Breastfeeding, consumption of ultraprocessed foods, and dental caries at 4 years of age: A birth cohort study.

BACKGROUND: Cohort studies have demonstrated an association between prolonged and/or frequent breastfeeding and early childhood caries (ECC). AIM: To investigate the association between prolonged breastfeeding and ECC at 48 months, while considering the interaction between prolonged breastfeeding and ultraprocessed foods (UPF). DESIGN: Data from a birth cohort study conducted in southern Brazil were used (n = 3645). Poisson regression was used to evaluate the influence of breastfeeding and UPF consumption on the prevalence and experience of caries. To measure the interaction on the additive scale between breastfeeding and UPF consumption on the prevalence and experience of ECC, the relative excess risk due to interaction (RERI) was calculated. RESULTS: Prolonged breastfeeding was associated with higher prevalence (PR = 1.82; CI:1.59-2.08) and experience (RR = 2.47; CI:1.97-3.10) of ECC. Greater prevalence (PR = 1.16; CI: 1.04-1.30) and experience of ECC (RR = 1.22; CI: 1.00-1.48) were found in children who had high consumption of UPFs. Negative RERIs were observed for the prevalence and experience of ECC (-0.25 and -0.001). CONCLUSION: High UPF consumption and prolonged breastfeeding were associated with ECC. No interaction, however, was observed, showing that the two exposures have independent effects. To prevent ECC, policies and programs are needed to support breastfeeding until the age of 2 years and to limit the consumption of UPF.

Dental Fear/Anxiety in Children and Child Emotional and Behavioural Problems

ABSTRACT Objective: To investigate the association between emotional and behavioural problems and dental fear/anxiety (DFA) in children aged four to 12 years treated at a clinic in southern Brazil. Material and Methods: In this cross-sectional study where mother-child dyads were interviewed, emotional and behavioural problems were investigated using the Strengths and Difficulties Questionnaire (SDQ) (considering five subscales). Children's DFA was evaluated through the Venham Picture Test. For each SDQ subscale, Poisson regression model was explored. Prevalence ratios (PR) were estimated, considering a significant level of p ≤ 0.05. Results: Overall, 128 children participated in this study. Most children were female (54.7%) and aged between 7 and 9 years (39.8%). The prevalence of emotional problems was 47.7% and behavioural problems were 46.1%. The prevalence of DFA was 18.8%. Children with emotional problems had a 2.3 higher prevalence of DFA (95%CI 1.06-5.04). In general, behavioural problems were not associated with DFA (95%CI 0.84-3.34) only when conduct problems were considered (2.20; 95%CI 1.02-4.70). Conclusion: Children aged between 4 and 12 years who present emotional and conduct problems tend to show higher DFA.

Translation and Cross-Cultural Adaptation of the "Child Drawing: Hospital" (CD:H) Scale for Paediatric Dentistry in Brazil

Abstract Objective: To translate and perform the cross-cultural adaption of the CD:H scale for use in Paediatric Dentistry in Brazilian Portuguese language. Material and Methods: The translation and cross-cultural adaptation of the CD: H was carried out in four stages: 1) translation of the instrument; 2) reverse translation (back translation); 3) cross-cultural adaptation, and 4) face validation. Face validation consisted of the evaluation of 30 subjects from the target population. A pilot study was conducted with 15 children aged 5-10 years treated at a university dental clinic and their drawings were analysed by two dentists. Data were analysed using Stata 12.0. Results: In the face validation, most items were understood; however, some words were changed, and terms were included to identify the dental environment. Good reproducibility was obtained: inter-examiner reliability was 0.9647 and intra-examiner reliability was 0.9619 for examiner A and 0.8260 for examiner B. Conclusion: The Brazilian version of the CD:H scale is a useful tool for dentists, helping identify children's emotions and being enjoyable for them.

Association between malocclusion and the severity of dental trauma in primary teeth.

BACKGROUND/AIMS: The literature does not clearly state whether the type of malocclusion is associated with a specific type of trauma and the severity of the injury. Hence, the aim of this retrospective study was to assess the occlusal condition in children with traumatic dental injuries of the primary teeth, and the association between the occlusal characteristics and the type and severity of these injuries. MATERIAL AND METHODS: Data were collected from records of children treated at a dental trauma center in Brazil over a period of 16 years. The data included age, gender, etiology of the trauma, place of occurrence, number of affected teeth, type of trauma, and injury severity. The occlusal condition was assessed by a trained dentist using photographs of the patients from their first visit. Chi-square tests and Poisson regression were used for data analyses. RESULTS: This study included 209 patients, and most were aged between 2-4 years (50.55%). Multivariate regression analysis showed that children with an anterior open bite had a 47% higher prevalence of severe trauma than those who did not have an anterior open bite, and those with class II canines had a 56% higher prevalence of severe trauma than those with class I and III canines. Children with an anterior open bite had a 46% higher prevalence of injuries affecting multiple teeth than those without an anterior open bite. CONCLUSIONS: Anterior open bite and class II canine relationship were associated with a higher prevalence of severe traumatic dental injury in primary teeth, and anterior open bite was associated with trauma affecting multiple teeth.

Oral health-related quality of life of preschool children assisted at a University Dental Clinic / Oral health-related quality of life of preschool children assisted at a University Dental Clinic

Objective: This study assessed parental perception on children?s oral health-related quality of life (OHRQoL), and children?s views on their own teeth. Subjects and method: The sample included in this cross-sectional study consisted of 106 parents and their children, aged 0-6 years, who were assisted at a School of Dentistry. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess OHRQoL. Socioeconomic information and reasons for seeking dental care were asked and obtained from parents, while clinical information were collected from files. Children expressed the views on their teeth through an instrument with drawings. Data was analyzed by the Fisher?s exact test and Poisson regression. Results: The mean ECOHIS score was 8.31. Higher impacts on OHRQoL were observed in older children (RR=1.75; 95% CI=1.21-2.54), children referred to the clinic due to either dental trauma (RR=2.44; 95% CI=1.28-4.66) or caries (RR=2.64; 95% CI=1.39-5.05), children who have hadcaries (RR=2.15; 95% CI=1.50-3.08), and children whose parents perceived their own oral health as poor (RR=1.45; 95% CI=1.02-2.05). Twenty-three (31%) children expressed dissatisfaction with their oral health. Conclusions: The impact of oral diseases was high for this population. Children whose parents considered their own oral healthas regular/poor presented higher impact on quality of life. Moreover, older children, taken to the dentist due to caries or dental trauma, and with previous dental caries experience, presented negative impact on OHRQoL.