Relação entre a condição bucal de gestantes internadas e desfechos adversos na gestação / Relationship between the oral condition of hospitalized pregnant women and adverse pregnancy outcomes

Objetivo: avaliar se a condição bucal favoreceu a presença de desfechos adversos da gestação (DAG) em mulheres internadas e acompanhadas em um hospital escola. Métodos: um estudo de coorte retrospectiva com mulheres grávidas que foram internadas entre setembro de 2019 e início de março de 2020 e que continuaram o acompanhamento obstétrico. Resultados: Das 65 gestantes que seguiram acompanhamento, 27 (41,5%) dos bebês nasceram pré-termo e 20 (30,8%) com baixo peso, sendo que as duas condições estavam presentes em 15 crianças (23,1%), sendo significantemente relacionadas com a menor semana gestacional na internação. Ao relacionar diferentes fatores com o desfecho pré-termo, houve diferença significante em gestantes com a ocupação "do lar" e com o tempo de internação igual ou maior que 10 dias e com a presença de baixo peso ao nascer. Não foi observada relação dos dados avaliados da condição bucal das gestantes na internação com o parto pré-termo. Conclusões: Gestantes que necessitam de internação hospitalar durante a gravidez, independente da condição bucal, aumentam a possibilidade de apresentarem DAG, sendo fundamental a realização do correto acompanhamento pré-natal.(AU)

Objective: to assess whether the oral condition favored the presence of adverse effects during pregnancy in pregnant women hospitalized and followed up at a teaching hospital. Methods: a retrospective cohort study with mothers who were hospitalized during pregnancy between September 2019 and early March 2020 and who continued obstetric follow-up. Results: 83 pregnant women were interviewed and 65 were followed up Of the 65 pregnant women who followed up, 27 (41.5%) of the babies were born preterm and 20 (30.8%) with low birth weight, and both conditions were present in 15 children (23.1%), being significantly related to the shortest gestational week at admission. When relating different factors with the preterm outcome, there was a significant difference in pregnant women with the occupation "housewife" and with the length of hospital stay equal to or greater than 10 days and with the presence of low birth weight. There was no relationship between the evaluated data on the oral condition of pregnant women during hospitalization and preterm delivery. Conclusions: Pregnant women who require hospitalization during pregnancy, regardless of oral condition, increase the possibility of having negative pregnancy outcomes, and correct prenatal care is essential. (AU)

A internação da gestante pode afetar a condição bucal do filho no terceiro ano de vida? / Can a pregnant woman's hospitalization affect the child's oral condition in the third year of life?

Objetivo: Avaliar se a hospitalização na gestação pode influenciar na condição bucal do filho no terceiro ano de vida. Métodos: Estudo longitudinal com bebês de gestantes internadas e acompanhadas no setor da Obstetrícia de um Hospital Escola em Pelotas, RS, Brasil. Os dados referentes a hospitalização e ao parto foram coletados do prontuário hospitalar e no terceiro de vida do filho (a) de um questionário aplicado a mãe e do exame bucal da criança. Cada agravo bucal foi avaliado com critérios específicos, por uma examinadora calibrada e analisado no programa IBM SPSS Statistics com 5% de nível de significância. Resultados: Participaram 20 díades mãe-filho (a). Alterações da oclusão acometeram 95% das crianças, sendo a mordida aberta anterior (MAA) a principal. Ainda, 25% das crianças apresentaram opacidades demarcas e/ou hipoplasia do esmalte, sendo significativamente maior em filhos de mães mais jovens e 20% tinham cárie da primeira infância (CPI), estando relacionada à ausência de creme dental fluoretado e à qualidade da higiene bucal. Conclusão: O reflexo mais evidente da hospitalização na gestação na saúde bucal no terceiro ano de vida do filho (a) foi a oclusão alterada, especialmente a MAA.(AU)

Objective: To assess whether hospitalization during pregnancy can influence the child's oral condition in the third year of life. Methods: Longitudinal study with babies of pregnant women hospitalized and followed up in the Obstetrics sector of a Teaching Hospital in Pelotas, RS, Brazil. Data referring to hospitalization and childbirth were collected from the hospital records and in the child's third of life through a questionnaire applied to the mother and the child's oral examination. Each oral condition was evaluated with specific criteria, by a calibrated examiner and analyzed in the IBM SPSS Statistics program with a 5% minimum significance level. Results: 20 mother-child participated. Occlusion alterations affected 95% of the children, with anterior open bite (AOB) being the main. Still, 25% of the children had opacities and/or enamel hypoplasia, which was significantly higher in children of younger mothers, and 20% had early childhood caries, which is related to the absence of fluoride toothpaste and the quality of oral hygiene. Conclusion: The clearest reflection of hospitalization during pregnancy on oral health in the third year of the child's life was altered occlusion, especially the AOB.(AU)

Agreement between schoolchildren and their parents on rating the child's oral health-related quality of life

Abstract The perceptions of parents/caregivers regarding their children's oral health can influence the standard of care and decision-making regarding oral health. The children's perspective on their own oral health-related quality of life (OHRQoL) may differ from the parents/caregivers' views. This cross-sectional study aimed to analyze the agreement between the perceptions of parents/caregivers and schoolchildren regarding OHRQoL. It was conducted with a sample of children between 8 and 11 years old and their parents/caregivers from Pelotas. Children answered the Child Perceptions Questionnaire 8-10 (CPQ), and parents/caregivers answered the short form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Socioeconomic data were also collected. Children's dental caries, traumatic dental injuries, and malocclusions were examined. The Spearman's correlation test was performed. A total of 119 parents/caregivers-children pairs were included. There was an agreement between the total scores of parents/caregivers and children (0.2770; p = 0.003), in the oral symptoms (0.1907; p = 0.038), and functional limitations (0.2233; p=0.015) domains. The Bland-Altman graph showed an agreement between children's and parents/caregivers' OHRQoL total score, but there was an underestimation of approximately two points in the parents/caregivers' perception compared to the children's score. There was an agreement between the reports of parents/caregivers and children regarding children's OHRQoL.

Translation and cultural adaptation of the Illness Perception Questionnaire-Revised for Dental to Brazil

Abstract This study aimed to translate and to perform the cultural adaptation of the instrument Illness Perception Questionnaire-Revised for Dental (IPQ-RD) into Brazilian Portuguese. The IPQ-RD consists of 34 items that assess the cognitive and emotional representation/perception of parents/caregivers of children with dental caries, with response options on a 5-point Likert scale, ranging from "Strongly agree" (score 1) to "Strongly disagree" (score 5). The higher the score, the lower the perception of the disease. The protocol consists of translation into Brazilian Portuguese, back-translation into English, revision by an Expert Review Committee, and pre-test (application in parents/caregivers of children in dental care). For some questions, the translated versions were identical (T1 = T2); for others, one version was preferred (T1 or T2); for still others, it was decided to modify terms to obtain greater clarity on the item (T3). In the first pre-test, three questions were misunderstood by more than 15% of the sample, after which the items were reviewed by the Expert Review Committee. In the second pre-test, the adapted version was applied to a new sample of parents/caregivers (n = 15) and the questions were understood by more than 85% of the participants. The Brazilian Portuguese version of the IPQ-RD was well understood by the evaluated population.

Translation and Cultural Adaptation of the Modified Child Dental Anxiety Scale - Faces (MCDASf) into Brazilian Portuguese

Abstract Objective: To translate and culturally adapt the Modified Child Dental Anxiety Scale - Faces (MCDASf) into Brazilian Portuguese. Material and Methods: The MCDASf consists of eight questions about anxiety toward dental procedures that are answered on a five-point Likert scale ranging from "not worried" (1 point) to "very worried" (5 points). The answers correspond to a scale of face drawings ranging from extremely negative to extremely positive. The process consisted of initial translation, back-translation, expert committee review, and pretesting. Results: The first revised version was applied to 32 children aged 5 to 12 years, 16 from the city of Governador Valadares, Brazil (southeastern region) and 16 from the city of Pelotas, Brazil (southern region). In the first pretest, Item 5 was misunderstood by 6.25% of children in the southern region; Item 6 by 6.25% in both regions; Items 7 and 8 by 87.5% and 100% of those from the southeastern region, respectively, and by 12.5% and 25% of those from the southern region, respectively. Items 7 and 8 were modified by the expert committee, and the second revised version was applied to 32 children, 16 from each region. The only misunderstood items were 4 and 5, both by a 7-year-old boy in Governador Valadares. Conclusion: The Brazilian Portuguese version of the MCDASf was well understood by the sample of children (AU).

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study / Lesões dentárias traumáticas na dentição decídua e sequelas na dentição permanente: um estudo retrospectivo de 7 anos

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can cause sequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primary dentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil. Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental records over 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-two patients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and in the 2 to 4-year age group (44.10%); most injuries occurred from fall from the child's own height (40.30%) and at home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinical and radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding the permanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion:According to this study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The major type of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is important to the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.(AU)

Objetivo: Lesões dentárias traumáticas (TDIs) afetam a estética e a função dos dentes decíduos e podem causar sequelas em sucessores permanentes. Este estudo avaliou a distribuição das TDIs e sequelas na dentição decídua e sua respectiva dentição permanente em crianças atendidas no Centro de Trauma Odontológico no Brasil. Material e Métodos: Trata-se de um estudo transversal realizado por meio da coleta de dados de 256 prontuários odontológicos ao longo de 7 anos. Foram utilizadas análises estatísticas descritivas e teste exato de Fisher (p <0,05). Resultados:Sessenta e dois pacientes apresentaram trauma na dentição decídua. As TDIs foram observadas principalmente em meninos (64,50%) e na faixa etária de 2 a 4 anos (44,10%); a maioria das lesões ocorreu por queda da própria altura (40,30%) e em casa (71,20%). O tipo de trauma mais comum foi a subluxação (22,90%). As sequelas clínicas e radiográficas mais prevalentes foram mobilidade (45,60%) e lesão periapical (31,80%), respectivamente. Em relação à dentição permanente, a sequela mais frequente foi a hipomineralização (33,30%). Conclusão: De acordo com este estudo, as TDIs em dentes decíduos foram de 29,24% de todos os casos do Programa de Trauma Dental. O principal tipo de trauma em crianças foi a subluxação, com sequelas em ambas as dentições. O acompanhamento após o trauma é importante para a manutenção da dentição decídua e para prevenir e tratar possíveis sequelas na dentição permanente. (AU)

Medo odontológico e saúde bucal: avaliação transversal do ciclo do medo entre universitários brasileiros / Dental fear and oral health: cross-sectional evaluation of the cycle of dental fear theory among Brazilian undergraduate students

Objetivo: Avaliar a presença do medo odontológico em universitários brasileiros e observar se a teoria do ciclo vicioso do medo é identificada nesta população. Materiais e métodos: Foi realizado um estudo transversal com universitários ingressantes na Universidade Federal de Pelotas em 2016. Os dados sociodemográficos, medo odontológico, o uso de serviços odontológicos, a percepção de cárie e dor dentária foram coletados através de um questionário auto--administrado. A exposição do estudo foi medo odontológico, e os desfechos incluíram padrão de consulta odontológica, experiência de cárie e dor dentária e autopercepção de saúde bucal. Características sociodemográficas foram incluídas como fatores de confusão. Para testar a associação do medo odontológico com os desfechos, foram utilizados modelos de regressão de Poisson com variância robusta, a fim de estimar as Razões de Prevalência e Intervalos de Confiança. Resultados: Foram avaliados 2.014 universitários, dos quais 22.4% reportaram medo odontológico. Aqueles que reportaram medo odontológico apresentaram uma maior prevalência de não terem ido ao dentista no último ano e, entre os que consultaram, a visita ter sido motivada por dor/problema. Adicionalmente, ter medo aumentou a presença de cárie, dor dentária e autorrelato da saúde bucal negativa. Discussão: Os achados sugerem a presença do ciclo vicioso do medo nesta população de universitários do sul do Brasil. Conclusão: Evidenciou-se a associação entre a presença de medo odontológico e a menor procura por atendimento odontológico, a presença de cárie dentária, dor dentária e saúde bucal autorreportada negativa, corroborando com a teoria do ciclo do medo.

Aim: To evaluate the presence of dental fear among Brazilian undergraduate students and to observe whether the cycle of dental fear theory applies to this population. Materials and methods: A cross-sectional study were conducted with first year students of the Federal University of Pelotas, Brazil, in 2016. Sociodemographic data, dental fear, as well as the use of dental services and perception of caries and dental pain were collected through a self-administered questionnaire. The exposure was dental fear, and the outcomes included dental visit pattern, experience of dental caries and dental fear and self-rated oral health (SROH). Sociodemographic characteristics were included as aconfounding factor. To test the association between dental fear and the outcomes, Poisson regression models with robust variance were used, to estimate Prevalence Rations and Confidence Intervals. Results: 2,014 undergraduate students were evaluated and 22.4% of them reported dental fear. Those who reported dental fear had a higher prevalence of not visiting the dentist in the last year and, among those who visited, to have had only a pain/problem-oriented visit. Additionally, having fear increased the presence of dental caries, dental pain and negative SROH. Discussion: Our findings suggest the presence of the vicious cycle of dental fear in this population of undergraduate students in southern Brazil. Conclusion: This study provided evidence on the association between dental fear and the lower frequency of dental visit, dental caries, dental pain experience and negative SROH, corroborating with the cycle of dental fear theory.

Relação da condição de cárie da criança com experiência de cárie da mãe / Relationship between the child's caries status and the mother's caries experience

Objetivo: verificar a relação da condição de cárie da criança com a experiência autopercebida de cárie da mãe através de um estudo observacional transversal. Métodos: O estudo foi realizado na Faculdade de Odontologia da Universidade Federal de Pelotas com crianças entre 8 e 11 anos e suas mães. A amostra contou com 105 pares mãe-filho. Os responsáveis responderam um questionário relacionado à situação socioeconômica e demográfica, a mãe respondeu sobre sua saúde bucal: experiência de cárie (restauração ou dente cariado e perda dentária por cárie). Nas crianças os desfechos foram avaliados através de exame clínico com a soma de dentes decíduos e permanentes cariados, perdidos e obturados (ceod/CPOD) e para severidade de cárie foi utilizado Significant Caries Index (SiC), ceod/CPOD≥3. Para testar a associação entre as variáveis relacionadas à mãe e o desfecho severidade de cárie foi realizado o teste Qui-quadrado, para média de cárie na criança (ceod/CPOD) foi utilizado o Teste Mann-Whitney. Resultados: Com relação à severidade de cárie não foi encontrada associação estatisticamente significante. A média do ceod/CPOD foi quase três vezes maior nas crianças cujas mães relataram que haviam tido ou estavam com algum dente cariado ou restaurado em função da cárie em comparação àquelas que não relataram esta experiência. As mães mais jovens apresentaram filhos com maior média de cárie do que as mães mais velhas. Conclusão: Entre as crianças atendidas neste serviço existe uma relação de uma maior média de cárie nas crianças com cujas mães tem ou tiveram experiência de cárie e mais jovens.(AU)

Objective: to verify the relationship between the child's caries condition and the mother's self-perceived caries experience through a cross-sectional observational study. Methods: The study was carried out at the Faculty of Dentistry of the Federal University of Pelotas with children between 8 and 11 years old and their mothers. The sample had 105 mother-child pairs. The guardians answered a questionnaire related to the socioeconomic and demographic situation, the mother answered about her oral health: caries experience (restoration or decayed tooth and tooth loss due to caries). In children, the outcomes were evaluated through clinical examination with the sum of decayed, missing and filled deciduous and permanent teeth (DMFT/DMFT) and for caries severity we used the Significant Caries Index (SiC), DMFT/DMFT≥3. To test the association between the variables related to the mother and the outcome of caries severity, the Chi-square test was performed, for mean caries in children (dmft/DMFT) the Mann-Whitney Test was used. Results: Regarding caries severity, no statistically significant association was found. The mean dmft/DMFT was almost three times higher in children whose mothers reported that they had had or had a decayed or restored tooth due to caries compared to those who did not report this experience. Younger mothers had children with a higher average of caries than older mothers. Conclusion: Among the children assisted in this service, there is a relation of a higher average of caries in children whose mothers have or had caries experience and younger.(AU)

Tabus e mitos da atenção odontológica na gestação: um estudo observacional de base hospitalar / Taboos and myths for the dental care during pregnancy: an observational study with a hospital basis

Objetivo: avaliar gestantes internadas no setor de obstetrícia do Hospital Escola da UFPel quanto à necessidade de receber atendimento odontológico de urgência, ao conhecimento a respeito do atendimento durante a gravidez e de como prevenir a doença cárie dentária em seus filhos. Método: este estudo observacional, de base hospitalar e transversal, foi conduzido a partir de instrumento contendo uma entrevista e uma avaliação bucal de 83 gestantes. Os dados foram coletados junto ao leito por dois residentes treinados e avaliados pelo Teste Exato de Fisher e por análise multivariada, com Regressão de Poisson e variância robusta. Resultados: a média de idade das gestantes foi de 28,7 anos, sendo que 31,3% relataram dor dentária, estando relacionada à atividade de cárie e à busca de atendimento odontológico nos últimos 6 meses. Das gestantes avaliadas, 66,2% apresentaram, pelo menos, um tabu ou mito, sendo que realizar tratamento endodôntico foi o mais prevalente. Realizar pré-natal reduziu a presença de tabus ou mitos. Apenas 7,2% das mulheres demonstraram ter conhecimento de como prevenir a doença cárie dentária no filho, sendo significativamente maior nas donas de casa e nas que receberam orientação prévia. Conclusão: o pré-natal favoreceu a redução da presença de tabus e mitos da odontologia na gestação. O cirurgião-dentista tem um papel importante na condução do pré-natal odontológico, para evitar e tratar as odontalgias na gestação e orientar sobre a saúde bucal dos filhos, efetivando a atenção odontológica nos mil dias da criança.(AU)

Evaluate pregnant women admitted to the Obstetrics department at UFPel School Hospital regarding the need to receive urgent dental care, knowledge about this care during pregnancy and how to prevent dental caries in Their child. Method: This observational, hospital-based and cross-sectional study was conducted using an instrument containing an interview and an assessment of the oral cavity of 83 pregnant women. The data were collected at the bedside by trained residents and evaluated by Fisher's exact test and multivariate analysis, using Poisson Regression with robust variance. Results: The average age of the pregnant women was 28.7 years, with 31.3% reporting dental pain, being related to dental caries and dental care-seeking in the last 6 months. Of the pregnant women evaluated, 66.2% had at least one taboo or myth, and endodontic treatment was more prevalent. Prenatal care reduced the presence of taboos or myths. Only 7.2% of women demonstrated knowledge of how to prevent dental caries disease in their child, being significantly higher in housewives and those who received prior guidance. Conclusion: Prenatal care favored the reduction of the presence of taboos and myths about dentistry during pregnancy. The dentist has an important role in the conduction of dental prenatal care, to prevent and treat toothache during pregnancy and to advise on the oral health of their child, providing dental care in the child's first thousand days.(AU)

Condição bucal de mulheres com diabetes mellitus gestacional internadas em um hospital escola no sul do Brasil / Oral condition of women with gestational diabetes mellitus admitted in a school hospital in southern Brazil

Objetivo: avaliar a condição bucal de mulheres com diabetes mellitus gestacional (DMG) internadas no Hospital Escola (HE) da Universidade Federal de Pelotas (UFPel). Métodos: trata-se de um estudo transversal retrospectivo de base hospitalar, em que dois residentes treinados realizaram a coleta dos dados por meio da avaliação dos prontuários médicos e odontológicos, no período de setembro de 2019 a março de 2020. Os dados socioeconômicos e demográficos e o diagnóstico de DMG foram coletados dos prontuários médicos, enquanto hábitos e condição bucal, dos prontuários odontológicos. A análise dos dados foi realizada no programa Stata 11.0, usando os testes Exato de Fisher e Regressão de Poisson. Resultados: foram avaliados os prontuários de 83 gestantes, destas, 37 (44,6%) apresentavam DMG. A presença de DMG esteve asso-ciada com as gestantes de maior faixa etária (62,2%) e no terceiro trimestre de gestação. Em sua maioria, tinham renda de até dois salários mínimos, eram solteiras, tinham filhos e realizaram pré-natal. Em relação à avaliação bucal, apenas a presença de cálculo dental e inflamação gengival foi estatisticamente associada à presença de DMG (p= 0,030 e 0,014 respectivamente). A autopercepção do sorriso foi considerada ruim por 40,5%, e a maioria teve dentes perdidos por cárie (64,9%). Conclusões: a prevalência de DMG foi alta entre as gestantes internadas, sendo maior em mulheres de mais idade. Presença de cálculo dental e inflamação gengival foram fortemente associadas à presença de DMG, enquanto hábitos bucais e presença de cárie não apresentaram associação. Novas pesquisas, com exames periodontais completos, são necessárias para verifi-car as condições periodontais dessas mulheres.(AU)

Aim: to assess the oral condition of women with Gestacional Diabetes Mellitus (GDM) admitted in a School Hospital (HE)/UFPel. Methods: medical and dental records, from September 2019 to March 2020, were evaluated in this hospital-based retrospective cross-sectional study. Socioeconomic and demographic data were collected from medical records, while oral condition and habits were obtained from the dental records. Statistical analysis was performed with Stata 11.0 software using Fisher's exact test and Poisson regression. Results: the medical records of 83 pregnant women were evaluated, of which 37 (44.6%) had GDM. The presence of GDM was associated with pregnant women of older age (62.2%) and most in the third trimester of pregnancy. Most of them had an income of up to two minimum wages, were single, had children and underwent prenatal care. Regarding the oral evaluation, only the presence of dental calculus and gingival inflammation was statistically associated with the presence of GDM (p = 0.030 and 0.014 respectively). The self-perception of the smile was considered bad to 40.5% and many of them had lost teeth due to caries (64.9%). Conclusions: the prevalence of GDM was high in hospitalized pregnant women, being higher in older women. Presence of dental calculus and gingival inflammation were strongly associated with the presence of GDM, while oral habits and the presence of caries were not associated. Further research, with complete periodontal examinations is necessary to verify the periodontal conditions of these women.(AU)

Discriminant validity of the CAST instrument compared to the dmf index in the deciduous dentition: a cross sectional study

Abstract This study aimed to assess the discriminant validity of the Caries Assessment Spectrum and Treatment (CAST) at different thresholds, compared with the Decayed, Missing, and Filled Teeth Index (dmf) instrument, to discriminate caries risk factors. A cross-sectional study was conducted including children aged 2-5 years from preschools in Southern Brazil. Parents answered a questionnaire, and children were clinically examined using the CAST instrument and, in the following weeks, using the dmf index. Two caries thresholds were adopted for CAST: caries in dentin (CAST4-7/CAST2,4-8) and enamel caries (CAST3-7/CAST2-8). Poisson regression was used in the analysis (p < 0.05). A total of 200 children were included. The prevalence of caries was 47.0% with dmf, 42.5% with CAST4-7, and 77.5% with CAST3-7. When the outcome was caries prevalence, CAST4-7 discriminated between sexes, household crowding, and dental pain, and CAST3-7 discriminated age and family income, while the dmf was associated with dental pain. When experience of caries was the outcome, all the criteria discriminated between sexes, age, family income, household overcrowding, visible dental plaque, and dental pain, while dmf and CAST2-8 also discriminated maternal schooling. The CAST discriminated caries risk factors similar to the dmf index when caries experience was the outcome. When prevalence was considered, CAST was able to discriminate for more individual characteristics than dmf.

Prevention and Management of Dental Trauma in Primary Teeth in the Context of the COVID-19: A Critical Literature Review

ABSTRACT Objective: To evaluate and discuss the prevention and management of dental trauma in primary teeth during the COVID-19 pandemic. Material and Methods: Critic literature review, searching electronic databases and Google for articles and guidelines published in English that described prevention and management of dental trauma in primary dentition during the pandemic of COVID-19. Results: 5 publications regarding management and 1 leaflet about prevention for parents were identified. Urgent care is required when the child presents tooth fracture resulting in pain or causing soft tissue trauma and luxation affecting bite. Avulsed teeth should not be replanted and advice and self-help may be sufficient in some situations. Instructions about soft diet and hygiene must be provided. Remote consults are recommended for non-urgent situations and during follow-up to evaluate the presence of sequelae. Aerosol generating procedures should be avoided and, in cases of poor prognosis, extraction is recommended to prevent recurring visits to the dental office. Conclusion: During COVID-19 pandemic, remote consults should be recommended to evaluate traumatic dental injuries in primary dentition. Follow-up should not be neglected and may be performed through remote consultation.

Association of Dental Anxiety with Psychosocial Characteristics among Children Aged 7-13 Years

Abstract Objective: To identify psychosocial characteristics associated with dental anxiety in children aged 7-13 years in the dental setting. Material and Methods: This cross-sectional study was conducted with children aged 7-13 years attended at the Dentistry School of Pelotas, Brazil. Data collection was based on a questionnaire administered to mothers and children, and the behavior of children during dental treatment was evaluated using the Frankl' Scale. Data were analyzed using Chi-square and Fisher's exact tests in order to analyze the association between independent variables and dental anxiety. The effect of variables on the outcome was assessed by the Poisson regression model with robust variance (Prevalence Ratio; 95% Confidence interval). Results: A total of 187 children were included. Dental anxiety prevalence was 40.11%. After adjustments, younger children (p=0.046), only child (p=0.019), and children with negative previous dental experience (p=0.046) showed higher dental anxiety prevalence. Children with uncooperative behavior in previous (p=0.033) and current (p≤0.001) dental appointments showed higher dental anxiety prevalence. Conclusion: In this sample of children treated at a dentistry school, a report of dental anxiety was associated with age, birth order, previous dental experience and behavior in dental settings.

Frenotomia lingual em lactentes

O objetivo deste trabalho foi realizar uma revisão de literatura acerca do freio lingual anômalo em lactentes, relacionando diagnóstico e tratamento. Revisão de literatura: esta anomalia limita os movimentos da língua durante o choro, lalação e pode gerar desconforto durante a amamentação. A metodologia do trabalho constituiu em buscas de artigos publicados em língua portuguesa e inglesa nas bases de dados Bireme, Google Acadêmico e PubMed, entre os anos de 2004 e 2016. Foram identificados 645 artigos através da combinação de palavras-chave, sendo que 29 foram utilizados por apresentarem resultados condizentes com o objetivo desta revisão. Considerações Finais: através dos estudos consultados não foi possível identificar um instrumento padrão-ouro que diagnostique a anquiloglossia em bebês, a despeito do fácil diagnóstico. Há controvérsias na literatura em relação ao tratamento por meio da frenotomia e sua contribuição para a melhora na amamentação, movimentos da língua e desconforto da mãe ao amamentar, embora grande parte dos estudos demonstre benefícios evidentes.

Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil

Abstract Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05). At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.

Prevalência de injúrias em tecidos moles em pacientes atendidos em um centro especializado no tratamento de traumatismos dentários

Avaliar a prevalência de lesões de tecidos moles em crianças que sofreram traumatismo alveolodentário na dentição decídua, atendidas em um serviço especializado da Faculdade de Odontologia da Universidade Federal de Pelotas. Métodos: os dados coletados dos prontuários dos pacientes atendidos de 2002 a 2011 foram: idade, sexo, injúria em tecidos moles e severidade do traumatismo. Os dados foram analisados por meio de estatística descritiva e associações foram feitas pelo Teste Qui-Quadrado, utilizando o programa Stata 11.0. Resultados: dos 707 prontuários analisados, 603 crianças foram incluídas no estudo. Desse total, 51,41% apresentaram lesões em tecidos moles, além das injúrias dentárias. A maior prevalência de lesões em tecidos moles foi em crianças de 25 a 36 meses (24,71%) e entre o sexo masculino (58,87%). A presença de lesões em tecidos moles foi estatisticamente significante em rela- ção à severidade do traumatismo (p≤0,001) e à idade da criança (p=0,004), no entanto, não foi observada diferença em relação ao sexo. A lesão em tecido mole mais prevalente foi a laceração, tanto na região extraoral (46,75%) quanto na intraoral (64,10%), seguida por contusão e abrasão. Considerando todos os tipos de lesões, a região intraoral foi a mais atingida (50,32%). Conclusão: as lesões em tecido mole estão presentes em grande parte das crianças que sofrem traumatismo (51,41%), portanto, é necessário ressaltar a importância do exame e do tratamento dessas lesões.

Condição de saúde bucal de crianças com deficiência auditiva matriculadas em uma escola de educação especial

Objetivo: avaliar a condição de saúde bucal de escolares entre 6 e 19 anos de idade com deficiência auditiva de uma escola de educação especial. Sujeitos e método: este estudo transversal prospectivo coletou dados sobre condições socioeconômicas, grau de deficiência auditiva e hábitos de higiene bucal por intermédio de um questionário direcionado aos cuidadores. A condição de saúde bucal foi obtida por meio de exame clínico, avaliando o índice de placa visível, o índice de sangramento gengival e o índice de dentes cariados, perdidos e obturados (ceo-d e CPO-D). A análise descritiva foi realizada com valores absolutos e relativos, usando o programa Stata versão 10.0. A associação entre as variáveis independentes e o desfecho do estudo foi verificada por meio dos testes Qui-Quadrado, Exato de Fisher e Mann-Whitney, com nível de significância de 5%. Resultados: foram avaliados cinquenta escolares, a maioria do sexo masculino, de baixa renda cujo cuidador era do lar. Em relação à saúde bucal, 90% dos escolares apresentaram placa visível, 22% tiveram sangramento gengival à sondagem e a média do índice CPO-D foi 1,8. Conclusões: a condição de higiene bucal dos escolares com deficiência auditiva avaliados foi insatisfatória e a doença cárie esteve presente em uma parcela considerável, porém, semelhante à população sem deficiência.

Crown-Root Fractures in Primary Teeth: A Case Series Study of 28 Cases

Abstract Crown-root fractures in primary teeth are rare, with a wide variation of patterns that make diagnosis and treatment difficult. The aim of this study was to present a case series of crown-root fractures in primary teeth of children who attended a reference center. The study followed 28 cases of crown-root fractures in 26 children, representing 4% of the total number of attendees over 11 years of reference service at the Universidade Federal de Pelotas, Pelotas, Brazil. In most cases, the maxillary central incisors (85.7%) were involved. In the crown, 57.1% of the cases had a simple line of fracture, and 42.9% had multiple lines. Simple lines predominated in the root (89.3%). In cases with simple fracture lines in the crown, 37.6% underwent a total extraction, 31.2% required a partial extraction and 31.2% underwent pulpectomy. In most teeth with multiple lines of fractures in the crown, total extraction was performed (91.7%) All cases were followed-up until the eruption of the permanent successor tooth, and all patients had favorable outcomes.

Resumo Fraturas coronorradiculares em dentes decíduos são raras, com uma ampla variação de padrões que dificultam o diagnóstico e tratamento. O objetivo deste estudo foi apresentar uma série de casos de fraturas coronorradiculares na dentição decídua de crianças atendidas em um centro de referência. O estudo acompanhou 28 casos de fratura coronorradicular em 26 crianças, representando 4% do número total de participantes ao longo de 11 anos no serviço de referência na Universidade Federal de Pelotas. Na maioria dos casos, o incisivo central superior (85,7%) foi o mais envolvido. Na coroa, 57,1% dos casos tiveram linha de fratura simples, e 42,9% tiveram múltiplas linhas. As linhas simples predominaram na raiz (89,3%). Nos casos com linhas de fratura simples na coroa, 37,6% foram submetidos à extração total, 31,2% necessitaram de extração parcial e 31,2% de pulpectomia. A maioria dos dentes com múltiplas linhas de fratura na coroa, a extração total foi realizada (91,7%). Todos os casos foram acompanhados até a erupção do dente permanente sucessor, e todos os pacientes tiveram resultados favoráveis.

Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19-41) for teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

Avaliação clínica e radiográfica de dentes decíduos intruídos por traumatismo alvéolo-dentário / Clinical and radiographic evaluation of intrusion in primary teeth by the dental trauma

A luxação intrusiva é causada por um impacto no sentido axial, no qual o dente é deslocado para dentro do osso alveolar, afetando comumente a dentição decídua e podendo gerar sequelas. O seu tratamento é definido por sinais clínicos e radiográficos. Objetivo: acompanhar dentes decíduos intruídos e observar a ocorrência de sequelas. Método: Avaliaram-se prontuários de pacientes com história de traumatismo alveolodentário na dentição decídua e selecionaram-se os prontuários de pacientes que sofreram intrusão com, no mínimo, dois anos de acompanhamento, verificando-se: graus de intrusão e de reerupção; presença de mobilidade dentária; coloração e posição do dente após reerupção; presença de fístula; condição do canal pulpar e da região periapical; presença de reabsorção radicular; e tratamento executado. Resultados: Dentre os 435 pacientes atendidos, foram encontrados 83 casos de intrusão e 29 desses foram incluídos na amostra, totalizando 39 dentes decíduos traumatizados. Assim, as intrusões representaram 19,1% dos traumatismos observados. Embora o sexo feminino fosse o mais acometido (55,2%), não existiu correlação entre sexo e prevalência de dentes decíduos traumatizados. Em relação aos dentes atingidos, o mais acometido foi o 61 (34,4%), seguido pelo 51 (31,0%). Ainda, em 31,0% dos casos, os dois incisivos centrais superiores foram acometidos. O estudo aponta, ainda, que queda da própria altura foi a etiologia prevalente, com 58,6% dos casos. Do total de dentes, 27 tiveram reerupção total, três reerupção de 2/3 da coroa e nove esfoliaram ou foram extraídos. Observando-se as sequelas, discoloração dentária foi a mais frequente, sendo encontrada em 23 dentes (79,3%). Quanto ao tratamento, dos 39 dentes, 28 foram apenas acompanhados (71,8%), nove necessitaram de endodontia (23,1%) e dois de extração (5,1%). Conclusão: o monitoramento da reerupção espontânea dos dentes intruídos e a observação cuidadosa do aparecimento de sequelas são as melhores alternativas, pois algumas complicações podem aparecer vários meses após o traumatismo. As sequelas e o grau de intrusão apresentam grande relação, visto que quanto maior o grau de intrusão, maior será a gravidade das sequelas e mais importante torna-se o acompanhamento por um profissional.

Intrusive luxation is caused by an impact in the axial direction by which the tooth is displaced into the alveolar bone. It usually affects the primary dentition and can generate sequalae. Its treatment is defined by clinical and radiographic signs. Objective: to follow intrusive primary teeth and observe sequela occurrence. Methods: Dental records of patients with a history of alveolodental trauma were evaluated and records from patients that had suffered intrusion with at least a two-year follow-up period were selected. Intrusion and reeruption degrees, dental mobility occurrence, coloration and tooth position after reeruption, fistula occurrence, pulp canal and periapical region condition, root resorption occurrence and treatment performed were checked. Results: Out of 435 treated patients, 83 intrusion cases were found, 29 of which were included in the sample, totaling 39 traumatized primary teeth. Thus, intrusion represented 19.1% of the analyzed traumas. Although females were more affected (55.2%) than males, a correlation between sex and traumatized primary teeth was not found. With reference to affected teeth, the most affected was tooth 61 (34.4%), followed by tooth 51 (31.0%). Also, in 31.0% of the cases, the two central upper incisives were affected. The study showed that fall from height was the prevailing etiology, encompassing 58.6 % of the cases. Out of the total, 27 teeth showed total reeruption, 3 presented a 2/3 reeruption of the crown, and 9 either exfoliated or were extracted. Upon observing sequelae, dental discoloration was most frequent, having been encountered in 23 teeth (79.3%). As to treatment, 28 out of 39 teeth were only followed up (71.8%), 9 needed endodontic treatment (23.1%) and 2 extraction (5.1%). Conclusion: the monitoring of the spontaneous reeruption of intruded teeth and the careful observation to determine sequela occurrence are the best choices, once complications might arise several months after trauma. Sequelae and inclusion degree are closely related, inasmuch as the higher the intrusion degree, the greater the sequela severity; thus, professional follow-up is indispensable.