregivers regarding the impact of malocclusion on adolescents’ oral health -related quality of life (OHRQoL). Methods: This cross-sectional study consisted of a sample of 280 parents/caregivers of 11 and 12-year-old adolescents who answered the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Parent-assessed quality of life of adolescents was the dependent variable. The main independent variable was adolescents’ malocclusion which was diagnosed by means of the Dental Aesthetic Index (DAI). Based on DAI cut-off points, adolescents were classified into four grades of malocclusion, with different orthodontic treatment recommendations assigned to each grade: no need/slight treatment need, elective treatment, highly desirable treatment and mandatory treatment. Adolescents’ age and sex, as well as family monthly income, were considered as confounding variables. Statistical analysis involved descriptive statistics, bivariate analyses, and Poisson regression with robust variance. Results: Of the 280 parents/caregivers initially accepted in this study, 18 refused to answer the P-CPQ. Therefore, 262 individuals participated in this assessment, providing a response rate of 93.5%. The severity of adolescents’ malocclusion was significantly associated with a higher negative impact on parents’/caregivers’ perception on the oral symptoms (p< 0.05), functional limitations (p < 0.001), emotional well-being (p < 0.001), and social well-being (p < 0.001) subscale scores as well as on the overall P-CPQ score (p < 0.001), even after having been adjusted for the controlling variables. Conclusions: Parents/caregivers reported a negative impact of malocclusion on adolescents’ OHRQoL. Increased severity of malocclusion is associated with higher adverse impact on OHRQoL.

RESUMO Objetivo: o objetivo deste artigo foi avaliar a percepção de pais/cuidadores com relação ao impacto da má oclusão na qualidade de vida relacionada à saúde bucal (QVRSB) de adolescentes. Métodos: este estudo transversal consistiu de uma amostra de 280 pais/cuidadores de adolescentes com 11 a 12 anos que responderam o Parental-Caregiver Perceptions Questionnaire (P-CPQ). A percepção de pais/cuidadores com relação à qualidade de vida dos adolescentes foi considerada a variável dependente. A variável independente principal foi a má oclusão dos adolescentes, que foi diagnosticada por meio do Índice Estético Dental (IED). Com base nos pontos de corte do IED, os adolescentes foram classificados em quatro categorias de má oclusão, com diferentes recomendações de tratamento ortodôntico atribuídas a cada uma dessas categorias: sem necessidade ou com leve necessidade de tratamento; tratamento eletivo; tratamento altamente desejável; e tratamento obrigatório. A idade e o sexo dos adolescentes e a renda familiar mensal foram consideradas variáveis de confusão. A análise estatística envolveu estatística descritiva, análise bivariada e regressão de Poisson com variância robusta. Resultados: dos 280 pais/cuidadores inicialmente aceitos nesse estudo, 18 se recusaram a responder ao P-CPQ. Portanto, 262 indivíduos participaram dessa avaliação, resultando em uma taxa de resposta de 93,5%. A gravidade da má oclusão dos adolescentes foi significativamente associada com um impacto mais negativo na percepção de pais / cuidadores nas subescalas sintomas bucais (p < 0,05), limitações funcionais (p < 0,001), bem-estar emocional (p < 0,001) e bem-estar social (p< 0,001), mesmo após o ajuste para as variáveis de confusão. Conclusões: os pais/cuidadores relataram um impacto negativo da má oclusão na QVRSB dos adolescentes. Quanto mais grave a má oclusão, mais adverso é o impacto dessa condição na QVRSB.

Validity of the Psychosocial Impact of Dental Aesthetics Questionnaire for use on Brazilian adolescents

ABSTRACT Introduction: The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a multi-item psychometric instrument used to assess patients' perspective of the impact specifically related to Orthodontics. The cross-culturally adapted Brazilian version of the PIDAQ has demonstrated good reliability, validity and acceptability. Objective: The aim of the present study was to test the validity and reliability of the Brazilian version of the PIDAQ for use among adolescents aged between 11 and 14 years old. Methods: Having established the possibility of maintaining the operational characteristics of the Brazilian version of PIDAQ for the target age group, 194 individuals in the city of Belo Horizonte, Brazil, completed the questionnaire. The subjects were examined for the presence/absence of malocclusion based on the criteria of the Dental Aesthetic Index (DAI) to test discriminant validity. Internal consistency was measured by means of Cronbach's alpha coefficient which ranged from 0.59 to 0.86 for the subscales. Test-retest reliability was assessed by means of intraclass correlation coefficient which ranged from 0.54 to 0.89 for aesthetic concern and psychological impact. Results: Discriminant validity revealed that subjects without malocclusion had different PIDAQ scores in comparison to those with malocclusion. Conclusion: These findings suggest that the Brazilian version of PIDAQ for adolescents has satisfactory psychometric properties and is applicable to this age group in Brazil.

RESUMO Introdução: o Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) é um instrumento psicométrico utilizado para avaliar a qualidade de vida relacionada à saúde bucal (QVSB), especificamente no que diz respeito à má oclusão do paciente. A versão brasileira adaptada culturalmente do PIDAQ demonstrou boa confiabilidade, validade e aceitabilidade. Objetivo: o objetivo do presente estudo foi verificar a validade e confiabilidade da versão brasileira do PIDAQ para uso em adolescentes brasileiros na faixa etária de 11 a 14 anos. Métodos: tendo-se estabelecido a possibilidade de manter a versão brasileira do PIDAQ que havia sido validada, esse questionário foi aplicado em 194 indivíduos, da faixa etária-alvo, residentes na cidade de Belo Horizonte, Brasil. Para testar a validade discriminante, os adolescentes foram examinados quanto à presença ou ausência de má oclusão, com base nos critérios do Dental Aesthetic Index (DAI). A confiabilidade foi medida pela consistência interna do instrumento (alfa de Cronbach = 0,59-0,86) e pelo teste-reteste, por meio do coeficiente de correlação intraclasse (ICC), que apresentou valores superiores a 0,8 para os domínios autoconfiança, impacto social e impacto psicológico, o que indica uma concordância satisfatória entre as avaliações. Resultados: a validade discriminante revelou uma diferença estatisticamente significativa entre os escores médios para os domínios de autoconfiança dentária e impacto psicológico, entre os grupos com e sem má oclusão. Conclusão: esses resultados sugerem que a versão brasileira do PIDAQ para adolescentes tem propriedades psicométricas satisfatórias e é aplicável a esse grupo etário no Brasil.

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.

Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting.Methods:Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID).Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score.Conclusion:Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances.

Objetivo: avaliar as percepções de pais e cuidadores com relação à qualidade de vida de adolescentes durante os primeiros 12 meses de tratamento ortodôntico com aparelhos fixos, e examinar as propriedades técnicas da versão brasileira do questionário Parental-Caregiver Perceptions Questionnaire(P-CPQ) no cenário ortodôntico.Métodos:dados de uma amostra de 96 pais e cuidadores de adolescentes em tratamento ortodôntico com aparelhos fixos foram coletados através do questionário P-CPQ. As avaliações foram realizadas antes da bandagem e colagem de braquetes (T1) e 12 meses após a colocação do aparelho fixo (T2). A análise estatística incluiu o teste Wilcoxon signed rankpara o escore total do P-CPQ e a correção de Bonferroni para as subescalas do questionário. As propriedades técnicas do P-CPQ foram examinadas por meio do cálculo da responsividade e da mínima diferença clinicamente importante (MDCI).Resultados:dos 96 participantes, 76 eram mães de pacientes, 16 eram pais e 4 possuíam outra relação familiar. A idade média dos adolescentes foi de 11,49 ± 0,50 anos. A maioria das famílias tinha uma renda mensal igual ou menor a três salários mínimos brasileiros. Houve uma melhora significativa nas subescalas de bem-estar emocional e bem-estar social, que contribuíram para uma melhora do escore total de qualidade de vida (p< 0,001). As reduções dos escores do P-CPQ foram associadas com alterações clinicamente moderadas para o escore total e para as subescalas de bem-estar emocional e bem-estar social. A MDCI para o escore total do P-CPQ foi de 6,16.Conclusões: pais e cuidadores relataram uma melhora significativa na qualidade de vida de adolescentes em tratamento ortodôntico com aparelhos fixos.

Influence of occlusal plane inclination and mandibular deviation on esthetics

Objective:The aim of this study was to assess the degree of perception of occlusal plane inclination and mandibular deviation in facial esthetics, assessed by laypeople, dentists and orthodontists.Methods:A woman with 5.88° of inclination and 5.54 mm of mandibular deviation was selected and, based on her original photograph, four new images were created correcting the deviations and creating more symmetric faces and smiles. Examiners assessed the images by means of a questionnaire. Their opinions were compared by qualitative and quantitative analyses.Results:A total of 45 laypeople, 27 dentists and 31 orthodontists filled out the questionnaires. All groups were able to perceive the asymmetry; however, orthodontists were more sensitive, identifying asymmetries as from 4.32° of occlusal plane inclination and 4.155 mm of mandibular deviation (p< 0.05). The other categories of evaluators identified asymmetries and assigned significantly lower grades, starting from 5.88° of occlusal plane inclination and 5.54 mm of mandibular deviation (p< 0.05).Conclusion:Occlusal plane inclination and mandibular deviation were perceived by all groups, but orthodontists presented higher perception of deviations.

Objetivo: o objetivo do presente estudo foi avaliar o grau de percepção, de leigos, dentistas e ortodontistas, quanto à influência das inclinações do plano oclusal e dos desvios mandibulares na estética facial.Métodos:uma mulher com 5,88o de desvio do plano oclusal e 5,54mm de desvio mandibular foi selecionada. A partir de sua fotografia original, quatro novas imagens foram criadas, corrigindo os desvios e criando rostos e sorrisos mais simétricos. Os examinadores avaliaram as imagens por meio de um questionário, sendo realizadas análises qualitativas e quantitativas.Resultados:45 leigos, 27 dentistas e 31 ortodontistas preencheram os questionários. Todos os grupos foram capazes de perceber a assimetria, no entanto, os ortodontistas foram mais sensíveis, sendo capazes de perceber a assimetria de 4,32o de inclinação do plano oclusal e 4,155mm de desvio mandibular (p > 0,05). Os demais avaliadores perceberam a assimetria apenas a partir de 5,88o de desvio do plano oclusal e 5,54mm de desvio mandibular (p > 0,05).Conclusão:inclinações do plano oclusal e desvios mandibulares foram percebidos por todos os grupos, mas os ortodontistas apresentaram maior sensibilidade aos desvios.