Assessing transparency practices in dental randomized controlled trials.

BACKGROUND: To evaluate transparency practices in randomized controlled trials (RCTs) in dentistry. METHODS: This meta-research study included RCTs in dentistry regardless of topic, methods, or level of detail reported. Only studies in English were considered. We searched PubMed for RCTs in dentistry published in English from December 31, 2016, to December 31, 2021. The screening was performed in duplicate, and data extracted included journal and author details, dental specialty, protocol registration, data and code sharing, conflict of interest declaration, and funding information. A descriptive analysis of the data was performed. We generated maps illustrating the reporting of transparency items by country of the corresponding author and a heat table reflecting reporting levels by dental specialty. RESULTS: A total of 844 RCTs were included. Only 12.86% of studies reported any information about data and code sharing. Protocol registration was reported for 50.36% of RCTs. Conflict of interest (83.41%) and funding (71.68%) declarations were present in most studies. Conflicts of interest and funding were consistently reported regardless of country or specialty, while data and code sharing had a low level of reporting across specialties, as well as low dissemination across the world. Protocol registration exhibited considerable variability. CONCLUSIONS: Considering the importance of RCTs for evidence-based dentistry, it is crucial that everyone who participates in the scientific production and dissemination process actively and consistently promotes adherence to transparent scientific standards, particularly registration of protocols, and sharing of data and code.

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.

Direct relations between sense of coherence and oral health-related quality of life in adolescents.

OBJECTIVE: To verify the relations between sense of coherence (SOC) and dental caries on oral health-related quality of life (OHRQoL) of adolescents. SUBJECT AND METHODS: A cross-sectional sample of 768 adolescents nested in a cohort study was evaluated. SOC was measured using Antonovsky's scale. Dental caries was collected considering the decayed, missing, and filled teeth index (DMFT). OHRQoL was collected through the Child Perception Questionnaire. Demographic, socioeconomic, and use of service variables were also collected. The mediation effects between variables were tested by structural equation modeling. RESULTS: The average age of the individuals was 17.5 years. Individuals with high SOC scores had a positive impact on OHRQoL (ß-coefficient = -0.573, p < 0.00). Individuals with high DMFT (ß-coefficient = 0.080, p = 0.034) and dental pain (ß-coefficient = 0.079, p = 0.039) negatively impacted OHRQoL. Still, adolescents who had dental pain (ß-coefficient = 0.112, p = 0.005), mothers with lower education levels (ß-coefficient = -0.114, p = 0.004), lower household income (ß-coefficient = -0.131, p = 0.003), and those who visited the dentist (ß-coefficient = 0.109, p = 0.005) exhibited a higher DMFT index. CONCLUSIONS: SOC and dental caries had a direct effect on OHRQoL, indicating that oral conditions and psychosocial characteristics are important contributors to OHRQoL.

Prevalence of psychological disorders in patients with temporomandibular disorders: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Temporomandibular disorders (TMDs) affect the muscles of mastication, the temporomandibular joint, and associated structures. They are generally classified as muscular or articular and are the main cause of pain in the orofacial region, eventually causing psychological problems. However, the real burden of psychological disorders is unknown. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the prevalence of psychological disorders in patients with TMDs. MATERIAL AND METHODS: The study was conducted through a bibliographic search carried out without initial limit until July 2021 in the following electronic databases: MEDLINE/PubMed, Scopus, and PsycINFO. Clinical observational studies investigating depression and somatization in patients with TMD diagnosed by the Diagnostic Research for Temporomandibular Disorders (RDC/TMD) criteria in muscular, articular, and disc disorders were included. A descriptive analysis of the included studies and a meta-analysis for the prevalence data were performed for the synthesis of evidence. RESULTS: A total of 2320 studies were found, of which 48 complete articles were assessed for eligibility and 22 were included in the analysis. The general prevalence of depression and moderate and severe somatization in patients diagnosed with TMD was estimated at 43.0% (95% confidence interval (CI), 36.0% to 50.0%) and 60.0% (95% CI 52.0 - 67, 0%). The average overall score for depression was estimated at 0.92 (95% CI, 0.69-1.15), being classified as moderate depression. The average overall score for somatization was estimated at 1.09 (95% CI, 0.81-1.36), being classified as severe somatization. All analyses showed high heterogeneity (I2>90%). Based on the quality assessment, 80.9% of studies included in the review had low to moderate risk of bias. CONCLUSIONS: Patients with TMDs who seek clinical care show a high prevalence of depression and somatization.

Protocol registration improves reporting quality of systematic reviews in dentistry.

BACKGROUND: The aims of this study were to assess whether the previous registration of a systematic review (SR) is associated with the improvement of the quality of the report of SRs and whether SR registration reduced outcome reporting bias. METHODS: We performed a search in PubMed for SRs in dentistry indexed in 2017. Data related to SR registration and reporting characteristics were extracted. We analyzed if the reporting of 21 characteristics of included SRs was associated with the prospective registration of protocols or reporting of a previously established protocol. The association between prospective registering of protocols, reporting of funding and number of included studies versus outcome reporting bias was tested via multivariable logistic regression. RESULTS: We included 495 SRs. One hundred and 62 (32.7%) SRs reported registering the SR protocol or working from a previously established protocol. Thirteen reporting characteristics were described statistically significant in SRs registered versus SRs that were not. Publication bias assessment and Report the number of participants showed the highest effects favoring the register (RR 1.59, CI 95% 1.19-2.12; RR 1.58, CI 95% 1.31-1.92 respectively). Moreover, Registration was not significantly linked with the articles' reporting statistical significance (OR 0.96, CI 95% 0.49-1.90). CONCLUSION: There is a positive influence of previously registering a protocol in the final report quality of SRs in dentistry. However, we did not observe an association between protocol registration and reduction in outcome reporting bias.

Knowledge synthesis: How to improve the use of evidence from clinical trials?

BACKGROUND: The value of systematic reviews (SRs) is determined by methodology and reporting quality of primary studies and how the SR is conducted and reported. AIM: This study discusses key aspects of clinical trials (CTs) that might affect the value of SRs. DESIGN: Narrative review. RESULTS: We highlighted the following CT factors that could affect SR value: Defining the purpose of CTs is important because it could directly impact whether an SR question is appropriately answered and formulated; choose the most appropriate intervention to answer a proposed SR question is critical because we can exclude or include different studies, directly influencing selection bias; when conducting SRs, the study's search must be restricted to equal or highly similar comparison groups, allowing suitable comparisons of the outcomes' estimates; in SRs, it may be interesting to explore the effect of the most common definition of the disease used in clinical practice, being useful in evidence-based dentistry and easily translated to daily practitioners; and deficiencies in CT reporting can lead to unusable reports, biased results, and conclusions. CONCLUSION: All aspects discussed were found to be important for improving the use of evidence from CTs.

The role of asthma in caries occurrence - meta-analysis and meta-regression.

Objective: We aimed to conduct a systematic review of the literature regarding the association between asthma and caries, assess the effect of asthma on the occurrence of caries in primary and permanent dentitions, and determine factors that could affect the estimates of this association. Data source: We used the following databases: PubMed, Web of Science, SCOPUS, and LILACS/BVS, for the literature review. Study selection: We included observational studies that investigated the association between asthma and dental caries, excluding studies with syndromic patients, literature reviews, case reports, and in vitro and in situ studies. A meta-analysis was performed to estimate a pooled effect, and meta-regression was conducted to determine study factors that could affect the estimates. Results: From 674 studies initially identified, 40 fulfilled the inclusion criteria, and 36 of these were used in the meta-analysis. Odds ratio (OR) for the pooled effect was 1.45 (95% confidence interval (CI): 1.22-1.72; I2, 71.8%; p < 0.001) and 1.52 (95% CI: 1.34-1.73; I2, 83.1%; p < 0.001) for primary and permanent dentitions, respectively. In addition, a small proportion of the heterogeneity was attributed to included factors in the meta-regression (primary dentition, 10.7%; and permanent dentition, 3.1%). Conclusions: This study provides reliable and robust evidence that emphasizes the impact of asthma on the occurrence of dental caries in both, primary and permanent, dentitions. The findings provide useful data for recommending that dentists and physicians collaborate to establish the control for both diseases in a multidisciplinary manner.

Industry sponsorship bias in clinical trials in implant dentistry: Systematic review and meta-regression.

AIM: Industry sponsorship might distort the conduct and findings of studies in a large range of medical disciplines. The objective of this study was to assess whether industry sponsorship bias is present in randomized controlled trials (RCTs) on dental implants. MATERIAL AND METHODS: Two databases were searched (MEDLINE; Web of Science) to identify RCTs published between 1996 and 2016 assessing different implant systems, components or techniques, such as implant-abutment connections, geometries, surfaces, loading protocols or regions of placement. Studies' sponsorship status was classified as unclear, non-sponsored or sponsored. Our outcome was marginal bone loss per year (MBL/year) of follow-up. Random-effects meta-analysis of MBL/year with subgroup analysis according to sponsorship status was performed. Moreover, multivariable stepwise-selection meta-regression was performed to assess whether sponsorship status, among other covariates, was associated with MBL/year. RESULTS: One hundred and two RCTs (4,775 patients, 8,806 implants) were included. Overall mean (95% confidence interval) MBL/year was 0.74 mm (95% CI 0.67/0.82). There was no significant difference in MBL/year among sponsorship categories; unclear: 0.64 (95% CI 0.37/0.91); non-sponsored: 0.65 (095% CI 0.55/0.75); and sponsored: 0.82 (95% CI 0.71/0.94). CONCLUSION: Meta-regression did not demonstrate a significant association of MBL/year with sponsorship status or other covariates was found. We did not detect significant sponsorship bias in RCTs on dental implants.

Trends in use of dental services by Brazilian pre-school children considering Age-Period-Cohort Effect.

BACKGROUND: Besides the growth in Brazilian public oral health investments, no pre-school children preventive policies were done, and surveys demonstrated lower prevalences of use of dental service. AIM: To verify trends in the use, type, and reason for seeking dental services among pre-school children considering time variations. METHODS: This study used data of clinical examinations and structured interviews of three cross-sectional surveys of southern pre-school children in Brazil, from 2008, 2010, and 2013. Chi-square test for trends and hierarchical age-period-cohort (HAPC) analysis using the multilevel Poisson regression model assessing the influence of social and clinical variables in the use, type, and reason for seeking dental services were performed. RESULTS: A total of 1765 pre-school children participated in all surveys. At least, one time-related variation affected one of three assessed outcomes. There was no significant change in prevalence of the use of dental services (75.8%, 77.4%, and 74.9%, respectively, for each year; P = 0.750). In the HAPC analysis, younger children and from low socio-economic backgrounds were less likely to have visited the dentist. CONCLUSION: The prevalence of use of oral health services did not change and socio-economic inequalities persisted through the years, indicating a need of reviewing the policies to promote public health.

Trends and age-period-cohort effect on dental caries prevalence from 2008 to 2019 among Brazilian preschoolers.

This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent's perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children.

BACKGROUND: Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents' socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children's use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1-5 years. METHODS: Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children's Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals. RESULTS: Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as "poor" used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child's oral health as "fair/poor" were less likely to have visited the dentist for preventive care. CONCLUSION: This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.

Exploring the use of preprints in dentistry.

OBJECTIVE: This study aims to assess the use, impact, and dissemination of preprints in dentistry. METHODS: This is a meta-research study with a cross-sectional design. We included preprints published in dentistry, regardless of the year of publication. Searches were performed in the medRxiv.org and Preprints.org platforms and restricted to English. One researcher extracted the data, and another researcher verified data consistency. The following data were extracted: year of publication, country of the corresponding author, number of abstract and full-text views and downloads, Altmetric attention score, whether the preprint was mentioned in other servers such as Twitter and Publons, number of mentions in other servers, number of citations in the Dimensions database, and whether the preprint had already been published in a peer-reviewed journal. If already published, we extracted the journal's impact factor (JCR 2021) and the number of citations in the Dimensions database. We conducted a descriptive analysis of the extracted characteristics and explored relationships between metrics using the Spearman correlation. RESULTS: We identified 276 preprints. Most of the studies were published between 2020 and 2022 (n = 229), especially those from ten countries. The most-cited preprint and published article are the same study. Only the correlation between the number of preprint citations and peer-reviewed article citations in the Dimensions database showed a large positive association (Spearman's rho = 0.5809). CONCLUSION: Preprints gained popularity over the last several years due to the COVID-19 pandemic and reached a larger audience, especially on platforms such as Twitter. CLINICAL SIGNIFICANCE: Preprint publishing allows faster dissemination of science for the benefit of society.

Metaresearch study highlights the gender gap in randomized controlled trials in dentistry.

BACKGROUND AND OBJECTIVES: This study aimed to assess the gender gap in randomized controlled trials (RCTs) in dentistry in terms of authorship, collaborations, metrics, funding and reporting of good research practice and transparecy. METHODS: The search was performed in PubMed for RCTs restricted to English texts in the dental field, indexed from 12/31/2016 to 12/31/2021. Two reviewers screened the studies in line with the eligibility criteria. A total of 844 articles were included. The name and gender of authors, citation metrics, funding, reporting of characteristics of good research practice and transparency were extracted. We considered "collaboration between authors" when the corresponding author was different from the first author. RESULTS: The proportion of women as first authors was 46.56% and 40.12% for corresponding authors. The analysis showed that when a woman is the corresponding author, the probability of the first author also being a woman is 57% higher compared to the first author being a man. For "protocol registration" and "data sharing," the prevalence of reporting was higher when women were first authors. CONCLUSION: A gender gap in dentistry RCTs was identified and related to the participation of women as first and corresponding authors and the collaboration between authors.

Does bullying due to oral conditions influence cigarette smoking in adolescents? A structural equation modeling.

This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.

There is room for improvement in the use of scoping reviews in dentistry.

OBJECTIVE: To evaluate the reporting of authors' justifications for choosing the scoping review methodology in oral health. STUDY SELECTION, DATA AND SOURCE: This is a meta-research study about scoping reviews in dentistry. This study searched for reviews in PubMed and Scopus without year restrictions and restricted to English-language publications. Study selection was undertaken by two reviewers independently. Each of these reviewers extracted data from half of the included studies considering general study characteristics and scoping reviews objectives, as well as data about whether or not the authors clearly explained why they chose the scoping review framework. RESULTS: We included 184 articles. Ninety-seven of the reports did not provide a rationale as to why they chose the scoping review method (52.7%). Regarding the reported aims of the studies, 29.9% (n = 29/87) of the scoping reviews presented more than one. When comparing studies reporting the use of the PRISMA-ScR to those not reporting the PRISMA-ScR, there is no difference in the reporting of a clear explanation of why the authors used a scoping review method. CONCLUSION: There is room for improvement in how authors report their justifications for choosing the scoping review method. CLINICAL SIGNIFICANCE: Scoping reviews may be used by researchers who are unaware of this method. Educational initiatives should thus be encouraged.

Self-reported oral health and normative indices of dental caries among adolescents: a cohort study.

This study assessed the association between self-reported oral health and the normative indices of dental caries in an adolescent population. This study is based on a 6-year data from a cohort, beginning in 2012, with 1,134 twelve-year-old adolescents. After three phases of data collection, 68% of the samples were followed up. Self-reported oral health was evaluated through the question: "Would you say that the health of your teeth, lips, jaws, and mouth is …?", and answers were categorized as "good" or "poor." Calibrated dentists examined clinical conditions using the decayed, missing, and filled teeth (DMFT) index. Statistical analysis was performed using multilevel logistic regression models, considering the dependence of those observed thrice and adjusted for demographic, socioeconomic, and dental visit variables. Adolescents who evaluated their oral health as poor had higher mean DMFT (OR: 1.35; CI95% 1.22-1.50). When evaluated separately, decayed (OR: 2.43; CI95% 1.83-3.23) and missing (OR: 3.94; CI95% 1.26-12.26) teeth also presented significant results, showing poor self-reported oral health associated with a higher mean. Adolescents' self-perceived oral health was associated with normative dental caries indices, and this association was maintained throughout adolescence.

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study.

BACKGROUND: Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance. OBJECTIVE: To ascertain the prevalence of self-reported xerostomia and to identify associated factors. DESIGN AND SETTING: Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality. METHODS: Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models. RESULTS: The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030). CONCLUSIONS: Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Influence of low-level laser therapy on implant stability in implants placed in healed sites: a randomized controlled trial.

BACKGROUND: The present study aims to assess the influence of low-level laser therapy (LLLT) on stability in implants placed in healed sites. MATERIAL AND METHODS: The present study followed the SPIRIT statement and is reported according to CONSORT. Patients were randomly allocated to LLLT or control groups. LLLT consisted in the application of 808-nm GaAlA laser applied before the preparation of the implant bed and after suturing (80 seconds; 11J/cm2). Implant stability quotient (ISQ) and the distance between the implant platform to the alveolar bone crest (millimeters) were assessed at implant placement (T0) and the abutment selection phase (4-6 months, Ta). RESULTS: A total of 64 implants were placed in 33 patients. The insertion torque ranged from 10 to 70 N.cm (mean 43.23; SD ±16.82). The T0 ISQ ranged from 18 to 95.5 (mean 61.7; SD ±18.23) and the crestal bone radiographic distance was 2.03 mm (SD±1.27). At Ta, the ISQ ranged from 39 to 90 (mean 64.2; SD±9.84), and the mean crestal bone radiographic loss was 1.70mm (SD±1.65). However, no differences were observed when LLLT and control groups were compared with ISQ difference (Ta-T0; p=0.598) or radiographical peri-implant alterations (p=0.531). CONCLUSION: LLLT did not influence the implant stability in implants placed in healed sites compared to a control group. TRIAL REGISTRATION: ReBEC, RBR-35TNJ7 . Registered May 23, 2018.

Racial and regional inequalities of dental pain in adolescents: Brazilian National Survey of School Health (PeNSE), 2009 to 2015.

The aim of the study is: (a) investigate the racial inequalities as one specific dimension that affects dental pain in Brazilian adolescents; and (b) investigate the regional variations of dental pain. This cross-sectional study used data from Brazilian National Survey of School Health (PeNSE), carried out with adolescents in 2009, 2012 and 2015. Dental pain was evaluated through the question: "Did you have dental pain in the last six months?". The main exposures were race and Brazilian regions, used to evaluate inequalities related to the outcome. Sex, age, school type and maternal education were used as covariables. The statistical significance of the trends in dental pain was tested using linear regression. The analysis was conducted in Stata 13.0 statistical package using the svy command. The standard prevalence of dental pain was 18.8%, 21.1% and 23.7%, showing an increasing trend over time (p < 0.001). We observed absolute inequalities in dental pain related to race and regions. A higher prevalence was found in non-white girls of public schools and in the Northern Region. The indexes of inequalities increased in the group of black girls, related to an increase of dental pain predominantly in girls whose mothers had lower educational level. It was observed that the prevalence of dental pain in Brazilian adolescents increased over time as well as its inequalities, which remained in marginalized populations and linked to Brazilian regions.