Qual a importância da detecção de lesões iniciais de cárie em crianças pré-escolares? Evidências de um estudo de coorte com 2 anos de acompanhamento / What is the importance of detecting initial caries lesions in preschool children? Evidences from a cohort study with 2 years of follow-up

Os objetivos desse estudo de coorte realizado em crianças pré-escolares foram: (1) avaliar a validade preditiva e de constructo utilizando um critério de avaliação de atividade de lesões de cárie associado ao Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS, do inglês International Caries Detection and Assessment System); (2) avaliar o risco de superfícies hígidas, com lesões iniciais de cárie (escores 1 e 2 do ICDAS) e lesões moderadas (escores 3 e 4) progredirem para lesões cavitadas em dentina (escores 5 e 6 do ICDAS) em dentes decíduos; (3) avaliar a influência da presença de lesões iniciais no risco de desenvolvimento de lesões de cárie; (4) avaliar se o impacto da cárie dentária na qualidade de vida de crianças se altera com o incremento de novas lesões ao longo do tempo; e (5) avaliar o impacto da cárie dentária em diferentes estágios de severidade na piora da qualidade de vida relacionada à saúde bucal em crianças. Um exame inicial foi realizado por 15 examinadores durante o Dia Nacional de Vacinação em junho de 2010, na cidade de Santa Maria (RS). Nesse dia, 639 crianças de um a cinco anos de idade foram examinadas utilizando o ICDAS para detecção das lesões de cárie e um critério adicional para avaliação da atividade das lesões de cárie. Outras variáveis demográficas e socioeconômicas relacionadas a cada criança foram coletadas com os pais das crianças. Um questionário para avaliar o impacto das condições bucais na qualidade de vida das crianças (ECOHIS, do inglês Early Childhood Oral Health Impact Scale) também foi aplicado aos pais...

The aims of the present cohort study carried out in preschool children were: (1) to evaluate predictive and construct validity of an additional criteria to assess caries lesions activity associated to the International Caries Detection and Assessment System (ICDAS); (2) to evaluate the risk of sound surfaces, initial (scores 1 and 2 of ICDAS) and moderate caries lesions (ICDAS scores 3 and 4) to progress to dentin cavitated lesions (ICDAS scores 5 and 6) in primary teeth; (3) to investigate the influence of presence of initial caries lesions on risk of occurrence of new caries lesions; (4) to evaluate if the impact of dental caries on quality of life of children suffers worsening due to the occurrence of new caries lesions; and (5) to investigate the impact of dental caries in different stages of progression on worsening of oral health-related quality of life. An initial examination was conducted by 15 examiners during the National Children's Vaccination Day in June, 2010, in Santa Maria (RS). At this day, 639 children aged from one to five years were examined using the ICDAS for the detection of caries lesions and with an additional criteria for evaluation of caries lesions activity. Other demographic and socioeconomic variables related to each child were collected with the children's guardians. A questionnaire to evaluate the impact of oral health on quality of life of the children (Early Childhood Oral Health Impact Scale - ECOHIS) was also applied for the parents...

Socioeconomic and clinical factors associated with traumatic dental injuries in Brazilian preschool children

The aim of this paper was to assess the epidemiology of traumatic dental injury (TDI) in preschool children and its relation to socioeconomic and clinical factors. This study was carried out in Santa Maria, Brazil, during National Children's Vaccination Day, and 441 children aged 12 to 59 months were included. Data about socioeconomic status were collected through a semi-structured questionnaire administered to parents. Calibrated examiners evaluated the prevalence of TDI, overjet, and lip coverage. Data were analyzed with a Poisson regression model (PR; 95% confidence intervals). The TDI prevalence was 31.7%. The maxillary central incisors were the most frequently traumatized teeth. The most common TDI was enamel fracture. No association was found between TDI prevalence and the socioeconomic status of children. After adjustments were performed, the eldest children with an overjet > 3 mm were more likely to have TDI than their counterparts. The data indicated a high prevalence of TDI. Only overjet was a strong predictor for TDI, whereas socioeconomic factors were not associated with TDI in this age group.

Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren

The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95 percent confidence interval). The prevalence of regular use of dental service was 47.8 percent. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.