The vicious cycle of dental fear at age 31 in a birth cohort in Southern Brazil.

OBJECTIVES: This longitudinal study assessed the prevalence of dental fear in adulthood and the association with socio-economic, behavioural and clinical variables. Also, the existence of a vicious cycle of dental fear was tested. METHODS: A random sample of adults (n = 535) from the 1982 Pelotas Birth Cohort, Brazil, was selected. Socio-economic data, behavioural characteristics and clinical variables were collected during different cohort waves. Oral health data were collected at ages 15, 24 and 31 years old, using questionnaires and oral examination. Dental fear (the outcome) was assessed by the question: 'Are you afraid of going to the dentist?', with possible responses: dichotomized into 'No' or 'A little/Yes/A lot'. Exposure variables were as follows: dental visit in the last years (at the ages 15 and 31); caries experience (DMFT ≥ mean) at the ages 15 and 31; the trajectory of caries prevalence from 15 to 31 years old; dental pain in the last six months in the two ages evaluated; and self-rated oral health at age 31. Several multivariable Poisson regression models were used to investigate the association between each of the exposure variables and dental fear. RESULTS: Dental fear prevalence was 22.1%, and it was more prevalent among non-white individuals and females. After controlling for potential confounders, dental fear was more likely to be reported by those individuals who had dental pain or a higher prevalence of dental caries at the age 15. Dental fear was also associated with a worse trajectory of dental caries, negative self-rated oral health at age 31 and with not having visited the dentist in the last year (at the age 31). Results supported the proposed vicious cycle of dental fear. CONCLUSIONS: Dental fear in adulthood was related to exposures occurring across the lifecourse. Also, it was possible to observe the occurrence of the vicious cycle of dental fear in the 1982 Pelotas Birth Cohort. Therefore, preventive measures during different periods of the life course are required to prevent dental fear and adulthood.

The impact of cyberbullying on schoolchildren's dental anxiety in Brazil: A cross-sectional multi-level study.

OBJECTIVES: This cross-sectional study assessed the correlation between individual and school-related social environment variables with dental anxiety in Brazilian schoolchildren aged 8-12 years. METHODS: A sample of children from 20 private and public schools (n = 1211) from Pelotas, Brazil, were selected. Socioeconomic data were collected from parents, and data regarding children characteristics were collected using a questionnaire. Dental anxiety (the outcome) was assessed by the following question: 'Are you afraid of going to the dentist?' Dental examinations were performed to assess caries experience (DMFT ≥ 1). The social school environment was assessed by a questionnaire administered to schools' coordinators and considered: type of school, verbal violence between students, presence of gangs at school and cyberbullying episodes. Multilevel Poisson regression was used to investigate the association between school social environment and dental anxiety. RESULTS: The prevalence of dental anxiety was 9.1% (95%CI 7.5-10.8). For the individual variables, anxiety was more prevalent in girls [1.85 (1.21-2.81)], in children with less-educated mothers [1.50 (1.00-2.27)] and in children who never attended to the dentist [2.48 (1.65-3.72)]. For contextual variables, episodes of cyberbullying in school increased the prevalence of dental anxiety by almost 80% [1.78 (1.14-2.78)]. CONCLUSIONS: The school social environment influences dental anxiety. The results suggest that it is important to establish strategies focused on promoting healthier environments and preventing cyberbullying in order to reduce the occurrence of dental anxiety.

Developmental defects of enamel and dental caries in the primary dentition: A systematic review and meta-analysis.

OBJECTIVES: This systematic review and meta-analysis evaluated the association between developmental defects of enamel and dental caries in the primary dentition. SOURCES: Electronic searches were performed in PubMed, Web of Knowledge, Scopus and Scielo for the identification of relevant studies. STUDY SELECTION: Observational studies that examined the association between developmental defects of enamel and dental caries in the deciduous dentition were included. Additionally, meta-analysis, funnel plots and sensitivity analysis were employed to synthesize the available evidence. Multivariable meta-regression analysis was performed to explore heterogeneity among studies. DATA: A total of 318 articles were identified in the electronic searches. Of those, 16 studies were included in the meta-analysis. Pooled estimates revealed that children with developmental defects of enamel had higher odds of having dental caries (OR 3.32; 95%CI 2.41-4.57), with high heterogeneity between studies (I2 80%). Methodological characteristic of the studies, such as where it was conducted, the examined teeth and the quality of the study explained about 30% of the variability. Concerning type of defect, children with hypoplasia and diffuse opacities had higher odds of having dental caries (OR 4.28; 95%CI 2.24-8.15; OR1.42; 95%CI 1.15-1.76, respectively). CONCLUSIONS: This systematic review and meta-analysis demonstrates a clear association between developmental defects of enamel and dental caries in the primary dentition.

Perfil de saúde bucal de crianças internadas em Unidade de Pediatria de um Hospital Escola / Oral health status of children in the pediatric unit of a teaching hospital

Objetivo: O objetivo deste estudo foi avaliar o perfil de saúde bucal e hábitos de higiene bucal em crianças hospitalizadas. Métodos: Estudo do tipo transversal, realizado com crianças de 0 a 12 anos internadas na Unidade Pediátrica de um hospital de ensino do Sul do Brasil, no período de maio a novembro de 2012. A coleta de variáveis comportamentais (hábitos de higiene oral), socioeconômicas (renda familiar e escolaridade materna) e demográficas (idade e gênero da criança) foi realizada através de entrevista com as mães. As crianças foram examinadas para avaliação dos níveis de saúde bucal, incluindo índice de cárie e placa. Foram realizadas análise descritiva, teste Quiquadrado e exato de Fisher (p <0,05). Resultados: Das 63 crianças examinadas, 35 apresentavam pelo menos um dente em boca. Destas, 7 crianças (20%) apresentavam cárie dentária (ceod/ CPOD>0) e 22 (62,8%) tinham placa dentária visível. O hábito de higiene bucal foi relatado por 33 mães e 42 mães não haviam levado itens de higiene bucal para a criança. Análises bivariadas indicaram que as variáveis associadas com os hábitos de higiene bucal foram a idade da criança e o tipo de dentição (p <0,05). Conclusão: Constatou-se que os cuidados com a saúde bucal têm baixa prioridade durante a hospitalização da criança. Os resultados destacam a importância de promover saúde bucal e orientação preventiva para crianças hospitalizadas, pois agravos na saúde bucal podem conduzir a tratamentos mais complexos e prolongar o período de internação hospitalar.