Individual and contextual determinants associated with traumatic dental injuries in children eight to ten years of age: a multilevel analysis.

OBJECTIVE: Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren. METHODS: A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05). RESULTS: The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15). CONCLUSION: Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.

The effect of sleep disorders, school jet lag, and anxiety in students 8-10 years of age on traumatic dental injuries.

BACKGROUND/AIM: Traumatic dental injuries (TDI) constitute a public health problem. The aim of the present study was to investigate whether sleep disorders, school jet lag, and anxiety are associated with TDI in schoolchildren 8-10 years of age. METHODS: An analytical, cross-sectional study was conducted with 739 pairs of parents/guardians and children enrolled in public and private schools. The parents/guardians answered a socioeconomic questionnaire, the Sleep Disturbance Scale for Children, Circadian Energy Scale, and Revised Children's Manifest Anxiety Scale. Four examiners underwent calibration exercises for the diagnosis of TDI (K > 0.80) using the criteria proposed by Andreasen (2007). A directed acyclic graph was used for the formulation of the theoretical model and statistical adjustments. Unadjusted and adjusted robust binary logistic regression analyses were performed (α = 5%). RESULTS: The prevalence of TDI was 16.2%. The following variables remained associated with the outcome in the final model: family income less than or equal to the minimum monthly wage (OR = 1.77; 95% CI: 1.09-2.88; p = .02), child's height >137.6 cm (OR = 1.68; 95% CI: 1.06-2.64; p = .02), the occurrence of school jet lag (OR = 2.12; 95% CI: 1.27-3.53; p = .004), anxiety (OR = 1.77; 95% CI: 1.04-3.00; p = .04) and sleep disorders (OR = 1.63; 95% CI: 1.38-1.93; p = .05). CONCLUSION: Children from families with a lower income, taller children, those with school jet lag, those with anxiety and those with sleep disorders had a greater occurrence of TDI.

Oral health-related quality of life of children before, during, and after anterior open bite correction: A single-blinded randomized controlled trial.

INTRODUCTION: One of the goals of malocclusion treatment is to improve the oral health-related quality of life (OHRQoL) of patients. The aim of this trial was to assess the OHRQoL of children before, during, and after anterior open bite (AOB) correction, compared with nontreated children, in a 2-arm parallel single-blind randomized controlled trial. METHODS: Eighty children with AOB aged 8-10 years were randomly assigned to 2 groups (n = 40 each): a group treated with the use of fixed palatal crib (FPC; TG) and a control group (nontreated; CG). Randomization was performed with the use of BioEstat software. The outcome (OHRQoL) was assessed with the use of the validated Brazilian Portuguese version of the Child Perceptions Questionnaire (CPQ8-10) applied before (baseline, phase 1), 3 months after FPC placement (phase 2), and 1 month after FPC removal (phase 3) in the TG. In the CG, CPQ8-10 was applied at baseline (phase 1), 3 months (phase 2), and 12 months (phase 3). Data were analyzed by means of a blinded statistic with the use of Friedman, Wilcoxon, and Mann-Whitney tests (α = 0.05). RESULTS: All participants finished the RCT, and demographic characteristics were similar between groups. In phase 1, the TG had lower scores for the "social well-being" domain (P = 0.02). In phase 2, the CG had higher scores than the TG for the "emotional well-being" and "social well-being" domains, but the opposite was observed for "oral symptoms" and "functional limitations" (P < 0.001). In phase 3, the TG showed a lower impact on OHRQoL than the CG in all domains and in the overall score (P < 0.001). In the 3 phases, the CG showed progressive increase (mean scores 70.37, 74.70, and 84.22, respectively; P < 0.001) and the TG a decrease (mean scores 70.20, 70.80, and 6.05, respectively; P < 0.001) in overall scores. The increase of scores in the CG was considered to represent a serious harm. CONCLUSIONS: Correction of AOB had a positive impact and failure to correct it had a negative impact on the OHRQoL of children. REGISTRATION: This trial was not registered. PROTOCOL: The protocol was not published before trial commencement.

Probiotic consumption decreases the number of osteoclasts during orthodontic movement in mice.

AIMS: The aim of the present study was to investigate the effect of probiotic (Bacillus Subtilis) supplementation on bone remodelling induced by mechanical loading. METHODS: C57BL/6 mice were divided in two groups: (1) Probiotic and (2) Vehicle (water). The probiotic (1.5×108CFU/mL) was administered orally for 14 days, starting two days before the induction of orthodontic tooth movement (OTM). OTM was determined by histomorphometric analysis by comparing the right to the left side of the maxilla. The number of osteoclasts was determined by counting TRAP-positive cells. Osteoblasts were counted on Masson's trichrome-stained slides. RESULTS: OTM was similar between groups (with and without probiotic supplementation) (p=0.46). The number of TRAP-positive cells increased (p<0.01) on the experimental side (where the spring coil was installed) in comparison to the control side in both groups. However, the number of osteoclasts decreased (p˂0.01) in the probiotic group, in comparison to the vehicle group. There was an increase in the number of osteoblasts (p˂0.05) in both the Vehicle and Probiotic groups on the side under OTM, independent of probiotic supplementation. CONCLUSION: Oral Supplementation with a probiotic influenced the number of osteoclasts adjacent to the tooth root during orthodontic movement in mice.

Prospective evaluation of the psychosocial impact of the first 6 months of orthodontic treatment with fixed appliance among young adults.

OBJECTIVE: To evaluate the psychosocial impact of the first 6 months of orthodontic treatment with a fixed appliance among young adults and compare the results with those of a control group of patients awaiting treatment for malocclusion. MATERIALS AND METHODS: A study was conducted with a sample of 120 patients on a waiting list for orthodontic treatment at a university. The participants were allocated to an experimental group submitted to treatment and a control group awaiting treatment. The groups were matched for sex and age. All participants were instructed to answer the Brazilian version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) at baseline and after 6 months. Statistical analysis involved the Wilcoxon test for the total PIDAQ score and the score of each subscale. All patients participated until the end of the study. RESULTS: Significant differences between baseline and the 6-month evaluation were found for the total PIDAQ score as well as the dental self-confidence and social impact subscales in both groups. No differences between baseline and the 6-month evaluation were found regarding the psychological impact or esthetic concern subscales in the control group. The patients in the experimental group reported greater esthetic impact 6 months after beginning treatment (P < .001). The first 6 months of orthodontic treatment seem to improve psychosocial impact. CONCLUSION: The first 6 months of orthodontic treatment seem to improve the psychosocial impact of malocclusion. The patients analyzed in the present study reported a greater esthetic impact and less psychological impact after 6 months of using an orthodontic appliance.

Locked mouths: Tooth loss in a women's prison in northeastern Brazil.

BACKGROUND: Prisoners, in general, exhibit unsatisfactory oral conditions, especially with regard to the large number of missing teeth and with untreated caries. The aim of this study was to assess tooth loss, use of and need for prosthetic rehabilitation, and use of dental services among inmates. A cross-sectional study involving 65 inmates was developed at the Regional Women's Prison of Campina Grande, Brazil. Data regarding sociodemographic and sentencing profile, use of dental services, dental morbidity, and self-perceived oral health impacts were investigated. Chi-square, Pearson, and Kruskal-Wallis (P < 0.05) statistical tests were used. The mean tooth loss was 11.3 teeth. Significant association between tooth loss and oral health satisfaction (P = 0.049), self-perceived need for dental prosthesis (P < 0.001), uncomfortable teeth brushing (P = 0.005), difficult speaking (P = 0.002), and difficulty in performing routine tasks (P = 0.025) was observed. It was observed that 29.2% of inmates were using some type of prosthesis, all deemed unsuitable for use, and 78.5% of inmates needed prosthetic rehabilitation. The oral health condition of the population studied was found to be poor, and prisoners showed significant tooth loss and need for dentures, with the aggravation of having tooth extraction as the major reason for seeking dental care.

Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study.

Dental erosion is a pathological condition resulting from the irreversible dissolution of the mineralized portion of the teeth, being recognized in modern society as an important cause of loss of tooth structure. The aim of this study was to assess the prevalence and its association with diet in Brazilian adolescents of Campina Grande, PB, Brazil. A population-based study was conducted on a stratified sample of 675 adolescents aged from 15 to 19 of both sexes using the index proposed by O'Sullivan. Dental examinations were performed by two calibrated dentists (kappa = 0.82). The significance level adopted was 5%. The prevalence of dental erosion was 21%, and the upper central incisors and lateral incisors were the most affected elements, with 50.5% and 40.2%, respectively. The buccal surface showed greater impairment (51.4%) and 67.8% of teeth with dental erosion had more than half of the surface of affected area. Most damage was on the enamel (93.5%). There were no statistically significant differences between the occurrence of dental erosion and gender, age, socioeconomic status, self-reported ethnicity, and diet. There was high prevalence of dental erosion in its early stages among adolescents and there were no significant differences in the frequency of the consumption of foods and beverages and the presence of dental erosion.

Incidence of dental trauma among adolescents: a prospective cohort study.

We estimated the incidence of traumatic dental injuries (TDI) in a 2-year follow-up of adolescents with and without previous dental trauma and verified the hypothesis that individuals with previous trauma are more prone to recurrent TDI events. The present study was developed in three phases. First, a dental trauma cross-sectional study was carried out with 2260 schoolchildren aged 11-13 years in Biguaçu, southern Brazil. In the second phase, a case-control study was developed to identify risk factors associated with dental trauma. The third step was a 2-year longitudinal observational study with the participants of the second phase of the study. The exposed group of individuals with previous dental traumatism (208) and a non-exposed group (208) of participants who had no previous signs of dental trauma were followed up for 2 years. Descriptive, univariate, simple and conditional multiple logistic regression analyses were performed. The greatest incidence of dental trauma was identified among adolescents with previous dental trauma (11.9%-11.44/1000 incisors) when compared with those without previous dental trauma (2.7%-2.45/1000 incisors) (P < 0.001). In the study period, adolescents with previous dental trauma showed a 4.85 times greater odds ratio for presenting further dental trauma when compared with adolescents without previous dental trauma (P = 0,005) after adjusting for incisal overjet, lip coverage and mother's schooling. A notable difference was observed regarding the incidence of TDI between the case and control groups. Individuals with previous dental trauma had greater chances of developing develop further dental trauma in a 2-year follow-up.