Self-Medication for Toothache and its Associated Factors in Children and Adolescents

Objective: To evaluate self-medication for toothache and its associated factors in children and adolescents. Material and Methods: A cross-sectional study was carried out with 252 children/adolescents aged 6-16 years. A questionnaire was applied with questions related to demographic and socioeconomic characteristics; experience of, and self-medication for, toothache; as well as aspects related to the condition. Descriptive and inferential statistical analyses (Pearson's Chi-square test and Fisher's exact test) were performed, with a 5% significance level. Results: The prevalence of toothache was 41.7%. In 96 cases analyzed, there was prevalence of 69.8% of self-medication for toothache. There were no statistically significant associations between self-medication for toothache and variables related to the children/adolescents (gender and age), their parents or guardians (age and schooling), socioeconomic characteristics (family income and number of people in the household) and aspects related to toothache (fever, crying and school absenteeism) (p>0.05). The most commonly used drug was paracetamol (60.7%), whose choice was based to its previous use by the study population for conditions not related to toothache (47.8%). Conclusion: There was a high prevalence of self-medication for toothache in the study population. No independent variable was associated with self-medication practice.

Anxiety of parents and children in dental care / Ansiedade dos pais e crianças no tratamento odontológico

ABSTRACT Objective: To verify the prevalence and association of parents' and children's anxiety concerning socioeconomic variables and child's behavior during dental care. Methods: This was a quantitative, observational, transversal and descriptive study. Data collection was performed through a questionnaire aiming at sociodemographic data and dental experience as well as Venham Picture Test, Corah Dental Anxiety Scales and Frankl Anxiety Scale. Data were analyzed using descriptive and inferential statistics (Chi-square and Fisher's exact test), α = 0.05. Results: The sample consisted of 7 to 9 year- old children (57.9%.), of whom 72.6% were submitted to invasive procedures. The prevalence of anxiety among children was 43.2% (n = 41). Regarding parents / guardians, the prevalence of anxiety was 88.4% (n = 84). A significant association was found between the dental appointment experience and the child's anxiety (p = 0.050) using the VPT. A significant association between anxiety and the type of dental procedure (p = 0.017) as well as the child's experience (p = 0.000) using the Frankl scale. Conclusion: There was no association between anxiety and socioeconomic variables. In the variables related to dental experiences, a significant association was found between the experience of the dental appointment and the anxiety of the child using the VPT scale. An association between anxiety and the type of procedure was observed, as well as dental appointment experience, using Frankl scale.

RESUMO Objetivo: Verificar a prevalência e a associação da ansiedade dos pais e filhos entre as variáveis socioeconômicas frente ao comportamento da criança durante o atendimento odontológico. Métodos: Este estudo foi caracterizado como quantitativo, observacional, transversal e descritivo. Para a coleta de dados, utilizou-se um questionário sobre dados sociodemográficos e experiência dentária, Escalas de Teste de Imagem de Venham, Escalas de Ansiedade Odontológica de Corah e Escala de Ansiedade de Frankl. Os dados foram analisados utilizando estatística descritiva e inferencial (Qui-quadrado e Teste exato de Fisher), α=0.05. Resultados: A maioria das crianças pertencia à faixa etária de 7 a 9 anos, 57,9%. Destas, 72,6% foram submetidos a procedimentos invasivos. A prevalência de ansiedade das crianças foi de 43,2% (n=41). Quanto aos pais/responsáveis, a prevalência de ansiedade foi de 88,4% (n=84). Foi verificada associação significativa entre experiência da consulta e ansiedade da criança (p= 0,050) utilizando a escala VTP. E foi verificada associação significativa entre a ansiedade e o tipo de procedimento (p= 0,017) e a experiência da criança (p=0,000) utilizando a escala de Frankl. Conclusão: Não houve associação entre ansiedade e as variáveis socioeconômicas. Nas variáveis relacionadas as experiências odontológicas, foi verificada associação significativa entre a experiência da consulta e a ansiedade da criança utilizando a escala VTP. Na escala de Frankl foi observada associação entre ansiedade e o tipo de procedimento, e experiência da consulta.

Sociodemographic and behavioral factors associated with dental caries in preschool children: Analysis using a decision tree.

BACKGROUND: Untreated dental caries can result a negative impact on oral health-related quality of life. AIMS: The aim of the present study was to determine the prevalence of dental caries and associated factors in children enrolled in public preschools in the city of Recife, Brazil. SETTINGS AND DESIGN: A descriptive, analytical, cross-sectional study was conducted with a representative random sample of 556 children aged 3-5 years. MATERIALS AND METHODS: Data were collected through clinical examinations using the International Caries Detection and Assessment System. The parents answered a questionnaire addressing sociodemographic and behavioral characteristics. Two examiners underwent training and calibration exercise for the calculation of interexaminer agreement (Kappa index of 0.83). STATISTICAL ANALYSIS USED: In addition to descriptive data, an inductive decision tree was constructed to analyze the results (Algorithm J48; α = 5%). RESULTS: The prevalence of dental caries was 92.1%. The following factors were associated with dental caries: brushing performed by the child (prevalence ratio [PR] = 4.39, 95% confidence interval [CI]: 2.57-7.51 P < 0.001), household income less than the minimum wage (PR = 1.79; 95% CI: 1.18-2.72, P = 0.005), brushing frequency (PR = 1.50; CI 95%: 0.50-4.49; P = 0.001), and parent's/caregiver's school equal to an incomplete elementary school education (PR = 1.65, 95% CI: 1.56-1.74, P < 0.001). CONCLUSIONS: The occurrence of dental caries in children was high and was associated with brushing performed by the child, household income less than the monthly minimum wage, low brushing frequency, and low parent's/caregiver's schooling.

The effect of atraumatic restorative treatment on adhesive restorations for dental caries in deciduous molars.

BACKGROUND: Minimal invasive approaches to managing caries, such as partial caries removal techniques and atraumatic restorative treatment (ART), are showing increasing evidence of improved outcomes over the conventional complete caries removal. OBJECTIVE: To evaluate clinically and radiographically the effect of ART on restorations using restorative cement and glass ionomer cement (GIC) for dental caries in the deciduous molars of children aged between 4 and 8 years. SETTINGS AND DESIGN: The study design was a split-mouth, randomized, blind clinical trial. MATERIALS AND METHODS: Eighty-six patients had 108 restorations placed with GIC (Ketac Molar Easy Mix - 3M ESPE) and 108 restorations placed with composite resin (CR) (Filtek Z250 - 3M ESPE). The restorations were assessed by means of images obtained with a digital camera and periapical radiographs at baseline and after 12 months of follow-up. STATISTICAL ANALYSIS: The Student's t-test, Pearson Chi-squared test, and Bonferroni paired comparison test were used to evaluate the differences in proportions and correlations between the variables. RESULTS: After 12 months of follow-up, the restorations were considered clinically successful in 89.3% of cases and radiographically successful in 80.5% of cases. There was statistical difference neither between the two restorative materials used nor between the numbers of restored surfaces. CONCLUSIONS: GIC and CR can be used successfully for restorations of one or two dental surfaces after ART.

Impact of oral health problems on the quality of life of preschool children: a case-control study.

BACKGROUND: There is a need for investigations into the impact of oral problems on OHRQoL with study designs that offer greater strength of evidence. AIM: To evaluate the impact of dental caries and traumatic dental injury (TDI) on the OHRQoL of Brazilian preschool children. DESIGN: A population-based, matched, case-control study was conducted involving 415 children aged 3-5 years enrolled at public and private preschools. The case group (impact on OHRQoL) and control group (no impact on OHRQoL) were matched for age, sex, and monthly household income at a 1 : 4 ratio (83 cases and 332 controls). Impact on OHRQoL was assessed using the B-ECOHIS. Dental caries and TDI were determined through clinical oral examinations. Data analysis involved descriptive statistics and conditional logistic regression analysis (P ≤ 0.05; 95% CI). RESULTS: The most frequent responses on the B-ECOHIS were 'felt pain' (79.7%) and 'difficulty in eating' (35.0%). The following variables were significantly associated with impact on OHRQoL: caries severity (OR = 12.58; 95% CI: 5.31-29.79) and TDI (OR: 2.11; 95% CI: 1.23-3.62). CONCLUSIONS: Caries severity and TDI impacted the OHRQoL of preschool children.

Influence of Oral Problems and Biopsychosocial Factors on the Utilization of Dental Services by Preschool Children.

PURPOSE: The purpose of this study was to evaluate the influence of oral problems and biopsychosocial factors on the use of dental services by preschoolers. METHODS: A cross-sectional study was carried out with preschoolers in northeastern Brazil. Parents answered questions on visits to the dentist and sociodemographic characteristics, and completed the Brazilian version of the Early Childhood Oral Health Impact Scale. An oral examination was performed by three dentists who were calibrated for the diagnosis of dental caries, traumatic dental injury, and malocclusion. Descriptive statistics and Poisson regression analysis with robust variance were performed (α equals five percent). RESULTS: There were 841 children in the study whose prevalence rate of utilization of dental services was 24 percent. Utilization was significantly associated with the child's age, mother's schooling over eight years, household income, severity of dental caries, and impact on the quality of life of the family. CONCLUSION: Caries severity, sociodemographic factors, and psychological factors exerted an influence on the utilization of dental services by preschool children.

Parental Perceptions of Oral Health Status in Preschool Children and Associated Factors.

The aim of the present study was to evaluate parental perceptions of oral health status in preschool children. A cross-sectional study was carried with 843 Brazilian children between 3 and 5 years of age. Parents/guardians answered a self-administered questionnaire on the health of their children and sociodemographic data. Parental perceptions of their child's oral health were determined by the responses to the following question: "How would you describe your child's oral health?" The Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) was answered by parents/guardians and used to measure the impact of oral health-related quality of life (OHRQoL) on preschool children and their families. Three examiners performed oral exams on the children (K= 0.85-0.90). Descriptive analytical statistics were carried out, followed by logistic regression for complex samples (α=5%). The following variables were significantly associated with parental perceptions of children's oral health: parental perception of general health as poor (OR=18.25; 95% CI: 3.36-98.96), negative impact on family's OHRQoL (OR=13.82; 95% CI: 4.27-44.72), child aged five years (OR=7.40; 95% CI: 1.49-36.63) and the interaction between history of toothache and dental caries (OR=10.02; 95% CI: 1.17-85.61). Thus, parental perceptions of oral health are influenced only by clinical conditions with symptoms, such as dental caries with toothache. Other oral conditions, such as malocclusion or traumatic dental injury, were not associated with parental perceptions of their child's oral health.

Parental Perceptions of Oral Health Status in Preschool Children and Associated Factors

The aim of the present study was to evaluate parental perceptions of oral health status in preschool children. A cross-sectional study was carried with 843 Brazilian children between 3 and 5 years of age. Parents/guardians answered a self-administered questionnaire on the health of their children and sociodemographic data. Parental perceptions of their child's oral health were determined by the responses to the following question: "How would you describe your child's oral health?" The Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) was answered by parents/guardians and used to measure the impact of oral health-related quality of life (OHRQoL) on preschool children and their families. Three examiners performed oral exams on the children (K= 0.85-0.90). Descriptive analytical statistics were carried out, followed by logistic regression for complex samples (α=5%). The following variables were significantly associated with parental perceptions of children's oral health: parental perception of general health as poor (OR=18.25; 95% CI: 3.36-98.96), negative impact on family's OHRQoL (OR=13.82; 95% CI: 4.27-44.72), child aged five years (OR=7.40; 95% CI: 1.49-36.63) and the interaction between history of toothache and dental caries (OR=10.02; 95% CI: 1.17-85.61). Thus, parental perceptions of oral health are influenced only by clinical conditions with symptoms, such as dental caries with toothache. Other oral conditions, such as malocclusion or traumatic dental injury, were not associated with parental perceptions of their child's oral health.

O objetivo do presente estudo foi avaliar a percepção dos pais sobre saúde bucal de pré-escolares. Um estudo transversal foi realizado com 843 crianças brasileiras entre três e cinco anos de idade. Os pais/responsáveis responderam a um questionário autoaplicável sobre a saúde de seus filhos e dados sociodemográficos. Percepções dos pais sobre a saúde bucal de seus filhos foram determinados pela resposta à seguinte pergunta: "Como você descreveria a saúde bucal do seu filho?" A versão brasileira da Early Childhood Oral Health Impact Scale (B-ECOHIS) foi respondido por pais/responsáveis e usada para medir o impacto da qualidade de vida relacionada à saúde bucal (OHRQoL) em crianças pré-escolares e suas famílias. Três examinadores realizaram exames bucais nas crianças (K=0,85-0,90). Análise descritiva foi realizada, seguida de uma análise de regressão logística para amostras complexas (α=5%). As seguintes variáveis foram significativamente associados com a percepção dos pais sobre saúde bucal dos filhos: percepção ruim dos pais sobre a saúde geral (OR=18,25; IC 95%: 3,36-98,96), impacto negativo sobre OHRQoL da família (OR=13,82; IC 95%: 4,27-44,72), crianças com idade de cinco anos (OR=7,40; IC 95%: 1,49-36,63) e a interação entre o histórico da dor de dente e cárie dentária (OR=10,02; IC 95%: 1,17-85,61). Percepções parentais de saúde bucal são influenciados pelo impacto sobre OHRQoL da família, a percepção ruim dos pais sobre a saúde geral do seu filho, e as condições clínicas com sintomas, tais como cárie dentária com dor de dente. Outros problemas bucais, tais como má oclusão ou traumatismo dentário, não foram associados com a percepção dos pais sobre saúde bucal de seus filhos.

Perceived Impact of Dental Pain on the Quality of Life of Preschool Children and Their Families.

The aim of the present study was to evaluate the perceived impact of dental caries and dental pain on oral health-related quality of life (OHRQoL) among preschool children and their families. A cross-sectional study was conduct with 843 preschool children in Campina Grande, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, their child's general/oral health and history of dental pain. The Brazilian version of the Early Childhood Oral Health Impact Scale was administered to determine the perceived impact of caries and dental pain on OHRQoL. The children underwent an oral examination. Logistic regression for complex sample was used to determine associations between the dependent and independent variables (OR: Odds ratio, α = 5%). The independents variables that had a p-value <0.20 in the bivariate analysis were selected for the multivariate model. The prevalence of dental caries and dental pain was 66.3% and 9.4%, respectively. Order of birth of the child, being the middle child (OR: 10.107, 95%CI: 2.008-50.869) and youngest child (OR: 3.276, 95%CI: 1.048-10.284) and dental pain (OR: 84.477, 95%CI: 33.076-215.759) were significant predictors of the perceived impact on OHRQOL for children. Poor perception of oral health was significant predictor of the perceived impact on OHRQOL for family (OR=7.397, 95%CI: 2.190-24.987). Dental caries was not associated with a perceived impact on the ORHQoL of either the children or their families. However, order of child birth and dental pain were indicators of impact of OHRQoL on preschool children and poor perception of oral health was indicators of impact on families.

Association between parental guilt and oral health problems in preschool children: a hierarchical approach.

BACKGROUND: Dental caries and traumatic dental injury (TDI) can play an important role in the emergence of parental guilt, since parents feel responsible for their child's health. The aim of the present study was to evaluate the influence of oral health problems among preschool children on parental guilt. METHODS: A preschool-based, cross-sectional study was carried out with 832 preschool children between three and five years of age in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The item "parental guilt" was the dependent variable. Questionnaires addressing socio-demographic variables (child's sex, child's age, parent's/caregiver's age, mother's schooling, type of preschool and household income), history of toothache and health perceptions (general and oral) were also administered. Clinical exams for dental caries and TDI were performed by three dentists who had undergone a training and calibration exercise (Kappa: 0.85-0.90). Poisson hierarchical regression was used to determine the significance of associations between parental guilt and oral health problems (α = 5%). The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems. RESULTS: The frequency of parental guilt was 22.8%. The following variables were significantly associated with parental guilt: parental perception of child's oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028). CONCLUSION: Based on the present findings, parental guilt increases with the occurrence of oral health problems that require treatment, such as dental caries and TDI of greater severity. Parental perceptions of poor oral health in their children and history of toothache were predictors of greater feelings of parental guilt.

Alcohol consumption among adolescents: attitudes, behaviors and associated factors.

The scope of this paper is to assess the attitudes and behaviors regarding alcohol use and analyze associated factors among schoolchildren in public schools of Campina Grande in the state of Paraíba. A cross-sectional study was carried out involving 574 adolescents, with the application of a semi-structured questionnaire. The chi-square test and Fisher's exact test were used (5% level of significance). Among the adolescents 54.5% had drunk alcohol and 6.7% of them were heavy drinkers. The majority of them drank alcohol between 11 and 14 years of age (42.8%); 26.3% of the adolescents purchased alcoholic beverages; and beer was the most drink most consumed (43.8%). The risk of alcohol drinking was higher between 16 and 19 years of age (OR = 4.44; p < 0.001), among those without religious affiliation (OR = 4.36; p = 0.002), among those who worked (OR = 2.13; p = 0.012) and among those who had a fair to poor relationship with their father (OR = 2.18; p = 0.010). The results of this study underscore the complexity of this issue and the need to pay particular attention to the adolescent population. Public policies alone are not sufficient. Support from family, school and society is essential to curtail early alcohol use and its consequences.

Alcohol consumption among adolescents: attitudes, behaviors and associated factors / Consumo de bebida alcoolica entre adolescentes: atitudes, comportamentos e fatores associados

The scope of this paper is to assess the attitudes and behaviors regarding alcohol use and analyze associated factors among schoolchildren in public schools of Campina Grande in the state of Paraíba. A cross-sectional study was carried out involving 574 adolescents, with the application of a semi-structured questionnaire. The chi-square test and Fisher's exact test were used (5% level of significance). Among the adolescents 54.5% had drunk alcohol and 6.7% of them were heavy drinkers. The majority of them drank alcohol between 11 and 14 years of age (42.8%); 26.3% of the adolescents purchased alcoholic beverages; and beer was the most drink most consumed (43.8%). The risk of alcohol drinking was higher between 16 and 19 years of age (OR = 4.44; p < 0.001), among those without religious affiliation (OR = 4.36; p = 0.002), among those who worked (OR = 2.13; p = 0.012) and among those who had a fair to poor relationship with their father (OR = 2.18; p = 0.010). The results of this study underscore the complexity of this issue and the need to pay particular attention to the adolescent population. Public policies alone are not sufficient. Support from family, school and society is essential to curtail early alcohol use and its consequences.

Avaliar as atitudes e os comportamentos relacionados ao uso do álcool e seus fatores associados entre escolares da rede pública de Campina Grande (PB). Foi um estudo transversal com 574 adolescentes entrevistados por meio de formulário semiestruturado. Os testes estatísticos foram o Qui-quadrado e o Exato de Fisher (significância de 5%). Dos adolescentes, 54,5% experimentou o álcool, destes, 6,7% faz uso pesado. A maioria experimentou o álcool na faixa etária de 11 a 14 anos (42,8%), 26,3% dos menores compraram bebidas e a cerveja foi o tipo mais consumido (43,8%). O risco de experimentar a bebida alcoólica foi maior entre adolescentes de 16 a 19 anos (OR = 4,44; p < 0,001), entre os que não tinham religião (OR = 4,36; p = 0,002), entre os que trabalhavam (OR = 2,13; p = 0,012) e os que tinham relacionamento regular/ruim com o pai (OR = 2,18; p = 0,010). Os resultados do presente estudo ressaltam a complexidade do tema e a necessidade de uma atenção especial para a população adolescente. As políticas públicas não são suficientes, o apoio de uma família, a escola e a socie dade são essenciais para combater o uso precoce de álcool e suas consequências.

Uso dos serviços odontológicos entre idosos residentes no município de Campina Grande, Paraíba / Use of Dental Services among Elderly Living in the City of Campina Grande, PB, Brazil

Objetivo: Investigar o uso dos serviços odontológicos por idosos cadastrados na Estratégia Saúde da Família no município de Campina Grande, Paraíba.Método: Estudo de base domiciliar, transversal, no qual foram entrevistados idosos com idade igual ou superior a 60 anos. A amostra do tipo probabilística foi composta por 283 indivíduos. O instrumento de pesquisa consistiu de um formulário semi-estruturado, composto por quatro dimensões: identificação, características demográficas, condições de moradia e consumo de serviços de saúde. Os dados foram processados usando-se o software Epi Info 3.5.1, sendo apresentados por meio da estatística descritiva.Resultados: Verificou-se maior frequência das mulheres (70,3%) e a idade variou de 60 a 104 anos (72,2 anos ± 9,3). A maioria dos idosos tem renda pessoal e familiar entre 1 e 2 salários mínimos (72,8% e65,7%, respectivamente), residindo em casa própria (90,5%). Apenas 4,2% dos idosos declararam jamais ter ido ao cirurgião-dentista e 67,2% haviam utilizado o serviço odontológico há mais de três anos. As principais razões que motivaram a busca pelo atendimento foram a exodontia (27,0%) e a necessidade de reparos ou manutenção nas próteses dentárias (26,6%). Quanto à autopercepção das necessidades de tratamento, 46,1% dos entrevistados informaram necessitar de tratamento odontológico.Conclusão: Apesar de a população idosa utilizar os serviços odontológicos de saúde, uma boa parte o fez há mais de três anos, sendo a exodontia o motivo principal da consulta, de modo que muitos afirmaram necessitar de tratamento odontológico.

Objective: To investigate the use of dental services by elderly registered in the Family Health Strategy in the city of Campina Grande, PB, Brazil.Method: In this cross-sectional, home-based study, elderly aged 60 years or older. The probabilistic sample was composed by 283 subjects. The data collection instrument was a semi-structured questionnaire composed by four dimensions: identification, demographics, living conditions and use of health services. Data were processed using the Epi Info 3.5.1 software and were presented by means of descriptive statistics.Results: There was higher frequency among females (70.3%) and the age ranged from 60 to 104 years (72.2 years ± 9.3). Most elderly have personal and family incomes between 1 and 2 minimum wages (72.8% and 65.7%, respectively) and live in their own property (90.5%). Only 4.2% of the elderly had never gone to the dentist and 67.2% affirmed to have used the dental service more than 3 years ago. The main reasons for visiting the dentist were extractions (27.0%) and need of repairs or maintenance of dentures (26.6%). Regarding the self-perception of treatment needs, 46.1% of the interviewees believed that they needed dental treatment.Conclusion: Although the elderly population use dental services, more than 3 years had elapsed since their last visit to the dentist, and extraction was the main reason for seeking dental care, in such a way that many of the interviewees affirmed to need dental treatment.

Potencial erosivo e cariogênico de anti-histamínicos de uso infantil / Erosive and cariogenic potential of pediatric anti-histaminic medicines

Objetivo: Avaliar in vitro o pH endógeno, a acidez total titulável (ATT), o teor de sólidos solúveis totais (SST) e os açúcares totais de anti-histamínicos de uso infantil apresentados sob a forma de xarope. Materiais e método: Cinco medicamentos foram avaliados por meio de um experimento aleatório com análise em triplicata. A avaliação do pH foi feita por potenciometria e a capacidade tampão foi realizada por meio da diluição de cada uma das substâncias. Incrementos de 0,1 N KOH foram adicionados até que se atingisse a neutralida-de. As leituras do oBrix foram feitas por refratometria usando o refratômetro de Abbé. Resultados: As médias do pH variaram de 3,33 (loratadina) a 6,84 (agasten) e quatro medicamentos mostraram pH abaixo do valor crítico de 5,5. As médias da ATT variaram de 0,30 para a dexametasona a 2,41 para o maleato de dexclo-feniramina. A dexametasona apresentou o menor valor de SST (13,25%) e o maleato de dexclorfeniramina, o maior valor de SST (63,66%). No tocante aos açúcares totais, o percentual variou de 24,80% (loratadina) a 49,34% (maleato de dexclorfeniramina). Conclusão: Os anti-histamínicos analisados têm um alto potencial erosivo e cariogênico, visto que possuem um baixo pH e elevado teor de sólidos solúveis totais.