Probable sleep and awake bruxism in adolescents: A path analysis.

BACKGROUND: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes. AIM: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. DESIGN: A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis. RESULTS: PSB and PAB are related to each other, with moderate and positive correlation (ß = .390). Poor sleep quality and higher household income had a direct effect on both PSB (ß = -.138; ß = .123, respectively) and PAB (ß = -.155; ß = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (ß = -.102). Adolescents that drool on the pillow (ß = .184) and/or have agitated sleep (ß = .104) tend to have PSB. CONCLUSION: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.

Sleep disturbances are associated with feeding practices and age in preterm infants.

BACKGROUND: Preterm infants are under risk of several shortcomings including sleep disturbances (SD). This cross-sectional study evaluated factors associated with SD in preterm and low birth weight infants in a reference center for preterm children at a University Hospital, southeastern Brazil. METHODS: A hundred-four dyads of mothers-infants 0-3 years participated. Mothers answered an online questionnaire (Google Forms®) evaluating childbirth characteristics, gestational age, breastfeeding, bottle feeding, non-nutritive sucking habits and sociodemographic information. The Brazilian version of the Brief Infant Sleep Questionnaire (BISQ) evaluated SD. Bivariate and Logistic Regression analyses were performed (p < 0.05). RESULTS: SD was present in 45.2% of the sample. Multivariate Logistic Regression Model showed that infants breastfed ≥3 times at night had 5.006 more chances to have SD (CI 95% = 1.229-20.400) compared to those who did not breastfeed at night. Infants who were bottle-fed 3 ≥ times at night had 6.952 more chances to have SD (CI = 95% = 1.364-35.427) compared to those who were bottle fed less frequently. The chance of SD decreased 6.6% (CI 95% = 0.889-0.982) for each increase of a month in infant's age, and infants from families with higher income had 3.535 more chances to have SD (CI 95% = 1.006-12.416). CONCLUSION: The younger the child, a higher frequency of night feeding and belonging to higher income families were associated with SD. Recognizing the associated factors with SD in newborns and infants can aid families to better deal with this issue, promote better sleep quality and individualized counseling.

Effects of different toothpaste formulations on erosive tooth wear prevention: systematic review / Efeitos de diferentes dentifrícios na prevenção do desgaste dentário erosivo: revisão sistemática de literatura

Objective: erosive tooth wear is a multifactorial condition that results in loss of dental hard tissue, caused by a chemical and mechanical process. This paper aims to carry out a systematic review presenting the effects of different toothpaste formulations on the loss of dental enamel surface in vitro. Material and Methods: the searches were performed in the databases PubMed, Web of Science, LILACS and Scielo. Articles published from 2010 to 2020 were filtered, without language restriction. Articles that included abrasion and erosion protocols were searched, as they were more similar to clinical reality, since toothpaste is applied through tooth brushing. The searches with descriptors and free terms on the topic resulted in 992 articles, however only 12 were within the search criteria. Results: the selected studies appointed that association of conventional fluorides (NaF) with metallic fluorides can be a promising strategy for the reduction of surface loss by erosive tooth wear. Toothpastes containing sodium fluoride, as well as tin without chitosan, showed a reduction in surface loss, considered sufficient for individuals with medium exposure to acids. In children's toothpastes, the one containing sodium fluoride showed a reduction in surface loss when compared to non-fluoride dentifrices. Conclusion: different protocols may result in less or greater loss of enamel surface, and methodological differences should be considered. To clarify the effects of dentifrices on erosive tooth wear, other properties of dentifrices should be investigated. (AU)

Objetivo: o desgaste erosivo é uma condição multifatorial que resulta em perda de tecido duro dentário, causado por um processo químico e mecânico. Este trabalho tem como objetivo realizar uma revisão sistemática de literatura apresentando os efeitos de diferentes formulações de dentifrícios na perda de superfície de esmalte dentário in vitro. Material e Métodos: a busca foi realizada nas bases de dados PubMed, Web of Science, LILACS e Scielo. Foram filtrados artigos publicados no intervalo de 2010 a 2020, sem restrição de idioma. Buscou-se artigos que incluíssem protocolos de abrasão e erosão, por mais se assemelhar a realidade clínica, uma vez que o dentifrício é aplicado através da escovação dentária. A busca com descritores e termos livres sobre o tema encontrou 992 artigos, entretanto somente 12 estavam dentro dos critérios da pesquisa. Resultados: os estudos selecionados apontaram que associação dos fluoretos convencionais (NaF) com os metálicos pode ser uma estratégia promissora para a redução de perda de superfície pelo desgaste dentário erosivo. Dentifrícios contendo fluoreto de sódio, assim como estanho sem quitosana, apresentaram redução na perda de superfície, sendo considerada suficiente para indivíduos com exposição média aos ácidos. Em dentifrícios infantis, aquele que continha fluoreto de sódio apresentou uma redução de perda de superfície quando comparado com dentifrícios sem fluoreto. Conclusão:diferentes protocolos podem resultar em menor ou maior perda de superfície de esmalte e as diferenças (AU)

Tooth wear due to dental attrition among 12-year-old adolescents / Desgaste dentário por atrição entre adolescentes de 12 anos de idade

Aim: To evaluate the prevalence and distribution of tooth wear due to dental attrition among 12-year-old adolescents according to their gender, reports of tooth grinding during sleep/while awake (bruxism), and sleep features related to sleep-disordered breathing. Methods: A cross-sectional study was conducted with 172 adolescents from southeast Brazil. Parents/caregivers answered questions about sociodemographic characteristics; reports of adolescents' tooth grinding during sleep, and sleep features (e.g. sleep duration and position, snoring, drooling on the pillow) in the previous two weeks. Adolescents self-reported the occurrence of tooth clenching/grinding while awake in the previous two weeks. Tooth wear due to dental attrition was assessed by a previously calibrated researcher, using a validated 5-point analogical ordinal occlusal/incisal tooth wear grading scale, with scores ranging from 0 (no wear) to 4 (loss of crown height ≥ 2/3), depending on tooth wear severity. Descriptive statistics and the Mann-Whitney test (p < 0.05) were performed to identify differences in tooth wear due to the distribution of dental attrition, according to adolescents' characteristics. Results: Most adolescents were female (58.0%) and 81.6% of the participants presented tooth wear due to dental attrition within the enamel. Adolescents who snored had a higher number of incisors with tooth wear due to dental attrition (p = 0.035). Females showed a higher number of canines with tooth wear due to dental attrition (p = 0.020). Adolescents whose parents reported tooth grinding during sleep presented a higher number of bicuspids with tooth wear due to dental attrition (p = 0.001). Conclusion:Tooth wear due to dental attrition within the enamel was observed in most adolescents. The distribution, depending on specific groups of teeth, was higher among female adolescents, adolescents' whose parents reported tooth grinding, and adolescents who snored during sleep.

Objetivos: Avaliar a prevalência e distribuição de DDA entre adolescentes de 12 anos de acordo com o sexo, relato de ranger de dentes durante o sono e vigília (bruxismo) e características relacionadas a desordens respiratórias do sono.Método: Desenvolveu-se um estudo transversal com 172 adolescentes do sudeste do Brasil. Seus pais/responsáveis responderam um questionário contendo informações sociodemográficas, relato sobre os filhos rangerem os dentes durante o sono e hábitos do sono dos filhos (duração do sono, posição que dorme, roncar, babar no travesseiro) nas duas últimas semanas. Adolescentes relataram ocorrência de ranger/apertar de dentes durante a vigília nas duas últimas semanas. DDA foi avaliado por um pesquisador previamente calibrado através de uma escala analógica ordinal de cinco pontos de desgaste dentário para faces oclusal/incisal previamente validada, com escores variando de 0 (sem desgaste) a 4 (perda da coroa em altura ≥ 2/3), dependendo da gravidade do desgaste. Análises descritivas e teste de Mann-Whitney (p < 0,05) foram realizados para identificar as diferenças na distribuição de DDA de acordo com as características dos adolescentes.Resultados: A maioria dos adolescentes eram meninas (58,0%) e 81,6% dos participantes apresentaram DDA em esmalte em algum elemento dentário. Adolescentes que rocavam apresentavam mais incisivos com DDA (p = 0.035). Meninas apresentaram maior número de caninos com DDA (p = 0.020). Adolescentes que rangiam os dentes durante a noite apresentaram maior número de pré-molares com DDA (p = 0.001).Conclusão: Desgaste dentário por atrição em esmalte foi observado na maioria dos adolescentes. A distribuição, dependendo de grupos de dentes específicos, foi maior entre meninas, adolescentes que roncavam durante o sono e que rangiam os dentes durante o sono.

The importance of full text screening when judging eligibility criteria in a systematic review: a systematic survey / A importância da avaliação do texto completo ao julgar os critérios de elegibilidade em uma revisão sistemática: uma revisão de métodos

Aim: To evaluate if statistically significant results are more likely to be reported in title/abstracts compared to non-significant outcomes. Methods: In this methodological survey, we reanalyzed 59 observational studies from a previous systematic review. The PECO question was: Patient (P): children with primary teeth; Exposure (E): low birth weight and/or preterm; Comparison (C): normal birth weight and/or full-term; Outcome (O): dental caries. We analyzed the presence of key terms in the titles and abstracts, such as gestational age, preterm, full-term, birth weight, low/normal birth weight. Full texts were analyzed for "positive outcomes" (statistically significant association, p < 0.05 or 95% CI not crossing the null effect line) related to the association between the outcome and the exposure; and "negative outcomes" (when the outcome had statistically similar occurrence between the exposure and the comparison group). The odds ratio (OR) was calculated between the presence of key terms in titles/abstracts and the type of outcome (positive or negative). Results: Of 59 studies, 66% cited the key terms in titles/abstracts, and 75% reported negative outcomes. Studies with positive outcomes were more likely to report key terms in the titles/abstracts compared to studies with negative outcomes (OR: 4.5; 95% CI: 0.9-22.4; Chi-square test: p = 0.06). Studies with statistically significant outcomes, favoring the exposure or the comparison, were more likely to report these data in the titles/abstracts. Conclusion: When conducting a systematic review, the final decision related to the inclusion of a study must be based on a full-text level.

Objetivo: Avaliar se os resultados estatisticamente significativos são mais prováveis de serem relatados nos títulos/resumos dos artigos do que os resultados não significativos. Métodos: Neste levantamento metodológico, foram reanalisados 59 estudos observacionais de uma revisão sistemática anterior. A questão PECO foi: Paciente (P): crianças com dentes decíduos; Exposição (E): baixo peso ao nascer e/ou pré-termo; Comparação (C): peso normal ao nascer e/ou a termo; Resultado (O): cárie dentária. Foi analisada a presença de termos-chave nos títulos/resumos, como idade gestacional, pré-termo, a termo, peso ao nascer, baixo/peso normal ao nascer. Textos completos foram analisados para "desfechos positivos" (associação estatisticamente significativa, p < 0,05 ou IC 95% não cruzando a linha de efeito nulo) relacionados à associação entre o desfecho e a exposição; e "desfechos negativos" (quando o desfecho teve ocorrência estatisticamente semelhante entre a exposição e o grupo de comparação). Foi calculada a odds ratio (OR) entre a presença de termos-chave nos títulos/resumos e o tipo de resultado (positivo ou negativo). Resultados: Dos 59 estudos, 66% citaram os termos-chave nos títulos/resumos e 75% relataram resultados negativos. Estudos com resultados positivos foram mais propensos a relatar os termos-chave nos títulos/resumos em comparação com estudos com resultados negativos (OR: 4,5; IC 95%: 0,9-22,4; teste do qui-quadrado: p = 0,06). Estudos com significância estatística os desfechos, favorecendo a exposição ou a comparação, foram mais propensos a relatar esses dados nos títulos/resumos. Conclusão: Ao realizar uma revisão sistemática, a decisão final quanto à inclusão de um estudo deve ser baseada por meio da análise do texto completo.

Self-reported awake bruxism and chronotype profile: a multicenter study on Brazilian, Portuguese and Italian dental students.

Objective: To assess the association between self-reported awake bruxism (AB) and the chronotype profile among Brazilian, Portuguese, and Italian dental students.Methods: A cross-sectional study involving 205 dental students was developed. Self-reported AB as well as information on sleep characteristics were collected from a questionnaire. The Morningness-Eveningness Questionnaire (MEQ) was used to measure the chronotype profile. Descriptive statistical analysis, the chi-square test, and univariate analysis were used to evaluate the factors associated with AB.Results: The prevalence of AB in all groups was 33.7%. The intermediate chronotype profile was the most prevalent (60.4%), and only 16.7% of the participants had the morning profile. The univariate analysis showed that older dental students (OR = 2.640, 95% CI 1.388-5.021) and those with the eveningness chronotype profile (OR = 3.370, 95% CI 1.302-8.725) are associated with AB.Discussion: Students over the age of 22 and those with the eveningness chronotype profile were prone to AB.

Acidic food choice among adolescents with bulimic symptomatology: a major risk factor for erosive tooth wear?

PURPOSE: Evaluate dietary habits and the presence of erosive tooth wear (ETW) among female adolescents with varying severity of bulimic symptomatology. METHODS: An explanatory study was conducted with 72 female school adolescents with bulimic symptomatology, aged 15-18 years in Southeastern Brazil. Dietary habits were evaluated through a food frequency questionnaire. Bulimic symptomatology was evaluated and classified (mild, moderate and severe) according to the Bulimic Investigatory Test of Edinburgh. ETW examinations were performed. Data analysis involved descriptive statistics, bivariate analysis, Kruskal-Wallis/Mann-Whitney tests and Poisson regression. Ethical approval and informed consents were obtained. RESULTS: The final population consisted of 62 participants. The prevalence of ETW differed among adolescents with mild, moderate and severe bulimic symptomatology (p = 0.001), corresponding to 5.9%, 8.0% and 45.0%, respectively. Adolescents with severe bulimic symptomatology presented higher daily consumption of acidic food: citric fruits (p < 0.005), diet soda (p < 0.009) and ketchup (p = 0.004). No difference related to vomiting practices was observed between groups (p = 0.060). The adjusted regression model showed that a higher prevalence of ETW was associated with self-induced vomit at least once a week (PR = 2.42, 95% CI = 1.00-5.86, p = 0.05) and higher frequencies of consumption of citric fruits (PR = 7.96, 95% CI = 1.50-42.11, p = 0.015) and diet soda (PR = 2.32, 95% CI = 1.09-4.91, p = 0.029). CONCLUSION: It was the food choices (acidic food) and not purging practices that differed among adolescents with varying severity of bulimic symptomology. Likewise, higher consumption of citric fruits was the main factor associated with higher prevalence of ETW. LEVEL OF EVIDENCE: III case-control analytic study.

Association of facial type with possible bruxism and its related clinical features in adolescents: A cross-sectional study.

OBJECTIVES: The assessment of bruxism and its clinical characteristics is acknowledged in literature. This study aimed to evaluate the association of adolescents' facial patterns with bruxism and its related clinical features in the form of signs and symptoms. MATERIALS AND METHODS: Four hundred and three adolescents answered a questionnaire evaluating sleep bruxism (SB) and awake bruxism (AB). Parents/caregivers answered a questionnaire evaluating the adolescents' sleep features (drooling on the pillow, snoring). Adolescents' facial (dolichofacial/brachyfacial/mesofacial) and clinical features (pain in masseter/temporal muscle, indentations marks on the tongue, linea alba, tooth attrition, mouth's maximum opening and masseter electrical activity) were evaluated. Multinomial regression was performed. Odds ratio (OR) and confidence intervals (CI) were provided. RESULTS: Brachyfacial adolescents were less likely to present possible AB compared to mesofacials (OR=0.46, CI=0.21-0.98). Brachyfacial adolescents were more likely to present pain in the temporal muscle (OR=6.59, CI=2.18-19.87) and a higher number of posterior teeth with attrition (OR=1.25, CI=1.02-1.57) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the masseter muscle (OR=2.23, CI=1.03-4.83), had a higher mouth's maximum opening (OR=1.43, CI=1.04-1.97), had a higher number of posterior teeth with attrition (OR=1.17, CI=1.00-1.37) and were more likely to drool on the pillow (OR=2.05, CI=1.15-3.67) compared to mesofacials. Dolichofacial adolescents were more likely of not presenting pain in the temporal muscle (OR=6.36, CI=2.30-17.54), to present themselves without marks on the tongue (OR=2.26, CI=1.09-4.69) and present a higher mouth's maximum opening (OR=2.09, CI=1.40-3.13) compared to brachyfacials. CONCLUSION: Bruxism and its clinical features differ among dolichofacial, brachyfacial and mesofacial adolescents.

Risk behavior for bulimia among adolescents / Comportamento de risco para bulimia em adolescentes

ABSTRACT Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson's chi-square , Fisher's exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.

RESUMO Objetivo: Analisar comportamentos de risco para bulimia em adolescentes do sexo feminino de escolas públicas e particulares. Métodos: Estudo transversal com amostra aleatória de 850 estudantes do sexo feminino, com idades entre 15 e 18 anos, realizado em cidade do Nordeste do Brasil, utilizando o Bulimic Investigatory Test of Edinburgh (BITE) para avaliar comportamentos de risco para transtornos alimentares. Os dados foram analisados utilizando o teste do qui-quadrado de Pearson, o teste exato de Fisher e a regressão de Poisson, com o software Statistical Package for the Social Sciences (SPSS), adotando o nível de significância de p<0,05. Resultados: Da amostra estudada, 42,0% apresentou padrões de risco e práticas de dieta e controle de peso e 1,4% já apresentava sinais de bulimia instalados. O medo de ganhar peso foi relatado por 62,8% das adolescentes. As práticas de risco foram menos frequentes em estudantes de escolas públicas (Odds Ratio - OR - 0,82; intervalo de confiança de 95% - IC95% - 0,69-0,97). Entre as práticas restritivas, jejum por um dia inteiro foi o mais aplicado pelas participantes (29,9%). Entre os indivíduos com situação de risco, quase metade acreditava ter hábitos alimentares normais (razão de prevalência - RP - 0,42; IC95% 0,36-0,49). Estudantes que consideram seus hábitos alimentares normais, que têm medo de ganhar peso, que procuram conforto emocional em alimentos e seguem dietas rigorosas tiveram maior risco para bulimia (p<0,05). Conclusões: O número de estudantes com práticas de comportamento de risco para bulimia é alto, e o número daquelas que desconhecem essa situação também é muito alto. As situações de risco emergem como problemas de saúde coletiva, e indivíduos de escolas particulares são mais propensos a apresentar transtornos alimentares.

RISK BEHAVIOR FOR BULIMIA AMONG ADOLESCENTS.

OBJECTIVE: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. METHODS: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson's chi-square , Fisher's exact and robust Poisson regression tests, adopting the significance level of 5%. RESULTS: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). CONCLUSIONS: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation.

Possible sleep bruxism, circadian preference, and sleep-related characteristics and behaviors among dental students.

Objective: To assess sleep bruxism prevalence and its association with circadian preference and sleep-related characteristics among dental students. Methods: Dental students of the Federal University of Minas Gerais participated in this cross-sectional study. Participants answered a scale assessing individuals' circadian preference, and a questionnaire regarding sleep-related characteristics and behaviors, history of muscle ache in the temporomandibular area, and history of bruxism. Results: One hundred fifty-two students participated in the study. Sleep bruxism was reported by 11.3%. Most students (63.2%) were classified as intermediary, 34.9% as morningness, and 1.3% as eveningness. Individuals who reported muscle ache in the temporomandibular area in the morning (PR = 3.5; 95% CI = 1.1-11.5) were more likely to be in the group with sleep bruxism. Conclusion: Muscle ache in the temporomandibular area is an important associated factor with sleep bruxism among dental students. Special attention should be paid to dental students' circadian preference.

Erosive tooth wear-why clinicians should be aware of this condition

Introduction: Erosive tooth wear (ETW) is defined as a chemical-mechanical process leading to the cumulative loss of hard dental tissue without the involvement of bacteria. Objective: to give to clinicians an overview about most important ETW topics. Data source: main scientific data base (PubMed, Lilacs) in the last 10 years, with the keywords: dental erosion, diagnosis and prevention. Classical articles were selected for the realization of an integrative literature review. Data synthesis : the prevalence of ETW has been reported to range from 10% to 80% in children and 4% to 82% in adults. The management of ETW should include early diagnosis, the evaluation of different etiological factors, risk identification and the proposal of preventive measures to avoid the progression of the condition. These measures include fluoride exposure, use of low abrasive toothpastes, clinical monitoring, and in more severe cases sealant application and restorations. Patients suffering from eating disorders with purging behaviour and gastroesophageal reflux disease are considered the most important risk groups. Conclusion : Clinicians should be aware of this condition with growing prevalence, once substance loss is an irreversible condition, providing prompt preventive measures during the early stages that are essential to reduce ETW.

Introdução: O Desgaste Dentário Erosivo é definido como um processo químico- mecânico que leva a uma perda cumulativa de tecido dentário duro, sem que ocorra o envolvimento de bactérias. Objetivo : atualizar os cirurgiões-dentistas sobre os principais tópicos a respeito do Desgaste Dentário Erosivo. Fonte de dados: principais bases científicas (PubMed, Lilacs) nos últimos 10 anos, com as palavras-chave: erosão dentária, diagnóstico e prevenção. Foram selecionados os artigos clássicos sobre o tema para a realização da revisão integrativa de literatura. Síntese de dados : A prevalência de Desgaste Dentário Erosivo tem sido reportada na literatura em porcentagens que variam de 10% a 80% em crianças e de 4% a 82% em adultos. A abordagem clínica do Desgaste Dentário Erosivo deve incluir um diagnóstico precoce, a avaliação dos diferentes fatores etiológicos, a identificação do risco e a proposta de medidas preventivas para retardar a progressão dessa condição. Essas medidas incluem a aplicação de fluoretos, o uso de dentifrícios com baixa abrasividade, monitoramento clínico e, em casos mais graves, a aplicação de selantes e procedimentos restauradores. Pacientes diagnosticados com transtornos alimentares ou com refluxo gastroesofágico são considerados um dos grupos de risco mais importantes para o desenvolvimento dessa condição. Conclusão: Os clínicos devem estar atentos a essa condição de prevalência crescente, uma vez que a perda de estrutura dentária é irreversível, promovendo medidas preventivas eficazes, desde os estágios iniciais, contribuindo assim para o controle e redução do Desgaste Dentário Erosivo entre seus pacientes.

Study of Associated Factors With Probable Sleep Bruxism Among Adolescents.

STUDY OBJECTIVES: To evaluate the prevalence of probable sleep bruxism (SB) and its association with sleep features, orthodontic fixed appliance wearing, and extraoral and intraoral clinical signs and symptoms in a population of adolescents. METHODS: Two hundred thirty-nine 12-year-old adolescents enrolled in private and public schools in Brumadinho, southeast Brazil, and their parents were invited to participate. They answered a questionnaire containing information regarding adolescents' sleep features and history of SB. Extraoral and intraoral examination was performed to identify some clinical signs (ie, absence of lip competence, presence of mouth breathing, clicks in the temporomandibular joint [TMJ], tooth wear) and symptoms (ie, pain in the masseter muscle upon palpation), and ongoing orthodontic treatment with fixed appliances. Parental report and clinical examination were used to determine probable SB. Descriptive statistics and logistic regression were performed to identify association of probable SB with independent variables. RESULTS: Of 239 adolescents initially selected, 231 (96.6%) participated in the study. Prevalence of probable SB was 16.9%. Adolescents who snored during sleep (odds ratio [OR] = 3.14; 95% confidence interval [CI] = 1.47-6.70), adolescents who did not have clicks in the TMJ (OR = 3.37; 95% CI = 1.11-10.15), and those who wore orthodontic appliances (OR = 2.72; 95% CI = 1.04-7.14) were more likely to be in the group with probable SB. CONCLUSIONS: Snoring, absence of clicks in the TMJ, and fixed appliance wearing were associated with probable SB among adolescents. This study adds to the ongoing research on SB in adolescents and its associated factors. COMMENTARY: A commentary on this article appears in this issue on page 1281.

Association among chronotype, dietary behaviours, and caries experience in Brazilian adolescents: Is there a behavioural pattern?

BACKGROUND: Dental caries (DC) remains a public health issue. Chronotype, diet, and oral hygiene may influence its development. OBJECTIVE: To investigate the association of chronotype, diet, oral hygiene, and DC among 12-year-olds. METHODS: A cross-sectional study with 245 adolescents was conducted in public and private schools in southeast Brazil. Sociodemographics, dietary and oral hygiene habits were collected through a self-reported questionnaire. Chronotype was assessed using the Portuguese version of the Puberty and Phase Preference Scale (PPPS). Subjects were examined for DC (WHO criteria). Bivariate and multivariate analyses were performed (P < 0.05). RESULTS: DC was present in 42.0% of the sample. In the bivariate analysis, a higher DMFT was associated with living in rural areas (P = 0.006), parents'/caregivers' lower schooling (P = 0.008), and a not daily intake of vegetables (P = 0.033). Chronotype was not associated with DMFT scores. The Poisson regression model showed that adolescents who did not have breakfast regularly (PR = 1.55; 95% CI = 1.17-2.08; P = 0.003), lived in rural areas (PR = 2.20; 95% CI = 1.59-3.04; P < 0.001) and did not consume vegetables daily (PR = 1.55; 95% CI = 1.11-2.17; P = 0.009) were more likely to present a higher DMFT. CONCLUSIONS: DC is associated to living in rural areas and dietary habits, such as not having breakfast regularly and lack of daily intake of vegetables.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old.

The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Associação do nível de escolaridade de pais e responsáveis com os hábitos alimentares e de higiene bucal de crianças / Association of parent's/guardian's level of education with the eating and oral hygiene habits of children

Objetivo: Investigar a associação entre hábitos alimentares e de higiene bucal de crianças de 2 a 14 anos e nível de escolaridade dos pais/responsáveis. Métodos: Este estudo transversal foi realizado com uma amostra de conveniência de 214 pais/responsáveis por crianças, selecionadas em cinco escolas públicas de Belo Horizonte, sudeste do Brasil. Um formulário preenchido pelos pais/responsáveis forneceu informações sobre seu nível de escolaridade e sobre hábitos dietéticos e de higiene bucal das suas crianças. A amostra foi estratificada em dois grupos: pais/ responsáveis de crianças de 2 a 6 anos (n=119; 55,6%) e de 7 a 14 anos (n=95; 44,4%). O estudo recebeu aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais, Brasil. A análise dos dados foi realizada pelo teste Qui-quadrado de Pearson e Teste Exato de Fisher (p < 0,05). Resultados: Maior nível educacional dos pais e responsáveis foi associado ao consumo de leite pelas crianças de 7 a 14 anos (OR=6,37; 95% IC: 2,27-17,88; p < 0,001) e inversamente relacionada ao consumo de balas na faixa etária de 2 a 6 anos (OR=0,26; 95% IC: 0,11-0,58, p < 0,001) e chicletes nos dois grupos (2 a 6 anos, p <0,001 e 7 a 14 anos p=0,014). A educação parental mais alta foi associada ao maior uso de pasta de dente infantil pelas crianças de 2 a 6 anos (OR=3,32; 95% IC: 1,52-7,24; p = 0,002), a uma frequência maior de escovação nas crianças de 2 a 6 anos (OR=4,26; 95% IC:1,50-12,08; p = 0,004) e ao uso de fio dental na faixa etária de 7 a 14 anos (OR=3,10; 95% IC:1,27-7,58; p = 0,011). Conclusões: O maior nível de escolaridade dos pais/responsáveis foi associado a hábitos alimentares mais saudáveis e melhores práticas de higiene bucal de suas crianças.(AU)

Aim: To investigate the association between eating and oral hygiene habits of 2 to 14-year-old children and the parent's/guardian's level of education. Methods: A cross-sectional study was conducted with a convenience sample of 214 parents/guardians of children, selected from five public schools in Belo Horizonte, in the southeastern region of Brazil. A questionnaire completed by the parents/guardians collected information about their educational level and about their children's eating and oral hygiene habits. The sample was stratified into two groups: parents/ guardians of children from 2 to 6 years old (n=119, 55.6%) and from 7 to 14 years old (n=95, 44.44%). The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais, Brazil. Data analysis was performed using the Pearson chi-square test and Fisher's Exact Test (p < 0.05). Results: Higher parental education was associated with children's milk consumption in the 7 to 14-year-old group (OR=6.37; 95% CI: 2.27-17.88; p < 0,001) and was inversely related to the consumption of candies from 2 to 6-year-old children (OR=0.26; 95% CI: 0.11-0.58; p < 0.001) and chewing gum in both groups (2 to 6 year olds, p < 0.001 and 7 to 14 year olds, p = 0.014). The highest parental education was associated with the use of children's toothpaste by 2 to 6-year-old children (OR=3.32; 95% CI: 1.52-7.24; p = 0.002) and higher tooth brushing frequency (OR=4.26; 95% CI: 1.50-12.08; p = 0.004) and dental floss usage in the group of 7 to 14-year-old children. Conclusions: The higher educational level of the parents/guardians was related to healthier food choices and better oral hygiene habits.(AU)

Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion.

The aim of this study was to evaluate whether there is an association between risk behavior for eating disorders (EDs) and dental erosion and caries. A controlled cross-sectional study was conducted in Brazil, involving 850 randomly selected female adolescents. After evaluating risk behavior for eating disorders through the Bulimic Investigatory Test of Edinburgh, 12 adolescents were identified with severe risk behavior for EDs and matched to 48 adolescents without such risk. Dental examinations, anthropometric measurements, and eating habits and oral hygiene were performed. Adolescents with high severity eating disorder condition were not more likely to show dental caries (p = 0.329; OR = 2.2, 95% CI: 0.35-13.72) or dental erosion (p = 0.590; OR = 2.33; 95% CI: 0.56-9.70). Adolescents with high body mass index (BMI) were five times more likely to have high severity eating disorder condition (p = 0.031; OR = 5.1; 95% CI: 1.61-23.07). Therefore, high severity risk behavior for EDs was not significantly associated with dental caries and dental erosion. However, high BMI was a risk factor for developing eating disorders and should be an alert for individuals with this condition.

Dental Erosion in Children with Gastroesophageal Reflux Disease.

PURPOSE: The purpose of this study was to investigate the impact of gastroesophageal reflux disease (GERD) on dental erosion (DE) in children and analyze the association between dental erosion and diet, oral hygiene, and sociodemographic characteristics. METHODS: This case-control study encompassed 43 two- to 14-year-olds diagnosed positive for GERD by the 24-hour pH monitoring, paired by age group with 136 healthy controls, in Belo Horizonte, Minas Gerais, Brazil. DE was assessed by one calibrated examiner using the O'Sullivan index. A questionnaire was self-administered by parents collecting information regarding sociodemographics, oral hygiene, and dietary habits. Dental erosion experience was compared between the groups, and a stratified analysis was performed (P<0.05). RESULTS: Dental erosion was diagnosed in 10.6 percent (N equals 19) of all the children; 25.6 percent (N equals 11) of GERD children and 5.9 percent (N equals eight) of children without GERD, P=0.001). Dental erosion was not associated with dietary consumption or sociodemographic characteristics in both groups (P≥0.05). Children who used adult toothpaste had a 5.79 higher chance of having dental erosion in the group with GERD. CONCLUSION: Children diagnosed with gastroesophageal reflux disease were at an increased risk of having dental erosion when compared to healthy subjects; among the GERD children, dental erosion was associated with the use of adult toothpaste.

The perception of graduate students in early childhood education regarding the oral habits of preschoolers / Percepção de estudantes de pós-graduação em educação infantil sobre hábitos orais de pré escolares

Aim: This cross-sectional study aimed to assess the perception of graduate students in early childhood education programs about the oral habits of preschoolers. Methods: All 47 graduate students enrolled in the early childhood education program at the Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil from 2012 to 2013 participated in the study. Participants were approached during their lecture classes and were asked to respond to a pre-tested self-completion questionnaire. Data analysis involved descriptive statistics. Results: The majority of participants were women (95.7%) between 25 and 46 years of age, with a mean of 32.3 years of age (SD = 4.36). Most believed that all children should be bottle fed (91.5%) and use a pacifier (80.9%). The majority also reported that they would like to receive further information on oral health (91.5%). Conclusion: Graduate students in the early childhood education field can be important allies in promoting oral health. However, they need to acquire further knowledge on the subject during their professional training.(AU)

Objetivo: O objetivo deste estudo transversal foi avaliar a percepção de estudantes de especialização em educação infantil sobre hábitos orais de pré escolares. Material e Métodos: Todos os 47 estudantes de pós-graduação, matriculados no curso de Especialização em Educação Infantil da Universidade Federal de Minas Gerais durante 2012 e 2013, participaram do estudo. Os participantes foram abordados durante as aulas teóricas e responderam a um questionário pré-testado. Os dados foram analisados por análise descritiva. Resultados: A maioria dos participantes era mulher (95,7%), com idade variando de 25 a 46 anos, cuja média foi de 32,3 anos (DP = 4.36). Muitos deles acreditavam que todas as crianças deveriam usar mamadeira (91,5%) e usar chupeta (80,9%). A maioria relatou que gostaria de receber mais informações sobre o tema (91,5%). Conclusão: Estudantes de pós-graduação envolvidos com educação infantil são importantes promotores da saúde bucal. Entretanto, eles necessitam adquirir maiores conhecimentos desta temática.(AU)