Factors associated with the survival of primary maxillary anterior teeth after intrusive luxation: a retrospective longitudinal study.

PURPOSE: To evaluate the survival rate of primary maxillary anterior teeth following intrusive luxation and identify associated factors. METHODS: A retrospective longitudinal study was conducted at a primary dental trauma centre using 88 dental records of children with intrusive luxation between 2007 and 2018. The variables of interest were time the tooth remained in the alveolus, degree of intrusion, accentuated overjet, lip protection, visible plaque, compromised germ of the permanent successor, clinical signs of infectious and inflammatory processes, endodontic treatment, pulp canal obliteration, sex, age at the time of trauma, family income, mother's schooling, and immediate care. Descriptive, bivariate, and Cox regression analyses were performed (p < 0.05; 95% CI). RESULTS: The 88 dental records of children with intrusive luxation included 128 teeth. Survival rate throughout the follow-up period was 65.6% (n = 84). Age older than three years and eight months (HR 2.28; 95% CI 1.04-4.99; p = 0.039), the development of an infectious process (HR 3.51; 95% CI 1.39-8.86; p = 0.008), development of an inflammatory process (HR 2.35; 95% CI 1.17-4.71; p = 0.016) and compromised germ of the permanent successor (HR 4.38; 95% CI 1.99-9.61; p < 0.001) were associated with a lower survival rate of intruded primary maxillary anterior teeth. CONCLUSION: The survival rate during the follow-up period of intruded primary maxillary anterior teeth was considered high. A significantly lower survival rate was associated with age, the occurrence of an infectious process and inflammatory process, and the compromised germ of the permanent successor.

Cross-sectional study on factors associated with flossing in Brazilian young children.

PURPOSE: This cross-sectional study aimed at evaluating the factors associated with flossing by caregivers in Brazilian young children. METHODS: Its sample consisted of 305 children aged 1-3 and their mothers from the Brazilian city of Diamantina. They were selected through the Municipal Health Department from a list of registered children who had recently used the public health services. Data collection was done by means of the mothers answering a questionnaire which addressed economic and socio-demographic factors and also the mother and child characteristics and habits. In addition, an oral clinical examination was performed in order to assess Baume arch type and caries occurrence. Descriptive statistical analysis, chi-square test and Poisson regression were performed. RESULTS: It was found that the sample presented a prevalent flossing habit in 20.3% of the subjects. The flossing habit in the children was associated with the mothers' own habit of flossing daily (PR 2.32; 95% CI 1.12-4.82) and with the frequent children's tooth brushing by the mother (PR 2.85; 95% CI 1.05-7.76). CONCLUSION: A higher prevalence of flossing by caregivers in young children is associated with the mothers' own habit of flossing daily and with the frequent children's tooth brushing by the mother.

Perceived impact of dental pain on the quality of life of children aged 1-3 years and their families.

PURPOSE: To evaluate the perceived impact of dental pain on oral health-related quality of life (OHRQoL) among children aged 1-3 years and their families. METHODS: A cross-sectional study was conducted with 306 randomly selected preschool and day care children in the city of Diamantina, Brazil. Parents/caregivers answered a questionnaire on socio-demographic information, the Brazilian version of the Early Childhood Oral Health Impact Scale, their child's general/oral health and the Brazilian version of the Dental Discomfort Questionnaire. The children underwent an oral examination. Descriptive statistics, Spearman's correlations, the Kruskal-Wallis test, Mann-Whitney test and Poisson regression were used to determine associations between the variables (prevalence ratio [PR], α = 5%). RESULTS: The prevalence of dental caries and dental pain was 43.1% and 40.2%, respectively. Dental pain (PR: 1.96, 95% CI 1.52-2.54; p < 0.001), monthly household income (PR: 1.38, 95% CI 1.04-1.83; p = 0.026) and dental caries (PR: 1.06, 95% CI 1.03-1.10; p < 0.001) were significantly associated with the perceived impact on OHRQoL. CONCLUSIONS: Dental pain, household income and dental caries were associated with a negative impact on the OHRQoL of children aged 1-3 years and their families.

Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis.

AIM: To evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents. METHODS: Searches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I2 statistic and a random effect model was employed. Summary effect measures were calculated as differences in means. RESULTS: The initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26-30 vs. 31-35. CONCLUSIONS: Based on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Association between sense of coherence and oral health-related quality of life among toddlers.

OBJECTIVE: To assess the relationship between sense of coherence (SOC) and oral health-related quality of life (OHRQoL) among children aged one to three years. PARTICIPANTS: A cross-sectional study was conducted with 276 mother-child pairs randomly selected from the city of Diamantina, Brazil. METHOD: Information was obtained on socio-demographic factors. The short version of Antonovsky's sense of coherence scale (SOC 13) and the Early Childhood Oral Health Impact Scale (ECOHIS) were administered. The children were examined for dental caries. Statistical analysis involved descriptive statistics, the calculation of Spearman's correlation coefficients and adjusted Poisson regression models. RESULTS: SOC was significantly associated with the child's OHRQoL in the multivariate analysis. Children of mothers with high SOC (PR 0.96; 95%CI 0.93,0.98; p=0.045) had a lower prevalence of a negative impact on OHRQoL. Children with severe dental caries had a greater prevalence of a negative impact on OHRQoL (PR 2.53; 95%CI 1.77,3.62; p⟨0.001). CONCLUSIONS: Maternal SOC could be a psychosocial determinant of the OHRQoL of children aged one to three years. Severe dental caries was associated with poorer quality of life.

Maternal identification of dental caries lesions in their children aged 1-3 years.

AIM: To analyse the maternal identification of different stages of dental caries in children aged 1-3 years. METHODS: A cross-sectional study was conducted with 274 children and their mothers. The mothers answered a questionnaire on the occurrence of dental caries in their children and completed questions addressing their demographic/socio-economic status. The oral examination of the children was performed using the International Caries Detection and Assessment System. Descriptive, Chi square test and Poisson regression statistical analyses were performed. RESULTS: The prevalence of initial and established/severe dental caries lesions by age were: 1 year (23.2 and 24.2%), 2 years (17.9 and 55.7%) and 3 years (23.3 and 60.3%) respectively. Significant associations between clinical examinations and the mothers' reports were observed among children aged 1 year old who had initial stage caries lesions (p = 0.006) and in children aged 1, 2 and 3 years old who had established/severe stage caries lesions (p < 0.001). After adjustment for confounding variables it was found that mothers were more able to identify dental caries both at initial (PR 4.01, 95% CI 1.35-11.94) and established/severe stages (PR 9.14, 95% CI 2.49-33.56) in children aged 1 year old. In children aged 2 and 3 years, this identification was more evident in the established/severe stage (2 years, PR 2.98, 95% CI 1.42-6.26; 3 years, PR 2.75, 95% CI 1.09-6.93). CONCLUSIONS: Mothers of children aged 1 year old identified dental caries at initial and established/severe stages. Mothers of children aged 2 and 3 years identified dental caries only at established/severe stages.

Effect of dark discolouration and enamel/dentine fracture on the oral health-related quality of life of pre-schoolers.

AIM: To determine the effect of different types of dental trauma on oral health-related quality of life (OHRQoL) among pre-school children. METHODS: Four hundred fifty-nine Brazilian pre-schoolers aged 3-5 years were submitted to an oral examination in the school environment for the evaluation of dental trauma using the criteria proposed by Andreasen et al. (2007). Parents answered a questionnaire on the OHRQoL of the children using the Early Childhood Oral Health Impact Scale (ECOHIS) and another one on socio-demographic characteristics of the children and their families. The questionnaires were sent to the parents to be answered at home. Descriptive statistics, Mann-Whitney test and Poisson regression were used for statistical analysis. RESULTS: Children with dark discolouration and enamel-dentine fracture without pulp exposure had higher mean ECOHIS scores than those without these alterations. The multivariate regression analysis demonstrated that pre-school children with dark discolouration (PR 1.79; 95% CI 1.24-2.58) and enamel-dentine fracture without pulp exposure (PR 1.89; 95% CI 1.22-2.92) had a higher impact on quality of life than those without these alterations. CONCLUSION: Dark discolouration and enamel-dentine fracture without pulp exposure were associated with a negative impact on the life of pre-schoolers.

Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors.

AIM: To assess the impact of dental pain on the daily living of 5-year-old preschool children using reports from parents/guardians. DESIGN AND METHODS: A cross-sectional study was carried out involving 549 five-year-old children randomly selected from preschools in the city of Belo Horizonte, Brazil. Data were collected using a previously validated parent-reported questionnaire. The children received dental examinations from a single calibrated examiner. The following outcome variables were selected: age, gender, dental caries, filled teeth, missing teeth, caries involving pulp and social class. Simple and multiple logistic regression analyses were performed on the data. RESULTS: According to parents' reports, 11.1% of children were affected by dental pain in the previous 4 months and of these 72.6% had their daily activities hampered by pain. The majority of these children had difficulty in eating, brushing teeth, sleeping, playing and going to school. The impact of dental pain had a statistically significant association with gender (p=0.001), social class (p=0.009), dental caries (p<0.001), missing teeth (p<0.001), filled teeth (p<0.001) and caries involving pulp (p<0.001). CONCLUSION: The prevalence of difficulties performing tasks of daily living due to dental pain was relatively high among the children studied.

Impact of exposure to positive images on dental anxiety among children: a controlled trial.

AIM: To determine whether exposing children to images of positive dental care would have an effect on their degree of anxiety, assessing anxiety three separate times. STUDY DESIGN: Controlled trial. METHODS: The 70 participants from 4-11 years of age were randomly assigned to one of two conditions. The intervention consisted of viewing positive images of dentistry and dental treatment (n=35). The control condition consisted of dentally neutral images (n=35). OUTCOME MEASURES: Anxiety was assessed using the Venham Picture Test (VPT) prior to the intervention, immediately following the intervention and following the dental appointment. STATISTICS: Statistical analysis (chisquare and Mann-Whitney tests) was conducted blind to group allocation. RESULTS: No significant difference was detected between the scores of the VPT in the two groups at any evaluation time (p>0.05). Dental anxiety at the three evaluation times was not correlated to age. There was no difference in level of anxiety between male and female participants (p>0.05). CONCLUSIONS: Viewing positive images of dentistry and dentists did not have a greater effect on child anxiety in the dental setting than viewing neutral images, however, showed lower rates of anxiety for all children although this was not significant.

Self-perception regarding the need for orthodontic treatment among impoverished schoolchildren in Brazil.

AIM: The objectives of the present study were to assess predictive factors associated to self-perception regarding the need for orthodontic treatment among 170 impoverished schoolchildren. MATERIALS AND METHODS: A cross- sectional study was conducted in public schools in the city of Belo Horizonte-MG (Brazil). Children's self-perception regarding the need for treatment was assessed using the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) and a questionnaire addressing biopsychosocial factors. The chi-square test and multiple logistic regression were used in the data analysis. RESULTS: The predictive factors for the self-perception of orthodontic treatment need on the part of the impoverished schoolchildren included ridicule from persons close to the children regarding the appearance of the teeth (OR 2.81; 95%CI 1.2 to 6.4), dissatisfaction with oral aesthetics due to the alignment of the teeth (OR 2.45; 95%CI 1.1 to 5.4) and missing teeth (OR 3.02; 95%CI 1.0 to 9.23). CONCLUSION: The alignment of the teeth, missing teeth and ridicule from others regarding the appearance of the teeth are the factors that most strongly influence self- perception regarding the need for orthodontic treatment among impoverished schoolchildren.