Factors Associated with Hyposalivation in Brazilian Adults

ABSTRACT Objective: To determine the occurrence of hyposalivation in Brazilian adults and its association with individual determinants, such as the use of medications, systemic conditions, smoking, and alcohol consumption. Material and Methods: A cross-sectional study with 402 adults was developed. Information was collected on sociodemographic and general health characteristics, and sialometry was performed with stimulated salivary flow. It indicated low salivary flow when ≤ 0.7 mL/min. Bivariate and multivariate analyses were conducted using a decision tree (p<0.05). Results: The sample was comprised predominantly of women (68.2%) aged ≤ 29 years (25.4%). Most participants did not use medication (56.7%). Among systemic diseases, the most cited was hypertension (25.1%). More than a third of the participants presented hyposalivation (40.3%), being associated with the following variables: age between 50 to 59 years (p=0.011), female sex (p<0.001), menopause (p=0.001), use of alcohol (p=0.033), systemic disease (p=0.002) and medication use (p<0.001). In multivariate analysis, in addition to sex (p<0.001) and hypertension (p=0.005), an association was also found between hyposalivation and diabetes (p=0.014). Conclusion: Factors associated with hyposalivation in adults were sex and the presence of hypertension or diabetes.

Usefulness, Reliability, Quality, and Content of Portuguese Language YouTube Videos on COVID-19

Abstract Objective: To investigate the usefulness, reliability, quality, and content of Portuguese-language YouTube videos on COVID-19. Material and Methods: Three keywords selected on Google Trends were searched on YouTube, and the 60 first videos listed with each term were analyzed. Two calibrated researchers evaluated the reliability (DISCERN Modified Scale), the quality (Global Quality Score - GQS), and the usefulness of videos for the users (COVID-19 Specific Score - CSS). The number of views, likes, and engagement were also analyzed. The data were evaluated by the Mann-Whitney test and Spearman correlation (α=5%). Results: 59 videos were included. The average scores of quality, reliability, and usefulness were 3.0 (±1.1), 3.2 (± 0.8), and 1.5 (± 0.9), respectively. Two-thirds of the videos (64.4%) had low/moderate quality, and the majority (76.2%) were about signs and symptoms. The numbers of views (p=0.005), likes (p=0.006), and engagement (p=0.014) were significantly higher in moderate/good quality videos. The number of comments (p=0.007), duration of videos (p=0.004), and the DISCERN score (p<0.001) were significantly higher in videos made by health professionals. The general quality of the videos was positively correlated to the CSS scores, number of views, likes, and engagement (p<0.05). Conclusion: Most videos had moderate quality and reliability and low usefulness for the users.

The impact of the COVID-19 pandemic in Brazil: a study in tertiary dental care

Abstract The pandemic caused by coronavirus has resonated throughout different levels of health care in Brazil and, in this context, the present research aimed to evaluate this impact on tertiary dental care provided by the Unified Health System (SUS). Therefore, an ecological study was conducted with data obtained from the Hospital Information System processed by the Portal of the Department of Informatics of SUS. The sample consisted of patients of all sexes and age groups, whose Hospital Admission Authorizations (AIHs) were approved for dental tertiary care procedures from January 2015 to December 2020. Descriptive analyses and the ANOVA test with a significance level set at p < 0.05 were used. When the annual mean numbers of AIHs approved were evaluated, findings showed that on an average, the Southeast region authorized a higher number of procedures (p-value < 0.001), however, in the pandemic year (2020), a reduction of approximately 24.5% of these hospitalizations occurred throughout Brazil, with the Midwest being the region most affected (32.12%). A percentage increase occurred in the Surgical Treatment of Oral sinus/Oral nasal Fistula (16.1%), in addition to a significant decrease in performing procedures for Resection of Mouth Lesion (33.4%). In the pandemic year, there was a reduction of 14% in expenditures related to hospital services and 23.26% related to professional services. It was concluded that the data presented demonstrated a significant reduction in AIHs for tertiary dental care in the pandemic year.

Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil

Abstract The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.

Desordens orais potencialmente malignas: uma análise bibliométrica dos trabalhos apresentados na sociedade brasileira de pesquisa odontológica (sbpqo) / Oral potentially malignant disorders: a bibliometric analysisof the works presented at brazilian society of dental research (sbpqo)

Objetivo: as Desordens Orais Potencialmente Malignas (DOPMs) consistem em lesões e condições epiteliais que apresentam risco aumentado de malignidade. Nessa pesquisa, buscou-se identificar o perfil da produção cien-tífica brasileira sobre as DOPMs, a partir de uma análise bibliométrica dos trabalhos apresentados nas Reuniões da Sociedade Brasileira de Pesquisa Odontológica (SBPqO). Materiais e Métodos: foi realizado um estudo bibliométrico, em que foram analisados os anais das reuniões anuais da SBPqO realizadas entre 2015 a 2019. Incluiu-se resumos sobre DOPMs apresentados em qualquer categoria e as seguintes informações foram extraídas: ano, desenho do estudo, tipo de DOPM, unidade federativa, localização e instituição de ensino superior de origem. Os dados foram analisados por meio de estatística descritiva. Resultados:foram identificados 91 resumos. A maior parte foi publicada em 2015 (24,2%) e por autores do estado de São Paulo (22%). A leucoplasia foi a desordem mais frequente (36,2%), seguida pela queilite actínica (35,2%). A maioria dos estudos foi de autoria de pesquisadores das regiões Sudeste (29%) e Sul (28%). Em relação à instituição de ensino, grande parte (68,1%) foi proveniente de universidades públicas. O tipo de estudo mais frequente foi pesquisa labo-ratorial básica (57,1%). Discussão: os achados do estudo indicam que o número de pesquisas sobre as DOPMs apresentadas nas Reuniões da SBPqO ainda é reduzido, concentrados na região sudeste e nas universidades públicas. Conclusão: realizar novas pesquisas a respeito desse tema é muito importante, pois permite a descoberta de informações relevantes para a saúde dos indivíduos frente a essa neoplasia.

Objective: Oral Potentially Malignant Disorders (OPMDs) are lesions and epithelial conditions that present an increased risk of malignancy. In this research, the aim was to identify the profile of Brazilian scientific produc-tion on DOPMs, based on a bibliometric analysis of the works presented at the Meetings of the Brazilian Dental Research Society (SBPqO). Materials and Methods: a bibliometric study was carried out, in which the annals of the annual SBPqO meetings held between 2015 and 2019 were analyzed. Abstracts about DOPMs presented in any category were included and the following information was extracted: year, study design, type of DOPM, federative unit, location and educational institution of origin. The data were analyzed using descriptive sta-tistics. Results: 91 abstracts were identified. Most were published in 2015 (24.2%) and by authors from the state of São Paulo (22%). Leukoplakia was the most frequent disorder (36.2%), followed by actinic cheilitis (35.2%). Most of the studies were authored by researchers from the Southeast (29%) and South (28%) regions. Regarding the educational institution, a large part (68.1%) came from public universities. The most frequent type of study was basic laboratory research (57.1%). Discussion: the study findings indicate that the number of researches on DOPMs presented at the SBPqO Meetings is still small, concentrated in the Southeast region and in public universities. Conclusion: conducting new research on this topic is very important, as it allows the discovery of information relevant to the health of individuals in the face of this neoplasm.

Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study

Abstract Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question "In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?" was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR= 1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR= 1.81; 95% CI: 1.51-2.15), dental trauma (PR= 1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR= 1.36; 95% CI:1.18-1.57), dental crowding (PR= 1.60; 95% CI:1.40-1.83), midline diastema (PR= 1.30; 95% CI:1.11-1.44), tooth loss (PR= 1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR= 1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR= 1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents (AU).

Use of electronic devices, practice of sports, and awake bruxism in schoolchildren aged eight to ten years

Abstract The aim of the present study was to investigate whether possible awake bruxism (AB) is associated with the use of electronic devices and the practice of sports in schoolchildren aged eight to ten years. A cross-sectional study was conducted with 739 students in public and private schools in the city of Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing sociodemographic data. The children answered questions about use of electronic devices, practice of sports, and AB. Statistical analysis involved robust logistic regression for complex samples (α = 5%). The prevalence of possible AB was 14.9%. Being female (OR = 1.71, 95%CI: 1.11-2.63), being the middle child (OR = 2.19, 95%CI: 1.14-3.88), having unmarried parents (OR = 1.73, 95%CI: 1.13-2.65), daily use of a cell phone/tablet/computer (OR = 1.82, 95%CI: 1.19-2.80), use of electronic devices for two or more hours per day (OR = 1.97, 95%CI: 1.35-2.86), and playing sports in and/or out of school (OR = 1.60, 95%CI: 1.18-2.52) remained associated with possible AB in the final model. The presence of possible AB was influenced by the use of electronic devices and the practice of sports among schoolchildren aged eight to ten years.

Development and validation of a short form of the BOHLAT-P

Abstract: The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review

Abstract Objective: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). Methodology: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). Results: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. Conclusion: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.

Contextual and individual factors associated with oral health literacy in adolescents: A multi-level approach

Abstract This study aimed to evaluate the association of contextual and individual factors with Oral Health literacy (OHL) in early adolescence. This is a population-based cross-sectional study carried out with 740 12-year-old adolescents randomly selected by a two-stage probabilistic cluster sampling process from schools in Campina Grande, Brazil. The guardians provided sociodemographic information. Adolescents answered the Brazilian version of the Family Adaptability and Cohesion Scales (FACES III) to measure family functioning, and the Brazilian Rapid Estimate of Literacy in Dentistry (BREALD-30) to measure OHL. Descriptive analysis was conducted, followed by robust Poisson's regression analysis for complex samples with a multilevel approach (p<0.05). Rate ratio (RR) and 95% confidence intervals (CI) were calculated. The two levels of the analysis were students and schools. Adolescents enrolled at schools with higher grade-retention rate had slightly worse OHL scores (RR = 0.99; 95% CI: 0.98 to 0.99). The following individual factors were associated with the level of OHL: the female sex (RR = 1.05; 95% CI: 1.01 to 1.10), mother's schooling more than eight years (RR = 1.13; 95% CI: 1.08 to 1.19), younger guardians (RR = 0.94; 95% CI: 0.90 to 0.97) and a balanced family functioning (RR = 1.08; 95% CI: 1.01 to 1.14). Individual and contextual factors were associated with OHL in early adolescence.

Resumo O objetivo deste estudo foi avaliar o efeito de um nanocomplexo recém-desenvolvido formado entre hidroxipropil-β-ciclodextrina e 1% de tetrafluoreto de titânio (TiF4) após distintos períodos de complexação (12/72 horas) na desmineralização do esmalte bovino in vitro. Blocos de esmalte (n = 60) foram alocados para cada grupo: água Mili-Q, hidroxipropil-β-ciclodextrina, TiF4 a 1%, hidroxipropil-β-ciclodextrina + TiF4 1% após 12 horas de complexação e hidroxipropil-β-ciclodextrina + TiF4 1% após 72 horas de complexação. As amostras foram avaliadas pela microdureza superficial, microdureza transversal e micro-CT. Microscopia eletrônica de varredura / espectrometria de raios X por dispersão de energia (MEV / EDX) foram obtidas. A hidroxipropil-β-ciclodextrina + TiF4 1% após 12h de complexação resultou em um menor percentual de perda de microdureza superficial em comparação com água Mili-Q, hidroxipropil-β-ciclodextrina, TiF4 a 1% e hidroxipropil-β-ciclodextrina + TiF4 1% após 72 horas de complexação com uma ampla magnitude de efeito (de 1,307 a 2,943) e alto poder (84,9 a 99%). Todos os grupos resultaram em similar perda integrada de minerais (ΔZ) obtida por ambas as técnicas de microdureza e micro-CT. O esmalte tratado com os grupos TiF4 e TiF4 + hidroxipropil-β-ciclodextrina apresentou camada de esmalte TiO2, enquanto a avaliação de EDX identificou Ti. A solução contendo o complexo de inclusão de hidroxipropil-β-ciclodextrina + TiF4 com 12 horas de período de complexação demonstrou uma capacidade significativa para reduzir a desmineralização superficial do esmalte hígido sob um desafio cariogênico artificial.

Validação de instrumentos de pesquisa odontológica no Brasil: um estudo bibliométrico com base nos anais de um congresso brasileiro / Validation of dental research instruments in Brazil: a bibliometric study, based on the annals of a Brazilian conference

Objetivo: analisar os estudos de validação de instrumentos de pesquisa publicados nos anais das reuniões anuais da Sociedade Brasileira de Pesquisa Odontológica (SBPqO), no período de 2010 a 2019. Métodos: Realizou-se um estudo bibliométrico em que foram incluídos trabalhos sobre a adaptação transcultural ou avaliação das propriedades psicométricas de instrumentos de pesquisa. Três pesquisadores independentes e calibrados realizaram a leitura dos resumos e extraíram informações sobre: ano, localização geográfica, tipo de instituição de ensino dos autores, financiamento, objetivo do trabalho, idioma original do instrumento, constructo e público-alvo. Os dados foram analisados através de estatística descritiva.Resultados:Foram incluídos 26 resumos, sendo a maioria publicada em 2018 (23%) e 2019 (30,5%) e por pesquisadores de instituições públicas de ensino (88,4%) localizadas nos estados de São Paulo (35%) e Minas Gerais (27%). Metade dos estudos realizou, concomitantemente, adaptação transcultural e avaliação das propriedades psicométricas. Os constructos mais frequentemente abordados foram alfabetismo em saúde bucal (ASB) (23%) e qualidade de vida relacionada a saúde bucal (QVRSB) (15,4%). O público-alvo mais prevalente envolveu os adultos (38,4%) e profissionais de saúde (19,3%). Conclusão:O número de estudos de validação de instrumentos de pesquisa foi baixo, concentrado, principalmente, nos anos de 2018 e 2019, e conduzidos em maioria por pesquisadores de universidades públicas dos estados de São Paulo e Minas Gerais. A maior parte dos estudos realizou, concomitantemente, adaptação transcultural e avaliação das propriedades psicométricas de instrumentos sobre ASB e QVRSB.

Aim: To analyze studies reporting the validation of research instruments published in the annals of the annual meetings of the Brazilian Society of Dental Research (SBPqO), between 2010 and 2019. Methods: A bibliometric study, including abstracts reporting the cross-cultural adaptation or evaluation of the psychometric properties of research instruments, was conducted. Studies reporting the development of research instruments were excluded. Three independent and calibrated researchers read the abstracts and extracted information regarding: year, geographic location, and type of educational institution of authors, funding, study objective, original language of the instrument, construct, and target audience. Data were analyzed descriptively. Results: Twenty-six studies were included; most were published in 2018 (23%) and 2019 (30.5%), by researchers from public institutions (88.4%) and from the states of São Paulo (35%) and Minas Gerais (27%). Half of the studies performed the cross-cultural adaptation and evaluation of psychometric properties jointly. The most frequent constructs were oral health literacy (OHL) (23%) and oral health-related quality of live (OHRQoL) (15.4%). Most instruments were directed toward adults (38.4%) and health professionals (19.3%). Conclusion: The number of studies reporting the validation of research instruments was low, concentrated in the years 2018 and 2019, and mainly conducted by researchers from public universities in São Paulo and Minas Gerais. Most studies performed the cross-cultural adaptation and evaluation of psychometric properties of instruments concerning OHL and OHRQoL.

Fissuras orofaciais: uma análise bibliométrica dos trabalhos apresentados em um congresso brasileiro / Orofacial fissures: a bibliometric analysis of the works presented at a Brazilian congress

Objetivo: Investigar a produção científica sobre fendas orofaciais em um congresso brasileiro, entre os anos de 2009 a 2019. Métodos:Realizou-se um estudo bibliométrico, observacional, pela análise de resumos publicados em anais das Reuniões Anuais da Sociedade Brasileira de Pesquisa Odontológica (SBPqO), que envolviam o tema de fissuras orofaciais.Os dados referentes aos resumos (ano de publicação, local do estudo ­ unidade federativa, tipo de fissura, grande área de conhecimento, desenho, tipo de instituição,recebimento de fomento) foram coletados e analisados através de uma estatística descritiva e analítica. Foi aplicado o teste não paramétrico de Mann-Whitney (p < 0,05). Resultados: Dentre 28.578 resumos, 194 (0,67%) eram sobre fissuras orofaciais. A maioria deles envolvia mais de um tipo de fissura (n = 180; 93,3%) e foram realizados,principalmente, em instituições públicas (n = 128; 66%) das regiões Sudeste (n = 121;62,3%), e Sul (n = 23; 11,8%), sem recebimento de fomento (60,8%). A área de conhecimento mais comum foi Epidemiologia/Saúde Coletiva (n = 60; 30,9%), com predominância dos desenhos de estudos transversais (n = 85; 43,8%). Houve associação estatisticamente significativa entre recebimento de financiamento e maior tamanho amostral. Conclusão: Poucos estudos investigaram as fissuras orofaciais na SBPqO.Uma investigação mais aprofundada nesse campo de pesquisa permite identificar problemáticas que possibilitam a organização, planejamento e monitoramento da atenção especializada para os portadores dessas anomalias, assim como criar condições para uma descentralização do cuidado pela ampliação da rede de serviços para outras localidades no Brasil.

Aim: To investigate the scientific production concerning orofacial clefts presented at a Brazilian congress, between 2009 and 2019. Methods: A bibliometric and observational study was conducted, though the analysis of abstracts published in the annals of the Annual Meetings of the Brazilian Society of Dental Research (SBPqO), concerning orofacial clefts. Data referring to the abstracts (year of publication, place of study - federative unit, type of fissure, broad area of knowledge, design, type of institution, receipt of funding) were collected and organized through descriptive and analytical statistics. The Mann-Whitney non-parametric test was applied (p < 0.05). Results: Among 28,578 abstracts, 194 (0.67%) concerned orofacial clefts. Most of them dealt with more than one type of cleft (n = 180; 93.3%) and were mainly conducted in public institutions (n = 128; 66%), in the Southeast (n = 121; 62.3%) and South (n = 23; 11.8%) regions, and without funding (60.8%). The most common field of knowledge was Epidemiology/Public Health (n = 60; 30.9%), with a predominance of cross-sectional studies (n = 185; 43.8%). There was a statistically significant association between funding and higher sample size. Conclusion:Few studies have investigated orofacial clefts in SBPqO. An in-depth investigation in this field of research allows for the identification of problems that make it possible to organize, plan, and monitor specialized care for people with these anomalies, as well as create conditions for the decentralization of care by expanding the service network to other locations in Brazil.

Patient-centered assessments: how can they be used in dental clinical trials?

Abstract Recently, there has been greater interest in adopting a more holistic approach to healthcare. However, this trend should not limit itself merely to the notion that a human being lies behind the mouth being treated. Rather, it should embrace the understanding that this human can actively participate in and contribute to the treatment process. Patient Report Outcome Measures (PROMs) and Patient Report Experience Measures (PREMs) provide means for measuring data from the patient's perspective, and enable health-related feelings and functions to be evaluated. Accordingly, this critical review aims to provide definitions, rationales and applications of patient-centered approaches in dental clinical research. Some patient-centered constructs are especially relevant to dental clinical trials, such as oral health-related quality of life, pain/discomfort, aesthetics and satisfaction concerning treatment and services. The selection and application of patient-reported measures can vary according to condition (generic, disease-specific or treatment-specific) and to the specific population evaluated (age and cognitive impairment). These measures can help weigh risks and benefits, as well as assess the cost effectiveness of treatments, thus influencing treatment recommendations and health policies. The incorporation of these measures into a professional's daily life not only represents an improvement in professional performance, but also addresses a humanitarian concern.

Validação para a língua portuguesa do Brasil e desenvolvimento da versão reduzida do Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) / Validation to the Brazilian Portuguese language and development of a reduced form of the Hong Kong Oral Health Literacy Assessment task for Paediatric Dentistry (HKOHLAT-P)

O objetivo do estudo foi adaptar transculturalmente e validar para a língua portuguesa do Brasil o questionário Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) e desenvolver uma versão reduzida deste instrumento. A adaptação transcultural envolveu traduções, unificação das traduções, retrotradução, revisão da retrotradução, pré-teste, discussão pelo comitê de especialistas e produção da versão final em português. Duzentos pais/responsáveis e pré-escolares entre 3 a 5 anos de idade de Campina Grande, Paraíba, participaram do estudo. O responsável pela criança respondeu à versão adaptada para o Brasil do HKOHLAT-P (BHKOHLAT-P), um questionário sócio demográfico e de hábitos de leitura, o questionário Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS), além do instrumento Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD30). O HKOHLAT-P foi respondido uma segunda vez por todos os pais/responsáveis, após 15 dias, para avaliação da confiabilidade teste-reteste. As crianças foram examinadas para diagnóstico de cárie dentária (ICDAS-II) por um examinador calibrado (K = 0,83-0,99). A confiabilidade do instrumento foi testada através da consistência interna e da confiabilidade teste-reteste. Análise fatorial exploratória (AFE) e confirmatória (AFC) avaliaram a dimensionalidade do instrumento. As validades convergente, divergente, concorrente e preditiva foram avaliadas. Modelos de regressão múltiplos de Poisson testaram a associação entre os escores do BHKOHLAT-P e variáveis de interesse (p<0,05). A Teoria da Resposta ao Item foi empregada para reduzir o número de itens do instrumento, utilizando curvas características dos itens e parâmetros de discriminação e dificuldade. A versão reduzida teve sua dimensionalidade avaliada pela AFC; sua validade e confiabilidade testadas. O instrumento demonstrou excelente consistência interna (Alfa de Cronbach = 0,92) e confiabilidade teste-reteste (CCI = 0,95). A AFE e AFC demonstraram que o instrumento é unidimensional. Houve correlação positiva entre os escores do BHKOHLAT-P e do BREALD-30 (r = 0,71; p<0,001) (validade convergente), número de anos de estudo (r = 0,60; p<0,001) e horas dedicadas à leitura (r = 0,34; p<0,001) (validade concorrente). Houve correlação negativa entre os escores do BHKOHLATP, escores do B-ECOHIS (r = -0,23; p=0,001) e o número de dentes cavitados (r = - 0,15; p=0,026) (validade preditiva). Após o controle por variáveis de confusão, os escores do BHKOHLAT-P não permaneceram associados com os do B-ECOHIS, número de dentes com cárie cavitada e presença de cárie (validade divergente). A versão reduzida compreendeu 30 itens (BHKOHLAT-P-30). A AFC demonstrou que o instrumento reduzido é unidimensional. O BHKOHLAT-P-30 demonstrou consistência interna (Alfa de Cronbach = 0,91) e confiabilidade teste-reteste (CCI = 0,95) excelentes. Os escores do BHKOHLAT-P-30 foram correlacionados com os escores do BREALD-30 (r = 0,71; p<0,001), número de anos de escolaridade (r = 0,60; p<0,001) e número de horas dedicadas à leitura (r = 0,33; p<0,001). Houve correlação negativa entre os escores do BHKOHLAT-P-30, do B-ECOHIS (r = -0,21; p=0,002) e o número de dentes cavitados (r = -0,18; p=0,010). Conclui-se que as versões longa e curta demonstraram boa confiabilidade e validade. A versão curta demonstrou propriedades psicométricas semelhantes às da longa, com substancial redução na quantidade de itens. (AU)

The aim of the study was to cross culturally adapt and validate for the Brazilian Portuguese language the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) questionnaire and to develop a reduced version of the instrument. The cross-cultural adaptation comprised translations, unification of translations, back-translation, analysis by an expert panel, pre-test, discussion by the expert panel and production of the final version in Portuguese. Two hundred parents/caregivers and preschoolers aged 3 to 5 years old from Campina Grande, Paraíba, participated in the study. One of the child's parent/caregiver answered to the Brazilian version of the HKOHLAT-P (BHKOHLAT-P), a sociodemographic and reading habits questionnaire, the Early Childhood Oral Health Impact Scale (BECOHIS) and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) instrument. BHKOHLAT-P was answered a second time by all participants, after a 15 days-interval, to assess test-retest reliability. Children were examined for the diagnosis of dental caries (ICDAS-II) by a calibrated examiner (K = 0.83-0.99). The reliability of the instrument was measured by internal consistency and test-retest reliability. Exploratory (EFA) and confirmatory factor analysis (CFA) evaluated the dimensionality of the instrument. Convergent, divergent, concurrent and predictive validity were evaluated. Poisson regression models tested the effect of family income and education on the association between BHKOHLAT-P and exploratory variables (p<0.05). Item response theory was employed to reduce the number of items of the instrument, using item characteristic curves, discrimination and difficulty parameters. The reduced version had its dimensionality assessed by FCA; its reliability and validity tested. The instrument showed excellent internal consistency (Cronbach's alpha = 0.93) and testretest reliability (ICC = 0.95). EFA and CFA showed the instrument to be unidimensional. There was a positive correlation between BHKOHLAT-P and BREALD-30 scores (r = 0.71; p<0.001) (convergent validity), the number of years of schooling (r = 0.60; p<0.001) and hours spent reading (r = 0.34; p<0.001) (concurrent validity). There was a negative correlation between BHKOHLAT-P and B-ECOHIS scores (r = - 0.23; p=0.001) and with number of cavitated teeth (r = - 0.15; p=0.026) (predictive validity). At the multivariate model, BHKOHLAT-P scores were not associated with B-ECOHIS scores, number of cavitated teeth or with the presence of caries (divergent validity). The reduced version comprised 30 items (BHKOHLAT-P30). CFA showed the reduced instrument to be unidimensional. BHKOHLAT-P-30 had excellent internal consistency (Cronbach's alpha = 0.91) and test-retest reliability (CCI = 0.95). BHKOHLAT-P-30 scores were correlated with BREALD-30 scores (r = 0.71; p<0.001), number of years of schooling (r = 0.60; p<0.001) and hours spent reading (r = 0.33; p<0.001). There was a negative correlation between BHKOHLAT-P-30 and BECOHIS scores (r = -0.21; p=0.002) and with number of cavitated teeth (r = -0.18; p=0.010). In conclusion, the long and reduced versions showed good reliability and validity. The reduced version demonstrated psychometric properties similar to those of the long version, with a substantial reduction in the number of items. (AU)

Approaches adopted by dentists for management of occlusal caries in primary teeth / Condutas adotadas por cirurgiões-dentistas frente à cárie oclusal em dentes decíduos

ABSTRACT Objective To evaluate the approaches used by Family Health Strategy dentists in the city of Campina Grande, Paraíba, Brazil, for management of occlusal caries in primary teeth. Methods In this observational, cross-sectional, census-based, descriptive study, 33 professionals completed a questionnaire designed to evaluate their approach to management of occlusal caries in enamel and dentin of deciduous teeth in different risk situations. Data were analyzed through descriptive and inferential statistics (Fisher's exact test with the level of significance set to 5%). Inter-examiner agreement was evaluated by Cohen's kappa statistic. Results For chronic enamel caries in primary teeth with low risk/activity, the approach of choice was preventive, with fluoride application being the most cited intervention (39.3%). For active carious dentin in primary teeth with high risk/activity and with low risk/activity, invasive approaches were most prevalent (93.9% and 78.8%, respectively), with complete caries removal (74.2%) and glass-ionomer restoration (69.2%) being the most frequent responses. Inter-examiner agreement was moderate (k = 0.44). Conclusion Although a wide range of approaches were adopted by dental practitioners, most preferred invasive interventions, even in situations where preservation of tooth structure was recommended.

RESUMO Objetivo Avaliar a conduta de cirurgiões-dentistas da Estratégia de Saúde da Família do município de Campina Grande, Paraíba, Brasil, frente à cárie oclusal em dentes decíduos. Métodos Foi um estudo observacional, transversal, censitário e descritivo no qual 33 profissionais responderam a um questionário que avaliou suas condutas diante de cáries oclusais em esmalte e dentina de dentes decíduos, em diferentes situações de risco. Os dados foram analisados por meio de estatística descritiva e inferencial (Teste Exato de Fisher com nível de significância de 5%). A concordância inter-examinador foi avaliada pelo Teste Kappa de Cohen. Resultados Para a cárie crônica em esmalte de dentes decíduos com baixo risco/atividade de cárie a conduta de eleição foi preventiva, sendo a aplicação de flúor a mais citada (39,3%). Nos casos de cárie ativa em dentina em dentes decíduos com alto risco/atividade de cárie e de cárie ativa em dentina de dentes decíduos com baixo risco/atividade de cárie, a conduta invasiva foi a mais indicada (93,9% e 78,8%, respectivamente), sendo a remoção total do tecido cariado (74,2%) e restauração com ionômero de vidro (69,2%) as respostas mais frequentes. A concordância inter-examinador foi moderada (k=0,44). Conclusão As condutas adotadas pelos profissionais variaram bastante, havendo uma preferência por condutas caráter invasivo em situações onde a preservação da estrutura dentária era o mais indicado.

Association between oronasopharyngeal abnormalities and malocclusion in Northeastern Brazilian preschoolers

Abstract Objective: Evidence is contradictory regarding the association between oronasopharyngeal abnormalities and malocclusion. The aim of the present study was to assess the association between oronasopharyngeal abnormalities and malocclusion (anterior open bite and posterior crossbite) in preschoolers. Methods: A cross-sectional study was conducted with a representative sample of 732 preschoolers aged 3-5 years old selected randomly from private and public preschools. Anterior open bite (AOB) and posterior crossbite (PC) were evaluated through a clinical exam. Parents/caregivers answered a questionnaire addressing sociodemographic indicators and oronasopharyngeal issues. Statistical analysis involved descriptive analysis and Poisson regression (p < 0.05). Results: The prevalences of AOB and PC were 21.0% and 11.6%, respectively. Being three years old (PR = 1.244; 95% CI = 1.110-1.394; p < 0.001), being four years old (PR = 1.144; 95% CI = 1.110 - 1.394; p = 0.015), absence of allergy (PR = 1.158; 95% CI = 1.057 - 1.269; p = 0.002), not having undergone nose surgery (PR = 1.152; 95% CI = 1.041 - 1.275; p = 0.006) and having a sore throat more than five times in the same year (PR = 1.118; 95% CI = 1.011 - 1.237; p = 0.030) were significantly associated with AOB. The absence of asthma (PR = 1.082; 95% CI = 1.012 - 1.156; p = 0.020), not having undergone throat surgery (PR = 1.112; 95% CI = 1.068 - 1.158; p < 0.001) and not having undergone nose surgery (PR = 1.114; 95% CI = 1.069 - 1.160; p < 0.001) remained associated with PC. Conclusion: Significant associations were found between oronasopharyngeal-reported abnormalities and the presence of AOB and PC in preschoolers.

resumo Introdução: não há consenso na literatura quanto à associação entre alterações oronasofaríngeas e as más oclusões. Objetivo: o objetivo do presente estudo foi avaliar a associação entre as alterações oronasofaríngeas e as más oclusões (mordida aberta anterior e mordida cruzada posterior) em pré-escolares. Métodos: um estudo transversal foi conduzido com uma amostra representativa de 732 pré-escolares com 3 a 5 anos de idade, aleatoriamente selecionados em pré-escolas privadas e públicas. A mordida aberta anterior (MAA) e a mordida cruzada posterior (MCP) foram avaliadas a partir de exames clínicos. Pais/cuidadores responderam a um questionário relativo a indicadores sociodemográficos e problemas oronasofaríngeos. A análise estatística envolveu análise descritiva e regressão de Poisson (p < 0,05). Resultados: as prevalências de MAA e MCP foram de 21,0% e 11,6%, respectivamente. Ter três anos de idade (RP = 1,244; IC = 1,110 - 1,394; p < 0,001, considerando-se RP = Razões de Prevalência e IC = Intervalo de Confiança 95%), ter quatro anos de idade (RP = 1,144; IC = 1,110 - 1,394; p = 0,015), ausência de alergia (RP = 1,158; IC = 1,057 - 1,269; p = 0,002), não ter se submetido a cirurgias do nariz (RP = 1,152; IC = 1,041 - 1,275; p = 0,006) e ter tido dor de garganta mais de cinco vezes no mesmo ano (RP = 1,118; IC = 1,011 - 1,237; p = 0,030) foram significativamente associados com MAA. Ausência de asma (RP = 1,082; IC = 1,012 - 1,156; p = 0,020), não ter realizado adenoidectomia (RP = 1,112; IC = 1,068 - 1,158; p < 0,001) e não ter se submetido a cirurgias do nariz (RP = 1,114; IC = 1,069 - 1,160; p < 0,001) permaneceram associados à MCP. Conclusão: associações significativas foram encontradas entre as alterações oronasofaríngeas relatadas e a presença de MAA e MCP em pré-escolares.

Case-control study examining the impact of oral health problems on the quality of life of the families of preschoolers

Abstract The aim of this study was to evaluate the impact of dental caries, traumatic dental injuries (TDI), toothaches, and malocclusion on the oral health-related quality of life (OHRQoL) of the families of Brazilian preschool children. A population-based, matched case-control study involving 415 pre-schoolers aged 3-5 years was conducted. The case (impact on OHRQoL) and control groups (no impact on OHRQoL) were matched for age, gender, and family income at an 1:4 ratio. Impact on the OHRQoL of a family was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Dental caries, TDI, and malocclusion were diagnosed by three calibrated dentists (Kappa: 0.85-0.90). Data analysis involved descriptive statistics and conditional logistic regression analysis (p ≤ 0.05; 95%CI). There were no differences between the cases and controls regarding age, gender, and family income (p > 0.05). The most frequent responses on the B-ECOHIS among cases were "felt guilty" (68.6%) and "been upset" (48.2%). The following variables were significantly associated with negative impacts on family OHRQoL (cases): caries severity (OR = 6.680; 95%CI = 2.731-16.349), a history of toothache (OR = 2.666; 95%CI = 1.492-4.765), parental rating of the child's oral health as poor (OR: 1.973; 95%CI = 1.072-3.634), and parent's/caregiver's age (OR = 2.936; 95%CI = 1.077-3.478). Anterior open bite was positively associated with OHRQoL (OR = 4.050; 95%CI = 1.333-12.314). Caries severity, a history of toothache, parental rating of the child's oral health as poor, and younger parents/caregivers were associated with impact on the OHRQoL of the families of preschoolers.

Impacto da saúde bucal na qualidade de vida de escolares do município de pequeno porte da paraíba / Impact of oral health in life quality of school children in a small municipality of Paraíba

Introdução: Doenças bucais são comuns na infância e causam um impacto negativo na qualidade de vida das crianças. Objetivo: Avaliar a relação do impacto da qualidade de vida e necessidade de tratamento odontológico de crianças na faixa etária de 8 a 10 anos em escolas municipais de ensino de Mari (PB). Material e método: Oitenta e seis escolares participaram da pesquisa que consistiu na aplicação do Child Perceptions Questionnaire (CPQ8-10) e exame bucal utilizando o índice INTO realizado por um único examinador calibrado (kappa interexaminador=0,83 e intraexaminador=0,54). Foi realizada estatística descritiva e inferencial (Qui quadrado e Exato de Fisher) com nível de significância de 5%, através do programa Statistical Package for the Social Sciences. Resultados: A maioria das crianças possuía 8 anos (38,4%, n=33), eram do sexo feminino (58,1%, n=50), sendo equitativamente distribuídas em escolas da zona urbana e rural. A maioria das crianças tinha necessidade de tratamento dentário (73,3%). O domínio mais frequente do CPQ foi alto e médio impacto na qualidade de vida das crianças foram os sintomas bucais (68,6%). Houve associação significativa entre os aspectos relacionados ao bem estar-social e a necessidade de tratamento cirúrgico restaurador, onde 72,7% dos pesquisados apresentavam elevada necessidade de tratamento restaurador e alto ou médio impacto em sua qualidade de vida (p<0,05). Houve associação estatisticamente significativa entre o impacto de qualidade de vida da criança e a necessidade de tratamento cirúrgico-restaurador (p<0,05). Conclusão: Pôde-se concluir que o impacto de qualidade de vida e a necessidade de tratamento estão associados nos escolares pesquisados.(AU)

Introduction: Oral Diseases are common in childhood and have a negative impact on quality of life of children. Objective: To evaluate the relationship of the impact of quality of life and need for dental treatment of children aged 8 to 10 years in municipal schools of education in Mari (PB). Methods: Eighty-six students participated in the survey which consisted of the application of the Child Perceptions Questionnaire (CPQ8-10) and oral examination using the INTO index performed by a single calibrated examiner (kappa = 0.83 inter and intra-rater = 0.54). Descriptive and inferential statistics (square and Fisher exact Thursday) with 5% significance level was performed using the Statistical Package for Social Sciences program. Results: Most of the children had 8 years (38.4%, n = 33) were female (58.1%, n = 50), and evenly distributed in schools in urban and rural areas. Most children had need of dental treatment (73.3%). The most common domain CPQ was high and medium impact on the quality of life of children were the oral symptoms (68.6%). A significant association between the aspects related to welfare and social and the need for surgical treatment restorer, where 72.7% of respondents had a high need for restorative treatment and high or medium impact on their quality of life (p <0.05). There was a statistically significant association between the child's quality of life impact and the need for surgical-restorative treatment (p <0.05). Conclusion: It was concluded that the impact of quality of life and the need for treatment are associated in schoolchildren.(AU)

Conhecimento de ergonomia e desordens osteomusculares entre estudantes de Odontologia / Knowledge of ergonomics and musculoskeletal disorders among dental students

Objetivo: Este trabalho tem o objetivo de avaliar o conhecimento de estudantes de Odontologia sobre os princípios ergonômicos aplicados à prática clínica e de investigar sintomas associados às doenças ocupacionais. Materiais e método: tratou-se de um estudo transversal censitário, no qual foram entrevistados 164 estudantes do 3º ao 9ºperíodo do curso de Odontologia de uma universidade do município de Caruaru-PE. Foram aplicados dois questionários: um, com perguntas relativas às características sociodemográficas, conhecimentos sobre ergonomia, doenças ocupacionais na Odontologia e medidas preventivas; e o outro, o Nordic musculoskeletal questionnaire, para mensuração de sintomas osteomusculares. Para análise estatística foi usado o teste de correlação de Pearson ou o Exato de Fisher (p<0,05). Resultados: a maioria dos pesquisados, 87,2%, soube expressar parcialmente o conceito de ergonomia, exemplificou como principais doenças ocupacionais os distúrbios osteomusculares, 54,3%, bem como destacou realizar medidas preventivas ?às vezes? (45,7%), sendo os alongamentos a principal prática em 53% dos casos. O local mais acometido por sintomas osteomusculares foi a parte superior das costas em 46,3% das ocorrências. Houve diferença estatística entre os períodos dos estudantes (3º, 5º, 70 e 9º) para as variáveis: definição de ergonomia, frequência de uso de medidas preventivas, principais doenças ocupacionais e localização anatômica da dor (p<0,05). Houve tendência de pior desempenho e maiores frequências de distúrbios osteomusculares nos acadêmicos dos períodos finais do curso. Conclusões: o conhecimento dos estudantes foi insatisfatório e as regiões mais acometidas por sintomas associados às doenças ocupacionais foram: a parte superior e a inferior das costas e do pescoço. Procedimentos normativos devem ser adotados com o intuito de prevenir as doenças ocupacionais no ambiente acadêmico.

Avaliação da condição gengivalde escolares / Evaluation of the gingival condition of school children

Verificar a condição periodontal e fatores associados de crianças e adolescentes matriculados em escola pública e privada de Caruaru-PE. Material e Métodos: A amostra foi composta por 121 escolares, de ambos os sexos, na faixa etária de sete a catorze anos. Para a coleta de dados foram utilizados o índice gengival (IG) e o índice de placa (IP). Também foi aplicado um questionário aos pais e responsáveis para avaliação da renda familiar e da escolaridade materna. Foram aplicados o teste do qui-quadrado e/ou Exato de Fischer; t-Student e Anova (α<0,05). Resultados: A maioria dos escolares tinha entre sete e dez anos de idade (57,9%), era do sexo feminino (55,4%), de escola pública (61,2%), com renda familiar abaixo de um salário-mínimo (51,2%) cujas mães tinham menos de 12 anos de estudo (62,8%). A prevalência de gengivite e índice de placa não aceitável foi de 18,2% e 79,3%, respectivamente. Verificou-se associação significativa entre o índice gengival e mães sem instrução(p=0,025) . Com exceção da variável sexo, houve associação significativa entre o índice de placa e as demais variáveis (p<0,05). Conclusão: A maioria dos pesquisados não apresentou alterações gengivais e dentre os que apresentaram gengivite, a inflamação leve foi predominante. Faz-se necessário uma melhor atenção à saúde bucal no serviço público, bem como o aumento da informação aos pais, em especial aqueles em situação de deprivação social...

To verify the periodontal condition and associated factors of children and adolescents enrolled in public and private schools in Caruaru-PE. Materials and Methods: The sample consisted of 121 students of both sexes, aged from seven to fourteen years old. Data was collected according to the gingival index (GI) and the plaque index (PI). Parents were asked to answer a questionnaire in order to assess family income and maternal education. We applied the Chi-Square and / or Fisher’s Exact, Student t test and ANOVA (α<0,05). Results: Of the 121 respondents, the majority (57.9%) was between seven and ten years old, were females (55.4%), from public school (61.2%), with family income lower than one minimum salary (51.2%), whose mothers had less than 12 years of education (62.8%). The prevalence of gingivitis and plaque index was not acceptable by 18.2% and 79.3%, respectively. There was a significant association between the gingival index and illiterate mothers(p=0,025). With the exception of gender, there was a significant association between the plaque index and the other variables (p <0.05). Conclusion: It’s necessary to pay more attention to oral health in the public service, as well as to increase the amount of information given to parents, specially to those in situations of social deprivation...