Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Brazilian Schoolchildren Aged 8 to 10 Years

ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.

Prevalence of Dental Fear and its Association with Painful Oral Conditions in Adolescents

ABSTRACT Objective: To estimate the prevalence of dental fear and evaluate its association with dental caries and with Molar Incisor Hypomineralization (MIH) in schoolchildren aged 11-14 years. Material and Methods: A cross-sectional study was conducted with 375 adolescents in Campina Grande, Brazil. Socioeconomic and oral health information was collected, while dental fear was measured using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The diagnosis of dental caries and MIH was performed by three trained examiners (κ ≥ 0.61) using the International Caries Detection & Assessment System - ICDAS II and a previously validated index, respectively. Data were descriptively analyzed using the Chi-Square, Fisher's Exact, and Poisson regression tests with robust variance (p<0.05). Results: The prevalence of dental fear was 18.4%, and the mean CFSS-DS total score was 28.96 ± 8.92. After adjusting for covariates family structure, schooling of parents/guardians, type of dental health service and dental pain in the last six months, the prevalence of dental fear was associated with dental pain in the last six months (PR=2.03; 95%CI=1.31-3.16; p=0.002). Conclusion: Although no association was found between dental fear, dental caries and MIH in adolescents, those who experienced dental pain in the last six months had a higher prevalence of dental fear.

Presence of molar-incisor hypomineralization is associated with dental caries in Brazilian schoolchildren

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

Avaliação micro e macroscópica de escovas dentais / Micro and macroscopic evaluation of toothbrushes

Introdução: as escovas dentais possuem como principal função a limpeza dos tecidos bucais. Objetivo: analisar as características micro e macroscópicas de escovas dentais de uso infantil e adulto. Metodologia: foram selecionadas 11 escovas dentais (cinco de uso infantil e seis de uso adulto). Dois pesquisadores treinados analisaram aspectos microcoscópicos e macroscópicos, de acordo com os parâmetros da Portaria n° 97/SVS (ANVISA). Os dados foram tabulados e analisados utilizando-se o Microsoft Excel, sendo apresentados por meio de estatística descritiva. Resultados: foram encontradas cerdas arredondadas em 40% das escovas de uso infantil e em 66,7% de uso adulto, com farpas em 60% das escovas de uso infantil e em 50% de uso adulto, com a parte ativa ovalada em 60% das escovas de uso infantil e em 50% de uso adulto e com as cerdas macias em 80% das escovas de uso infantil e em 50% de uso adulto. O comprimento e a largura da parte ativa das de uso infantil variaram de 19,14 a 25,03 mm e de 8,82 a 13,98 mm respectivamente, enquanto, nas de uso adulto, o comprimento variou de 25,77 a 37,02 mm e a largura de 12,57 a 15,40 mm. As escovas de uso infantil possuíam comprimento total entre 137,91 e 163,82 mm e as de uso adulto entre 180,08 mm e 195,42 mm. Conclusão: a maioria das escovas dentais analisadas não estão adequadas aos parâmetros estabelecidos na legislação brasileira, sendo essencial que o cirurgião-dentista oriente individualmente o paciente acerca de qual escova é a mais indicada.

Introduction: toothbrushes have the main function of cleaning the oral tissues. Objective: to analyze the micro and macroscopic characteristics of children's and adult's toothbrushes. Methodology: eleven toothbrushes were selected (five for children and six for adults). Two trained researchers analyzed microscopic aspects and macroscopic aspects of the brushes, according to the parameters of Ordinance Number 97/SVS (ANVISA). Data were tabulated and analyzed by using Microsoft Excel and were presented by using descriptive statistics. Results: rounded bristles were found in 40% of the children's brushes and 66.7% of the adult, with barbs in 60% of the children's brushes and 50% of the adult, with the active part oval in 60% of the children's brushes and 50% adult brushes and soft bristles on 80% of the children's brushes and 50% of the adult. The length and width of the active part of the children's brushes ranged from 19.14 to 25.03 mm and from 8.82 to 13.98 mm respectively, while the adult brushes ranged from 25.77 to 37.02 mm in length and from 12.57 to 15.40 mm in width. The children's brushes had a total length between 137.91 and 163.82 mm and the adult brushes were between 180.08 mm and 195.42 mm. Conclusion: most of the toothbrushes analyzed are not adequate by the parameters established by the Brazilian legislation, so it is essential that the dentist individually guide the patient as to which toothbrush is the most suitable.

Atitudes e práticas de profissionais atuantes na Estratégia Saúde da Família quanto à abordagem aos usuários de drogas no município de Campina Grande, Paraíba, Brasil / Attitudes and practices of professionals who working in the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. Brazil

Resumo O objetivo deste estudo foi avaliar as atitudes e as práticas dos profissionais da Estratégia Saúde da Família (ESF) quanto à abordagem aos usuários drogas no município de Campina Grande, Paraíba. Tratou-se de um estudo transversal e exploratório realizado com 126 médicos, enfermeiros e dentistas da Atenção Primária à Saúde (APS). As variáveis investigadas foram relacionadas a dados sociodemográficos, atuação profissional, atitudes e práticas sobre a abordagem aos usuários de drogas de acordo com o Plano Integrado de Enfrentamento ao Crack e outras Drogas. Foi realizada estatística descritiva e multivariada por meio da Análise de Correspondência Múltipla (ACM). A maioria dos profissionais era do sexo feminino (88,9%) e relatou questionar apenas às vezes quanto ao uso de drogas durante a anamnese (53,2%). Baseando-se na ACM, as variáveis com maior poder discriminatório para a dimensão 1 foram: tempo de formado (0,776), tempo de trabalho na APS (0,688), faixa etária (0,656); enquanto que para a dimensão 2 foram: categoria profissional (0,383) e se conhece os usuários de drogas em sua área de abrangência (0,166). Existem diferenças importantes nas atitudes e nas práticas acerca da abordagem dos usuários de drogas entre os profissionais.

Abstract The aim of this study was to evaluate the attitudes and practices of professionals of the Family Health Strategy regarding the approach to drug users in the municipality of Campina Grande. Paraíba. The cross-sectional and exploratory study carried out with 126 doctors. nurses and dentists of Primary Health Care (PHC). Variables investigated were related to sociodemographic data. professional profile. attitudes and practices about the approach to drug users according to the Integrated Plan to Confront Crack and Other Drugs. Descriptive and multivariate statistics were performed through Multiple Correspondence Analysis (MCA). Most professionals were female (88.9%) and reported questioning only sometimes about the use of drugs during the anamnesis (53.2%). Based on MCA results. variables with the greatest discriminatory power for dimension 1 were: training time (0.776). working time in the PHC (0.688). age group (0.656); while for dimension 2 were: professional category (0.383) and knowledge of drug users in their coverage area (0.166). There are important differences in attitudes and practices about the approach of drug users among professionals.

Analysis of prevalence and diagnostic criteria of molar-incisor hipomineralization / Análisis de prevalencia y criterios diagnósticos de hipomineralización molar-incisiva

To identify the prevalence and diagnostic criteria of Molar-Incisor Hipomineralization (MIH) in the scientific literature. Materials and Methods: This is a bibliographical research conducted through the analysis of indexed articles until October 2017 in the PubMed, Web of Science and Scopus databases. The Medical Subject Headings (MESH) used were "Dental Enamel Hypoplasia" and "Molar Incisor Hypomineralization". The analysis of articles was carried out by two reviewers, who collected information independently. The following information was collected: author, year of publication, place of work (continent and country), sample calculation, sample number, age of participants, type of study, prevalence of molar-incisor hypomineralization and criteria used for diagnosis. Data were tabulated using Microsoft Excel for Windows and presented using descriptive statistics. Results: A total of 484 articles were found and 57 were included in the study. Most of the studies were conducted in Europe (35%), and 31.6% of the studies mentioned using a probability sampling. The number of study participants ranged from 99 for a study in Brazil to 3,591 in Kenya. The most frequent age was 8 years, while the predominant type of study was cross-sectional (91.2%). The prevalence varied from 0.4% to 37.3% and most studies (73.6%) employed the European Academy of Pediatric Dentistry criteria for the diagnosis of MIH. Conclusion: There is great variability in prevalence in different countries, probably due to the use of different diagnostic criteria being used, and due to different age groups and geographical variation.

Objetivo: Identificar la prevalencia y los criterios diagnósticos de la hipomineralización de incisivos molares (HIM) en la literatura científica. Materiales y métodos: Investigación bibliográfica realizada a través del análisis de artículos indexados hasta octubre de 2017 en las bases de datos PubMed, Web of Science y Scopus. Los Medical Subject Headings (MESH) utilizados fueron "Dental Enamel Hypoplasia" y "Molar Incisor Hypomineralization". El análisis de los artículos fue llevado a cabo por dos revisores, quienes recolectaron información de manera independiente. Se recopiló la siguiente información: autor, año de publicación, lugar de trabajo (continente y país), cálculo y número de muestra, edad de los participantes, tipo de estudio, prevalencia de hipomineralización molar-incisiva y criterios utilizados para el diagnóstico. Los datos se tabularon con Microsoft Excel para Windows y se presentaron con estadísticas descriptivas. Resultados: Se encontraron un total de 484 artículos y 57 se incluyeron en el estudio. La mayoría de los estudios se llevaron a cabo en Europa (35%), y el 31,6% de los estudios mencionados utilizaron una muestra probabilística. El número de participantes en el estudio varió de 99 en un estudio en Brasil a 3.591 en un estudio desde Kenia. La edad más frecuente fue de 8 años, mientras que el tipo de estudio predominante fue transversal (91,2%). La prevalencia varió de 0,4% a 37,3% y la mayoría de los estudios (73,6%) emplearon los criterios de la Academia Europea de Odontología Pediátrica para el diagnóstico de HIM. Conclusión: Existe una gran variabilidad en la prevalencia de HIM en diferentes Países, probablemente debido al uso de diferentes criterios de diagnóstico, al utilizar diferentes grupos de etarios y a la variación geográfica.

Caracterização dos ensaios clínicos sobre cárie dentária desenvolvidos no Brasil e registrados no clinical trials: uma análise de 15 anos (2003-2017) / Characterization of clinical trials about caries developed in Brazil and registered on clinical trials: an analysis of 15 years (2003-2017)

Objetivo: Caracterizar os ensaios clínicos sobre cárie dentária desenvolvidos por pesquisadores brasileiros e registrados na plataforma Clinical Trials. Material e método: Tratou-se de estudo bibliográfico sobre a cárie dentária por meio da análise dos registros feitos na plataforma Clinical Trials. O período de busca compreendeu todos os estudos registrados entre os anos de 2003 a 2017. Para a estratégia de pesquisa foi utilizada a palavra-chave "Dental caries" na seção "Condition or disease" e "Brazil" na seção "Country". Os dados foram apresentados por meio de estatística descritiva. Resultados: Foram obtidos 55 ensaios clínicos, constituindo- se o Estado de São Paulo como principal local de execução (51,8%). A amostra variou de três a 800 indivíduos. Quanto à análise do período de registro, a maioria dos ensaios clínicos foram registrados nos últimos cinco anos (2013-2017) (63,6%). A maioria dos ensaios clínicos analisados recrutou crianças entre 0-12 anos (67,7%). Com relação à alocação dos grupos, apenas um estudo (1,8%) não se caracterizou como randomizado. O modelo de intervenção mais frequente foi o paralelo (70,9%). Quanto ao tipo de mascaramento, o estudo cego (34,5%) foi o mais prevalente e os estudos com finalidade terapêutica foram predominantes (67,3%). A maior parte dos estudos dividiu os participantes em dois grupos (67,3%) e não usou grupo placebo (80,0%). Conclusões: Os ensaios clínicos desenvolvidos por pesquisadores brasileiros voltados à temática da cárie dentária são majoritariamente desenvolvidos em crianças, predominando o desenho paralelo e a finalidade terapêutica. Existe grande variabilidade no número amostral, sendo baixo o uso de grupo placebo.

Objectives: To caracterize the clinical trials about dental caries developed by brazilian resourchers and registered on Clinical Trials Plataform. Methods: A bibliographic study about dental caries theme by means of the analysis of registries made at the Clinical Trials, an international plataform for registration of clinical trials. The search included all the registered studies between the years of 2003 and 2017. The search strategy used "dental caries" as key word on section "Condition or disease" and "Brazil" on section "Country". The data were presented through a descriptive statistics. Results: The search obtained 55 (fifty five) clinical trials, having the state of São Paulo as the principal execution place (51,8%). The sample varied between 3 (three) and 800 (eight hundred) individuals. In relation to the period of registry, most of the clinical trials belong to the last 5 (five) years - 2013-2017 (63,6%). Most of clinical trials analyzed had recruited children between 0-12 years (67,7%). With regard to allocation of groups, only 1 (one) study didn't caracterize as randomized. The most frequent intervation model was the parallel (70,9%). As the type of masking, the blind study prevailed and the studies with therapeutic purpose were predominant (67,3%). The most part of studies divided the participants into 2 (two) groups (67,3%) and didn't use a placebo group. Conclusion: The clinical trials developed by brazilian resourchers toward dental caries theme are mostly developed on children, predominating the parallel design and therapeutic purpose. There is large variability on sample numbers, with low use of placebo groups.

Hipomineralização molar-incisivo: etiologia, características clínicas e tratamento / Molar incisor hypomineralization: etiology, clinical characteristics and treatment

Introdução: a Hipomineralização Molar-Incisivo (HMI) é um defeito de desenvolvimento do esmalte dentário que afeta de um até todos os primeiros molares permanentes, podendo estar presente nos incisivos permanentes. Objetivo: revisar a literatura sobre a HMI objetivando proporcionar informações ao cirurgião-dentista que realiza atendimento infantil sobre o diagnóstico, características clínicas e tratamento. Metodologia: revisão integrativa da literatura, sendo utilizado as bases de dados LILACS, PubMed, Web of Science e Scopus. Foram usadas as palavras-chaves "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" e " Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization". Resultados: fatores etiológicos associados a complicações pré, peri e pós-natais, ambientais e genéticos têm sido evidenciados e a prevalência de HMI mostra-se variada entre as populações. Apresenta-se como manchas opacas bem delimitadas e, com o aumento da gravidade, ocorre a perda do esmalte resultando em fratura, destruição coronária e indicação de exodontia. As fraturas pós-eruptivas atuam como áreas de retenção de biofilme, o que facilita seu acúmulo e aumenta a susceptibilidade à cárie dentária. A Academia Europeia de Odontopediatria (EAPD) estabeleceu critérios que facilitam o diagnóstico deste agravo por meio de pesquisas epidemiológicas. As medidas terapêuticas são direcionadas de acordo com a gravidade da lesão. Conclusão: a HMI deve receber adequada atenção do cirurgião-dentista em função das consequências clínicas e estéticas que acarreta ao paciente, interferindo negativamente na sua qualidade de vida nos casos mais graves. Novas pesquisas são necessárias com a finalidade de expandir o conhecimento acerca da HMI, objetivando ofertar ao paciente o correto diagnóstico e a melhor opção terapêutica.

ntroduction: molar Incisor Hypomineralization (HMI) is a developmental defects of enamel that affects from one to all first permanent molars and also permanent incisors. Aim: to review the literature with the aim of providing information to the pediatric dentist about the diagnosis, clinical characteristics and treatment of HMI. Methodology: integrative literature review, using the LILACS, PubMed, Web of Science and Scopus databases. The keywords "Hipoplasia do Esmalte Dentário/Dental Enamel Hypoplasia" and "Hipomineralização Molar-Incisivo/Molar Incisor Hypomineralization" were used. Results: etiologic factors are associated with prenatal and postnatal factors, environmental and genetic complications. The prevalence of HMI is varied among the populations. It's clinically characterized as delimited opaque spots. With increasing severity, can occurs enamel loss, fracture, coronary destruction and indication of exodontia. Post-eruptive fractures act as areas of biofilm retention, which facilitates their accumulation and increases susceptibility to dental caries. European Academy of Pediatric Dentistry (EAPD) has established criteria that facilitate diagnosis of HMI in epidemiological research. Therapeutic measures are indicated according to the severity of the lesion. Conclusion: MIH should receive adequate attention from the dentist due to its clinical and aesthetic consequences, interfering negatively in quality of life of patients in the most severe cases.