Sleep Disorders in Patients with Temporomandibular Disorders (TMD) in an Adult Population-Based Cross-Sectional Survey in Southern Brazil.

PURPOSE: To verify the prevalence of sleep disorders in temporomandibular disorders (TMD) subjects in a Brazilian population-based, cross-sectional survey (N = 1,643). MATERIALS AND METHODS: Patients were assessed with the Research Diagnostic Criteria for TMD (RDC/TMD) Axes I and II and the Sleep Assessment Questionnaire. Student t test and Pearson chi-square test were used for continuous and categorical data analyses, respectively. RESULTS: TMD subjects had significantly worse sleep disorders than controls (Graded Chronic Pain Severity categories I through IV vs 0, respectively) in RDC/TMD Axis II variables. Sleep disorders were also worse in the Axis I TMD groups (myofascial pain and arthralgia/osteoarthritis/osteoarthrosis), with the exception of disc displacements. CONCLUSION: TMD subjects had worse sleep disorders, mainly in Axis I TMD groups, with higher pain/disability levels.

General Health Quality of Life in Patients with Temporomandibular Disorders in a Population-Based Cross-Sectional Study in Southern Brazil.

PURPOSE: To assess the impact of temporomandibular disorders (TMD) on general health quality of life in a Brazilian population-based cross-sectional survey. MATERIALS AND METHODS: A total of 1,643 patients were assessed using the World Health Organization Quality of Life Bref (WHOQOL-Bref) and the Research Diagnostic Criteria for Temporomandibular Disorders Axes I and II (RDC/TMD). Cross-tabulation of the data was carried out to compare TMD subjects to controls in all domains of the WHOQOL-Bref and the RDC/TMD. RESULTS: TMD subjects had significantly worse quality of life than controls in Axes I and II of the RDC/TMD and in all WHOQOL-Bref domains except for disc displacement. Osteoarthrosis was significantly different only in the WHOQOL-Bref physical domain. CONCLUSION: TMD subjects had worse general health quality of life, particularly in Axis I groups with higher pain/disability levels (muscle disorders/arthralgia/arthritis).

Depression and Somatization in Patients with Temporomandibular Disorders in a Population-Based Cross-Sectional Study in Southern Brazil.

PURPOSE: To assess the prevalence of depression and somatization in patients with temporomandibular disorders (TMD) in a Brazilian population-based cross-sectional survey. MATERIALS AND METHODS: A total of 1,643 subjects were assessed for TMD using the Research Diagnostic Criteria for Temporomandibular Disorders Axes I and II and were assessed for depression and somatization using the Graded Chronic Pain Scale. The data were cross-tabulated for comparison between TMD subjects and controls. RESULTS: TMD subjects had significantly worse depression and somatization levels than controls in the RDC/TMD Axis II. The levels were also worse in most Axis I TMD groups (muscle disorders and arthralgia/osteoarthritis/osteoarthrosis). CONCLUSION: TMD subjects had worse depression and somatization, particularly in diagnostic groups with higher pain/disability levels.

Clinical, social and psychosocial factors associated with self-rated oral health in Brazilian adolescents.

OBJECTIVE: The objective of this study is to investigate the main social, psychosocial and clinical factors associated with poor self-rated oral health in adolescents. METHODS: A cross-sectional survey was carried out in two cities of the Distrito Federal, Brazil. Data were collected by clinical examinations and by self-administered questionnaires from 1302 adolescents aged 14- 15 years in 39 schools. Data analysis was carried out using a Poisson regression model taking into account the cluster sample. RESULTS: Adjusting for social, psychosocial and clinical factors, results showed that poor self-rated oral health was significantly associated (P < 0.001) with sex (males) [prevalence ratio (PR) = 0.8, 95% confidence interval (95% CI): 0.7-0.9]; low social class (PR =1.4, 95% CI: 1.2-1.6); poor self-rated general health (PR = 2.6, 95% CI: 2.3-3.1); mouth appearance (PR = 1.9, 95% CI: 1.6-2.2) and with presence of untreated dental decay (PR = 1.4, 95% CI: 1.3-1.6). CONCLUSIONS: The single question on self-rated oral health appears to be a simple and easy way to collect dental health information in adolescents. Assessment and understanding of self-rated oral health should take into account social, psychosocial and oral factors.

The potential impact of neighborhood empowerment on dental caries among adolescents.

OBJECTIVE: Empowerment has been considered a dimension of social capital. It refers to social interaction processes that enable people to enhance their individual and collective skills and to exert greater control over their lives. This relationship has not been explored in relation to dental health. The objective of this study was to investigate the association between neighborhood empowerment and dental caries in adolescents. METHODS: A multilevel study was designed to assess the individual and neighborhood effects on the oral health of adolescents. Four sources of data were used: (a) clinical examinations (WHO), (b) students' questionnaires, (c) parents' questionnaires and (d) census data. The study population was 1302, 14/15-year-old students from 39 public schools of two cities of the Distrito Federal (DF), Brazil. Data analysis used logistic multilevel modeling at two levels: students (sources a and b) and neighborhood as defined by catchment areas of schools (sources c and d). RESULTS: High DMFT (DMFT > median, DMFT > or =3) rates were significantly lower in areas with higher levels of empowerment. This relationship was independent of socioeconomic variables at the individual and area levels and of all other individual risk factor variables such as sex, fluoride, sugar consumption, tooth brushing and dental attendance [OR for low compared with high empowerment was 1.54 (95% CI = 1.09-2.18), P = 0.014]. CONCLUSIONS: Neighborhood empowerment may play an important role in explaining inequalities in the levels of dental caries. New perspectives are needed so that more effective interventions can be implemented using area-based perspectives.