Dental caries in the permanent dentition and health-related quality of life among children and adolescents with sickle cell disease.

The aim was to associate living, health and oral health conditions with the quality of life (QL) of children and adolescents (CA) with sickle cell disease (SCD). Of the 120 eligible users of a public hematological service, 106 CA with SCD from 6 to 18 years of age, and their caregivers, answered semi-structured questions about socio-demographic, health and oral health conditions. For QL, we used the validated instrument PedsQLSCD™. The oral clinical examination occurred according to the guidelines of WHO and SB Brazil 2010. The majority of CA were non-white people (88%), mean age of 10.4 (±2.9) years, family income of up to two monthly minimum wages, for 03 to 05 members, with diagnosis of sickle cell anemia by neonatal screening, hospitalizations were due allergic crises, polypharmacy and dental caries (51%) were present. "About the Impact of My Pain" was the best-fit model for the QLSCD (adjusted R²=56%; AIC=28.67; p=0.04). Dental caries in permanent dentition worsened the QLSCD (OR=0.53; IC95%=0.35-0.78; p<0.05) and was associated with the type of school, car ownership, number of family members, of complications and of the medications. To overcome this scenario, programmatic actions are required, and implementation of public policies specifically directed towards these groups.

Prevalence and associated factors of adverse childhood experiences (ACE) in a sample of Brazilian university students.

BACKGROUND: Adverse childhood experiences (ACEs) have long been associated with health risk behaviors, but they are poorly studied in Brazilian university students. OBJECTIVE: To estimate the prevalence of ACEs and investigate their association with sociodemographic data, health risk factors and self-related health in a sample of university students. PARTICIPANTS AND SETTING: A cross-sectional study conducted with 546 students from a Brazilian public university. METHOD: The self-reported 10-ACE Study questionnaire (ACE-Q) and sociodemographic information (age, sex, family income), health risk factors (body mass index, physical exercise, alcohol and tobacco use) and self-related health were assessed. Chi-square Test and multivariate logistic regression were used to evaluate the association between the cumulative occurrence of ACE (ACE ≥4) and the studied factors. RESULTS: Of the 546 participants, 464 responded to all ACE-Q questions; 74.4% reported at least one ACE, and 13.1 % reported four or more. Lower family income (OR = 2.02; 95%CI = 1.13-3.61; p = 0.01) and self-related poor health (OR = 2.29; 95%CI = 1.28-4.08; p = 0.00) were associated with the occurrence of ACE ≥4. CONCLUSION: Most students reported at least one ACE, while a minority reported ≥4 ACEs associated with lower family income and poor self-health. The data suggest that preventive actions should be considered to mitigate the problem, with lower-income students being treated as a priority.

World trends in publication for maxillofacial and dental trauma in the elderly.

Aging may increase the risk of maxillofacial and dentoalveolar trauma (MDT). This review assessed global trends in scientific publications on MDT in the elderly. Six databases were searched. Studies about MDT in the elderly (≥60 years old) were included in two text mining stages (S1 and S2). In S1, all studies with elderly subjects were included, while in S2 only studies in which the elderly were assessed in a separate set of data or in a subanalysis by age groups were included. In S1, relevant data were mined using VantagePoint™ software. In S2, data were descriptively analyzed. There were 2265 studies at S1 and 110 at S2. The publication dates spanned from 1963 to 2023. In S1, the most cited keywords and terms were aged (n = 1872), male (n = 1839), female (n = 1777), "mandible fracture" (n = 460), "orbit fracture" (n = 362), and "maxilla fracture" (n = 118). Thirty authors published 10 or more articles with visible collaboration networks. There was a progressive increase in publications, especially in Europe (n = 150). In S2, most studies were case reports/case series (n = 62). The primary etiology was accidental falls (n = 84), the most affected region was the middle third of the face (n = 65), and dental trauma was rarely reported (n = 15). Cone Beam computed tomography was the most used diagnostic tool (n = 67). Of the 81 articles that addressed therapy, 52 opted for surgical treatment. Although there has been an increase in the number of articles on MDT over the years, studies with the elderly population as a specific study group are still needed. Accidental falls were the most reported etiology, while the middle third of the face and the mandible were the anatomic region and bone most affected, respectively. The high number of case reports indicates the need for improvement in the available scientific evidence about MDT in the elderly.

Dental caries in the permanent dentition and health-related quality of life among children and adolescents with sickle cell disease / Cáries dentárias na dentição permanente e qualidade de vida relacionada à saúde entre crianças e adolescentes com doença falciforme

Abstract The aim was to associate living, health and oral health conditions with the quality of life (QL) of children and adolescents (CA) with sickle cell disease (SCD). Of the 120 eligible users of a public hematological service, 106 CA with SCD from 6 to 18 years of age, and their caregivers, answered semi-structured questions about socio-demographic, health and oral health conditions. For QL, we used the validated instrument PedsQLSCD™. The oral clinical examination occurred according to the guidelines of WHO and SB Brazil 2010. The majority of CA were non-white people (88%), mean age of 10.4 (±2.9) years, family income of up to two monthly minimum wages, for 03 to 05 members, with diagnosis of sickle cell anemia by neonatal screening, hospitalizations were due allergic crises, polypharmacy and dental caries (51%) were present. "About the Impact of My Pain" was the best-fit model for the QLSCD (adjusted R²=56%; AIC=28.67; p=0.04). Dental caries in permanent dentition worsened the QLSCD (OR=0.53; IC95%=0.35-0.78; p<0.05) and was associated with the type of school, car ownership, number of family members, of complications and of the medications. To overcome this scenario, programmatic actions are required, and implementation of public policies specifically directed towards these groups.

Resumo Objetivou-se associar condições de vida, de saúde e de saúde bucal à qualidade de vida (QLV) de crianças e adolescentes (CA) com Doença Falciforme (DF). Dos 120 usuários elegíveis de um serviço público hematológico, 106 CA entre 6 e 18 anos de idade, e seus cuidadores, responderam questões semiestruturadas sobre condições sociodemográficas, de saúde e saúde bucal. Para a QLV, o instrumento validado PedsQL DF® foi aplicado. Na sequência, realizou-se o exame clínico bucal nas CA segundo diretrizes da OMS e do SB Brasil 2010. A maioria das CA era negra (88%), idade média de 10,4 (±2.9) anos, renda familiar de até dois salários mínimos, para 03 a 05 membros, diagnosticadas na triagem neonatal com anemia falciforme, internadas por crises álgicas, em uso de polifarmácia e com cárie dental (51%). O domínio "Sobre o Impacto da Minha Dor" foi preditivo da QLVDF (R² ajustado =56%; AIC=28.67; p=0,04). Nele, a cárie dental na dentição permanente piorou a QLVDF das CA (OR=0.53; IC95%=0.35-0.78; p<0,05), associando-se ao tipo de escola, posse de carro e do número de membros na família, de complicações da DF e de medicamentos. Os achados ratificam a dor como marca da DF e mostram a importância da saúde bucal na QLDF das CA. A implementação de políticas públicas específicas pode superar esse cenário.

YouTube™ as a source of tooth avulsion information: A video analysis study.

BACKGROUND/AIM: Evaluate the informative content in tooth avulsion videos intended for dentists available on YouTube™ and analyse their compliance with the International Association of Dental Traumatology (IADT) guidelines 2020. MATERIALS AND METHODS: Google Trends was used to identify the most searched term for tooth avulsion. Tooth avulsion-related videos in Brazilian Portuguese intended for dentists were searched on YouTube™ with a 12-month filter. Two raters reviewed these videos to extract their features and evaluate and qualify them with two 9-point checklists based on the IADT 2020 guidelines. The emergency steps for tooth avulsion at the accident site were assessed before, during and after clinical management; each step received 1 point if present and 0 points if absent. The final score ranged from 0 to 9 points on each checklist (18 points total), and the total score was used to classify the videos as having poor, moderate or rich content. Reliability and video quality were evaluated by an adapted version of the DISCERN tool and global quality scale (GQS), respectively. The data were analysed with the Mann-Whitney U-test, Pearson chi-square test, and the Kappa statistic (p < .05). RESULTS: Of 60 videos, 8 were included. All were uploaded by dental professionals or undergraduate students; the average duration was 11 min (range: 0.40-65 min), and the average number of views was 56.75. Half the videos (50%) had maximum completeness scores for questions about emergency dentist referral before clinical management, and more than half (75%) had maximum completeness regarding the steps required during and after treatment. Rich videos had higher GQS scores (p = .049) without significant correlation. CONCLUSIONS: Although most videos in Brazilian Portuguese were considered high-quality according to the IADT checklist, half of them presented partial absence of information regarding orientations at the accident site.

Traumatic dental injuries and their sequelae in visually impaired adolescents.

BACKGROUND/AIM: Traumatic dental injuries are a public health problem. Visual impairment can be considered a risk factor for traumatic dental injury given the difficulties imposed upon visually impaired patients by limited physical perception. The aim of this study was to evaluate the frequency of traumatic dental injuries and their sequelae in adolescents with visual impairment. MATERIAL AND METHODS: Adolescents (12-18 years) with visual impairment (blind or low vision) and no other special needs were included in the study. Data were collected after a clinical and radiographic examination. Data regarding gender, age, type of visual impairment, site of traumatic dental injury, tooth type, and affected tissues, care, and sequelae were obtained. The data were analyzed descriptively and with the chi-square test (p < .05). RESULTS: Among 96 adolescents (65% blind; 55% female), 20.8% (n = 20) reported they had previously experienced a traumatic dental injury of 33 teeth (78.8% maxillary central incisors). Combined injuries (30.3%; n = 10) were the most common traumatic dental injuries, followed by concussion (27.3%, n = 9) and enamel-dentine fractures (21.2%, n = 7). Sequelae were observed in 27.3% (n = 9) of the teeth affected by a traumatic dental injury, and apical periodontitis (77.8%, n = 7) was the most common. CONCLUSION: The frequency of traumatic dental injuries among visually impaired adolescents can be considered high, and the observed sequelae could have been minimized if adequate clinical and radiographic follow up had been carried out. These results suggest the importance of enhanced educational efforts to reduce traumatic dental injuries.

Critical appraisal of the information available on traumatic dental injuries found in applications.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health problem and the search for information becomes essential to help in their management. The aim of this study was to search existing TDI applications (Apps) to critically describe the characteristics and main information found in them regarding TDI. METHODOLOGY: Searches were performed in the Play Store (Android) and App Store (iOS), using MeSH terms, synonyms and terms related to dental emergencies and TDI, in English, Spanish and Portuguese. Apps with information on the management of post-TDI emergencies or TDI prevention were included. The type of operating system (Android/iOS), cost (free/paid), target audience (dentist/patient), age of classification (free/>17 years old), language, star rating (1★ to 5★), number of downloads and post-download ratings, type of dentition (primary/permanent), reference used for classification according to TDI type and management (International Association for Dental Traumatology/Andreasen/others/not reported), and available content (prevention/emergency management/preservation/illustrations) were evaluated. RESULTS: Among 486 apps, 13 were eligible: 11 for Android and 2 for iOS. Most were free (92.3%), for patients (38.4%) and had a free age classification (90.9%). The main language was English (53.8%), and most of the Apps either had no information on star ratings (46.1%) or received 4★ (23.1%). The number of downloads was not reported (23.1%) or was fewer than 100 (23.1%). Most of the Apps were for permanent teeth (61.5%) and had explanations about dental management for TDI emergencies (92.3%) and multiple TDIs (61.5%). Most Apps addressed the importance of monitoring TDIs (76.9%) and contained illustrative images (76.9%). However, many did not report the TDI classification (46.1%), and 38.5% reported TDI prevention. CONCLUSIONS: Information on dental trauma management according to dental injury, inclusion of images, target audience, type of TDI and their prevention varied in the available Apps. However, most were focused on permanent teeth and addressed several TDI in English language only.

Anxiety about dental treatment - a gender issue.

This study compared prevalence and risk factors of dental anxiety between men and women. The sample consisted of 244 participants (n = 122 men) aged 18 years or older who sought dental care at a public Dental Education Institution from March 2018 to November 2019. The Modified Dental Anxiety Scale was used to determine presence of dental anxiety. The following risk factors were recorded: age, years of schooling, preoperative pain, and type of dental treatment. Bivariate analysis was used to assess the difference in dental anxiety between the sexes. Multivariate logistic regression was used to analyze the association between dental anxiety and gender, regardless of the influence of other variables. Total prevalence of dental anxiety was 18% (n = 44), 22.9% (28/122) in women and 13.1% (16/122) in men (p = 0.04). Gender (odds ratio: 1.83, 95% confidence interval: 0.92-3.62) and preoperative pain (odds ratio: 2.095, 95% confidence interval: 0.97-4.49) were associated with dental anxiety. We concluded that women had a higher prevalence of dental anxiety. Preoperative pain was associated with dental anxiety regardless of gender.

Este estudo avaliou a prevalência e os fatores de risco da ansiedade odontológica entre homens e mulheres. O cálculo amostral foi composto por 244 participantes (n = 122 homens) com 18 anos ou mais que procuraram atendimento odontológico em uma instituição pública de Educação Odontológica no período de março de 2018 a novembro de 2019. A Escala de Ansiedade Odontológica Modificada foi utilizada para determinar a presença de ansiedade odontológica. Os seguintes fatores de risco também foram coletados: idade, anos de estudo, dor pré-operatória e tipo de tratamento odontológico. A análise bivariada foi usada para avaliar a diferença na ansiedade odontológica entre os gêneros. A regressão logística multivariada foi utilizada para analisar a associação entre ansiedade odontológica e gênero, independentemente da influência de outras variáveis. A prevalência total de ansiedade odontológica foi de 18% (n = 44), 22,9% (28/122) nas mulheres e 13,1% (16/122) nos homens (p = 0,04). O gênero (odds ratio: 1,83, intervalo de confiança de 95%: 0,92­3,62) e a dor pré-operatória (odds ratio: 2,095, intervalo de confiança de 95%: 0,97­4,49) foram associados à ansiedade odontológica. Concluímos que as mulheres apresentaram maior prevalência de ansiedade odontológica. A dor pré-operatória foi associada à ansiedade odontológica, independentemente do gênero.

Anxiety about dental treatment / Ansiedade em relação ao tratamento dentário

ABSTRACT This study compared prevalence and risk factors of dental anxiety between men and women. The sample consisted of 244 participants (n = 122 men) aged 18 years or older who sought dental care at a public Dental Education Institution from March 2018 to November 2019. The Modified Dental Anxiety Scale was used to determine presence of dental anxiety. The following risk factors were recorded: age, years of schooling, preoperative pain, and type of dental treatment. Bivariate analysis was used to assess the difference in dental anxiety between the sexes. Multivariate logistic regression was used to analyze the association between dental anxiety and gender, regardless of the influence of other variables. Total prevalence of dental anxiety was 18% (n = 44), 22.9% (28/122) in women and 13.1% (16/122) in men (p = 0.04). Gender (odds ratio: 1.83, 95% confidence interval: 0.92-3.62) and preoperative pain (odds ratio: 2.095, 95% confidence interval: 0.97-4.49) were associated with dental anxiety. We concluded that women had a higher prevalence of dental anxiety. Preoperative pain was associated with dental anxiety regardless of gender.

RESUMO Este estudo avaliou a prevalência e os fatores de risco da ansiedade odontológica entre homens e mulheres. O cálculo amostral foi composto por 244 participantes (n = 122 homens) com 18 anos ou mais que procuraram atendimento odontológico em uma instituição pública de Educação Odontológica no período de março de 2018 a novembro de 2019. A Escala de Ansiedade Odontológica Modificada foi utilizada para determinar a presença de ansiedade odontológica. Os seguintes fatores de risco também foram coletados: idade, anos de estudo, dor pré-operatória e tipo de tratamento odontológico. A análise bivariada foi usada para avaliar a diferença na ansiedade odontológica entre os gêneros. A regressão logística multivariada foi utilizada para analisar a associação entre ansiedade odontológica e gênero, independentemente da influência de outras variáveis. A prevalência total de ansiedade odontológica foi de 18% (n = 44), 22,9% (28/122) nas mulheres e 13,1% (16/122) nos homens (p = 0,04). O gênero (odds ratio: 1,83, intervalo de confiança de 95%: 0,92-3,62) e a dor pré-operatória (odds ratio: 2,095, intervalo de confiança de 95%: 0,97-4,49) foram associados à ansiedade odontológica. Concluímos que as mulheres apresentaram maior prevalência de ansiedade odontológica. A dor pré-operatória foi associada à ansiedade odontológica, independentemente do gênero.

Healing complications of traumatized permanent teeth in pediatric patients: a longitudinal study.

BACKGROUND: Traumatic dental injuries (TDI) can affect soft and hard dental tissues and supporting structures in different ways and severity. AIM: This study describes the complications associated with health in traumatized permanent teeth (TPT) over a 12-month period and assesses the relationships between TDI, involved tissues, and root development (RD). DESIGN: The study enrolled 294 patients with 548 TPT. Data were collected on the TDI, RD, and the healing complication (HC) and when they were examined (03, 06, and 12 months). Frequencies are described and analyzed using the chi-squared test, relative risk (RR), and Mantel-Haenszel analysis (P≤0.05). RESULTS: Healing complications were present in 201 (36.68%) teeth and were more frequently diagnosed 3 months (63.68%) after the TDI. Pulp necrosis was the most common HC (38.3%), and it was significantly associated with avulsion (P=0.023). Teeth with complete RD showed a tendency of developing HC over time, independent of TDI (P=0.05). HC in teeth with complete RD related to support tissue trauma (P=0.005) and avulsion (P<0.001) appeared more frequently after 3 months. CONCLUSION: Healing complications are more common in teeth that have suffered trauma in supporting tissues and avulsion, especially in teeth with complete RD. The HC occur more frequently in the first 3 months, and a necrotic pulp was the most common complication.

Studies of dental anomalies in a large group of school children.

The identification of specific patterns of dental anomalies would allow testing the hypothesis that certain genetic and environmental factors contribute to distinct dental anomaly subphenotypes. A sexual dimorphism in tooth agenesis and its association with other dental anomalies has been suggested. The aim of this study was to investigate a large group of children to define dental anomaly subphenotypes that may aid future genetic studies. Orthopantamograms of 1198 subjects were examined and 1167 were used in this study. The frequency of tooth agenesis in the studied population was 4.8%. Male:female ratios varied from 2:1 in the agenesis of upper lateral incisors to 0.5:1 in premolar agenesis. The risk of infra-occlusion of primary molars and double formation of primary incisors was increased in individuals with tooth agenesis.