Hipersensibilidade dentinária e satisfação com a saúde mediada pela presença de impacto físico e psicossocial das condições bucais: uma análise de caminhos / Dentin hypersensitivity and health satisfaction mediated by the presence of physical and psychosocial impacts of oral conditions: a pathway analysis

Objetivo: Objetivou-se investigar associação direta e mediada pela presença de impacto físico e psicossocial das condições bucais entre HD e satisfação com a saúde entre adultos. Métodos: Estudo transversal foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos residentes em Rio Acima (MG). Entrevista e exame bucal foram realizados por examinadoras calibradas. Satisfação com a saúde foi avaliada por meio da pergunta doWHOQoL-bref "Quão satisfeito (a) você está com a sua saúde?" e suas respostas categorizadas entre "satisfeito" e "insatisfeito". HD foi avaliada por estímulo tátil na região cervical dos dentes. Presença de impactos físicos e psicossociais das condições bucais foi definida pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do OHIP-14. Covariáveis foram dados sociodemográficos e econômicos, comportamentos em saúde, condições de saúde bucal e uso de serviços odontológicos. Associações foram investigadas por modelos de Regressão de Poisson e Modelagem de Equações Estruturais (MEE) para estimar associações diretas e indiretas (Stata 16). Resultados: Dos 197 adultos, 132 (66,18%) declararam estar satisfeitos com sua saúde e 73 indivíduos (38,75%) apresentavam HD. Houve associação significativa entre presença de HD e presença de impacto físico e psicossocial das condições bucais (RP: 1.34; IC 95%: 1.08­1.67), enquanto para satisfação a associação com HD não foi significativa (RP: 1.08; IC 95%: 0.75-1.54) após a inclusão da variável presença de impacto físico e psicossocial das condições bucais. MEE demonstrou associação direta não significativa entre HD e satisfação, enquanto a associação indireta mediada pela presença de impacto físico e psicossocial das condições bucais foi significativa. Conclusão: Indivíduos com HD podem relatar maior insatisfação com a vida quando esta experiência dolorosa está associada com impactos físicos ou psicossociais.

Aim: Dentin Hypersensitivity (DH) is a painful condition that affects the Oral Health-related Quality of Life and can affect the satisfaction with health of individuals who have it. This study aimed to investigate the direct association mediated by the presence of physical and psychosocial impacts of oral conditions between DH and satisfaction with health among adults. Methods: A cross-sectional study was carried out between 2018-2019 with a probabilistic sample consisting of a cluster of adults living in Rio Acima (MG). Interviews and epidemiological examinations were performed using calibrated tests. The dependent variable of satisfaction with health was assessed using the WHOQoL-bref question "How satisfied are you with your health?" Participants' answers were categorized between "satisfied" and "dissatisfied". The independent DH variable was assessed by tactile stimulation in the cervical region of the teeth. The presence of physical and psychosocial impacts of oral conditions was defined by the answers "farly often" or "very often" to at least one of the OHIP-14 items. Covariates were sociodemographic and psychological data, health behavior, oral health conditions, and use of dental services. Associations were investigated by Poisson Regression and Structural Equation Modeling (SEM) models to estimate direct and indirect associations (Stata 16). Results: Of the 197 adults, 132 (66.18%) reported being satisfied with their health, and 73 individuals (38.75%) had DH. There was a significant association between the presence of DH and the presence of physical and psychosocial impacts of oral health (PR:1.34; 95% CI: 1.08­1.67), while for receiving the association with DH, it was not significant (PR:1 .08; 95% CI: 0.75-1.54) after including the presence of impact variables. SEM showed a non-significant direct association between DH and satisfaction, while the indirect association mediated by the presence of impact was significant. Conclusion: Individuals with HD may report greater dissatisfaction with life when this painful experience is associated with physical or psychosocial effects.

Association between Dentin Hypersensitivity and Health/Oral Health-related Quality of Life: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To investigate the association between DH and Health (HRQoL) or Oral Health-Related Quality of Life (OHRQoL). Material and Methods: PubMed, Web of Science, Scopus, EMBASE, Cochrane, Scielo, LILACS/BBO, Biblioteca Digital de Teses e Dissertações (BDTD), Open Grey, and Google Scholar databases were screened in September 2019 (updated in October 2022). Observational studies were selected to compare HRQoL/OHRQoL(outcome) according to DH(exposure) or evaluate the association among these variables. Standardized Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies was used to analyze the risk of bias. A random-effects meta-analysis was conducted to synthesize evidence for the association between DH and OHRQoL. Results: 10 papers met inclusion criteria and were evaluated. In most studies, presenting or having a greater intensity of DH was associated with a negative impact on one's quality of life. However, most of these studies showed a moderate to high risk of methodological bias. The consistent finding from studies with a low risk of bias suggests a significant association between DH and OHRQoL. Meta-analysis was feasible for three studies with substantial heterogeneity. The pooled Odds Ratio was 2.14 (95%CI 1.15-3.99; I2= 57,44%). Conclusion: Many studies presented a high risk of bias; therefore, the actual effect of DH on one's quality of life remains uncertain.

Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies

Abstract The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

Evaluation of temporal bone pneumatization using panoramic radiography and cone beam computed tomography / Avaliação da pneumatização do osso temporal por meio de radiografia panorâmica e tomografia computadorizada de feixe cônico

Aim: To evaluate the presence and characteristics of pneumatizations in the roof of the mandibular fossa and articular eminence by panoramic radiography and cone beam computed tomography (CBCT).Methods: This study analyzed CBCT images of the temporomandibular joint of 705 patients, In 60 exams, it was possible to compare tomographic with panoramic images. For cases where pneumatization was present, laterality and pattern of manifestation were considered. A chi-square test was used to compare the differences between CBCT and panoramic radiography in the diagnosis of pneumatization. Results: Descriptive analysis revealed a sample profile that was predominantly female (75.9%), with a mean age of 42.6 years (± 17.4). The presence of pneumatizations in the roof of the mandibular fossa and articular eminence in CBCT images was identified in 330 (46.8%) and 154 (21.8%) exams, respectively, and the most frequent pneumatization pattern was the multilocular type in both locations. Bilateral pneumatization was more prevalent in the roof of the mandibular fossa. Considering the analysis of 60 pairs of exams, in panoramic radiography, pneumatizations in the roof of the mandibular fossa and articular eminence were identified in 22 (36.7%) and 12 (20.0%) examinations, respectively. Regarding CBCT images, pneumatizations in the roof of the mandibular fossa was observed in 24 (40.0%) exams, while articular eminence was found in 14 (23.3%) images. There were no statistically significant differences between the proportion of pneumatization identified by panoramic radiography and CBCT (p > 0.05). Conclusion: This study suggests that panoramic radiography may be an imaging method used to evaluate pneumatization in the temporomandibular joint region.

Objetivos: Avaliar a presença e as características da pneumatização no teto da fossa mandibular e eminência articular por meio de radiografias panorâmicas (RP) e tomografias computadorizadas de feixe cônico (TCFC). Métodos: Foram analisadas imagens tomográficas da ATM de 705 pacientes, sendo que 60 desses pacientes também possuíam RP. Para todos os casos foram avaliadas a presença, a lateralidade e o padrão de manifestação da pneumatização. O teste qui-quadrado foi empregado para comparar os resultados obtidos a partir das RP e das TCFC no que tange o diagnóstico das pneumatizações. Resultados: A análise descritiva revelou uma amostra predominantemente feminina (75,9%) com uma média de idade de 42,6 anos (± 17,4). A pneumatização no teto da fossa mandibular e eminência articular foi evidenciada em 330 (46,8%) e 154 (21,8%) imagens de TCFC, respectivamente, e o padrão de pneumatização mais frequente foi o multilocular em ambas as regiões. A pneumatização bilateral foi mais prevalente no teto da fossa mandibular. Considerando a análise dos 60 pares de exames, nas radiografias panorâmicas as pneumatizações no teto da fossa mandibular e eminência articular foram identificadas em 22 (36,7%) e 12 (20,0%) exames, respectivamente. Em relação às imagens tomográficas, a presença desse achado no teto da fossa foi observada em 24 (40,0%) exames e na eminência articular em 14 (23,3%). Não houve diferença com significância estatística entre a proporção de pneumatização identificada em RP e TCFC (p > 0,05). Conclusão: Os resultados obtidos sugerem que a radiografia panorâmica pode ser um método de diagnóstico por imagem empregado para avaliação de pneumatizações na região da ATM.

Brazilian Adults Believe that Complete Dentures would be the Solution to the Oral Impacts Caused by Reduced Dentition

Abstract Objective: To evaluate the direct and oral impact-mediated association between reduced dentitions and the self-perceived need for complete dentures (CD) in dentate adults. Material and Methods: Data from the Brazilian Oral Health Survey (2010) were analyzed. The outcome was self-perceived need for CD. Functional dentition (FDClassV) was defined by the presence of the following criteria: level I - ≥1 tooth in each arch, level II - 10 teeth in each arch, level III - 12 anterior teeth, level IV - ≥ 3 posterior occluding pairs (POPs) of premolars and level V - ≥1 bilateral POPs of molars. Oral impacts were assessed with Oral Impacts on Daily Performances scale. Results: FDClassV was associated with a less self-perceived need for CD both directly and mediated by oral impacts. Dentitions without level V were associated with the outcome mediated by oral impacts. Between individuals with 10 teeth in each arch, self-perceived need for CD was similar for those who had or not anterior teeth and POPs. Individuals with <10 teeth in each arch and level III did not have a higher frequency of self-perceived need for CD compared to those with level II. Conclusion: Oral impacts mediated the association between reduced dentitions and self-perceived need for CD. Individuals with tooth loss may report need for CD, even when they have dental configurations compatible with functionality.

Mother's education and family relations protect children from dental caries experience: a salutogenic approach

Abstract The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.

Cárie dentária na América do Sul: realidade entre escolares do Brasil e Argentina / Dental caries in South America: reality among schoolchildren from Brazil and Argentina

Objetivo: este estudo transversal multicêntrico objetivou determinar a proporção de cárie dentária, sua gravidade e atividade em escolares brasileiros e argentinos. Métodos: a amostra foi composta por escolares selecionados por conveniência, 406 do Brasil (Belo Horizonte - MG) e 241 da Argentina (Córdoba-Cba). Os dados foram coletados por seis dentistas previamente treinados e calibrados (kappaintra≥0,63; kappainter≥0,67). A proporção e gravidade da cárie foram medidas pelos índices ceod e CPOD. A alta experiência de cárie foi identificada pelo Significant Caries Index (SiC). A atividade de cárie foi avaliada segundo a reflexão e a textura da superfície (Nyvad et al., 1999) e o Índice de Cuidados (O/CPO*100) foi mensurado. Resultados: a proporção de livres de cárie (ceod e CPOD = 0) no Brasil foi de 45,7% e 19,9% na Argentina. O ceod foi de 1,48 (IC95%: 1,26-1,71) e 2,38 (IC95%: 2,0-2,72) entre escolares do Brasil e da Argentina, respectivamente. Nos dois países, o componente cariado foi o mais frequente. Entre os indivíduos com experiência de cárie (ceod > 1 e/ou CPOD > 1), a atividade de cárie esteve presente em 77,5% das crianças examinadas no Brasil e em 26,4% na Argentina. No grupo SiC, o CPOD foi de 2,20 (IC95%: 1,95-2,20) no Brasil e 2,17 (IC95%: 1,91-2,43) na Argentina, e o ceod no Brasil foi de 3,37 (3,01-3,72) e na Argentina 5,56 (5,04-6,07). O Índice de Cuidados foi baixo. Conclusão: em ambos os países, a proporção de crianças com experiência de cárie foi alta. Concentração de carga e atividade de cárie foi encontrada em grupos de polarização. Cabe ressaltar que a cárie dentária na dentição decídua é um problema relevante que necessita de esforços direcionados em ambos os países.

Objective: This multicentric cross-sectional study aimed to determine the proportion of dental caries, its' severity and activity among Brazilian and Argentines schoolchildren. Methods: The sample was selected by convenience and comprised of 406 schoolchildren from Brazil (Belo Horizonte-MG) and 241 in Argentina (Córdoba-Cba). Data were collected by six previously trained and calibrated dentists (kappaintra≥0.63; kappainter≥0.67). The proportion and severity of dental caries were measured by dmft and DMFT index. The high caries experiences was identified using Significant Caries Index (SiC). The caries activity was evaluated according to the reflection and texture of the surface (Nyvad et al., 1999) and the Care Index (O/CPO * 100) was measured. Results: The caries free (dmft and DMFT = 0) in Brazil was 45.7% and 19.9% in Argentina. The dmft was 1.48 (95% CI: 1.26-1.71) and 2.38 (95% CI: 2.0-2.72) among schoolchildren in Brazil and Argentina, respectively. In both countries, decayed component was the most frequent observed. Among subjects with caries experience (dmft > 1 and / or DMFT > 1) the caries activity was present in 77.5% of the children examined in Brazil and 26.4% in Argentina. In SiC group, DMFT was 2.20 (95% CI: 1.95-2.20) in Brazil and 2.17 (95% CI: 1.91-2.43) in Argentina and dmft in Brazil was 3.37 (3.01-3.72) and in Argentina was 5.56 (5.04-6.07). The Care Index was low. Conclusions: In both countries, the proportion of children with caries experience was high. Concentration of burden and caries activity was found in polarization' groups. It is noteworthy that caries in the primary dentition is a relevant problem that needs targeted efforts in both countries.