Association between obesity and traumatic dental injuries in pre-school children-A case-control study.

BACKGROUND/AIM: Obese children are more prone to accidents due to poorer motor skills which increase the likelihood of falls and the occurrence of traumatic dental injuries (TDIs). The aim of this study was to determine the association between overweight/obesity and TDI in pre-school children. MATERIAL AND METHODS: The case group was formed by children with TDI identified during a clinical examination (n = 262). Each pre-school child identified as a case was matched by a peer of the same age, gender and pre-school but without TDI to form the control group (n = 262). TDI was evaluated using the criteria proposed by Andreasen. The weight and height of the children were measured for the calculation of the body mass index which was plotted on the growth curve established by the World Health Organization. Socio-demographic variables were collected through questionnaires sent to the parents/guardians. Data analysis involved the determination of frequency distribution, the chi-square test and logistic regression analysis. RESULTS: The sample was composed of 253 children in each group. Among the children in the case group, 15.4% (n = 39) were overweight and 15.8% (n = 40) were obese. In the control group, 13.8% (n = 35) were overweight and 8.3% (n = 21) were obese. Children with trauma were more likely to be obese than children without trauma (OR = 2.05; 95%CI: 1.14 to 3.67; p = .016). In contrast, TDI was not associated with being overweight. A greater odds of TDI was also associated with an open bite (OR = 3.61; 95% CI: 1.64 to 7.96; p = .001) and accentuated overjet (OR = 2.19; 95% CI: 1.37 to 3.50; p = .001). CONCLUSIONS: Pre-school children with a history of dental trauma were more likely to be obese than those without a history of dental trauma whereas being overweight was not associated with TDI.

Is there an association between attention deficit hyperactivity disorder in children and adolescents and the occurrence of bruxism? A systematic review and meta-analysis.

Aim of the present systematic review was to evaluate whether children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are at greater chance of developing bruxism compared to individuals without this disorder. Observational studies that evaluated the occurrence of bruxism in children and adolescents with ADHD were included. The quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Thirty-two studies involving a total of 2629 children/adolescents with ADHD and 1739 with bruxism (1629 with sleep bruxism and 110 with awake bruxism) were included. The prevalence of bruxism, irrespective of type, in the children/adolescents was 31% (95% CI: 0.22-0.41, I2 = 93%). ADHD was associated with an increased chance of bruxism (OR: 2.94, 95% CI: 2.12-4.07, I2 = 61%), independently of the type [sleep bruxism (OR: 2.77, 95% CI: 1.90-4.03, I2 = 66%) or awake bruxism (OR: 10.64, 95% CI: 2.41-47.03, I2 = 65%)]. The presence of signs of ADHD without a diagnostic confirmation was not associated with an increased chance of bruxism (OR: 3.26, 95% CI: 0.76-14.04, I2 = 61%). Children and adolescents with a definitive diagnosis of ADHD are at greater chance of developing sleep and awake bruxism than those without this disorder.

The impact of crown fracture in the permanent dentition on children's quality of life.

BACKGROUND/AIM: Among the diseases related to oral health, traumatic dental injuries (TDI) can lead to pain, loss of function and aesthetic problems, with physical, emotional and social consequences for children and their families. The aim of this study was to investigate the relationship between enamel fracture and enamel-dentin fracture with oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: This cross-sectional study had a representative sample of 1589 children between 8-10 years of age from public schools. The OHRQoL was obtained through the Child Perceptions Questionnaire (CPQ8-10 ), which is a questionnaire validated for Brazilian children. Clinical data were collected by 4 calibrated examiners (Kappa > 0.7) using the Decay, Missing, Filled Teeth (DMFT) Index, Dental Aesthetic Index (DAI) and TDI. A socio-economic questionnaire was sent to the caregivers to be answered at home. Descriptive statistics and Poisson regression with prevalence ratio (PR) and 95% confidence interval (CI) were used for statistical analysis. RESULTS: The prevalence of TDI was 10.6%, and among these 10.3% who had an impact on the OHRQoL, it was due to enamel-dentin fracture. Children with enamel-dentin fracture had (PR 1.35; 95% CI 1.07-1.70) higher prevalence of impact on the OHRQoL. Children with enamel fracture had no impact on the OHRQoL (P = .254). CONCLUSION: Enamel fracture had no significant impact on children's quality of life, while enamel-dentin fracture did have an impact on quality of life.

Association and comparison between visual inspection and bitewing radiography for the detection of recurrent dental caries under restorations.

PURPOSE: The aim of the present study was to investigate, in posterior teeth, the association between the characteristics of the margins of a restoration visually inspected and the presence, under restorations, of recurrent or residual dental caries detected by radiographic examination. Furthermore, the agreement between visual inspection and radiographs to detect dental caries was assessed. METHODS: Eighty-five permanent molars and premolars with resin restorations on the interproximal and/or occlusal faces, from 18 patients, were submitted for visual inspection and radiographic examination. The visual inspection involved the criteria of the International Caries Detection and Assessment System (ICDAS). Bitewing radiographs were used for the radiographic examination. Logistic regression was used to analyse the association between the characteristics of the margins of a restoration assessed by visual inspection (absence of dental caries, or early, established, inactive and active lesions) and the presence of recurrent caries detected by radiographs. Kappa coefficients were calculated for determining agreement between the two methods. RESULTS: The Kappa coefficient for agreement between visual inspection and radiographic examination was 0.19. Established lesions [odds ratio (OR) = 9.89; 95% confidence interval (95% CI): 2.94-33.25; P < 0.05] and lesion activity (OR = 2.57; 95% CI: 0.91-7.27; P < 0.05) detected by visual inspection, were associated with recurrent or residual dental caries detected by radiographs. Restorations with established and active lesions at the margins had a greater chance of exhibiting recurrent or residual lesions in the radiographic examination. CLINICAL SIGNIFICANCE: The present findings demonstrate that restorations with established and active lesions at the margins when visually inspected often require removal and retreatment.

Prevalence of sleep bruxism and associated factors in preschool children.

PURPOSE: The purpose of this study was to evaluate the prevalence of sleep bruxism and associated factors in three- to five-year-olds. METHODS: A representative cross-sectional study was conducted with a sample of 749 preschool children during immunization campaigns. Data acquisition involved an oral clinical exam, anthropometric measures, and a questionnaire administered in interview form. All data were analyzed using the chi-square test and Poisson regression with robust variance with the aid of SPSS software. RESULTS: The prevalence of sleep bruxism among preschool children was approximately 14 percent. Statistically significant associations were found: between sleep bruxism and lower dental crowding (prevalence ratio=3.38; 95% confidence interval=1.9-5.7); for the habit of biting on objects (PR=2.49; 95% CI=1.4-4.4); for duration of breast-feeding for a period longer than 12 months (PR=1.98; 95% CI=1.2-3.2); and for bottle-feeding for more than 24 months (PR=1.93; 95% CI=1.2-3.1). CONCLUSIONS: Lower arch crowding, the habit of biting on objects, and prolonged breast-feeding and bottle-feeding were associated with sleep bruxism in the preschool children analyzed in the present study.

Impact of treated/untreated traumatic dental injuries on quality of life among Brazilian schoolchildren.

BACKGROUND/AIM: The joint evaluation of oral health-related quality of life and traumatic dental injury (TDI) is an important tool for setting priorities in public oral health programs. The purpose of the present study was to compare the impact of treated TDI, untreated TDI, and absence of TDI on the quality of life of schoolchildren aged 11-14 years. MATERIAL AND METHODS: A cross-sectional study was carried out with 668 schoolchildren from the city of Diamantina, Brazil. The clinical examination involved the determination of the presence and type of TDI based on the criteria proposed by O'Brien. Malocclusion was evaluated using the criteria of the Dental Aesthetic Index, and dental caries was diagnosed using the DMFT/dmft index. The impact of TDI on quality of life was assessed using the Child Oral Impact on Daily Performances (Child-OIDP). The outcome was the absence (Child-OIDP = 0) or presence (Child-OIDP ≥ 1) of impact on quality of life. RESULTS: The prevalence of TDI was 34.3%. Schoolchildren with untreated TDI experienced a greater impact on eating (P = 0.016) and smiling (P < 0.001) in comparison with those without TDI. No significant differences were found in the Child-OIDP score between schoolchildren with treated TDI and those without trauma. The unadjusted and adjusted results of the Poisson regression analysis of the Child-OIDP demonstrated that schoolchildren with untreated TDI were more likely to experience an impact on 'eating and enjoying food', 'smiling and showing teeth', and 'overall score'. CONCLUSIONS: Untreated TDI was associated with a negative impact on the quality of life of schoolchildren, whereas treated TDI and absence of TDI were not associated with impact on quality of life.

Impact of untreated dental caries on quality of life of preschool children: different stages and activity.

OBJECTIVE: The aim of the present population-based cross-sectional study was to evaluate the association between untreated dental caries, considering stages and activity, and the impact on OHRQoL among preschool children and their parents/caregivers. METHODS: A randomly selected sample of 451 Brazilian preschool children aged three to 5 years underwent a clinical oral examination for the assessment of dental caries using the ICDAS II criteria. Parents/caregivers were asked to answer two questionnaires: one on the OHRQoL of the children (ECOHIS) and another on the demographic and socioeconomic characteristics of the children and families. Statistical analysis involved descriptive statistics, the chi-square test, Mann-Whitney test and hierarchically adjusted Poisson regression models. RESULTS: The prevalence of early childhood caries was 51.2%. The majority of teeth with caries exhibited severe decay (60.6%). Untreated severe decay, such as active lesions within visible dentin (P < 0.001), extensive active and inactive cavity without pulp exposure or fistula (P < 0.001 and P = 0.001, respectively), extensive cavity with pulp exposure and absence of fistula (P = 0.003) and root remnant (P = 0.002), were associated with a negative impact on quality of life. CONCLUSION: Active and inactive untreated severe carious lesions were associated with a negative impact on the quality of life of preschoolers and their parents/caregivers.

Developmental defects of enamel in primary teeth: prevalence and associated factors.

BACKGROUND: Studies on the prevalence of enamel defects in the primary dentition as a whole are scarce, as most investigations examine specific population groups. OBJECTIVES: The aim of this study was to evaluate the prevalence of enamel defects in primary teeth and determine whether prematurity, birthweight, and socio-demographic variables are associated with such defects. DESIGN: A cross-sectional study was carried out with 381 children aged 3-5 years. Data were collected through clinical examinations and interviews with parents during the National Immunisation Day. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel (DDE) Index. Through interviews, information was collected on socio-demographic aspects, pregnancy, birthweight, prematurity, and breastfeeding. Statistical analysis was performed using the SPSS program for Windows and involved descriptive analysis, Fisher's exact test, the chi-square test, and Poisson regression. RESULTS: The prevalence of developmental defects of enamel was 29.9%. Demarcated opacity was the most frequent type of defect. Children with a history of very low birthweight had a greater prevalence of enamels defects (PR, 2.7; 95% CI, 1.66-4.61). Prematurity and socio-demographic variables were not associated with enamel defects. CONCLUSION: Children with a history of very low birthweight had a greater frequency of enamel defects in primary teeth.

Cyanoacrylate versus laser in the treatment of dentin hypersensitivity: a controlled, randomized, double-masked and non-inferiority clinical trial.

BACKGROUND: Dentin hypersensitivity (DH) is a painful, exaggerated response to normal stimuli, such as cold, sweetness, and brushing. The aim of the present controlled, randomized, double-masked, non-inferiority clinical trial is to evaluate the effectiveness of cyanoacrylate in the treatment of DH when compared to the application of low-intensity laser. METHODS: The study includes 434 sensitive teeth from 62 patients. A total of 216 teeth were treated with laser and 218 with cyanoacrylate. A numeric rating scale was used to record the parameters of pain related to the stimuli at baseline and after the treatment at intervals of 24 hours and 30, 90, and 180 days. RESULTS: Both groups had significant reductions in DH. However, there was no significant difference between the two groups ≤6 months. Intragroup analysis showed that the effect of cyanoacrylate obtained at 24 hours remained for 90 days in response to air-jet test and 30 days for cold-spray test. There was a statistically significant difference between all other intragroup comparisons at the time intervals (P <0.001). CONCLUSIONS: It was concluded that cyanoacrylate is as effective as low-intensity laser in reducing DH. In addition, it is a more accessible and low-cost procedure and can be safely used in the treatment of DH.

Degree of dental anxiety in children with and without toothache: prospective assessment.

BACKGROUND: Few prospective studies on the anxiety of children in the dental office have been published. AIMS: To monitor dental anxiety levels in children with and without previous experience with toothache over a period of six consecutive visits. DESIGN: A longitudinal study was carried out involving 167 children treated at a public dental service. Levels of anxiety in the dental setting were assessed in children without toothache (G1) and those with toothache (G2) using the modified Venham picture test (VPT). Data acquisition was carried out over a 6-week period, with each child treated in the dental office once a week. Six assessments of anxiety were performed in the waiting room prior to dental treatment. RESULTS: A significant reduction in anxiety scores occurred between appointments in both groups. In the inter-group comparison, G2 had significantly higher anxiety scores than G1. Although statistically significant reductions in anxiety scores occurred through to the fifth appointment, a tendency toward stagnation in anxiety scores was observed beginning with the fourth appointment. CONCLUSIONS: Dental anxiety scores were reduced over the course of six appointments. Children with toothache had higher levels of dental anxiety than those that had never experienced toothache.

Association between dental trauma and alcohol use among adolescents.

AIM: To investigate the association between dental trauma and alcohol use among adolescents between 14 and 19 years of age. MATERIALS AND METHODS: A cross-sectional study was carried out involving a clinical exam performed by a calibrated researcher (intra-examiner Kappa = 0.93) and a self-administered questionnaire. The sample was representative of schoolchildren from the city of Diamantina (Brazil) and was made up of 738 adolescents. The type of school (public or private) was used as a socioeconomic indicator. Information on alcohol use (high risk and hazardous use) was acquired through the administration of the Alcohol Use Disorders Identification Test, which has been validated for use in Brazil. RESULTS: The prevalence of dental trauma was 26.6%, and the prevalence of dangerous alcohol use was 44.3%. Dental trauma was significantly associated with a high risk of problems related to alcohol intake (P = 0.031), hazardous alcohol use (P = 0.009) and binge drinking (P = 0.036). The results of the Poisson logistic regression revealed that hazardous alcohol use [PR = 1.30 (95% CI: 1.01-1.66) P = 0.042] remained associated with dental trauma independently from age, gender, overjet, and type of school. CONCLUSIONS: The high prevalence of dental trauma found among adolescents in the city of Diamantina (Brazil) was greater among those at high risk for problems related to alcohol intake and was significantly associated with hazardous alcohol use.

Association among stress, personality traits, and sleep bruxism in children.

PURPOSE: The purpose of this study was to determine the association among stress levels, personality traits, and sleep bruxism in children. METHODS: A population-based case control study (proportion=1:2) was conducted involving 120 7- to 11-year-olds with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from schools in Belo Horizonte, Minas Gerais, Brazil. The following instruments were used for data collection: questionnaire administered to parents; child stress scale; and neuroticism and responsibility scales of the big five questionnaire for children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism was diagnosed from parents' reports. The chi-square test, as well as binary and multivariate logistic regression, was applied for statistical analysis. RESULTS: In the adjusted logistic model, children with a high level of stress, due to psychological reactions (odds ratio=1.8; confidence interval=1.1-2.9) and a high sense of responsibility (OR=1.6; CI=1.0-2.5) vs those with low levels of these psychological traits, presented a nearly 2-fold greater chance of exhibiting the habit of sleep bruxism. CONCLUSION: High levels of stress and responsibility are key factors in the development of sleep bruxism among children.

Does intellectual disability affect the development of dental caries in patients with cerebral palsy?

The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of these, 76 individuals had been diagnosed with spastic cerebral palsy and 89 had no neurological impairment. The subjects were matched based on age and gender and selected randomly by lottery. All patients were examined to determine the number of dental cavities, and tested for their intellectual functioning (Raven Test) and motor abilities. The study showed that children with CP who presented with intellectual disabilities had a larger number of dental cavities than children with CP without intellectual disabilities. Considering intellectual functioning and motor impairment in the multivariate logistic regression, only intellectual functioning was found to have a significant effect on the development of dental cavities. These results suggest that intellectual disability can be considered a contributing factor for the development of dental caries in patients with cerebral palsy.

Prospective longitudinal study of signs and symptoms associated with primary tooth eruption.

OBJECTIVE: To assess the association between primary tooth eruption and the manifestation of signs and symptoms of teething in infants. METHODS: An 8-month, longitudinal study was conducted with 47 noninstitutionalized infants (ie, receiving care at home) between 5 and 15 months of age in the city of Diamantina, Brazil. The nonrandomized convenience sample was based on the registry of infants in this age range provided by the Diamantina Secretary of Health. Eligible participants were infants with up to 7 erupted incisors and no history of chronic disease or disorders that could cause an increase in the signs and symptoms assessed in the study. Tympanic and axillary temperature readings and clinical oral examinations were performed daily. A daily interview with the mothers was conducted to investigate the occurrence of 13 signs and symptoms associated with teething presented by the infants in the previous 24 hours. RESULTS: Teething was associated with a rise in tympanic temperature on the day of the eruption (P = .004) and with the occurrence of other signs and symptoms. Readings of maximal tympanic and axillary temperatures were 36.8°C and 36.6°C, respectively. The most frequent signs and symptoms associated with teething were irritability (median: 0.60; P < .001), increased salivation (median: 0.50; P < .001), runny nose (median: 0.50; P < .001), and loss of appetite (median: 0.50; P < .001). CONCLUSIONS: Irritability, increased salivation, runny nose, loss of appetite, diarrhea, rash, and sleep disturbance were associated with primary tooth eruption. Results of this study support the concept that the occurrence of severe signs and symptoms, such as fever, could not be attributed to teething.

Oral disease and social class in a random sample of five-year-old preschool children in a Brazilian city.

PURPOSE: The objective of the present study was to determine the association between oral disease, access to dental care and social class in a random sample of five-year-old preschool children in Belo Horizonte, Minas Gerais, Brazil. MATERIALS AND METHODS: A cross-sectional study was carried out on a sample of 551 five-year-old children who were randomly selected from preschools. Oral health status was assessed using the decayed, missing or filled teeth (dmft) index as well as the presence of visible plaque, gingivitis and supragingival calculus. Oral examinations were performed by two examiners (j > 0.80). The clinical outcome variables were dental caries, filled and missing teeth, dental pulp exposure due to caries, dental root fragment, visible plaque, gingivitis and supragingival calculus. Social class was assessed using the City Hall database. RESULTS: Children without caries represented 63.9% of the sample. Mean overall dmft was calculated to be 1.56, and the decayed teeth component was the highest in all of the social classes. Missing teeth, caries with pulp involvement and dental root fragment had higher proportions and the filled teeth component had the lowest proportion in children from the lowest social class. Visible dental plaque was present in 45.4% of the children. Except for the filled teeth component, all of the clinical outcome variables had a significant association with social class status (P < 0.001), regardless of child's gender. CONCLUSIONS: Oral disease in the primary dentition and access to dental treatment are affected by social and cultural factors.

Factors associated with the desire for orthodontic treatment among Brazilian adolescents and their parents.

BACKGROUND: In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents. METHODS: The sample consisted of 403 subjects aged 14 to 18 years, selected randomly from a population of 182,291 schoolchildren in the same age group. The outcome variable "desire for orthodontic treatment" was assessed through a questionnaire. Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and the Dental Aesthetic Index (DAI) was used for clinical assessment. Statistical analysis involved the chi-square test as well as both simple and multiple logistic regression analyses. RESULTS: The majority (78%) of the Brazilian adolescents desired orthodontic treatment and 69% of the parents reported that their children were not in orthodontic treatment due to the high costs involved. There was significant association (p < or = 0.05) between the desire for orthodontic treatment and most types of malocclusion. However, there was no significant association between the desire for orthodontic treatment and the variables gender and age. CONCLUSIONS: The following were considered factors associated to the desire for treatment: upper anterior crowding > or = 2 mm and parents' perception of their child's need for treatment.

Aesthetic impact of malocclusion in the daily living of Brazilian adolescents.

OBJECTIVE: The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions. DESIGN: Cross-sectional. SETTING: Public and private schools in the city of Belo Horizonte, Brazil. SUBJECTS AND METHODS: The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis. RESULTS: Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding > or = 2 mm (P=0.009), median diastema > or = 2 mm (P=0.040), normative treatment need (highly desirable) (P<0.001) and low economic level (P<0.001). CONCLUSION: Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.

Psychometric properties of the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14) - short forms.

BACKGROUND: The need to evaluate the impact of oral health has led to the development of instruments for measuring oral health-related quality of life (OHQoL). One such instrument is the Child Perceptions Questionnaire (CPQ(11-14)), developed specifically for 11-to-14-year-old children. As this questionnaire was considered long (37 items), shorter forms were developed with 8 (Impact Short Form: 8--ISF:8) and 16 items (Impact Short Form: 16--ISF:16) to facilitate use in the clinical setting and population-based health surveys. The aim of the present study was to translate and cross-culturally adapt these CPQ(11-14) short forms for Brazilian Portuguese and evaluate the measurement properties of these versions for use on Brazilian children. METHODS: Following translation and cross-cultural adaptation, the ISF:8 and ISF:16 were tested on 136 children from 11 to 14 years of age in the city of Belo Horizonte, Brazil. The instrument was administered by a trained researcher who also performed clinical examinations. The measurement properties (i.e. criterion validity, construct validity, internal consistency reliability, test-retest reliability) were determined. Discriminant validity was tested between groups, which were divided into children with no cavities and no malocclusion; children with cavities and without malocclusion; and children with malocclusion and without cavities. RESULTS: The mean total score was 6.8 [standard deviation (SD) 4.2] for the ISF:8 and 11.9 (SD 7.6) for the ISF:16 (p < 0.001). Statistically significant associations were found between oral abnormalities and the subscales of the ISF:8 and ISF:16 (p < 0.05). Both test-retest stability and internal consistency, as measured by the intra-class correlation coefficient (ICC) (ISF:8 = 0.98 and ISF:16 = 0.97) and Cronbach's alpha (ISF:8 = 0.70 and ISF:16 = 0.84) proved to be adequate. Construct validity was confirmed from the correlation between the short form scores and oral health and overall well-being ratings. The score on the short forms of the CPQ(11-14) was able to discriminate between different oral conditions. Criterion validity was satisfactory (p < 0.05). CONCLUSION: The Brazilian versions of CPQ(11-14) ISF:8 and ISF:16 have satisfactory psychometric properties, similar to those of the original instrument.

Influence of psychosocial factors on the development of sleep bruxism among children.

BACKGROUND: Bruxism is described as an orofacial parafunction that affects both children and adults. The maintenance of the childhood habit into adulthood may compromise health. As there are few studies on this issue, there is a need for further research on sleep bruxism among children. AIM: The aim of this study was to assess the prevalence of sleep bruxism in children and the influence of psychosocial factors. METHODS: A cross-sectional study was carried out on 652 randomly selected children aged 7-10 years at public and private schools in Belo Horizonte, Brazil. The instruments used were: questionnaire for parents, Child Stress Scale, and the scales on neuroticism and responsibility from the prevalidated Big Five Questionnaire for Children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism among children was reported by parents. The Social Vulnerability Index from the city hall database was used to determine the social classification of the families. The chi-squared test, binary and multivariate logistic regressions were used, with the significance level set at 5%. RESULTS: A 35.3% prevalence of bruxism was found. No association was found between bruxism and stress, gender, age, or social vulnerability. The adjusted logistic model determined that children with high levels of neuroticism (OR = 1.9, CI 1.3-2.6) and responsibility (OR = 2.2, CI 1.0-5.0) are twice as likely to have the habit of sleep bruxism when compared to those who have low levels of these personality traits. CONCLUSIONS: A high degree of responsibility and neuroticism, which are individual personality traits, are determinant factors for the development of sleep bruxism among children.

Occupational exposure to potentially infectious biological material in a dental teaching environment.

The aims of this cross-sectional study were to determine the prevalence of occupational accidents with exposure to biological material among undergraduate students of dentistry and to estimate potential risk factors associated with exposure to blood. Data were collected through a self-administered questionnaire (86.4 percent return rate), which was completed by a sample of 286 undergraduate dental students (mean age 22.4 +/-2.4 years). The students were enrolled in the clinical component of the curriculum, which corresponds to the final six semesters of study. Descriptive, bivariate, simple logistic regression and multiple logistic regression (Forward Stepwise Procedure) analyses were performed. The level of statistical significance was set at 5 percent. Percutaneous and mucous exposures to potentially infectious biological material were reported by 102 individuals (35.6 percent); 26.8 percent reported the occurrence of multiple episodes of exposure. The logistic regression analyses revealed that the incomplete use of individual protection equipment (OR=3.7; 95 percent CI 1.5-9.3), disciplines where surgical procedures are carried out (OR=16.3; 95 percent CI 7.1-37.2), and handling sharp instruments (OR=4.4; 95 percent CI 2.1-9.1), more specifically, hollow-bore needles (OR=6.8; 95 percent CI 2.1-19.0), were independently associated with exposure to blood. Policies of reviewing the procedures during clinical practice are recommended in order to reduce occupational exposure.