Contextual and individual determinants of tooth loss in adults: a multilevel study.

BACKGROUND: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. METHODS: This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. RESULTS: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. CONCLUSIONS: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

Gender differences in predictors of self-rated health among older adults in Brazil and Chile.

BACKGROUND: The determinants of self-rated health (SRH) have been widely investigated to explain social differences and gender differences in health. This study aimed to investigate the gender differences in predictors of SRH among Brazilian and Chilean older adults. METHODS: We used two samples of older people: 2052 Brazilian community-dwelling participants (1226 women and 862 men) and 1301 Chilean community-dwelling participants (855 women and 446 men). Sequential logistic regression analysis was used to examine the relationships between SRH and potential predictors in a hierarchical model. RESULTS: Overall, 35.5% and 52.1% of individuals in Chile and Brazil, respectively, reported good SRH. There was a gradient association between good SRH and chronic diseases in both countries. Chilean men without chronic disease or with one had a higher chance of good SRH, compared to two or more diseases. For Brazilian men, no or one chronic disease was associated with good SRH. For women, the set of independent predictors for good SRH included no chronic diseases or one chronic disease, and no activities of daily living limitation. For men, the set also included instrumental activities limitation. For Brazilian adults of both genders, depression demonstrated the strongest independent association with good SRH. CONCLUSIONS: We conclude that when examining gender differences in predictors of SRH, the similarities are greater than the differences between Brazilian and Chilean older adults. In both countries, physical health was the most important predictor of SRH. In addition, absence of depression was the strongest predictor of good health in older Brazilian adults.

Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults.

BACKGROUND: In Brazil, a rapidly aging country suffering from large inequalities, the study of the quality of life (QOL) of aged people is important for the future health. The aim of this study was to examine the associations among QOL, gender, and physical and psychosocial health in older Brazilian community-dwelling adults to identify factors that are associated with better QOL. METHODS: The "Aging, Gender and Quality of Life (AGEQOL)" study, which included 2,052 respondents aged 60 or older, was conducted in Sete Lagoas, Brazil between January and July 2012. The respondents answered questions regarding their socioeconomic and demographic information, health and social situations, cognitive impairment, depressive symptoms and family satisfaction. The authors also applied the Brazilian version the World Health Organization Quality of Life QOL Assessment-Brief Instrument (WHOQOL-BREF) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Ordinal logistic regression with the Proportional-Odds and Logit function was used to test the association between QOL and physical and psychosocial health according to age and socioeconomic status. RESULTS: Older adults of both genders with five or more years of education, good self-rated health, an absence of depressive symptoms, and no family dysfunction reported better QOL. Retired men had a better QOL compared to non-retired men (OR = 2.2; 95% CI = 1.4-3.2), but this association was not observed in females. Men living in mixed arrangements (OR = 0.5; p = 0.033) and women who did not practice physical activity (OR = 0.7; p = 0.022) tended to have poorer QOL. CONCLUSIONS: We conclude that there are gender differences related to better QOL in this sample. Women with good physical and psychosocial health are more likely to have a better QOL. For men, the best QOL was associated with high socioeconomic conditions and good physical and psychosocial health.

Validity and reproducibility of the revised oral assessment guide applied by community health workers.

OBJECTIVE: To determine the validity and reproducibility of the Revised Oral Assessment Guide (ROAG) as pre-diagnostic tool used in elderly citizens by community health workers (CHWs) of the Family Health Strategy (FHS). MATERIAL AND METHODS: Initially, we adjusted the English version to Portuguese and then developed a training program for use of ROAG, with the participation of CHWs, in selected districts that had the highest enrolled number of elderly people in the city. The elderly persons were distributed among 10 previously trained CHWs. To assess the validity of the ROAG, a CHW and a dentist (considered as the gold standard) independently evaluated the same individual. The reproducibility of the ROAG was evaluated by each of the CHWs examining 5-6 elderly individuals twice with a 7-day interval. RESULTS: The sensitivity ranged from 0.17 for evaluation of saliva to 0.80 for voice. The specific ranged from 0.69 for teeth/dentures to 0.98 for saliva using mirror and the accuracy ranged from 0.92 for swallow to 0.64 for mucosa. The intra-rater reproducibility of the ROAG was perfect for evaluation of voice, lips and swallow (κ=1.000). CONCLUSION: When used by trained CHWs, the ROAG is a tool with high sensitivity and specificity to assess voice, swallowing, tongue and teeth/dentures. Moreover, it can efficiently detect patients showing no alteration in lips, saliva, mucosa and gums. High reproducibility was observed in almost all the categories. Trained CHWs can use this tool to improve the access of elderly patients to dental services.

Impact of aesthetic restorative treatment on anterior teeth with fluorosis among residents of an endemic area in Brazil: intervention study.

BACKGROUND: Endemic dental fluorosis has already been described in some regions of the world. The aim of this study was to evaluate the functional and psychosocial impact of direct aesthetic restorative treatments in endemic fluorosis patients in the northern state of Minas Gerais, Brazil. Was a quasi-experimental intervention study. METHODS: The reference population consisted of individuals between 9 and 27 years of age that were served by a project intended to recover the smiles of patients with severe fluorosis. The questionnaires were administered on two occasions, 24 months apart (before and after dental treatment). Initially, descriptive analyses were conducted. Prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders were estimated based on the Oral Health Impact Profile instrument (OHIP-14). Comparisons between baseline and follow-up and between treatment techniques were carried out using the McNemar, Wilcoxon, and Mann-Whitney tests. RESULTS: The study involved 53 individuals, with a mean age of 15.9 years, treated with microabrasion, dental composite, or a combination of both techniques. The treatments performed proved to be competent for reducing the functional and psychosocial impact of oral disorders as measured by the OHIP-14, pointing to the possibility of establishing protocols to be used in programs aimed at restoring the aesthetics and functionality of the anterior teeth in large populations. CONCLUSIONS: After performing the direct aesthetic restorative treatments in patients with endemic fluorosis, a significant improvement was observed in the prevalence and severity, as well as the extent of the functional and psychosocial impact of oral disorders.

Health Professionals: Identifying and Reporting Child Physical Abuse-a Scoping Review.

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category.

Social determinants of health and periodontal disease in Brazilian adults: a cross-sectional study.

BACKGROUND: Recently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants. METHODS: A cross-sectional study was performed using a sample of 743 adults (aged 35-49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health. RESULTS: The periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4-5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9-12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4-5 mm. The members of this group were typically white men aged 40-44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers. CONCLUSION: The results suggest that periodontal health is worse in the group for which the social indicators are worse. Therefore, the social determinants of health also affect the severity of periodontal disease in adults Brazilian society.

Development and Validation of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 Years of Age (QoL-N-Kids 8-10).

Create and evaluate the psychometric properties of the Quality of Life in the Neighborhood Questionnaire for Children 8 to 10 years of Age (QoL-N-Kids 8-10). The present study was conducted in a medium-sized city in southeastern Brazil with children at four public schools and one private school. The study involved three phases: a) generation and validation of the content of the items through a qualitative study and expert panel (n = 8); b) face validity through a pilot study and interviews with children (n = 30); and c) application of the final version (n = 261) for the evaluation of internal consistency, temporal stability, construct validity and discriminant validity. All statistical tests applied during this step were interpreted considering a 5% significance level. Among the 56 items generated, 38 were maintained in the scale and submitted to face validation. In this phase, the children suggested the inclusion of an additional item, resulting in a measure with 39 items. The questionnaire was submitted to reliability tests (Cronbach's alpha) and exploratory factor analysis, leading to a questionnaire with 27 items distributed among five domains. The measures exhibited good internal consistency (Cronbach's alpha = 0.805) and good test-retest reliability (weighted Kappa = 0.305 to 0.724; intraclass correlation coefficient = 0.917). Regarding discriminant validity, differences between groups (p < 0.001) were found for sex, age, income and place of residence. The QoL-N-Kids 8-10 instrument exhibited satisfactory psychometric properties and has potential for the assessment of neighborhood quality of life in children eight to ten years of age.

Validation of a child dental pain questionnaire instrument for the self-reporting of toothache in Children.

PURPOSE: The purpose of the present study was to test the reliability and validity of a novel child dental pain questionnaire (child-DPQ). METHODS: The child-DPQ is structured to measure toothache using 3 subscales: (1) prevalence; (2) severity; and (3) impact on daily life. It was tested on 174 8- and 9-year-old children. The instrument's reliability was assessed by testing internal and test-retest consistency, and its validity was assessed by testing construct and discriminant validity. Specifically, discriminant validity was tested by comparing the mean scores of 2 clinical groups: (1) absent or treated caries (N =110); and (2) untreated caries (N =64). RESULTS: Internal consistency was confirmed by a Cronbac's alpha coefficient of 0.93. Test-retest reliability was found to be highly reproducible (intraclass correlation coefficient=0.99). The construct validity was satisfactory, demonstrating highly significant correlations among the global indicator, the total score, and subscale scores (P<.001). The child-DPQ score was able to discriminate between the 2 clinical groups (P<.001). CONCLUSION: The present study provides evidence for the reliability and validity of the child dental pain questionnaire in assessing the impact of toothache on the daily life of children.

Facial Injuries and the Gender Issue: Expressions of Violence in a Metropolitan Region of Northeastern Brazil.

The aims of this investigation were to describe the profile of men and women victims of violence and identify factors associated with the severity of facial trauma. A retrospective study was carried out from 762 records of victims attended at the Institute of Legal Medicine and Dentistry located in a metropolitan region of Northeastern Brazil. The dependent variable was type of facial trauma suffered by victims. Independent variables were the sociodemographic characteristics of victims, characteristics of aggressors and circumstances of violence. Descriptive, bivariate (c2 test) and multivariate statistics were made through logistic regression. Level of significance was set at p < 0.05. The mean age of victims was 29.78 years (SD=13.33). Based on the final regression model, male subjects [odds ratio (OR)=2.22, 95% CI=1.08-4.57, p=0.030], assaulted by other male subjects (OR=4.88; 95% CI=1.12-21.26; p=0.035) through instrument (OR=6.67; 95% CI=2.85-15.60; p<0,001) or mixed aggressions (OR=4.34; 95% CI=1.44-13.02; p=0.009) were more likely to exhibit facial bone fractures or dentoalveolar fractures. The findings highlight that men and women present important victimization differentials in relation to interpersonal violence and facial trauma. Victim's gender, aggressor's gender and mechanism of aggression may exert influence on facial trauma patterns.

Prevalence and factors associated to dental trauma in infants 1-3 years of age.

The aims of this study were to assess the epidemiology of traumatic dental injuries (TDI) to primary teeth in infants and toddlers between 1 and 3 years of age and investigate whether TDI was related to biological and social factors. A representative sample of infants and toddlers in the city of Belo Horizonte, Minas Gerais, Brazil (n = 519) was examined during a vaccination campaign. The evaluation of clinical signs of previous dental trauma was performed by nine previously calibrated examiners (intra-examiner Kappa = 0.95%; inter-examiner Kappa = 0.88%). Data were analysed through descriptive analysis, the chi-squared test (P < 0.050) and logistic regression. The prevalence of dental trauma was 41.6%. Among the 519 children examined, 193 (37.2%) had enamel fractures, 30 (5.7%) had enamel-dentin fractures and only three (0.6%) had enamel-dentin fractures involving the pulp. Dental care had been performed within the first 24 h in 4.1% of the sample and after 36 h in 0.8% of the sample. There was no statistically significant difference between genders. The most reported aetiologies were falls (28.8%) and collisions (6.8%). There were no statistically significant associations between the prevalence of dental trauma and non-nutritive sucking habits, dental caries or lip incompetence (P > 0.050). Children of mothers with low levels of schooling (0-6 years of study) had a greater prevalence of TDI (P = 0.001). The results of the logistic regression also demonstrated a significant association between dental injury and the Social Vulnerability Index (P = 0.045). Children from families with high social vulnerability (worse living conditions) had a 1.51 (95% confidence interval 1.0-2.2) greater chance of exhibiting TDI. These results can help guide the implementation of health promotion policies.

Complete removable prostheses: from expectation to (dis)satisfaction.

OBJECTIVE: The purpose of this survey was to increase our knowledge on the experience and feelings of edentulous people, 6 months after having acquired and worn a pair of complete removable prostheses. BACKGROUND: The incorporation of conventional, complete removable prostheses may be an appropriate treatment which can result in an improvement in the quality of life of people who have lost their teeth. METHODS: The 12 patients of the sample were interviewed individually according to a semi-structured questionnaire so as to create an atmosphere for open conversation regarding the subject matter. For each participant, photographs, before dental treatment and after the use of the prostheses, were taken. The images of the prostheses were reviewed and impressions were collected. RESULTS: The analysis of participant's statements allowed one to verify if the complete removable prostheses improved the quality of life; however, difficulties encountered could lead users to abandon their prostheses. CONCLUSION: Appropriate investment on the part of health professionals, together with the clarification of information and the monitoring of patients, may well minimise these difficulties.

Epidemiological and spatial characteristics of interpersonal physical violence in a Brazilian city: A comparative study of violent injury hotspots in familial versus non-familial settings, 2012-2014.

This study explores both epidemiological and spatial characteristics of domestic and community interpersonal violence. We evaluated three years of violent trauma data in the medium-sized city of Campina Grande in North-Eastern Brazil. 3559 medical and police records were analysed and 2563 cases were included to identify socioeconomic and geographic patterns. The associations between sociodemographic, temporal, and incident characteristics and domestic violence were evaluated using logistic regression. Using Geographical Information Systems (GIS), we mapped victims' household addresses to identify spatial patterns. We observed a higher incidence of domestic violence among female, divorced, or co-habitant persons when the violent event was perpetrated by males. There was only a minor chance of occurrence of domestic violence involving firearms. 8 out of 10 victims of domestic violence were women and the female/male ratio was 3.3 times greater than that of community violence (violence not occurring in the home). Unmarried couples were twice as likely to have a victim in the family unit (OR = 2.03), compared to married couples. Seven geographical hotspots were identified. The greatest density of hotspots was found in the East side of the study area and was spatially coincident with the lowest average family income. Aggressor sex, marital status, and mechanism of injury were most associated with domestic violence, and low-income neighbourhoods were coincident with both domestic and non-domestic violence hotspots. These results provide further evidence that economic poverty may play a significant role in interpersonal, and particularly domestic violence.

Endodontic teleconsulting by Telehealth in Minas Gerais state, Brazil / Teleconsultorias endodônticas do Telessaúde no estado de Minas Gerais, Brasil

Abstract Background The Telehealth Brazil Program aims to improve the quality of Primary Health Care. Objective This cross-sectional study evaluated the Telehealth Brazil Networks Program's dental teleconsulting in Minas Gerais state to elucidate the prevalent questions in endodontics. Method Secondary databases of offline dental teleconsulting from the Clinical Hospital and Medical School of the Universidade Federal de Minas Gerais from July 2015 to July 2017 were used. The variables analyzed were telehealth center, dental specialty and sub-area, and question type. The results were descriptively analyzed using the SPSS v.22.0 program. Results A total of 3,920 teleconsulting sessions were carried out. Endodontics was the field with the sixth-highest demand for questions (7.4%). The most prevalent endodontic questions were related to pulpal and periapical alterations (32.3%), being more related to diagnosis, followed by dental trauma (15.6%), endodontic emergencies (11.4%), and intracanal medication (7.3%), all of them with most questions related to clinical conduct. Conclusion The endodontic field questions were related to prevalent conditions in the daily activities of the primary health care professionals. It is crucial to continuously update the professionals through continuing education programs and the search for new knowledge to reinforce these competencies.

Resumo Introdução O Programa de Telessaúde tem o objetivo de aprimorar a qualidade da Atenção Primária em Saúde. Objetivo Este estudo transversal avaliou as teleconsultorias odontológicas do Programa Telessaúde Brasil Redes em Minas Gerais para elucidar as dúvidas prevalentes em endodontia. Método Bancos de dados das teleconsultorias offline de odontologia do Hospital das Clínicas e Faculdade de Medicina da Universidade Federal de Minas Gerais de Julho de 2015 a Julho de 2017 foram utilizados. As variáveis analisadas foram: núcleo de telessaúde, especialidade odontológica e subárea, e tipo de dúvida. Resultados Os resultados foram analisados descritivamente utilizando o programa SPSS v.22.0. Um total de 3920 teleconsultorias foi realizada. A Endodontia foi a área com a sexta maior demanda por dúvidas (7,4%). As dúvidas endodônticas mais prevalentes foram relacionadas às alterações pulpares e perirradiculares (32,3%), sendo mais relacionadas ao diagnóstico, seguidas por trauma dentário (15,6%), emergências endodônticas (11,4%) e medicação intracanal (7,3%), sendo a maioria das dúvidas relacionadas à conduta clínica. Conclusão As dúvidas na área endodôntica foram relacionadas a condições prevalentes nas atividades diárias dos profissionais da atenção primária a saúde. É crucial a atualização constante dos profissionais, por programas de educação continuada e pela busca por novos conhecimentos, reforçando essas competências.

Temporal trends in physical violence, gender differences and spatial vulnerability of the location of victim's residences.

The aim of study was to describe trends in physical violence among Brazilian victims and investigate spatial vulnerability of the location of victim's residences. This study performed an ecological-level longitudinal analysis, examining violence rates over 4 years. Cases of 4795 victims of physical aggression attended at a Center of Legal Medicine were investigated. Trend analysis was used to evaluate the data, with the creation of polynomial regression models (p < 0.05). Violence rates showed significant temporal variations according to sociodemographic characteristics of victims (p < 0.05) and the circumstances of aggressions (p < 0.05). Moreover, there was a significant increase in violence rate in the North (R2 = 16.1%; p = 0.019) and South (R2 = 18.4%; p = 0.010), whereas the rural zone (R2 = 10.1%; p = 0.028) presented a decrease. The findings highlight the need for protection policies that address spatial-temporal aspects.

Associations between oral disorders and the quality of life of older adults in Brazil.

AIM: To evaluate the effect of oral disorders on the quality of life of older adults. METHODS: A cross-sectional study of older adults (aged ≥ 60 years) who reside in a small Brazilian city was carried out. Trained and calibrated academics and dentists collected the data. The analyses carried out were descriptive, univariate and multiple through logistic regression using pasw Statistics 18.0 software. RESULTS: A total of 351 older adults were included in the study. The majority of older adults did not express impacts as a result of oral disorders. The physical domain of quality of life was compromises more in older adults who had physical incapacities related to oral health (odds ratio 3.62, 95% confidence interval 1.34-9.73). CONCLUSION: In general, among the older adults evaluated, it was found that both the overall score and the individual scores for the four domains of quality of life were influenced by one of the seven domains of the impacts of oral disorders.

[Determinants of active aging according to quality of life and gender]. / Determinantes do envelhecimento ativo segundo a qualidade de vida e gênero.

The scope of this study was to construct an indicator of active aging and assess its association with quality of life and possible determinants according to gender. The AGEQOL (Aging, Gender and Quality of Life) study was used to interview 2052 individuals aged 60 years and older residing in Sete Lagoas in the State of Minas Gerais. The association between active aging, quality of life and possible determinants was performed by multiple logistic regression with a 5% level of statistical significance separately for each gender. Most men were in the active aging group (58%), and 51.8% of women were in the normal aging group (p < 0.001). The quality of life in the Physical, Psychological, and total Score domains remained associated with the outcome in the final model for both genders. Among the men, the behavioral and community participation factors were positive predictors of active aging. Women with higher incomes, who did not suffer falls and engaged in community participation, had a better chance of belonging to the active aging group. The conclusion drawn is that quality of life and participation in groups are the main determinants of active aging, and the other factors associated with active aging are different for each gender.

Measuring social capital through multivariate analyses for the IQ-SC.

BACKGROUND: Social capital can be viewed as a societal process that works toward the common good as well as toward the good of the collective based on trust, reciprocity, and solidarity. Our study aimed to present two multivariate statistical analyses to examine the formation of latent classes of social capital using the IQ-SC and to identify the most important factors in building an indicator of individual social capital. FINDINGS: A cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample consisted of 363 individuals, and data were collected using the World Bank Questionnaire for measuring social capital. First, the participants were grouped by a segmentation analysis using the Two Step Cluster method based on the Euclidian distance and the centroid criteria as the criteria for aggregate answers. Using specific weights for each item, discriminant analysis was used to validate the cluster analysis in an attempt to maximize the variance among the groups with respect to the variance within the clusters. "Community participation" and "trust in one's neighbors" contributed significantly to the development of the model with two distinct discriminant functions (p < 0.001). The majority of cases (95.0%) and non-cases (93.1%) were correctly classified by discriminant analysis. CONCLUSIONS: The two multivariate analyses (segmentation analysis and canonical discriminant analysis), used together, can be considered good choices for measuring social capital. Our results indicate that it is possible to form three social capital groups (low, medium and high) using the IQ-SC.

Facial injuries and the gender issue: expressions of violence in a metropolitan region of Northeastern Brazil

Abstract The aims of this investigation were to describe the profile of men and women victims of violence and identify factors associated with the severity of facial trauma. A retrospective study was carried out from 762 records of victims attended at the Institute of Legal Medicine and Dentistry located in a metropolitan region of Northeastern Brazil. The dependent variable was type of facial trauma suffered by victims. Independent variables were the sociodemographic characteristics of victims, characteristics of aggressors and circumstances of violence. Descriptive, bivariate (c2 test) and multivariate statistics were made through logistic regression. Level of significance was set at p < 0.05. The mean age of victims was 29.78 years (SD=13.33). Based on the final regression model, male subjects [odds ratio (OR)=2.22, 95% CI=1.08-4.57, p=0.030], assaulted by other male subjects (OR=4.88; 95% CI=1.12-21.26; p=0.035) through instrument (OR=6.67; 95% CI=2.85-15.60; p<0,001) or mixed aggressions (OR=4.34; 95% CI=1.44-13.02; p=0.009) were more likely to exhibit facial bone fractures or dentoalveolar fractures. The findings highlight that men and women present important victimization differentials in relation to interpersonal violence and facial trauma. Victim's gender, aggressor's gender and mechanism of aggression may exert influence on facial trauma patterns.

Resumo Os objetivos desta investigação foram descrever o perfil de homens e mulheres vítimas de violência e identificar fatores associados à gravidade do trauma facial. Foi realizado um estudo retrospectivo de 762 prontuários de vítimas atendidas no Instituto de Medicina Legal e Odontologia de uma região metropolitana do Nordeste do Brasil. A variável dependente foi o tipo de trauma facial sofrido pelas vítimas. Variáveis ​​independentes foram as características sociodemográficas das vítimas, características dos agressores e circunstâncias de violência. Estatísticas descritivas, bivariadas (teste c2) e multivariadas foram feitas por meio de regressão logística. O nível de significância foi fixado em p<0,05. A idade média das vítimas foi de 29,78 anos (DP =13,33). Com base no modelo de regressão final, os indivíduos do sexo masculino [odds ratio (OR)=2,22, IC 95%=1,08-4,57, p=0,030], agredidos por outros sujeitos do sexo masculino (OR=4,88; IC 95%=1,12-21,26; p=0,035) por meio de instrumentos (OR=6,67; IC 95%=2,85-15,60; p<0,001) ou agressões mistas (OR=4,34; IC 95%=1,44-13,02; p=0,009) foram mais propensos a apresentar fraturas de ossos faciais ou fraturas dentoalveolares. Os achados apontam que homens e mulheres apresentam importantes diferenciais de vitimização em relação à violência interpessoal e trauma facial. O gênero da vítima, o gênero do agressor e o mecanismo de agressão podem exercer influência sobre os padrões de trauma facial.

Is there an association between traumatic dental injury and social capital, binge drinking and socioeconomic indicators among schoolchildren?

OBJECTIVES: Traumatic dental injury is defined as trauma caused by forces on a tooth with variable extent and severity. The aim of the present study was to investigate the prevalence of traumatic dental injury and its association with overjet, lip protection, sex, socioeconomic status, social capital and binge drinking among 12-year-old students. RESEARCH DESIGN AND METHOD: A cross-sectional study was conducted with a sample of 633 12-year-old students. Data were collected through a clinical exam and self-administered questionnaires. Socioeconomic status was determined based on mother's schooling and household income. The Social Capital Questionnaire for Adolescent Students and Alcohol Use Disorders Identification Test (AUDIT-C) were used to measure social capital and binge drinking, respectively. RESULTS: The prevalence of traumatic dental injury was 29.9% (176/588). Traumatic dental injury was more prevalent among male adolescents (p = 0.010), those with overjet greater than 5 mm (p < 0.001) and those with inadequate lip protection (p < 0.001). In the multiple logistic regression analysis, overjet [OR = 3.80 (95% CI: 2.235-6.466), p < 0.0001], inadequate lip protection [OR = 5.585 (95% CI: 3.654-8.535), p < 0.0001] and binge drinking [OR = 1.93 (95% CI: 1.21-3.06), p = 0.005] remained significantly associated with traumatic dental injury. CONCLUSIONS: The present findings suggest that a high level of total social capital and trust are not associated with TDI in adolescents, unlike binge drinking. The effects of social and behavioral factors on TDI are not well elucidated. Therefore, further research involving other populations and a longitudinal design is recommended.