Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil.

INTRODUCTION: There is an inconclusive causal association between asthma symptoms and dental caries in the primary dentition. This study aimed to investigate, using SEM (structural equation modeling), a possible causal relation between asthma and dental caries in the primary dentition. METHODS: Using data from the 2004 Pelotas Birth Cohort Study, a sub-sample of 1,303 individuals was selected. Dental caries was clinically evaluated at 5 years old based on decayed, missing, and filled tooth (dmft) index criteria. Asthma-related symptoms (wheezing and shortness of breath) at 1- and 4-year-olds composed a latent variable and were the main exposures to caries occurrence. SEM was used to identify possible direct, indirect, and mediated effects of asthma in primary dentition dental caries. RESULTS: The general prevalence of caries at age 5 was 1.95 (SD: 3.56). When comparing the dmft values for children with asthma symptoms and those without, they presented similar values in both periods where asthma symptoms were evaluated (1- and 4-year-old). SEM analysis showed that asthma was neither directly nor indirectly related to dental caries. CONCLUSION: Asthma, using a latent variable constructed based on asthma symptoms, showed no causal effect on dental caries occurrence in the primary dentition.

Association among headache, temporomandibular disorder, and awake bruxism: A cross-sectional study.

OBJECTIVE: To evaluate the association between headache, myofascial temporomandibular disorder (TMD), and awake bruxism (AB). BACKGROUND: Bruxism seems to act as a risk factor for TMD and its associated comorbidities, such as headaches. METHODS: In total, 406 medical records of individuals who sought care at a university dental clinic were screened. The Research Diagnostic Criteria for Temporomandibular Disorders was used to assess and diagnose TMD, as well as to obtain self-reports of AB and headache. RESULTS: The sample consisted of 307 medical records. About 72.5% (221/305) of the sample reported having headaches, and 67.4% (180/267) and 68.4% (210/307) were diagnosed with AB and TMD, respectively. Individuals who reported having AB (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.09-4.7) and who were diagnosed with myofascial TMD (OR, 2.53; 95% CI, 1.15-5.5) were more likely to have had headaches in the past 6 months when compared with patients without myofascial TMD and bruxism. Also, individuals who self-reported headache were 2.27 times (95% CI, 1.09-4.7) more likely to have AB and 2.45 times (95% CI, 1.13-5.34) more likely to have myofascial pain than individuals without headaches. CONCLUSIONS: Individuals with myofascial TMD, headaches, or AB were more likely to have at least one of the other conditions.

Socioeconomic inequalities in oral health-related quality of life in adolescents: a cohort study.

PURPOSE: Socioeconomic inequalities are recognized as a major problem with people in low socioeconomic groups having worse subjective oral health outcomes, including oral health-related quality of life (OHRQoL). However, only a few longitudinal studies assessed the impact of contextual and individual socioeconomic determinants in adolescents' OHRQoL. We estimate the impact of socioeconomic inequalities on adolescents' OHRQoL over a 2-year period. METHODS: This study followed up a random sample of 1134 12-year-old schoolchildren for 2 years in Brazil. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-year-old Children (CPQ11-14) at baseline and follow-up. Participants were clinically examined for dental caries, gingival bleeding, and malocclusion. The schoolchildren's parents answered a questionnaire regarding socioeconomic status, social capital, and adolescents' use of dental service. Socioeconomic contextual variables were collected from official city publications. Multilevel linear regression models fitted the associations between socioeconomic factors and overall CPQ11-14 scores over time. RESULTS: A total of 747, 14-year-old adolescents were reassessed for OHRQoL (follow-up rate of 66%). Adolescents with lower mean income school's neighborhood (P < 0.05), household income (P < 0.05), and maternal schooling (P < 0.05) had higher overall CPQ11-14 scores. Female sex, attending a dentist by toothache, dental caries, and malocclusion were also associated with higher overall CPQ11-14 scores. CONCLUSIONS: Adolescents from low socioeconomic background reported worse OHRQoL at 2-year follow-up compared to those from high socioeconomic background. Actions toward health inequalities need to address socioeconomic factors in adolescence.

Oral health and happiness in adolescents: A cohort study.

OBJECTIVES: To investigate the influence of oral health conditions, socioeconomic status and dental care utilization on subjective happiness and identify the factors associated with changes in happiness among adolescents. METHODS: Data were collected in 2012 and 2014. Oral health conditions were evaluated by performing clinical examinations; socioeconomic status and dental care utilization were assessed by using a questionnaire. The participants answered the Child Perceptions Questionnaire 11-14 for the evaluation of the impact of these variables on oral health-related quality of life (OHRQoL). Happiness was assessed using the Brazilian version of the Subjective Happiness Scale. For longitudinal data analysis, a mixed-effect model of linear regression was used to assess the factors related to happiness and multinomial logistic regression to appraise prospective changes in happiness. RESULTS: A total of 1134 12-year-old adolescents were examined at baseline (response rate: 93%), and 770 were reevaluated after 2 years (retention rate: 68%). The adolescents who lived in households with lower equivalized income and greater overcrowding, had not visited the dentist in the later 6 months, had a higher number of cavitated carious lesions, and reported a higher impact on OHRQoL in 2012 presented lower happiness levels. Additionally, the adolescents with a higher number of decayed, missing or filled teeth and who reported a higher impact on OHRQoL were more likely to belong to the most unfavourable happiness trajectory categories. CONCLUSIONS: The presence of dental caries, socioeconomic conditions, dental care utilization and OHRQoL influence happiness in adolescents. Having more teeth affected by dental caries and worse self-perception in early adolescence can lead to a decrease in happiness.