Impact of untreated dental caries and dental pain on sadness related to oral health of Brazilian children.

PURPOSE: Children should feel sad when they believe that a negative outcome is permanent. The sadness that an oral problem might bring tends to contribute to children's loneliness and increase the social stress levels. The aim of this study was to evaluate the impact of untreated dental caries, dental pain, malocclusion, and traumatic dental injury on prevalence of sadness related to oral health among Brazilian children. METHODS: This cross-sectional study was carried out with 397 children aged 8-10 years randomly selected from public and private schools in Diamantina, Brazil. The Brazilian version of the CPQ8-10 was applied. Sadness was collected through the question, "In the last month how often did you feel sad because of your teeth or mouth?" and dental pain through the question, "In the last month, how many times have you had pain in your teeth?" One calibrated examiner (Kappa value intra examiner: 0.77-0.91; Kappa value inter examiner: 0.80-1.00) performed the exam for dental caries (DMFT), malocclusion (DAI), and dental trauma (O'Brien). Parents answered questions addressing socioeconomic issues. Descriptive analyses, Chi-square test, and hierarchical Poisson regression models were performed (IC 95%; p < 0.05)." RESULTS: The prevalence of sadness related to oral health was 30.5% (n = 121). Sadness related to oral health was associated with untreated dental caries (PR: 1.46; 95% CI 1.32-2.46; p = 0.001 ) and dental pain (PR: 2.91; 95% CI 2.00-4.22; p < 0.001). Other clinical variables analyzed (traumatic dental injury and malocclusion) were not significantly associated with sadness related to oral health. CONCLUSIONS: Children with untreated dental caries and dental pain presented a higher report of sadness related to oral health.

Socio-economic inequalities and COVID-19 incidence and mortality in Brazilian children: a nationwide register-based study.

OBJECTIVES: This study aimed to estimate the incidence and mortality rates of coronavirus disease 2019 (COVID-19) in Brazilian children and to analyze its relationship with socio-economic inequalities in a state-level analysis. STUDY DESIGN: This is a nationwide register-based study. METHODS: To estimate the incidence and mortality rates of COVID-19 in Brazilian children aged 0-19 years, we extracted data of confirmed cases and deaths from the de-identified microdata catalog and official bulletins of the 27 Brazilian states' health department websites until September 3, 2020. Social and economic inequalities were evaluated using the Social Vulnerability Index and Gini coefficient, respectively. The relationship between COVID-19 rates in Brazilian children and socio-economic vulnerability at the state level was analyzed using Spearman's rank correlation. RESULTS: Of the 3,998,055 individuals with COVID-19 included in our database, 335,279 (8.4%) were children aged 0-19 years. Eight hundred deaths in children were registered, which accounts for about 0.7% of the deaths related to COVID-19 in the country. There were important differences in the incidence and mortality rates among Brazilian regions, and a correlation between mortality rates and social (ρ = 0.519; P-value = 0.007; effect magnitude: moderate) and economic (ρ = 0.615; P-value < 0.001; effect magnitude: strong) inequalities was found in a state-level analysis. CONCLUSIONS: This population-based study showed important regional differences in COVID-19 estimates for children in Brazil and a relationship between mortality rates and socio-economic inequalities. The knowledge of sociogeographic differences in the estimates of COVID-19 is crucial to planning societal strategies and local decision-making to mitigate the effects of disease in the pediatric population.

The impact of two root canal treatment protocols on the oral health-related quality of life: a randomized controlled pragmatic clinical trial.

AIM: To assess the impact of two root canal treatment protocols on the oral health-related quality of life (OHRQoL) of patients in need of root canal treatment on their anterior teeth. METHODOLOGY: The sample consisted of 120 participants (mean age: 34 years) enrolled in a pragmatic randomized clinical trial evaluating two root canal treatment protocols. Anterior teeth with nonvital pulps were allocated for root canal preparation with either hand files and filled with lateral compaction of gutta-percha (manual protocol) or canal preparation with a single file in a reciprocating movement and filled with a single cone technique (Reciproc protocol). OHRQoL data were assessed using the Oral Health Impact Profile instrument (OHIP-14), which was administered before the root canal intervention (baseline), and 6 and 12 months after treatment. Demographic and clinical characteristics of participants were collected at baseline. Data were analysed using bivariate analyses, Poisson univariate and multiple regression (α = 0.05). RESULTS: The drop-out rate from baseline was 27% and 28% at 6 and 12 months after treatment, respectively. Both root canal protocols significantly enhanced patients' OHRQoL, regardless of the follow-up time (P < 0.001). After 6 months, patients treated with the Reciproc protocol had significantly lower OHIP-14 overall scores (P = 0.030), as well as significantly lower scores for psychological discomfort (P = 0.031) and social disability (P = 0.013). After 12 months, no significant difference was observed between the two root canal protocols for OHIP-14 overall scores (P = 0.174). Either large or moderate effect sizes were observed for all domains and overall scores at both evaluation times, irrespective of the protocol. Low-income persons (RR = 2.03) and the Reciproc protocol (RR = 1.52) had a higher likelihood of a positive impact on OHRQoL 12 months after root canal treatment. CONCLUSIONS: The two root canal protocols improved the OHRQoL and differences in scores were observed only after 6 months with poorer OHRQoL for the manual protocol. After 12 months, patients with low-income status and treated with Reciproc were associated with a greater improvement in OHRQoL scores.

Self-Perceptions of the Impact of Oral Problems on the Social Behavior of Preschoolers.

INTRODUCTION: Investigating preschool children's social behaviors and the association with oral health variables helps to understand child development. Besides that, different perceptions need to be explored regarding the impact of oral problems on the social behavior between the child's self-report and parent's/caregiver's proxy report. OBJECTIVE: To determine which socioeconomic and oral factors are associated with difficulty sleeping and playing and the avoidance of smiling in preschoolers. METHODS: A cross-sectional study was conducted with a representative random sample of 769 pairs of parents/caregivers and 5-y-old preschoolers. The preschoolers answered a questionnaire on difficulty sleeping, difficulty playing, and the avoidance of smiling for reasons related to oral problems. The parents/caregivers answered a questionnaire addressing socioeconomic characteristics as well as the use of dental services. Two calibrated dentists examined the children for the determination of dental caries, traumatic dental injury (TDI), malocclusion, and bruxism. Descriptive and Poisson regression analysis for complex samples with robust variance was used to test the associations (α = 5%). RESULTS: The variables associated with difficulty sleeping were low household income (confidence interval [CI]: 1.40-3.01), number of untreated dental caries (CI, 1.02-1.04), dental pain (CI, 1.76-3.59), TDI (CI, 1.08-2.11), and anterior open bite (CI, 1.11-2.20). Difficulty playing also was associated with the low household income (CI, 1.34-3.15), number of untreated dental caries (CI, 1.01-1.04), dental pain (CI,1.42-3.61), and TDI (CI, 1.13-2.33). The number of untreated dental caries (CI, 1.02-1.05), dental pain (CI, 1.03-2.88), anterior open bite (CI, 1.30-3.26), and not using dental services (CI, 1.13-2.73) were determinant factors for the avoidance of smiling. CONCLUSION: Socioeconomic, symptomatic, and/or oral esthetic problems exerted an impact on the social behavior of the preschoolers analyzed, such as playing, sleeping, and smiling. KNOWLEDGE TRANSFER STATEMENT: The results of the present study may help parents and clinicians to understand better the association of oral problems with the social behavior of preschool children. Moreover, this study shows the importance of listening to children in clinical decisions. These results also can help in the elaboration of oral health policies.

Dental caries are more likely to impact on children's quality of life than malocclusion or traumatic dental injuries.

AIM: To measure the impact of dental caries, malocclusion, and traumatic dental injuries (TDI) on the oral health-related quality of life (OHRQoL) of Brazilian children. STUDY DESIGN: population-based cross-sectional study. MATERIALS AND METHODS A representative sample of 1,204 8-to-10-year-old children randomly selected from 19 public and private schools in Belo Horizonte (Brazil) was evaluated. The Decayed, Missing and Filled Teeth Index (DMFT), the Dental Aesthetic Index (DAI), and Andreasen's classification were used by two calibrated examiners to diagnose dental caries, malocclusion, and TDI, respectively. Children were clinically examined at school. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years (CPQ8-10) was used to assess the impact on OHRQoL. RESULTS: There were statistically significant differences (p<0.001) between groups (dental caries, malocclusion, and TDI) in all subscales and the CPQ8-10 total score. The presence of dental caries alone and its association with TDI and malocclusion were associated with all CPQ8-10 subscales (p<0.05). STATISTICS: the Poisson regression model with a robust variance estimator was utilised for the multivariate analysis. Adjusted prevalence ratios were obtained for the association between oral conditions and the total score on the CPQ8-10 and its subscales. CONCLUSION: Dental caries seems to be the oral condition most commonly associated with a higher impact on the OHRQoL of Brazilian 8-to-10-year-olds.

The prevalence of sleep bruxism and associated factors in children: a report by parents.

AIM: To evaluate the prevalence of sleep bruxism and associated factors among children aged 3-12 years as reported by parents via a questionnaire. METHODS: A cross-sectional study was conducted with a sample of 148 parents/caregivers of children aged 3-12 years treated at paediatric dentistry clinics. Parents/caregivers answered a questionnaire in the waiting room. Information on the gender and age of the child, age of parent/caregiver, meaning of bruxism and child's sleep (type of sleep, if he/she slept alone, hours of sleep per night and if nocturnal bruxism could affect his/her health) were collected. Descriptive statistics were performed and Poisson regression with robust variance was employed (p < 0.05). RESULTS: The prevalence of sleep bruxism was 32.4%. Most parents (64.2%) did not know the meaning of bruxism. In the final Poisson regression model, child's gender (PR 1.32; 95% CI 1.06-1.66) and restless sleep (PR 1.39; 95% CI 1.12-1.72) were significantly associated with sleep bruxism. CONCLUSION: The prevalence of sleep bruxism was high and was associated with gender and having restless sleep. Most parents/guardians did not know the meaning of bruxism.

Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study.

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.

Is there an association between verbal school bullying and possible sleep bruxism in adolescents?

The aim of this study was to determine the association between verbal school bullying and possible sleep bruxism (SB) in adolescents. A case-control study was carried out at the population level by recruiting 13- to 15-year-old participants among the attendants of schools of Itabira, Brazil. The case group was composed of 103 adolescents with possible SB (i.e. self- or parental-reported), while the control group included 206 adolescents without possible SB. All participants answered a questionnaire on the occurrence of their involvement in verbal school bullying episodes, based on the National School of Health Research (PeNSE) as well as an evaluation of their economic class according to the criteria of the Brazilian Association of Research Companies. Pearson's chi-square, McNemar test and conditional logistic regression were performed to assess the association between possible SB, verbal school bullying and economic class. There were 134 (43·3%) participants who reported involvement in verbal school bullying episodes as a victim, bully or both. The majority of them were males (90·3%). Adolescents with possible SB were more likely to have been involved in episodes of verbal school bullying (OR: 6·20; 95% CI: 3·67-10·48). Based on these findings, it can be suggested that possible SB in young teenagers is associated with a history of episodes of verbal school bullying.

Impact of periodontal disease on quality of life: a systematic review.

The diagnosis of periodontal disease is commonly based on objective evaluations of the patient's medical/dental history as well as clinical and radiographic examinations. However, periodontal disease should also be evaluated subjectively through measures that quantify its impact on oral health-related quality of life. The aim of this study was to evaluate the impact of periodontal disease on quality of life among adolescents, adults and older adults. A systematic search of the literature was performed for scientific articles published up to July 2015 using electronic databases and a manual search. Two independent reviewers performed the selection of the studies, extracted the data and assessed the methodological quality. Thirty-four cross-sectional studies involving any age group, except children, and the use of questionnaires for the assessment of the impact of periodontal disease on quality of life were included. Twenty-five studies demonstrated that periodontal disease was associated with a negative impact on quality of life, with severe periodontitis exerting the most significant impact by compromising aspects related to function and esthetics. Unlike periodontitis, gingivitis was associated with pain as well as difficulties performing oral hygiene and wearing dentures. Gingivitis was also negatively correlated with comfort. The results indicate that periodontal disease may exert an impact on quality of life of individuals, with greater severity of the disease related to greater impact. Longitudinal studies with representative samples are needed to ensure validity of the findings.

Lesion Activity Assessment (LAA) in Conjunction With International Caries Detection and Assessment System (ICDAS) for Occlusal Caries Diagnosis in Permanent Teeth.

OBJECTIVE: The aim of this study was to investigate the clinical performance and to validate the Lesion Activity Assessment (LAA) in conjunction with the International Caries Detection and Assessment System (ICDAS) for occlusal caries diagnosis in permanent teeth. METHODS: Patients with erupted or partially erupted third molars were recruited from the surgery clinic of the School of Dentistry of the Universidade Federal de Minas Gerais, Brazil. A calibrated examiner evaluated 49 teeth using the ICDAS-LAA criteria. The histologic criterion proposed by Ekstrand and others was used to validate severity at the thresholds D1 (outer half of the enamel), D2 (inner half of the enamel and outer third of the dentin), and D3 (inner or middle third of the dentin). Lesion activity was validated using 0.1% methyl red solution. RESULTS: The method demonstrated good reliability (weighted kappa for severity=0.60; unweighted kappa for activity=0.61). The ICDAS presented a higher performance for lesion detection (area under the receiver operating characteristic curve [Az]=0.79) using the threshold D3. At the thresholds D1 and D2, the results for Az were 0.57 and 0.74, respectively. Regarding the ICDAS-LAA, Az = 0.59. CONCLUSIONS: Clinical protocols can use ICDAS for the severity diagnosis of occlusal caries, but the LAA performance was poor.

Effect of malocclusion among adolescents on family quality of life.

AIM: To evaluate the effect of malocclusion among adolescents on their families' oral health-related quality of life (OHRQoL). METHODS: A consecutive sample of 125 parents/caregivers of Brazilian adolescents was chosen. Participants were asked to answer the Brazilian version of the Family Impact Scale (FIS). The main independent variable was adolescents' malocclusion, which was measured with the Dental Aesthetic Index. Gender, age, and family monthly income were the other independent variables. Data analysis involved descriptive statistics, Mann-Whitney test, and univariate and multiple logistic regression. RESULTS: Among the 125 participants initially admitted to the present study, two were excluded so that 123 parents/caregivers participated providing a response rate of 98.4 %. The overall FIS score revealed a more frequent effect for families of adolescents who presented malocclusion (P = 0.005). Significant findings were also observed for parental emotions (P = 0.022), family conflict (P = 0.010), and financial burden (P = 0.010) subscales. When the independent variables family monthly income and malocclusion were inserted together in the regression model, families with a monthly income of <5 Brazilian minimum wages (approximately US$ 325.00 per month) were more likely to have a worse OHRQoL, and families whose adolescents presented malocclusion were 3.55 more likely to have a poorer quality of life than those families whose adolescents did not present malocclusion. CONCLUSIONS: Families of adolescents with malocclusion were more likely to report a worse OHRQoL.

Association between oral conditions and functional limitations in childhood.

The aim of this study was to evaluate the impact of oral conditions on functional limitations among preschoolers. A preschool-based, cross-sectional study was carried out with 843 preschoolers in Campina Grande, Brazil. Parents/caregivers answered a questionnaire addressing socio-demographic characteristics and perceptions regarding the general/oral health of their children as well as the Brazilian version of the Early Childhood Oral Health Impact Scale. The nonparametric Kruskal-Wallis test followed by Mann-Whitney test (α = 5%) was used to compare mean children's quality-of-life scores for each independent variable. Poisson regression analysis was used to test associations between the independent and dependent variables (difficulties eating, drinking and speaking) (α = 5%). The multivariate regression model involved a hierarchical approach with four levels (distal to proximal determinants): (i) socio-demographic aspects; (ii) health perceptions; (iii) oral conditions; and (iv) pain conditions. The prevalence of negative impact on function was 24.7% for eating/drinking and 8.0% for speaking. Significant associations were found between toothache and negative impact on eating/drinking (PR = 5.38; 95%CI: 3.20-9.02) as well as between high severity dental caries and negative impact on speaking (PR = 14.91; 95%CI: 1.98-112.32). Dental caries, traumatic dental injury and malocclusion were not significantly associated with a negative impact on eating or drinking. However, toothache was an indicator of negative impact on eating/drinking and dental caries severity was an indicator of negative impact on speaking.

Effect of year one orthodontic treatment on the quality of life of adolescents, assessed by the short form of the Child Perceptions Questionnaire.

AIM: To evaluate the effect of the first 12 months of orthodontic treatment on the quality of life of Brazilian adolescents and to examine the evaluative properties of the short form of the Child Perceptions Questionnaire (CPQ11-14). STUDY DESIGN AND METHODS: This study involved a sample of 101 adolescents undergoing orthodontic treatment with a fixed appliance. Participants were asked to answer the Brazilian version of the short form of the CPQ11-14 before treatment (T1) and 12 months after the placement of the fixed appliance (T2). Statistical analysis was carried out using the Wilcoxon signed-rank test and the Bonferroni correction for the overall score and the short form of the CPQ11-14 subscales. Responsiveness of the measure and the minimal clinically important difference (MCID) were also evaluated. RESULTS AND STATISTICS: Out of the 101 individuals originally admitted to this study, three were excluded due to cessation of treatment and failure to return the questionnaire, providing a response rate of 97.0%. Statistically, significant improvements were found in the overall score (P < 0.001) as well as in both emotional well-being (P < 0.001) and social well-being (P = 0.007) subscales. The reductions in score were associated with an effect of size showing moderate clinically meaningful changes in the overall score and in the functional limitations, emotional well-being and social well-being. The MCID was 3.35. CONCLUSION: The first 12 months of orthodontic treatment with a fixed appliance had a positive effect on the quality of life of western adolescents.

Factors associated with dental caries in Brazilian children: a multilevel approach.

OBJECTIVES: The aims of the present study were to assess caries experience among Brazilian children aged eight to 10 years and determine social factors of this disease, through a multilevel approach. METHODS: This is a cross-sectional study in which a representative sample of 1204 eight-to-ten-year-old children were randomly selected from 19 public and private schools in the city of Belo Horizonte, Brazil. After formal authorization from the parents, the children were clinically examined at school by two calibrated examiners (Kappa=0.78). Individual socioeconomic status was determined using household income, number of residents in the home and parents'/caregivers' schooling. The social vulnerability index and type of school were used as contextual variables. The outcome variables were severity score of dental caries in permanent teeth (DMFT index), dental caries experience in permanent teeth (DMFT = 0 or ≠ 0), severity score of dental caries in primary teeth (dmft index) and dental caries experience in primary teeth (dmft = 0 or ≠ 0). RESULTS: The minority of children (37.2%) had dental caries experience. Chi-squared and Mann-Whitney tests showed that age, parents'/caregivers' schooling, household income and type of school were associated with dental caries experience in permanent and primary teeth (P < 0.05). Mann-Whitney, Kruskal-Wallis tests and Spearman correlation coefficient showed that age, parents'/caregivers' schooling, household income, and type of school were associated with severity score of dental caries in permanent and primary teeth (P < 0.05). In multilevel approach, the individual variables, age and household income demonstrated association with dental caries experience and with severity score of dental caries in primary teeth (P < 0.05). Type of school was also associated with dental caries experience and with severity score of dental caries in these teeth (P < 0.05). In the Poisson multilevel approach, the analysis of the final estimation of variance components of the null model revealed a significant difference among the 19 schools with regard to severity score of dental caries in permanent teeth too (P < 0.001). Younger children and attending private schools showed lower severity score of dental caries in permanent teeth. CONCLUSION: Dental caries experience and severity score of dental caries in primary teeth was influenced by age, household income, and the type of school The dental caries experience in permanent teeth was influenced by age, parents'/caregivers' schooling, household income, and type of school, whereas the severity score of dental caries in permanent teeth was influenced by age and type of school.

Mothers' reports on systemic signs and symptoms associated with teething.

PURPOSE: The purpose of this study was to compare mothers' actual observations of signs and symptoms associated with the eruption of primary incisors in their infants with their own recollections of the same period after eruption was completed. METHODS: A comparative study was carried out with 45 non-institutionalized infants and their mothers. Oral clinical exams were performed daily for detection of tooth eruption. The mothers were also interviewed daily about signs and symptoms they thought were associated with teething in the previous 24 hours. One week after the data collection was done, the mothers answered the same questionnaire. Descriptive analysis and the McNemar test (P<.05) were performed. RESULTS: Statistically significant differences were found between the prospective and retrospective studies. Increased salivation (P<.04) and runny nose (P<.001) were reported less often and fever was reported more often (P<.001) in the retrospective evaluation. CONCLUSIONS: Mothers reported similar manifestations of sleep disturbance, diarrhea, loss of appetite, and irritability in the prospective and retrospective studies. Increased salivation and runny nose were more frequently reported in the prospective study, whereas fever was reported 5 times more often in the retrospective study.

Dental trauma among Brazilian schoolchildren: prevalence, treatment and associated factors.

AIM: To assess the prevalence of traumatic dental injury (TDI), as well as associated factors, behaviour of affected schoolchildren and normative treatment needs. METHODS: The present cross-sectional study involved 590 children aged 7-14 years at state schools in Campina Grande, Brazil. The O'Brien classification [1994] was used for the diagnosis of TDI and the body mass index (BMI) was used as an indicator of overweight/obesity. Clinical tests were carried out by two duly calibrated examiners (intra-observer and inter-observer agreement: 0.87 and 0.90, respectively). The Chi-square test was used (5% level of significance) to determine whether TDI was associated with age, gender, ethnicity, overweight/obesity, lip seal and overjet. Backward stepwise multivariate regression analysis was performed. Normative treatment needs were determined based on the criteria of the International Association of Dental Traumatology (IADT). When the absence of treatment was detected, each child/adolescent was asked about the reason for non-treatment. RESULTS: The prevalence of TDI was 12.7%. The most common type of trauma was enamel fracture (67.0%), followed by enamel-dentine fracture (25.3%). TDI was 4.9-fold greater (95% CI: 1.6-14.4) among children aged 13 and 14 years, 1.9- fold greater (95% CI: 1.1-3.2) among males and 2.6-fold greater (95% CI: 1.2-5.4) among those with inadequate lip seal. The majority of schoolchildren did not undergo treatment (82.6%) due to a belief that it was unnecessary (53.2%). The normative clinical evaluation revealed that adhesive restoration was the most common form of treatment (84.0%). CONCLUSION: The prevalence of TDI was low. Age, gender and inadequate lip seal were associated with dental trauma. A significant number of schoolchildren did not receive treatment for dental trauma.

Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors.

AIM: To assess the impact of dental pain on the daily living of 5-year-old preschool children using reports from parents/guardians. DESIGN AND METHODS: A cross-sectional study was carried out involving 549 five-year-old children randomly selected from preschools in the city of Belo Horizonte, Brazil. Data were collected using a previously validated parent-reported questionnaire. The children received dental examinations from a single calibrated examiner. The following outcome variables were selected: age, gender, dental caries, filled teeth, missing teeth, caries involving pulp and social class. Simple and multiple logistic regression analyses were performed on the data. RESULTS: According to parents' reports, 11.1% of children were affected by dental pain in the previous 4 months and of these 72.6% had their daily activities hampered by pain. The majority of these children had difficulty in eating, brushing teeth, sleeping, playing and going to school. The impact of dental pain had a statistically significant association with gender (p=0.001), social class (p=0.009), dental caries (p<0.001), missing teeth (p<0.001), filled teeth (p<0.001) and caries involving pulp (p<0.001). CONCLUSION: The prevalence of difficulties performing tasks of daily living due to dental pain was relatively high among the children studied.

Prevalence of malocclusion in primary dentition in a population-based sample of Brazilian preschool children.

AIM: The purpose of the present study was to assess the prevalence of malocclusion in the primary dentition in a randomised representative sample of Brazilian preschool children. MATERIALS AND METHODS: A cross-sectional survey was carried out in Belo Horizonte, Brazil, involving 1069 male and female preschool children from 60 to 71 months of age, randomly selected from public and private preschools and daycare centers. A questionnaire addressing demographic data was sent to parents/guardians in order to characterise the sample. The oral examination of the children was performed by a single, previously calibrated dentist (kappa inter-examiner agreement value = 0.82). The criterion for the categorisation of malocclusion was at least one of the following conditions: posterior crossbite, overjet (> 2 mm), anterior crossbite, anterior open bite and deep overbite. Univariate analysis was performed using the SPSS software RESULTS: The prevalence of malocclusion was 46.2%. Deep overbite was the most prevalent alteration (19.7% of the sample). Posterior crossbite was diagnosed in 13.1% of the children; 10.5% had accentuated overjet; 7.9% had anterior open bite; and 6.7% had anterior crossbite. CONCLUSION: Malocclusion in primary dentition is becoming a significant problem. The prevalence in the present study was high, especially vertical and transversal malocclusions.

Prevalence and risk indicators of temporomandibular disorder signs and symptoms in a pediatric population with spastic cerebral palsy.

OBJECTIVE: To determine risk indicators for signs and symptoms of temporomandibular disorders (TMD) in children with cerebral palsy (n = 60) and control subjects (n = 60). STUDY DESIGN: The subjects were assessed by means of questionnaire and clinical exam: 1) signs and symptoms of TMD; 2) malocclusions [Dental Aesthetic Index (DAI)]; 3) harmful habits; and 4) bio-psychosocial characteristics. Statistical analysis involved the chi-square, Fisher's exact tests (p < or = 0.05) and multivariate logistic regression (forward stepwise procedure). Variables that achieved a p-value < or = 0.20 were used as potential predictors of signs and symptoms of TMD and applied as co-variables in the multivariate analysis. RESULTS: The prevalence of at least one sign and/or symptom of TMD in the present sample was 1.7% (n = 1) among the individuals in the control group and 13.3% (n = 8) among the individuals with cerebral palsy. The presence of cerebral palsy (Odds Ratio: 9.08; p = 0.041), male gender (OR: 6.21; p = 0.027), severity of the malocclusion (OR: 4.75; p = 0.031), mouth breathing (OR: 5.40; p = 0.022) and mixed dentition (OR: 4.73; p = 0.035) were identified as risk indicators for signs and symptoms of TMD. CONCLUSIONS: It was concluded that children with cerebral palsy had a significantly greater chance of developing signs and symptoms of TMD.

Chemotherapy-induced oral mucositis in a patient with acute lymphoblastic leukaemia.

BACKGROUND: Oral mucositis is the main complication of chemotherapy and radiotherapy used in the treatment of cancer. Phototherapy has proven effective in the treatment of mucositis, as it accelerates the tissue healing process and has both analgesic and anti-inflammatory properties. CASE REPORT: This paper reports the case of a paediatric patient with oral mucositis stemming from chemotherapy employed for the treatment of acute lymphoblastic leukaemia. TREATMENT: The lesions were treated daily with a light-emitting diode (LED). FOLLOWUP: Remission of the lesions occurred after 10 days of treatment. CONCLUSIONS: LED was effective in the treatment of mucositis, as it diminished pain symptoms and accelerated the tissue repair process.