Explicit discrimination among Brazilian dental students: A multicenter study.

OBJECTIVE: To test the association between socioeconomic and sociodemographic status of Brazilian dental students with discriminatory experiences suffered by them. METHODS: This multicenter cross-sectional study was conducted with 531 undergraduate dental students from four different Brazilian states. The Explicit Discrimination Scale (EDS) was used to measure the experience of discrimination in several daily situations. A questionnaire about sociodemographic and socioeconomic characteristics, form of admission, and permanence in dental schools was developed and validated by experts and six dental students through cognitive interviews. The EDS and questionnaire were sent to students by an online platform using snowball sampling. Descriptive analysis, bivariate tests, and multiple Poisson regression were performed. RESULTS: Among the participants, most were female, white, heterosexual, and cisgender. The mean EDS total score was higher among those students who used Brazilian Affirmative Actions for higher education access and permanence (p < 0.005). The multiple analysis indicated that students who were black (prevalence ratio [PR] = 1.484; 95% confidence interval [95%CI]: 1.291-1.705), women (PR = 1.227; 95%CI: 1.030-1.462), had lower monthly income (PR = 1.212; 95%CI: 1.043-1.409) and were lesbian, gay, bisexual, transgender, intersex, queer, pansexual, and plus (LGBTQIAP+) (PR = 1.466; 95%CI: 1.238-1.735) showed a higher probability of discriminatory experiences when compared to white, male and heterosexual students with higher monthly income. CONCLUSION: There is a racial and social class pattern among dental students. The exclusionary factors such as black race, female gender, lower monthly income and being LGBTQIAP+ make students more vulnerable to discriminatory experiences.

Quality of life in children and adolescents with blood coagulation disorders and hemoglobinopathies.

The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.

Parental Reports of Children's Dental Pain Experience and Associated Factors among Brazilian Children.

Exploring children's dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their child's oral hygiene practices, free sugar consumption, and dental history. The questionnaire was created using Google Forms and was disseminated to parents/caregivers via E-mail and/or WhatsApp©. Descriptive and Poisson regression analyses were performed (p < 0.05). Children's dental pain experience was reported by 20.3% of the parents. The authoritative parenting style was predominant. The child's mean age at the first consumption of sugar was 1.38 (±0.64) years, and 40.3% of the children had high-free sugar consumption. The mean age for the first dental appointment was 2.26 (±1.31) years, and 24.3% of the children never went to a dental appointment. The prevalence of dental pain experience was higher in children who attended their first dental appointment later (PR: 1.02; CI 95%: 1.01-1.03) and among those with high-free sugar consumption (PR: 1.90; CI 95%: 1.21-3.00). High sugar consumption and delay in the first dental appointment may increase the likelihood that children will experience dental pain.

Acceptability of dental students and professionals concerning child behaviour management techniques: Systematic review.

INTRODUCTION: During child dental treatment, different behavior management techniques (BMTs) are applied and it is important to understand the possible discomfort in the operator. OBJECTIVE: The present systematic review aimed to evaluate the acceptability of dental students and professionals concerning BMTs applied with paediatric dentistry patients. MATERIALS AND METHODS: A systematic search was conducted, following the PEOS strategy: Population (P) - dental students/professionals (S); Exposure (E) - BMTs preconized by the American Academy of Paediatric Dentistry, Outcome (O) - proportion of BMT acceptance; and Study design (S) - observational studies based on data from PubMed, Scopus, Web of Science, BVS (Lilacs/BBO), Cochrane, and Open Grey databases up to September 2021. The eligible studies were submitted to data extraction and to the evaluation of methodological quality, using the Joanna Briggs Institute Critical Appraisal Tool. The certainty of evidence was evaluated by GRADE. RESULTS: The search retrieved 710 articles; a total of 21 fulfilled the eligibility criteria and were used for qualitative analysis. Among the undergraduate students and dentists, the most accepted techniques were tell-show-do and positive reinforcement, while paediatric dentists preferred the tell-show-do technique and dental professionals with graduate degrees preferred sedation using nitrous oxide and positive reinforcement. The least accepted technique was protective stabilization. Seven students presented a low risk for bias, while 14 presented a high risk. The certainty of evidence was classified as very low. CONCLUSION: Although the basis of available certainty of evidence is scarce and with a considerable risk for bias, it is still possible to conclude that the more accepted techniques were based on communication.

Early Childhood Caries and Its Consequences Impact Sleep in Preschool Children.

Purpose: To assess the impact of early childhood caries (ECC) and its clinical conse- quences on preschool children's sleep, as reported by caregivers. Methods: A representative cross-sectional study was carried out with preschoolers aged four to six years in Brazil. Caregivers responded to the Brazilian version of the Early Childhood Oral Health Impact Scale and a specific question from this questionnaire was used to determine sleep-related quality of life: "Has your child had trouble sleeping because of dental problems or dental treatments?" Additionally, a self-administered questionnaire with socioeconomic questions was used. Clinical examinations were performed by two calibrated dentists to diagnose dental caries (International Caries Detection and Assessment System -epi) and its clinical consequences (pulpal involvement, tissue ulceration, fistula and abscesses [pufa] index). Adjusted and unadjusted Poisson regression was used for data analysis (P<0.05). Results: The sample consisted of 533 preschoolers, with 259 girls (51.4 percent) (n=259). The mean age of preschoolers was 4.78±0.6 (standard deviation) years. One-third (n=176) exhibited extensive carious lesions, and 14.1 percent (n=75) had clinical consequences of ECC. Conclusion: Children with clinical consequences of ECC were approximately 3.04 times more likely to have difficulty sleeping than children without them (95 percent confidence interval=1.75 to 5.25). The clinical consequences of ECC were significantly associated with difficulty sleeping among preschool children.

Late Eruption of Mandibular Central Incisor in Small for-Gestational-Age Infants: A Cohort Study.

Purpose: To evaluate the chronology of the eruption of primary mandibular central incisors in infants born preterm and with low weight (PLBW) and its association with weight/length ratio for gestational age (GA) at birth, individual characteristics and hospitalization at birth. Methods: A cohort of 46 infants was followed at a multidisciplinary reference center at a university hospital in Belo Horizonte, Brazil. The inclusion criteria were infants born preterm with low/very low/extreme low birth weight and at least four months of age. Oral clinical examinations were carried out by a calibrated dentist for a total of eight months, with a one-month interval between each examination, to verify the chrono- logy of eruption of the primary mandibular central incisors. Caregivers completed a sociodemographic and health questionnaire. Data on neonatal hospitalization were collected from medical records. Data were analyzed with the Kaplan-Meier method and log rank test, and bivariate analysis was done using the Mann-Whitney method and Kruskal-Wallis test (P <0.05). Results: The average age at eruption of primary lower central incisors was 11 months for both sexes. No association was found between tooth eruption and child hospitalization or individual characteristics (P >0.05). Infants large for gestational age had earlier tooth eruption (9.3±1.41 months) than infants small for gestational age (13.6±3.29 months; P <0.05).Conclusion: The most likely age for the eruption of the first primary teeth in infants born preterm and with low weight was 11 months, and there was no influence of individual characteristics and hospitalization at birth. Small-for-gestational age infants experienced delayed tooth eruption compared to large-for-GA infants.

Profile of Dental Caries in Eastern and Western Parakanã Children at Amazônia Paraense, Brazil

ABSTRACT Objective: To evaluate the prevalence of dental caries in children from 18 months to 5 years of age in eastern (near urban centers) and western (far from urban centers) Parakanã, verify the influence of proximity to non-indigenous cultures, and compare with other ethnicities and non-indigenous. Material and Methods: The universe of children was examined by one researcher in a cross-sectional study. Descriptive analysis and the Mann-Whitney test (p<0.05) were performed. Results: It was observed that 68.8% (N = 53) of children from 18 to 36 months of age presented dmft = 0 (without caries), while 12.5% (N = 6) of children of five years of age presented this condition. For children between 18 and 36 months, the average dmft values were 0.74 (SD=1.91) for eastern children and 1.25 (SD=1.65) for western children. At five years of age, the average dmft values were 4.35 (SD=3.29) and 3.75 (SD=2.05) for eastern and western, respectively. Mann-Whitney test (p<0.05) showed no difference between East and Western children. When compared with non-indigenous Brazilian children, the values behaved similarly. Conclusion: Knowledge of the epidemiological profile of dental caries in Indigenous Parakanã children is relevant both in planning oral health actions for this population and for aggregating information, which is still scarce for Indigenous.

Quality of life in children and adolescents with blood coagulation disorders and hemoglobinopathies

Abstract The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.

Early Introduction of Total Sugar Foods and Early Childhood Caries.

Purpose: To evaluate the association between the introduction of total sugar foods (TSF) in the first six months of age and the prevalence of early childhood caries (ECC) and its consequences for dental pulp in preschool children. Methods: A representative cross-sectional study was conducted with 533 preschool children (four to six years old) in Ribeirão das Neves, Brazil. The decayed, missing, and filled teeth (dmft) index was used for determining ECC. The visible pulp, oral mucosa ulceration due to root fragments, fistula, and abscess (pufa) index was used for the pulp consequences of dental caries. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the children's diet. Statistical analysis was performed using multiple logistic regression (P<0.05). Results: The multiple logistic regression model adjusted for family income and breastfeeding showed that preschool children who were introduced to TSF prior to six months of age were 1.58 times more likely to have ECC (95 percent confidence interval equals 1.09 to 2.30). The multiple logistic regression model, adjusted for family income, breastfeeding, and brushing behaviors, showed that preschool children who were introduced to TSF prior to six months of age were 2.30 times more likely to have pulp consequences (95 percent confidence interval equals 1.35 to 3.91). Conclusion: The early introduction TSF is associated with a higher prevalence of early childhood caries and pulp consequences in preschool children. The negative effects on oral health may be greater when the introduction of TSF occurs prior to six months of age.

Association Between Attention-Deficit/Hyperactivity Disorder Symptoms and Sleep, Bruxism and Dental Trauma in Pediatric Population: A Preliminary Study.

Purpose: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms reported by parents and the variables sleep problems, possible sleep bruxism, possible awake bruxism and dental trauma (DT), and its mode of occurrence in children and adolescents.
Methods: A cross-sectional study was conducted with the parents of 144 four- to 16-year-old subjects through a questionnaire on demographics, subjects' sleep, self-reported bruxism and DT mode of occurrence. The Swanson, Nolan and Pelham scale IV was used to assess ADHD signs and subtypes. Bivariate and multivariate analysis were performed (P <0.05).
Results: The subjects' mean age was 7.9 years (±2.8 years) and 50.7 percent were boys. DT was reported in 80 percent of those with the hyperactive/impulsive subtype (ADHD-HI) and 72.7 percent of those with the combined subtype (ADHD-C). DT was caused solely by falls in the ADHD-C and inattention subtypes (ADHD-I). ADHD-C was associated with somniloquy (prevalence ratio [PR]=1.075; P =0.010). ADHD-HI was associated with bad sleep quality (PR=1.194; P =0.005), possible sleep bruxism (PR=1.088, 95% confidence interval=1.006 to 1.176; P =0.034), possible awake bruxism (PR=1.146; P =0.024) and sleep duration (PR=0.88; P =0.02).
Conclusion: ADHD-C and -HI subtypes were associated with sleep characteristics. Possible sleep and awake bruxism were associated with symptoms of ADHD-HI. Despite no significant association, DT was present in most ADHD subjects, mostly due to falls.

Psychosocial associated factors of early childhood caries and oral health-related quality of life: Structural equation model approach.

OBJECTIVE: To identify a structural model for the identification of psychosocial associated factors of early childhood caries (ECC) and oral health-related quality of life (OHRQoL) in preschool children and their families. METHODS: A population-based cross-sectional study was conducted with 533 preschool children from 4 to 6 years-old public and private preschools, from Ribeirão das Neves, MG. Parents/caregivers self-completed the Brazilian versions of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and Resilience Scale as well as a structured questionnaire addressing socioeconomic status and child's oral health behavior. Two dentists who had undergone training and calibration exercises for ICDAS­epi and pufa index (Kappa≥0.95) performed the examinations for ECC. Stages of ECC were classified as free of visible carious lesion, initial caries, moderate caries, extensive caries without pulp consequences and extensive caries with pulp consequences. Data were analyzed using structural equation modeling, using Mplus version 8.6. RESULTS: Lower socioeconomic status (b=-0.250; p<0.001) and higher frequency of free sugar consumption (b = 0.122; p = 0.033) were directly associated with a more severe stage of ECC. Lower parental resilience had an indirect impact on more severe stage of ECC which was mediated by the variable 'frequency of free sugar consumption' (b=-0.089; p = 0.048). ECC was associated with lower child's OHRQoL (b = 0.587; p<0.001) and lower family's OHRQoL (b = 0.506; p<0.001). CONCLUSION: Structural modeling revealed that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families. The main associated factors of the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience. CLINICAL SIGNIFICANCE: T The findings indicate that psychosocial and behavior variables can be associated with the severity of ECC, and ECC can be associated with negative impact on wellbeing and ability to perform daily activities of preschoolers and their families.

Development and validation of a questionnaire on the feelings of undergraduate dental students regarding child dental care.

OBJECTIVES: This study aimed to develop and test a questionnaire's validity and reliability to evaluate undergraduate dental students' feelings regarding child dental care. METHODS: The questionnaire was developed using a focus group of 10 undergraduate dental students. This questionnaire was then structured and applied digitally via Google Forms to 90 dental students aged 22.95 years (±0.89) who had already completed or were enrolled in a pediatric dentistry discipline. The test-retest was conducted with 15 students. Descriptive analysis, exploratory factorial analysis (EFA), and intraclass correlation coefficient were performed to evaluate the test-retest reliability, Cronbach's alpha (α) to measure the internal consistency, and Mann-Whitney test was used to determine the discriminant validity (p < 0.05). RESULTS: The final version of the questionnaire concerning the feelings of dental students when faced with pediatric dental treatment comprised three items, which evaluated anxiety, fear, and insecurity. The visual analog scale was used to evaluate the answer for each item. The questionnaire resulted in a total score that varied from 0 to 10. The higher the score on the questionnaire, the greater the negative feelings regarding pediatric dental treatment. The results of the EFA were satisfactory (Bartlett's sphericity = 0.001; Kayser-Meyer-Olkin measure = 0.725). The EFA extracted a single dimension with an eigenvalue of 2.4 and a total explained variance of 80%. The internal consistency of the questionnaire was satisfactory (α = 0.877), and the test-retest reliability was good (intraclass correlation coefficient = 0.691). Students who felt confident about carrying out invasive procedures in children demonstrated more positive feelings related to the pediatric dental treatment (average = 3.50 ± 2.73) than those who did not feel such confidence (average = 5.00 ± 2.35; p = 0.007). CONCLUSIONS: The unidimensional questionnaire proposed by this study is valid and reliable in evaluating the feelings of undergraduate dental students regarding child dental care.

The relationship between temperament and dental fear and anxiety: a systematic review.

OBJECTIVE: To investigate the relationship between temperament traits and dental fear and anxiety (DFA) in children and adolescents by the means of a systematic review (PROSPERO #CRD42020207578). METHODS: The PEO (Population, Exposure, and Outcome) strategy was followed using children and adolescents as the population, temperament as the exposure, and DFA as the outcome. A systematic search for observational studies (cross-sectional, case-control, and cohort) without restrictions on year or language of publication was performed in seven databases (PubMed, Web of Science, Scopus, Lilacs, Embase, Cochrane, and PsycINFO) in September 2021. Grey literature search was performed in OpenGrey, Google Scholar, and in the reference list of included studies. Study selection, data extraction, and risk of bias assessment were carried out independently by two reviewers. The Fowkes and Fulton Critical Assessment Guideline was used to assess methodological quality of each study included. The GRADE approach was performed to determine the certainty of evidence of relationship between temperament traits. RESULTS: This study recovered 1362 articles, of which 12 were included. Despite the high heterogeneity of methodological aspects, qualitative synthesis by subgroups showed a positive association/correlation between emotionality, neuroticism, and shyness with DFA in children and adolescents. Different subgroups analysis showed similar results. Eight studies were classified as having low methodological quality. CONCLUSION: The main shortcoming of the included studies is the high risk of bias and a very low certainty of evidence. Within its limitations, children and adolescents with a temperament-like emotionality/neuroticism and shyness are more likely to present higher DFA.

Determination of dental caries, molar-incisor hypomineralization, and oral health-related quality of life in schoolchildren: A structural equation modeling approach.

BACKGROUND: Some oral conditions can have psychosocial consequences that affect children's daily life and well-being. AIM: To create a structural model for the determination of dental caries, molar-incisor hypomineralization (MIH), and the impact of these conditions and socioeconomic status on schoolchildren's oral health-related quality of life (OHRQoL). DESIGN: A representative cross-sectional study was conducted in Lavras, Brazil, with 1181 female and male schoolchildren 8-9 years of age. OHRQoL was measured using the Brazilian version of the CPQ8-10. Clinical examinations were performed by a calibrated dentist for the diagnosis of dental caries (WHO) and MIH (EAPD). Parents/caregivers answered questionnaires addressing the child's medical history and socioeconomic status. Data were analyzed using structural equation modeling. RESULTS: The model revealed that greater MIH severity (ß = .874; p < .001) and worse socioeconomic status (ß = -.060; p = .001) were associated with a greater number of teeth with caries experience. The higher the number of teeth with caries experience (ß = .160; p = .007) and worse socioeconomic status (ß = -.164; p < .001), the greater the negative impact on OHRQoL. CONCLUSION: The model created showed that dental caries and socioeconomic status had a direct negative impact on the OHRQoL of schoolchildren and MIH had an indirect impact mediated by the occurrence of caries experience.

Development and validation of a short form of the BOHLAT-P.

The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

Cárie dentária em molares decíduos, doenças comuns na infância e condição socioeconômica: estudo representativo de escolares brasileiros / Dental caries in deciduous molars, common childhood diseases and socioeconomic status: a representative study of brazilian schoolchildren

Objetivo: verificar a experiência de cárie em molares decíduos e a sua associação com doenças comuns na infância, uso de medicamentos, condições socioeconômicas. Materiais e Métodos: foi realizado um estudo transversal representativo com uma amostra de 1181 crianças entre 8 e 9 anos, de ambos os sexos. O exame clínico foi realizado em ambiente escolar por uma dentista calibrada para diagnóstico de cárie dentária através do índice de dentes cariados, extraídos ou com extração indicada e obturados (Índice ceo-d). Os responsáveis responderam questionários sobre a história médica da criança e condições socioeconômicas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa Local. Os dados foram analisados através da Regressão de Poisson, sendo que as variáveis com p<0,20 foram introduzidas em um modelo multivariado e hierárquico (p<0,05). Razão de Prevalência (RP) e Intervalo de Confiança (IC) de 95% foram calculados. Resultados: a maioria das crianças apresenta cárie em molares decíduos (54,6%). Doenças comuns na infância e uso medicamentos não apresentaram associação estatisticamente significativa com cárie dentária (p>0,05). Estudantes de escolas públicas tiveram uma prevalência 27% maior de (IC95%=1,05-1,59) experiência de cárie em molares decíduos quando comparados aos estudantes de escolas particulares. Menor escolaridade materna também se mostrou associada à experiência de cárie em molares decíduos, sendo que crianças cujas mães tinham até 4 anos de estudo tinham uma prevalência 60% maior de cárie dentária (IC95%:1,19-2,16). Conclusão: a maioria das crianças apresentou experiência de cárie em molares decíduos, mas esta condição não foi associada com doenças e medicamentos utilizados até os 4 anos de idade. Entretanto, crianças de escola pública e cujas mães possuíam menor escolaridade apresentaram maior experiência de cárie.

Objective: to verify the caries experience in deciduous molars and its association with common childhood diseases, medication use, socioeconomic conditions. Materials and Methods: a representative cross-sectional study was carried out with a sample of 1181 children between 8 and 9 years old, of both sexes. The clinical examination was performed in a school environment by a dentist calibrated for the diagnosis of dental caries through the index of decayed teeth, extracted or with the indicated and filled samples (ceo-d index). Those responsible for the child answered about the child's medical history and socioeconomic conditions. The project was approved by the Research Ethics Committee Local. The data were analyzed using an analysis model, and as p<0.20, varied with variables were evaluated in a model and hierarchical. Prevalence Ratio (PR) and 95% Confidence Interval (CI) were calculations. Results: 54.6% of the children had caries experience in the deciduous molars. Common childhood diseases and medication use were not significantly associated with dental caries (p>0.05). Public school students had a prevalence of 27% of students (95%CI=1.05-1.59) of caries experience in deciduous molars when compared to school students. Lower maternal schooling was also associated with caries experience in deciduous molars, with mothers with up to 4 years of schooling having a 60% higher probability of having children with dental caries (95%CI:1.19-2.16). Conclusion: most children had caries experience in deciduous molars, but it was not associated with diseases and medications used between 0 and 4 years old. However, school children and whose mothers had less schooling had a greater experience of caries.

Prevalence of ankyloglossia according to different assessment tools: A meta-analysis.

BACKGROUND: Prevalence of ankyloglossia may vary depending on the assessment tool. This systematic review aimed to evaluate the prevalence of ankyloglossia in distinct age groups according to different assessment tools. TYPES OF STUDIES REVIEWED: Nine electronic databases were searched from inception through November 2021 without restrictions of language or year of publication. Paired independent reviewers selected cross-sectional and cohort studies reporting the diagnosis of ankyloglossia, extracted data, and assessed methodological quality. The number of patients with ankyloglossia and the sample were extracted to calculate the overall prevalence of ankyloglossia and 95% CI. The authors calculated the prevalence of ankyloglossia per assessment tool, age group, and sex. They assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Seventy-one studies were included. Seven different diagnostic tools were used. The overall prevalence of ankyloglossia was 5% (95% CI, 4.0% to 5.0%) and ranged from 2% (using an unspecific tool) to 20% (Coryllos classification). The prevalence per age group was higher in infants (7%). The prevalence ratio was 1.34 (95% CI, 1.17 to 1.54) for boys, with very low certainty of evidence. PRACTICAL IMPLICATIONS: The prevalence of ankyloglossia is higher among infants and differs depending on the assessment tool used for the diagnosis. It is uncertain whether boys are more affected by ankyloglossia than girls.

Validation of the Brazilian Oral Health Literacy-Adults Questionnaire.

BACKGROUND: Recognizing that a deficit of reading and numeracy skills is associated with poorer oral health, contemporary researchers have identified additional components as important attributes of oral health literacy (OHL). So, the use of comprehensive functional OHL tools is crucial. The Oral Health Literacy-Adults Questionnaire (OHL-AQ) evaluates reading comprehension, numeracy, listening and decision-making skills. OBJECTIVE: Describe the validation process of the OHL-AQ Brazilian version (BOHL-AQ). METHODS: The cross-culturally adapted version, BOHL-AQ, was applied to 180 employees age 18 to 71 years (mean = 37.2; standard deviation [SD] = 11.7) from a private university located in the Southeast of Brazil. Psychometric properties were evaluated through the analysis of internal consistency (Cronbach's alpha), reproducibility (test-retest), convergent validity (BREALD-30; education level), discriminant validity (family income; dental services), predictive validity (self-perception; literacy questions) and construct validity (Exploratory Factor Analysis). Confirmatory Factor Analysis (CFA) evaluated the dimensionality of the BOHL-AQ, with Promax method for rotation. Data were analyzed using SPSS Statistics software and the Mplus program. KEY RESULTS: BOHL-AQ mean score = 11.84 (SD = 3.1); administration mean time = 8 minutes (SD = 1.6); good internal reliability (Cronbach's alpha = 0.73) and excellent reproducibility (kappa = 0.89; intraclass correlation coefficient = 0.97). Preliminary tests showed that data were suitable for PCA (Kayser-Meyer-Olkin measure = 0.75; Barlett's Test of Sphericity significant [p < .001]). CFA showed that the instrument had a four-factor solution with excellent model fit estimates (χ2 = 636.587154.16, p value = .00117, Comparative Fit Index = 0.9787, Tucker Lewis index = 0.97, and Root Mean Square Error of the Approximation = 0.03). BOHL-AQ high scores significantly correlated to high education level, dental visit within the last year and for preventive reason, more independence and self-confidence on reading and filling out health forms, and better oral health self-perception (p < .05). CONCLUSIONS: The BOHL-AQ showed to be a fast and reliable instrument to assess a comprehensive functional OHL at Brazilian community and clinical settings. [HLRP: Health Literacy Research and Practice. 2022;6(3):e224-e231.] Plain Language Summary: Recognizing the need of advancing knowledge related to OHL, this study aimed to describe the validation process of the BOHL-AQ. Cross-cultural adaptation and psychometric properties evaluation presented satisfactory results. The BOHL-AQ proved to be a fast and valid instrument to measure comprehensive functional OHL in the Brazilian context.

Responsiveness of the B-ECOHIS to detect changes in OHRQoL following dental treatment of children with autism spectrum disorder.

The Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) is an oral health-related quality of life (OHRQoL) questionnaire. This paper aims to investigate the responsiveness of the B-ECOHIS to dental treatment in individuals diagnosed with autism spectrum disorder (ASD) and determine if dental treatment has an impact on OHRQoL. The survey targeted 27 ASD individuals aged 4 to 14 years attending the Acolher Project of the University Federal Fluminense. This project provides children and adolescents with disabilities with oral health services. A group of randomly selected caregivers self-completed the B-ECOHIS before and 14 days after their children's dental treatment. The dental treatment included meticulous screening, preventive treatment, and restorative treatment. Responsiveness was assessed by investigating the effect size (ES) and standardized response mean (SRM). Wilcoxon test was used to evaluate internal responsiveness (distribution-based approach). The B-ECOHIS showed significant changes in the total score (p<0.001) and in all domains. The ES of the total B-ECOHIS after treatment was 1.28 and ranged between 0.70 and 1.14 for the domains. The SRM for each of the domains was large, except for the symptom domain. The B-ECOHIS is sensitive and responsive to ASD individuals undergoing dental treatment. Individuals with ASD showed improvement in their OHRQoL score after dental treatment.

Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach.

BACKGROUND: Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries. AIM: To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis. DESIGN: This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05). RESULTS: Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS. CONCLUSION: Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.