Socioeconomic Disparities in Oral Health Related Quality of Life of Schoolchildren: A Cross-Sectional Study

Abstract Objective: To analyze whether demographic and socioeconomic factors can influence the OHRQoL in schoolchildren. Material and Methods: A cross-sectional study using a representative sample of 1137 children aged 8-10 years, enrolled in public schools in Florianópolis, Brazil, was conducted. Children answered the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) quality of life questionnaire and their parents responded to socioeconomic and demographic questions. Logistic regression models were used to analyze the data. Results: Higher probability of presenting a negative impact on the OHRQoL was observed in children whose skin color was non-white (OR 1.46, 95% CI 1.04-1.69) and female (OR 1.33, 95% CI 1.04-1.69). Children in whom the head of the family had years of schooling 9-11 (p=0.001), 5-8 (p=0.005) and ≤4 (p=0.000) were more likely to have a negative impact on the OHRQoL. CPQ8-10 domains evaluation showed that variables education, gender, skin color, and age were associated with a negative impact on OHRQoL (p≤0.05). Conclusion: The educational level of the head of the family and the demographic characteristics of the children are associated with a negative impact on the OHRQoL.

Prevalence of self-reported dental pain and associated factors among eight- to ten-year-old Brazilian schoolchildren.

AIM: To assess the prevalence of self-reported dental pain and its association with sociodemographic, clinical and behavioral/psychosocial indicators among 8- to 10-year-old Brazilian schoolchildren. DESIGN: A cross-sectional study was carried out with 1,589 eight- to ten-year-old children randomly selected from public schools of Florianopolis, Brazil. Self-reports of dental pain were collected through a single question as follows: "In the last month, how many times have you had pain in your teeth?" Caries experience was determined by the DMFT/dmft index and its clinical consequences by the PUFA/pufa index. Dental trauma, dental fluorosis and molar-incisor hypomineralization were assessed through the Andreasen, Dean and European Academy of Pediatric Dentistry classifications, respectively. Clinical signs of dental erosion were also observed. Sociodemographic indicators were obtained through a questionnaire answered by the children's caregivers. Information about behavioral/psychosocial indicators was collected through questions from the Brazilian version of the Child Perception Questionnaire 8-10 years (CPQ8-10). Descriptive analysis, chi-square test, and hierarchically adjusted Poisson regression models were performed. RESULTS: 819 children (51.5%) reported episodes of dental pain in the last month prior to the study, whereas 55.6% (n = 509) were girls. The presence of dental pain was significantly associated with sex, trouble sleeping, difficulty eating, school absenteeism, difficulty with paying attention in class, difficulty doing homework, staying away from recreational activities, caries experience, PUFA/pufa index and ulceration (p<0.05). CONCLUSION: The prevalence of self-reported dental pain in 8- to 10- year-old Brazilian schoolchildren was high and was associated with sociodemographic, clinical and behavioral/psychosocial indicators.

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.

Mouth Breathing and Prevalence of Sleep Bruxism among Preschoolers aged 2 to 5 years

Objective: To determine the prevalence of bruxism, associating it with mouth breathing in preschool children in Florianopolis, Brazil. Material and Methods: Clinical examination and questions to parents/guardians of 429 children aged 2-5 were conducted. The clinical examination was performed by three calibrated examiners to register the presence of tooth wear on incisors and molars. The questions were related to sleep bruxism (teeth grinding) and mouth breathing. For determinate diagnosis, were "possible" bruxism by the American Academy of Sleep Medicine and "probable" bruxism, whereas the Item Response Theory was employed for mouth breathing. To determine the associations, a Chi-square test and Fisher exact test with a standard error of 5% and 95% interval confidence were applied. Results: The clinical examination revealed bruxism in 8.2%, whereas the parental report revealed bruxism in 17.2%. When clinical examination was associated with the parent's report, bruxism was present in 2.1%. Among the non-clinical variables, the most prevalent changes included: child presenting a regular stuffy nose (19.6%), followed by child is always open-mouthed (16.1%). A significant statistical association between bruxism and age was obtained (p<0.05), the age group with prevalence of 4 and 5 years old with 68.9%. There was no mouth breathing association with the presence of bruxism (p>0.05). Conclusion: Bruxism was prevalent for children aged 4-5 and bruxism had no association with mouth breathing.

A interação mãe-bebê ao longo dos dois primeiros anos de vida do bebê / The mother-baby interaction through the first two years of baby's life

O presente estudo investiga as características da interação da díade mãe-bebê ao longo dos dois primeiros anos de vida do bebê, utilizando como método uma análise longitudinal da interação mãe-bebê. Esta interação foi filmada aos 8, 14 e 20 meses do bebê e demonstra que a mesma se tornou mais complexa, com episódios interativos mais longos e maior repertórios de comportamentos. Além disso, foi possível acompanhar a construção da forma particular da díade interagir, com a continuidade e a modificação de alguns comportamentos. Tal observação trouxe maior compreensão acerca dos aspectos relacionados à interação em momentos diferentes do desenvolvimento da díade, evidenciando a mútua regulação entre mãe e filho, na qual ambos assumem papel importante na interação e participam ativamente das trocas. Desta forma, possibilita-se que o bebê manifeste suas necessidades e emoções e que a mãe responda ao filho.

This study investigates the mother baby interaction for the first two years of the baby's life, with a longitudinal analysis of the mother baby interaction as a method. This interaction whas recorded at 8, 14 and 20 months old, and shows that it became more complex, with longer interactive episodes and more behavioral repertoire. Besides that, it was possible to follow how the interaction of the duo was particularly built, keeping and changing some behaviors. Such observation brought more comprehension about some aspects related to the interaction during differents moments of the duo development, indicating a mutual self regulatory relationship between mother and baby, where both have an important role in this interaction and participate actively in it. This will allow the baby to express his needs and emotions, and for the mother to respond to her child

Untreated Dental Caries Is Associated with Reports of Verbal Bullying in Children 8-10 Years Old.

The objective of this research was to verify the association between verbal bullying and untreated dental caries. The present cross-sectional study had a representative sample of 1,589 children, aged 8-10 years, from public schools. Information on verbal bullying related to the oral condition was obtained through a questionnaire directed to the students. Clinical data were collected by 4 calibrated examiners (kappa > 0.70) using the DMFT/dmft and PUFA/pufa indexes for caries. Socioeconomic issues were answered by those responsible. The prevalence of verbal bullying related to the oral condition was 27%. The results of the Poisson regression, in an adjusted multiple model, showed a significant association between bullying and untreated caries lesions (prevalence ratio, PR: 1.27; 95% CI: 1.07-1.52), PUFA/pufa index (PR: 1.34; 95% CI: 1.11-1.61), pulp involvement (PR: 1.35; 95% CI: 1.09-1.67), and abscess (PR: 1.74; 95% CI: 1.18-2.56). It was concluded that children with untreated dental caries had a higher prevalence of verbal bullying when compared to caries-free or disease-treated children.

Estudo do conhecimento clínico dos profissionais da fisioterapia no tratamento de crianças autistas / Study of clinical knowledge of physical therapy professionals in the treatment of autistic children

O autismo compõe a categoria dos transtornos invasivos do desenvolvimento, inclui prejuízos na interação social, na comunicação, padrões restritivos e repetitivos de comportamento, interesses e atividades. É de suma importância o profissional atuante com a criança autista, ser um bom conhecedor da patologia e de suas técnicas terapêuticas. Muito se fala, na atualidade, sobre a função da fisioterapia no acompanhamento deste paciente, inicialmente trabalhando no desenvolvimento motor, e posteriormente ativando áreas da concentração e da interação social. Assim, torna-se imprescindível que durante a graduação os futuros profissionais recebam informações sobre o assunto, para que venham para o campo de trabalho informados sobre a relação fisioterapeuta ? paciente autista. Desta forma, o objetivo deste estudo foi analisar o conhecimento do profissional da fisioterapia, quanto a sua função na humanização e tratamento da criança autista. Para isso, foram avaliados 30 profissionais, de ambos os sexos, sem fator de idade, graduados em fisioterapia atuantes na cidade de Toledo-PR. O estudo foi possível por meio da aplicação de um questionário, abordando as características da doença e as técnicas fisioterapêuticas utilizadas. Os resultados mostraram que 56,6% dos entrevistados adquiriram conhecimentos sobre a síndrome na graduação, entretanto, somente 20% buscaram aprimorar seus conhecimentos posteriormente. Foi possível concluir que existe a necessidade de uma melhora científica, proporcionando um desempenho ideal das habilidades práticas fisioterapêuticas voltadas para este paciente.

Autism is a pervasive developmental disorder that impairs social interaction and communication, restrictive and repetitive patterns of behavior, interests and activities. It is fundamental that a professional working with autistic children have good knowledge of their pathology and therapeutic techniques. Presently, much is said on the monitoring role of physiotherapy in this kind of patient, initially working the motor development and later activating areas of concentration and social interaction. Therefore, it is essential that during their undergraduation course, future professionals receive information on the subject so that they become more prepared for the work regarding the relationship therapist - autistic patient. Thus, the aim of this study was to analyze the professional knowledge of physiotherapists and their role in the humanization and treatment of autistic children. 30 graduated professionals of both sexes, regardless of age, working in the city of Toledo, PR, were evaluated. The study was done by applying a questionnaire about the characteristics of the disease and used physical therapy techniques. The results showed that 56.6% of the surveyed individuals learned about the syndrome in their undergraduate course; however, only 20% tried to improve their knowledge afterwards. It can be concluded that there is a need for scientific improvement that provides optimal performance of practical skill-oriented physical therapy for this kind of patient.

Relação entre atividade física e osteoporose / The relation between physical activity and osteoporosis

Sabe-se que o envelhecimento afeta o sistema ósseo, promovendo diminuição fisiológica da densidade mineral, podendo, inclusive, se de forma demasiada, provocar uma doença sistêmica, conhecida como osteoporose, que é a redução da massa óssea e deteriorização da micro-arquitetura deste tecido, levando a uma fragilidade mecânica e predisposição a fraturas. Este estudo objetiva, através de sucinta revisão bibliográfica, elucidar a relação da osteoporose com a atividade física, destacando a importância da prática de exercícios na manutenção da integridade óssea. Parte da população não praticante de atividade física é representada, principalmente, pelos idosos e pelas mulheres na pós-menopausa, que apresentam maior predisposição a adquirir deficiências na densidade óssea. Recomendada-se a prática de exercícios para auxiliar na prevenção da perda e manutenção da massa óssea, embora algumas variáveis como componentes genéticos, étnicos, hormonais e nutricionais também possam influenciar.

It is known that aging affects the bone system by promoting the physiologic reduction of the mineral density causing – in extreme situations - a systemic illness known as osteoporosis, which is the reduction of the bone mass and the deterioration of the tissue micro architecture, resulting in a mechanical fragility and breaking predisposition. Thus, this study aims to briefl y review the related literature by searching to elucidate the relation between osteoporosis and the physical activity, detaching the importance of practicing exercises to preserve bone integrity. The amount of population which do not perform any physical activity is mainly represented byelderly people and post-menopausal women, who present higher predisposition to bone density defi ciency. The practice of exercises is recommended to prevent bone mass loss, although some variants can also infl uence such as genetic, ethnic, hormones and nutritionists components.

Resistance to cefotaxime and peptidoglycan composition in Enterococcus faecalis are influenced by exogenous sodium chloride.

The influence of NaCl on the susceptibility of Enterococcus faecalis to cefotaxime was tested with JH2-2, a laboratory strain, and 20 clinical strains grown on tryptic soy agar supplemented with 5% horse blood. Growth with 3% NaCl in the medium resulted in an increase in cefotaxime resistance and the appearance of a heterogeneous resistance phenotype: for the majority of the strains, the MICs of cefotaxime increased from 4 to 512 micrograms ml-1. By a competition assay using cefotaxime and [3H]benzylpenicillin, it was shown for strain JH2-2 that at the MIC penicillin-binding protein (PBP) 2 and PBP3 were the apparent essential PBPs in medium without NaCl, whilst the low-affinity PBPs 4 and 1 were the apparent essential PBPs for cell growth in medium containing 3% NaCl. Analysis of JH2-2 peptidoglycan by HPLC and MS after growth in the presence of 3% NaCl showed a relative increase in unsubstituted monomers and a relative decrease in alanine- and dialanine-substituted monomers. It is therefore hypothesized that modification of the number of alanine-substituted precursors in the presence of NaCl could interfere with the functions of the different PBPs and thus play a role in cefotaxime resistance in E. faecalis.