Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren.

This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.

Oral health, socio-economic and home environmental factors associated with general and oral-health related quality of life and convergent validity of two instruments.

BACKGROUND: The objective of this study was to evaluate the convergent validity between the domains of the Autoquestionnaire Qualité de Vie Enfant image (AUQUEI) and the Child Perceptions Questionnaire instrument (CPQ(11-14)) among schoolchildren and to assess the difference between socio-economic and clinical variables associated with their scores. METHODS: An analytical cross-sectional study was conducted in Juiz de Fora, Minas Gerais, Brazil, with 515 schoolchildren aged 12 years from 22 public and private schools, selected with the use of a random multistage sampling design. They were clinically examined for dental caries experience (DMFT and dmft index) and orthodontic treatments needs (DAI index) and were asked to complete the Brazilian versions of Child Perception Questionnaire (CPQ(11-14)) and Autoquestionnaire Qualité de Vie Enfant image (AUQUEI). In addition, a questionnaire was sent to their parents inquiring about their socio-economic status and home characteristics. The convergent validity of the Brazilian versions of CPQ(11-14) and AUQUEI instruments was analyzed by Spearman's correlation coefficients. For comparison between the summarized scores of each questionnaire with regard to the schoolchildren's socio-environmental and clinical aspects the nonparametric Mann-Whitney was used at level of significance of 5%. RESULTS: The mean DMFT index was 1.09 and 125 (24.3%) children had orthodontic treatment needs (DAI ≥ 31). There was a similarity and a weak correlation between the scores of the domains of CPQ(11-14) and AUQUEI (r ranged between -0.006 and 0.0296). In addition, a significant difference was found between the scores of the two instruments according to the socio-economic variables (p < 0.05) and presence of teeth with carious lesions (p < 0.05). CONCLUSIONS: The general and oral health-related quality of life instruments AUQUEI and CPQ(11-14) were both found to be useful, and significant influence of socio-economic and clinical variables were detected with both instruments.

LGBTQ+ related curricular activities in Brazilian Dental Schools: Do institutional and/or deans' profiles matter?

PURPOSE: The aim of this cross-sectional study was to investigate whether the characteristics of dental schools and the profiles of their deans were associated with curricular activities related to LGBTQ+ in Brazilian dental schools. METHODS: A survey was mailed to the deans of all Brazilian dental schools for the purpose of assessing the development of pedagogical activities focused on the topic of oral health of the LGBTQ+ population, and the characteristics of the institutions and profiles of their deans. The data collected were analyzed with hierarchical multiple logistic regression models in order to analyze associations between variables of interest. RESULTS: Of the deans approached, 156 (response rate of approximately 32.4%) completed and returned the survey. The majority of dental schools (67.3%) of the sample were private institutions and 39% of them developed pedagogical activities directed toward the LGBTQ+. This percentage was much lower in public institutions (18%). The results of the hierarchical multiple logistic regression demonstrated that deans who attributed high relevance to the theme "oral health of the LGBTQ+ population" were more likely to develop pedagogical activities directed toward the LGBTQ+ population (odds ratio = 4.74; 95% confidence interval: 1.65-13.48), than those who attributed low or little importance to this topic (p < 0.05). CONCLUSION: A low percentage of activities aimed at the LGBTQ+ population was observed in the sample of Brazilian dental schools. Deans must be aware of the importance of the topic and be motivated to implement pedagogical activities for this population.

Online social networks for prevention and promotion of oral health: a systematic review.

Aim: To evaluate the impact of online social networks (OSN) as resources for promoting behaviour changes related to the prevention and promotion of oral health. Methods: This was a systematic review with meta-analysis of randomized clinical trials identified in databases (MEDLINE/Embase/Lilacs), published up until May 2022, and prepared according to Cochrane recommendations. Studies that used OSN (WhatsApp®, Telegram®, TikTok®, Facebook®, Twitter®, YouTube®, Instagram®, Soundcloud®, Flickr®, LinkedIn®, and Webradio®) were included. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42021248045). Results: In total, 3171 studies were evaluated, of which 12 studies met the inclusion criteria for the review and contained data on 1669 participants. The most frequently investigated OSN were WhatsApp®, followed by Telegram®, and YouTube®. All studies included were at high risk of bias. Data extraction allowed the meta-analysis of gingival index (GI) and oral health knowledge (OHK) outcomes for young people. Findings revealed that young people exposed to digital interventions via OSN showed a reduction in GI when compared with traditional educational interventions. This reduction occurred in all young people (standardized mean difference, -0.48; 95% CI, -0.75 to -0.21; p = 0.0006, I2 = 0%; very low certainty), including those who were undergoing orthodontic treatment (standardized mean difference, -0.58; 95% CI, -0.92 to -0.24; p = 0.0008, I2 = 0%; very low certainty). Furthermore, young people undergoing orthodontic treatment and exposed to OSN showed an increase in OHK when compared with participation in traditional educational interventions (standardized mean difference, +0.86; 95% CI, +0.46 to +1.26; p < 0.0001, I2 = 0%; very low certainty). Conclusion: OSN could be effective tools for improving oral health outcomes in young people.

Objet: Évaluer l'incidence des réseaux sociaux comme ressources pour promouvoir les changements de comportement liés à la prévention et à la promotion de la santé buccodentaire. Méthodes: Il s'agit d'un examen systématique avec méta-analyse d'essais cliniques randomisés répertoriés dans des bases de données (MEDLINE/Embase/Lilacs) publiés jusqu'en mai 2022 et préparés selon les recommandations de Cochrane. Les études utilisant les réseaux sociaux (WhatsApp®, Telegram®, TikTok®, Facebook®, Twitter®, YouTube®, Instagram®, SoundCloud®, Flickr®, LinkedIn®, et Webradio®) ont été incluses. Le protocole a été enregistré dans le PROSPERO (International Prospective Register of Systematic Reviews, numéro CRD42021248045). Résultats: Au total, 3 171 études ont été évaluées. De celles-ci, 12 répondaient aux critères d'inclusion de l'examen et comportaient des données sur 1 669 participants. Les réseaux sociaux qui ont le plus fréquemment fait l'objet d'une enquête sont WhatsApp®, suivi de Telegram® et YouTube®. Toutes les études incluses présentaient un risque élevé de biais. L'extraction des données a permis la méta-analyse des résultats de l'indice gingival (IG) et des connaissances en santé buccodentaire chez les jeunes. Les résultats ont révélé que les jeunes exposés aux interventions numériques par l'intermédiaire des réseaux sociaux présentaient un IG réduit par rapport à ceux exposés aux interventions éducatives traditionnelles. Cette réduction était présente chez tous les jeunes (différence moyenne standardisée, ­0,48; IC à 95 %, ­0,75 à ­0,21; p = 0,0006, I2 = 0 %; certitude très faible), y compris ceux qui suivaient un traitement orthodontique (différence moyenne standardisée, ­0,58; IC à 95 %, ­0,92 à ­0,24; p = 0,0008, I2 = 0 %; certitude très faible). De plus, les jeunes recevant un traitement orthodontique exposés aux réseaux sociaux ont montré une plus grande connaissance en santé buccodentaire que ceux participant aux interventions éducatives traditionnelles (différence moyenne standardisée, +0,86; IC à 95 %, +0,46 à +1,26; p < 0,0001, I2 = 0 %; certitude très faible). Conclusion: Les réseaux sociaux pourraient être des outils efficaces pour améliorer les résultats en matière de santé buccodentaire chez les jeunes.

The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life.

BACKGROUND: The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL). METHODS: A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances. RESULTS: Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life. CONCLUSIONS: It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.

Oral Health Literacy, Sense of Coherence and Associations With Poor School Performance.

BACKGROUND: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. METHODS: This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. RESULTS: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. CONCLUSIONS: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

Increase in severity of molar-incisor hypomineralization and its relationship with the colour of enamel opacity: a prospective cohort study.

BACKGROUND: Predicting risk of posteruptive enamel breakdown (PEB) of molar-incisor hypomineralization (MIH) opacity is a difficult but important clinical task. Therefore, there is a need to evaluate these aspects through longitudinal studies. OBJECTIVE: The aim of this longitudinal study was to analyse the relationship between colours of MIH opacity of children aged 6-12 (baseline) and other clinical and demographic variables involved in the increase in severity of MIH. MATERIALS AND METHODS: A blinded prospective 18-month follow-up was conducted with 147 individuals presenting mild MIH. Tooth-based incidence of increase in severity of MIH (PEB or atypical restorations) was used as dependent measurement. Enamel opacities were recorded according to colour shades of white, yellow and brown, allowing assessment of susceptibility to structural loss over time, according to colour of MIH opacity. Poisson regression models were used to adjust the results for demographic and clinical variables. RESULTS: Brown and yellow MIH opacities were at higher risk for PEB and atypical restorations than those of white ones, even after adjustment for clinical and demographic variables. CONCLUSION: Teeth presenting mild MIH severity associated with yellow and brown enamel opacities were at high risk for increase in severity of MIH than lighter ones. This result could help clinicians determine a risk-based treatment for children with MIH.

Association between demarcated enamel hypomineralization on second primary molars and dental caries in childhood.

Hypomineralized Second Primary Molars (HSPM) is the name used to describe the presence of demarcated enamel hypomineralization in second primary molars. HSPM has been compared with Molar Incisor Hypomineralization (MIH) as regards its clinical appearance and consequences. The aim of this study was to investigate associations between HSPM and dental caries in childhood. It was a cross-sectional populationbased study that included 216 children aged 4-6 years from public schools in Botelhos, Brazil. Children with all second primary molars erupted were eligible for participation. Clinical examination was performed by one calibrated examiner. HSPM was recorded according to modified European Academy of Paediatric Dentistry criteria. The main outcome was dental caries experience as indicated by the dmft index (%dmft>0) according to WHO criteria. Chi-square test and Logistic Regression Model were used to adjust the results for effects of covariates Among the 216 children examined, 22.2% presented HSPM. After adjustment for logistic regression, children with HSPM were found to have a 2.28 times greater chance of presenting dental caries. Our results reinforce the importance of HSPM in caries development in children, which should be considered by public health dentists in the process of planning actions aimed at this population.

A hipomineralizacao de segundo molar decíduo (HSMD) é denominação utilizada para descrever a presença de hipomineralização demarcada do esmalte nos segundos molares decídus. A HSMD foi comparada com a hipomineralização de molares e incisivos (HMI) no que diz respeito à aparência e às consequências clínicas. O objetivo deste estudo foi investigar associações entre HSMD e cárie na infância. Foi realiza um estudo transversal de base populacional, composto por 216 crianças de 4 a 6 anos de idade de escolas públicas de Botelhos, Brasil. As crianças com todos os segundos molares decíduos foram elegíveis para participação. O exame clínico foi realizado por um examinador calibrado. A HSMD foi registrada de acordo com os critérios modificados da European Academy of Paediatric Dentistry. O desfecho principal foi a experiência de cárie dentária nos dentes decíduos conforme o índice ceo (% ceo> 0), segundo os critérios da OMS. Os testes de Qui-quadrado e o modelo de regressão logística foram utilizados para ajustar os resultados dos efeitos das covariáveis. Verificou-se que entre as 216 crianças examinadas, 22,2% apresentaram HSMD. Após o ajuste da regressão logística, as crianças com HSMD tiveram 2,28 vezes mais chances de apresentar cárie dentária. Nossos resultados reforçam a importância do HSMD no desenvolvimento da cárie em crianças, fato que deve ser considerado pelos dentistas de saúde pública no processo de planejamento de ações voltadas a essa população.

Factors associated with last dental visit or not to visit the dentist by Brazilian adolescents: A population-based study.

OBJECTIVES: We investigated the factors associated with no dental visit within the last two years by adolescents in the state of São Paulo, Brazil, by using data from the Oral Health Conditions of São Paulo state population Project (SBSP-2015) conducted in 2015. METHODS: This was a cross-sectional epidemiological study with a representative sample of adolescents aged 15 to higher years residing in São Paulo State. The examiners were calibrated and dental visits were measured categorically as 1- Less than 1 year, 2- One to two years, 3 - Three years or more, 4- I have never visited the dentist. Based on the literature we dichotomized the outcome in two groups: response 1 plus 2 against response 3 plus 4. Then, Multilevel Poisson Regression (MPR) was used to estimate the prevalence ratios of last dental visit three years or had never been to a dentist by adolescents compared with those who had visited the dentist within the past two years, with contextual variables as the distal level; sociodemographic variables, mesial; and individual variables, proximal level. RESULTS: A high percentage of adolescents (84.9%) reported visiting the dentist in the last 2 years. Whereas, 626 (11.6%) had not visited the dentist for over 3 years and 188 (3.4%) had never been. A significantly higher proportion of females than males reported visiting the dentist in the past 2 years (p = 0.003). The oral and dental condition was reported as satisfactory by 4,350 respondents (80.6%), and when they accessed the health service, 2,286 (42.3%) went to the public service. Lower mean family income (1.62PR;95%CI;1.36-1.94); ≥ 1,000 inhabitant/Dental Surgeons (1.25PR;95%IC;1.03-1.56);male (1.26PR;95%CI; 1.11-1.43) non-Caucasian ethnicity (Mulatto:1.30PR;95%CI;1.13-1.50 and Black:1.58PR;95%CI;1.29-1.93); dissatisfaction with the oral health condition (1.20PR;95%CI;1.01-1.45),last visit to the public service versus private service (2.26PR; 95%CI;1.91-2.65) and presenting with periodontal disease in the form of dental calculus as the worst situation (1.38PR; 95%CI; 1.16-1.53) were associated with last visit to the dentist. CONCLUSIONS: A high proportion of adolescents had visited the dentist in the last two years. No dental visit within the last two years by adolescents were associated with contextual, health care system, sociodemographic, personal and oral health status, demonstrating that this is a complex phenomenon. Actions to promote regular dental visits by adolescents in Brazil should take these factors into consideration.

Association between demarcated enamel hypomineralization on second primary molars and dental caries in childhood / Associações entre hipomineralização demarcada de esmante nos segundos molares decíduos e cárie dentària na infância

ABSTRACT Hypomineralized Second Primary Molars (HSPM) is the name used to describe the presence of demarcated enamel hypomineralization in second primary molars. HSPM has been compared with Molar Incisor Hypomineralization (MIH) as regards its clinical appearance and consequences. The aim of this study was to investigate associations between HSPM and dental caries in childhood. It was a cross-sectional population-based study that included 216 children aged 4-6 years from public schools in Botelhos, Brazil. Children with all second primary molars erupted were eligible for participation. Clinical examination was performed by one calibrated examiner. HSPM was recorded according to modified European Academy of Paediatric Dentistry criteria. The main outcome was dental caries experience as indicated by the dmft index (%dmft>0) according to WHO criteria. Chi-square test and Logistic Regression Model were used to adjust the results for effects of covariates Among the 216 children examined, 22.2% presented HSPM. After adjustment for logistic regression, children with HSPM were found to have a 2.28 times greater chance of presenting dental caries. Our results reinforce the importance of HSPM in caries development in children, which should be considered by public health dentists in the process of planning actions aimed at this population.

RESUMO A hipomineralizacao de segundo molar deciduo (HSMD) é de-nominação utilizada para descrever a presenga de hipomineralização demarcada do esmalte nos segundos molares decídus. A HSMD foi comparada com a hipomineralização de molares e incisivos (HMI) no que diz respeito á aparencia e as conse-quencias clínicas. O objetivo deste estudo foi investigar asso-ciações entre HSMD e cárie na infáncia. Foi realiza um estudo transversal de base populacional, composto por 216 criangas de 4 a 6 anos de idade de escolas públicas de Botelhos, Brasil. As criangas com todos os segundos molares deciduos foram elegíveis para participação. O exame clínico foi realizado por um examinador calibrado. A HSMD foi registrada de acordo com os critérios modificados da European Academy of Paediatric Dentistry. O desfecho principal foi a experiencia de cárie dentària nos dentes deciduos conforme o índice ceo (% ceo> 0), segundo os critérios da OMS. Os testes de Qui-quadrado e o modelo de regressao logística foram utilizados para ajustar os resultados dos efeitos das covariáveis. Verificou-se que entre as 216 criangas examinadas, 22,2% apresentaram HSMD. Após o ajuste da regressao logística, as criangas com HSMD tiveram 2,28 vezes mais chances de apresentar cárie dentària. Nossos resultados reforgam a importáncia do HSMD no desenvolvimento da cárie em criangas, fato que deve ser considerado pelos dentistas de saúde pública no processo de planejamento de ações voltadas a essa população.