Discrimination and dental students: What is the reality in Brazilian institutions?

INTRODUCTION: This study aimed to evaluate whether there is discrimination in the dental educational environment, assess the main reasons for the discriminatory events, and if there is an association between discriminatory episodes and sociodemographic characteristics of undergraduate dental students. MATERIALS AND METHODS: This observational cross-sectional study was conducted with a self-administered questionnaire to students enrolled in three Brazilian dental schools. Questions included sociodemographic characteristics and the occurrence of discriminatory episodes in the dental academic environment. Descriptive analysis was performed in RStudio 1.3 (R Core Team, RStudio, Inc., Boston, USA) software and the associations were tested using Pearson's chi-square test, considering 95% confidence intervals. RESULTS: A total of 732 dental students were included, with a response rate of 70.2%. The vast majority of students were female (66.9%), with white/yellow skin colour (67.9%), and with a mean age of 22.6 (SD 4.1) years. Sixth-eight percent of students reported having experienced some discrimination in the academic environment and most reported feeling uncomfortable with the episode. The main reasons to have been discriminated against raised by students were specific behaviour/habit, have specific moral, ethical, and aesthetic values, gender, and socioeconomic status or social class. The occurrence of discriminatory episodes was associated with female gender (p = .05), non-heterosexual sexual orientation (p < .001), studying in public institutions (p < .001), receiving an institutional scholarship (p = .018), and being in the final undergraduate cycle (p < .001). CONCLUSION: The occurrence of discriminatory episodes was common in Brazilian dental higher education. Discriminatory situations generate traumas and psychological marks, causing a loss of diversity within the academic environment that leads to loss of productivity, creativity, and innovation. Thus, strong institutional policies against discrimination are crucial to create a healthy dental academic environment.

Periodontal disease and preterm birth: Findings from the 2015 Pelotas birth cohort study.

OBJECTIVES: To verify the association between periodontal conditions and preterm birth. MATERIALS AND METHODS: This study used data from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth in 2015 were interviewed and dentally examined by a trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Exposure was periodontal disease. Outcomes were preterm birth (all births <37 weeks of gestational age) and early preterm birth (<34 weeks). Analysis was carried out using Poisson regression according to a directed acyclic graph. RESULTS: A total of 2,474 women participated in the study. Incidence of preterm births was 10.2% and of early preterm births was 3.5%. Frequency of gingivitis was 21.7%, and periodontitis was 14.9%. Periodontitis was associated with a risk almost two times higher of having early preterm delivery compared with healthy pregnant women (RR 1.93; 95% CI 1.09-3.43). Presence of 5+ mm periodontal pocket with bleeding on probing was also associated with higher risk for early preterm delivery. CONCLUSIONS: The association between periodontal disease in pregnancy and the occurrence of preterm delivery is sensitive to the case definitions. Periodontal disease increased the risk of early preterm delivery.

Restorations in primary teeth: a systematic review on survival and reasons for failures.

BACKGROUND: Several restorative materials with specific indications are used for filling cavities in primary teeth. AIM: To systematically review the literature in order to investigate the longevity of primary teeth restorations and the reasons for failure. DESIGN: Electronic databases were screened, and eligible studies were hand-searched to find longitudinal clinical studies evaluating the survival of restorations (class I, class II, and crown) placed with different materials in primary teeth with at least one year of follow-up. RESULTS: Thirty-one studies were included, and a high bias risk was observed. Overall, 12,047 restorations were evaluated with 12.5% of failure rate. A high variation on annual failure rate (AFR) was detected (0-29.9%). Composite resin showed the lowest AFRs (1.7-12.9%). Stainless steel crowns (SSC) had the highest success rate (96.1%). Class I restorations and restorations placed using rubber dam presented better AFR. The main reason for failure observed was secondary caries (36.5%). CONCLUSIONS: An elevated number of failures were observed due to recurrent caries, highlighting the need for professionals to work with a health-promoting approach. The high variation on failure rate among the materials can be due to children's behavior during the procedure, which demands short dental appointments and a controlled environment.

Validity of the Brazilian version of the Venham's behavior rating scale.

BACKGROUND: Venham's Behavior Rating Scale (VBRS) is a measure of uncooperative behavior developed to assess children's responses to dental stress. AIM: To evaluate the validity of the Brazilian version of the VBRS. DESIGN: Children aged 7-13 years were invited to participate in this study. Child behavior was concurrently assessed with both the VBRS and the Frankl Scale. A receiver operating characteristic curve (ROC) was plotted to determine the cut-off points of the Brazilian version of the VBRS. Criterion validity was determined using Spearman's correlation coefficient. Discriminant validity was tested before and after scale dichotomization. RESULTS: A total of 265 children participated in this study. According to the ROC curve, the ≥1 cut-off point was best for this population (SENS 97.4%; SPEC 94.7%). The Brazilian version of the VBRS was significantly correlated with the Frankl Scale (r -0.69; <0.001, r -0.72; <0.001). Child behavior assessed was related to complexity of treatment, type of procedure, use of local anesthesia, and dental fear. CONCLUSIONS: The results provide strong evidence for the validity of Brazilian version of the VBRS in behavior assessment of children aged 7-13 years during dental care.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study.

Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

Discriminatory episodes negatively impact the quality of life of Brazilian dental students: A cross-sectional study.

PURPOSE: This study aimed to evaluate whether discriminatory episodes occurring in the university environment were associated with dental students' self-perceived overall quality of life and assess the cumulative effect of perceived discriminatory experiences on the overall quality of life. METHODS: In this cross-sectional study, all students enrolled in three Brazilian dental schools were invited to participate in a survey between August and October 2019. The outcome was students' self-perceived quality of life, measured through the overall quality of life item of the World Health Organization-Quality of Life Abbreviated Version (WHOQOL-BREF). Descriptive, bivariate, and multivariable logistic regression analyses (95% confidence intervals and α of 5%) were conducted using RStudio software. RESULTS: The sample was composed of 732 students (70.2% response rate). The great part was female (66.9%), white or yellow skin color (67.9%), and were children of highly educated mothers. About 68% of the students reported having experienced at least one of the seven discriminatory experiences presented in the questionnaire and 18.1% reported neutral or negative quality of life. In multivariable analyses, it was estimated that students who experienced at least one episode of discrimination were 2.54 times (95% CI: 1.47-4.34) more likely to report worse quality of life than their counterparts who reported no experience of discrimination. There was also a 25% (95% CI: 1.10-1.42) increase in the odds of reporting poorer quality of life for each additional discriminatory experience reported. CONCLUSION: Reporting at least one discriminatory situation in the academic environment was associated with worse quality of life among dental students, and a cumulative effect was also noted.

Gender inequalities in the dental science: An analysis of high impact publications.

OBJECTIVE: To assess the participation of women in publications of dental journals with a high impact factor. METHODS: Articles published in 2016, 2011, and 2006 in 10 dental journals chosen for their highest impact factors in each dental fields were included in this research. Articles-related variables collected included the country of origin of each author, the type of study, and gender of the researchers. Gender was examined through PubMed, Scopus, ResearchGate, and respective affiliated institutions. Furthermore, a website designed to discover the gender of names was used when the previous alternatives were not conclusive. Forward stepwise Poisson regression models were used for data analysis. RESULTS: A total of 3365 studies were included in the first authorship analysis and 3398 in analysis related to last authorship. The prevalence of women as first authors was 37.2% (confidence interval (CI) 95% 34.5-37.5) and as last authors was 22.6% (CI 95% 21.3-23.9). Having a woman as the last author increased the presence of women in the first author position in scientific dental articles by 16% (prevalence ratio = 1.16, CI 95% [1.04-1.29]). The year of publication, journal, and region of the author were associated with an increase in the prevalence of women as last authors. From 2006 to 2016, the prevalence of women as last authors increased by 61%. Despite these trends, women were still underrepresented in science in the evaluated period. CONCLUSIONS: There are meaningful gender inequalities in publications of scientific dental papers. Encouraging women to lead research groups can reduce the inequities observed in the present study.

Accuracy of partial protocol to assess prevalence and factors associated with dental caries in schoolchildren between 8-12 years of age.

The aim of this study was to test accuracy and reliability of a partial protocol (PP) of oral examination involving the permanent first molars. This cross-sectional study was carried out in two stages. First, a cross-sectional study was performed in a representative sample of 1,211 children using DMFT-index in a full-mouth protocol (FM). A PP was simulated from FM data using only data from the permanent first molars. A second part was performed with 202 children examined by a gold standard examiner (FM) and three dentists using the PP to assess its reliability. Accuracy of PP was assessed by sensitivity/specificity/predictive positive and negative values. Inter-examiner reliability in comparison with gold standard examiner was assessed using weighted kappa. The prevalence of dental caries observed using DMFT index was 32.4% and was 30.2% for PP . The PP presented high sensitivity (93.1%; 95%CI: 91.5-94.5), showing similar magnitude of association's measures for all associated factors investigated. When compared with the gold standard FM examination, all examiners obtained high parameters of sensitivity and specificity (around 90%). Predictive negative values were higher than predictive positive values for the examiners. This study showed that this partial protocol involving the permanent first molars is accurate and reliable as a screening tool to assess dental caries prevalence and associated factors in schoolchildren.

Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study

Abstract Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.

[Needs for dental prostheses and their use in elderly Brazilians according to the National Oral Health Survey (SBBrazil 2010): prevalence rates and associated factors]. / Uso e necessidade de prótese dentária em idosos brasileiros segundo a Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): prevalências e fatores associados.

The objectives of this study were to evaluate the use of and need for dental prostheses among elderly Brazilians (65-74 years of age) and to verify associated factors. Data were analyzed from 7,496 elderly participants in the National Oral Health Survey in 2010 (SBBrazil 2010). Use of and need for dental prosthesis were the outcomes. The exposure variables included demographic and socioeconomic characteristics, dental services use, and self-rated oral health. Descriptive, bivariate, and multivariate analyses were performed. Prevalence rates for use of and need for dental prostheses were 78.2% and 68.7%, respectively. The Southeast Region had the highest prevalence of use (71.3%) and the greatest need for dental prostheses (82.9%). Multivariate Poisson regression analyses showed greater use of dental prostheses by women, individuals with 5 to 7 years of schooling, and users of private dental services, and lower use by black individuals and those with self-reported need for dental prostheses. Less need for dental prostheses was seen in women and in users of private services, and greater need in those with self-reported need for dental prostheses. Regional differences were seen in the distribution of use and need for dental prostheses. Still, the findings showed high prevalence rates for both outcomes in all regions of Brazil. Socioeconomic and demographic variables and use of dental services influenced the use of and need for dental prostheses.

Analysis of dentistry content on Instagram®and the use of social networks by Brazilian dental students

Aim: The aim of our study was to analyze the content related to dentistry published on Instagram® and to investigate the students' profiles related to the use of social networks in a sample from a Dentistry School. Methods: This study was carried out in two stages. First, research was conducted to analyze content published on Instagram® related to dentistry. The second part investigated the profiles of students' from a dental school in relation to the use of social networks through a questionnaire. A descriptive analysis was performed and associations between the variables were tested using Fisher's exact test. Results: We found a diversified and large amount of content related to dentistry published on Instagram®, and publications that involved advertising were more prevalent in our study. There are also many publications that are violating the Code of Dental Ethics. In addition, in the second part of our study, we observed an enormous use of social networks by dental students (98.4%). Conclusions: As a result, we believe that it is important to update professionals about the ethical infractions related to social networks which could be approached during graduate courses in universities. Finally, the analyzed social network seems to be an interesting alternative for disseminating health information in order to dialogue with greater proximity to the large number of users who participate in it

Evaluation of parasite contamination on toothbrushes in children in Southeastern Brazil / Evaluación de la contaminación parasitaria en cepillos de dientes en niños del sudeste de Brasil

ABSTRACT Introduction : The toothbrush is an important object for the hygiene of the oral cavity and an effective mechanism to remove the oral waste. Objective : To evaluate the perception of care, storage and parasitic contamination of toothbrushes in children with special health care needs (CSHCN) and children without special health care needs (CWSHCN) in Southern of Minas Gerais State. Material and Methods : This is an observational cross-sectional non-randomized study. The population consisted in 54 children, with age between 7 and 14 years. The questionnaire was distributed to patients to evaluate the perception of care and storage of children's toothbrushes. Investigation of toothbrushes contamination was performed by parasitological examination and real-time polymerase chain reactions. Results : Regarding the procedures performed after brushing, 50.0% of children with special health care needs (CSHCN) and 56.3% of children without special health care needs (CWSHCN) report washing their brush bristles with water (p <0.001). Both groups did not use an antiseptic solution on toothbrushes. 73.3% of (CSHCN) and 58.7% of (CWSHCN) answered that they use some protection (brush holder and bathroom cabinet) to avoid exposure of brushes to the environment (p <0.001). Conclusion : The children investigated by the study presented good conditions of care and storage of their toothbrushes. No contamination by pathogenic parasites was found during the study period.

RESUMEN Introducción : El cepillo de dientes es un objeto importante para la higiene de la cavidad bucal y un mecanismo eficaz para eliminar los residuos bucales. Objetivo : Evaluar la percepción del cuidado, almacenamiento y contaminación parasitaria de los cepillos dentales en niños con necesidades especiales de salud (CSHCN) y niños sin necesidades especiales de salud (CWSHCN) en el sur del estado de Minas Gerais. Material y Métodos : Se trata de un estudio observacional transversal no aleatorio. La población consistió en 54 niños, con edad entre 7 y 14 años. El cuestionario fue distribuido a los pacientes para evaluar la percepción del cuidado y almacenamiento de los cepillos dentales de los niños. La investigación de la contaminación de los cepillos dentales se realizó mediante un examen parasitológico y reacciones en cadena de la polimerasa en tiempo real. Resultados : En cuanto a los procedimientos realizados tras el cepillado, el 50,0% de los niños con necesidades especiales de atención sanitaria (NCNEAS) y el 56,3% de los niños sin necesidades especiales de atención sanitaria (NSNEAS) refieren lavar las cerdas del cepillo con agua (p <0,001). Ambos grupos no utilizaron una solución antiséptica en los cepillos de dientes. El 73,3% de los (NCNEAS) y el 58,7% de los (NSNEAS) contestaron que utilizan alguna protección (portacepillos y mueble de baño) para evitar la exposición de los cepillos al medio ambiente (p <0,001). Conclusiones : Los niños investigados por el estudio presentaron buenas condiciones de cuidado y almacenamiento de sus cepillos dentales. No se encontró contaminación por parásitos patógenos durante el período de estudio.

Pandemia de COVID-19 no Brasil: quais as repercussões no comportamento, qualidade do sono, uso de telas e alimentação de crianças? / COVID-19 pandemic in Brazil: what are the impactson child behavior, sleep quality, screen time and diet?

Objetivo: Descrever as possíveis repercussões que o distan-ciamento social e pandemia de COVID-19 promoveram no comportamento, qualidade do sono, uso de telas e alimentação de crianças brasileiras de 0 a 12 anos. Materiais e Métodos: Este estudo observacional descritivo foi realizado através de um questionário on-line autoaplicado direcionado aos pais, cuidadores ou responsáveis legais de crianças de 0-12 anos. O questionário foi aplicado entre 19 de agosto de 2020 a 19 de setembro de 2020, em dois grupos, um composto por usuários de serviços de saúde e outro pela população em geral. Os da-dos foram analisados descritivamente, considerando α=5%. Resultados: Compuseram a amostra final 271 respondentes. Segundo os cuidadores, 59,4% das crianças tiveram alterações de comportamento e 48% reportou ou demonstrou medo da COVID-19. Além disso, melhora na qualidade do sono foi reportada de forma importante para crianças de até 2 anos e, 33,3% dos cuidadores em ambos os grupos reportaram piora em qualidade do sono entre 9 e 12 anos. Aumento do uso de telas ocorreu para 85% das crianças. O consumo de alimentos considerados saudáveis se manteve igual para grande parte das crianças e o consumo de alimentos ultraprocessados aumentou para mais de 40% das crianças, principalmente entre 3 e 5 anos e 9 e 12 anos de idade. Discussão: Os resultados encontrados devem ser fonte de atenção a fim de garantir o adequado desenvolvimento infantil após um período de pandemia. Conclusão: O distancia-mento social provocado pela pandemia de COVID-19 promoveu repercussões importantes na rotina das crianças avaliadas, impactando negativamente seu comportamento, alimentação e uso de telas. Ainda, a qualidade do sono de crianças maiores foi impactada negativamente, apesar de ter sido observada melhora na qualidade do sono de crianças mais jovens.

Aim: To describe the potential consequences of social distancing and the COVID-19 pandemic on the behavior, sleep quality, screen time, and diet of Brazilian chil-dren aged 0 to 12 years. Materials and methods: This descriptive observational study was conducted using a self-administered online questionnaire distributed to parents, caregivers or guardians of children aged 0-12 years. The same questionnaire was distributed to two groups between August 19, 2020 and September 19, 2020. Users of Pelotas Public Health Services made up one group, while the general Brazilian population made up the other. The data was analyzed descriptively considering α=5%. Results: The total sample consisted of 271 respondents. According to caregivers, 59.4% of children showed behavioral changes and 48% reported or demonstrated COVID-19 fear. Moreover, improve-ment in sleep quality was reported for children up to 2 years, and 33.3% of caregivers in both groups reported a decline in sleep quality among children aged 9 to 12. Eighty-five percent of children increased their screen time. The intake of healthy foods remained the same for most of the children, but the intake of ultra-processed food increased for over 40% of them, primarily between 3 to 5 years old and 9 to 12 years old. Discussion: The results should be a focus of attention in order to maintain proper child development following a pandemic. Conclusion: The social distancing caused by the COVID-19 pandemic had a significant impact on the children's routine, with negative effects on their behavior, diet and screen time. In addition, a decline in sleep quality was observed among older children, while better sleep quality was reported for younger children.

Use of P-CPQ to measure the impact of oral health on the quality of life of children with special health care needs / Uso de la P-CPQ para medir el impacto de la salud oral en la calidad de vida de los niños con necesidades especiales de atención médica / Uso do P-CPQ para mensuração do impacto da saúde bucal na qualidade de vida de crianças com necessidades especiais de saúde

Abstract Introduction and objective: the WHO defined the concept of quality of life as the self-perception that the individual has about his position in the social, cultural and ideological context, being these factors the main responsible for denoting the worst parameters regarding oral health care during the dental clinical examination performed by the dentist. To evaluate the impact of oral health on the quality of life of children with special health care needs aged 7 to 14 years old and the influence of different types of specialties on the quality of life, in the view of parents/caregivers in the Brazil southeast region. Materials and methods: the sample was composed of 62 children enrolled in municipal public schools and the Association of Parents and Friends of the Exceptional. The validated Parental- Caregivers Perception Questionnaire (P-CPQ) was used as an instrument for data collection, applied in the home environment and answered by the main responsible. The relation between demographic factors, type of special need and P-CPQ was evaluated with alpha of 0.05. Results: the worst parameters in Family Impact Scale were observed when the mother and father was responsible for data transmission (p= 0.004). Oral health was associated with the worst parameters of oral symptoms on quality of life in the view of parents (p = 0.012). There was no statistically significant difference regarding the impact of the child's type of specialty on quality of life. Conclusion: the variables caregiver and oral health status child are related to the worst indicators regarding the impact of oral health on quality of life.

Resumen Introducción y objetivo: la OMS definió el concepto de calidad de vida como la autopercepción que tiene el individuo sobre su posición en el contexto social, cultural e ideológico, siendo estos factores los principales responsables de denotar los peores parámetros en cuanto al cuidado de la salud bucal durante el examen clínico dental realizado por el dentista. Evaluar el impacto de la salud bucal en la calidad de vida de los niños con necesidades especiales de atención de la salud de 7 a 14 años de edad y la influencia de los diferentes tipos de especialidades en la calidad de vida, en opinión de los padres/cuidadores de la región sudoriental del Brasil. Materiales y métodos: la muestra se compuso de 62 niños matriculados en escuelas públicas municipales y en la Asociación de Padres y Amigos de los Excepcionales. Se utilizó el cuestionario validado Parental- Caregivers Perception Questionnaire (P-CPQ) como instrumento para la reunión de datos, aplicado en el entorno doméstico y contestado por el principal responsable. La relación entre los factores demográficos, el tipo de necesidad especial y el P-CPQ se evaluó con un alfa de 0,05. Resultados: los peores parámetros en la Escala de Impacto Familiar se observaron cuando la madre y el padre fueron los responsables de la transmisión de datos (p= 0,004). La salud oral se asoció con los peores parámetros de los síntomas orales sobre la calidad de vida a juicio de los padres (p = 0,012). No hubo diferencias estadísticamente significativas en cuanto al impacto del tipo de especialidad del niño en la calidad de vida. Conclusión: las variables "cuidador" y "estado de salud bucal del niño" se relacionan con los peores indicadores relativos al impacto de la salud bucal en la calidad de vida.

Resumo Introdução e objetivo: a OMS definiu o conceito de qualidade de vida como a autopercepção que o indivíduo tem sobre sua posição no contexto social, cultural e ideológico, sendo esses fatores os principais responsáveis por denotar os piores parâmetros quanto aos cuidados com a saúde bucal durante o exame clínico odontológico realizada pelo dentista. Avaliar o impacto da saúde bucal na qualidade de vida de crianças com necessidades especiais de cuidados de saúde de 7 a 14 anos de idade e a influência de diferentes tipos de especialidades na qualidade de vida, na visão dos pais/cuidadores na região sudeste do Brasil. Materiais e métodos: a amostra foi composta por 62 crianças matriculadas nas escolas públicas municipais e na Associação de Pais e Amigos dos Excepcionais. Foi utilizado o Parental- Caregivers Perception Questionnaire (P-CPQ) como um instrumento de mensuração, aplicado no ambiente familiar e respondido pelo responsável principal. A relação entre fatores demográficos, tipo de necessidade especial e o P-CPQ foi avaliada com alfa de 0,05. Resultados: os piores parâmetros em relação à qualidade de vida foram observados quando a mãe foi a responsável pela transmissão dos dados (p= 0,004). A variável estado de saúde bucal (p= 0,012) apresentou resultados relevantes quando relacionadas com os piores parâmetros na percepção do impacto da saúde bucal na qualidade de vida na percepção dos cuidadores sobre suas crianças. Não houve diferença estatisticamente significante com relação ao impacto do tipo de especialidade da criança na qualidade de vida. Conclusão: as variáveis cuidador e estado de saúde oral da criança estão relacionadas com os piores indicadores relativos ao impacto da saúde oral sobre a qualidade de vida.

Crown-Root Fractures in Primary Teeth: A Case Series Study of 28 Cases.

Crown-root fractures in primary teeth are rare, with a wide variation of patterns that make diagnosis and treatment difficult. The aim of this study was to present a case series of crown-root fractures in primary teeth of children who attended a reference center. The study followed 28 cases of crown-root fractures in 26 children, representing 4% of the total number of attendees over 11 years of reference service at the Universidade Federal de Pelotas, Pelotas, Brazil. In most cases, the maxillary central incisors (85.7%) were involved. In the crown, 57.1% of the cases had a simple line of fracture, and 42.9% had multiple lines. Simple lines predominated in the root (89.3%). In cases with simple fracture lines in the crown, 37.6% underwent a total extraction, 31.2% required a partial extraction and 31.2% underwent pulpectomy. In most teeth with multiple lines of fractures in the crown, total extraction was performed (91.7%) All cases were followed-up until the eruption of the permanent successor tooth, and all patients had favorable outcomes.

Efficacy of Bacillus thuringiensis against Phyllocnistis citrella (Lepidoptera: Phyllocnistidae).

The purpose of this work was to analyze the efficacy of Bacillus thuringiensis Berliner on the control of Phyllocnistis citrella Stainton (Lepidoptera: Phyllocnistidae) in laboratory and field trials. In the laboratory, four B. thuringiensis were used: Dipel (commercial formulation) tested at the concentrations of 25 x 10(6) and 25 x 10(8) spores/ml and the isolates K, 6, and 15 (collections of the University of Azores) at the concentration of 25 x 10(6) spores/ ml. A surfactant solution of nonoxinol also was tested with or without the different suspensions of B. thuringiensis. Leaves of Citrus sinensis (L.) Osbeck with second or third instars of leafminer larvae were used in all tests. Bacterial suspensions were applied topically on the surface of intact leaf mines or by injection inside the mine, near the head of the leafminer. When injecting both concentrations of Dipel into the mines, mortality of the leafminers increased compared with the topical application, although no significant differences were observed. The addition of the nonoxinol to the Dipel suspension, applied topically, increased the effect of B. thuringiensis, but differences were not significant. The mortality of the leafminers treated only with the nonoxinol solution increased significantly 48 h after treatment, compared with the control group, suggesting an insecticidal effect of this surfactant when used at a concentration of 0.01%. All the tested B. thuringiensis were equally active against the leafminer, either when applied topically or by mine injection. Field trials showed a significant difference between larval mortality of the control group and the results observed at the trees treated with B. thuringiensis 48 h after treatments.

#Dentalpain: what do the brazilian Instagram® users want to mean?

Aim: The aim of this study was to evaluate what brazilian Instagram® users manifest when they use #dordedente (#dentalpain in portuguese). Methods: The content of 1,000 publications related to dental pain was evaluated. Through print screens posts were collected in two periods (2015 and 2020) and organized into files. Variables related to characteristics of users, publication's type, cause of pain, impact on daily life and actions take to relieve pain were collected. Data analysis was realized through the qualitative methodology of conventional content analysis and a descriptive analysis (95% CI) was performed. Results: In the first assessment period 76% of the posts referred to self-declaration of pain. Regarding to the users' characteristics, 54% were female, 20.4% male, and the remaining 25.6% were clinic/ company profiles, or it was not possible to identify the user's gender. Apparently, 34.4% of users were adults, 18.6% were adolescents and only 1.2% were children. On the other hand, in the second evaluation the vast majority (99.6%) were clinic/company profiles. In addition, 90.2% were informative posts and only 3 posts (0.6%) were related to self-declaration of pain. Conclusions:The social network Instagram® serves as an efficient means of communication for informative and advertising purposes being an interesting alternative for the dissemination of health information, and as an instrument of health surveillance

Nonuse of dental service by schoolchildren in Southern Brazil: impact of socioeconomics, behavioral and clinical factors.

OBJECTIVES: To assess clinical, behavioral and socioeconomic factors associated with nonuse of dental services by schoolchildren. METHODS: A cross-sectional school-based study with 1211 children aged 8-12 years was carried out in Pelotas, Brazil. The outcome (never having had a dental appointment) and independent variables were collected through interview with parents and children, including sex, age, parent's schooling, family income, self-perception about oral health, and dental fear. Dental caries was assessed by clinical examination performed at schools. RESULTS: 291 (24.3 %; 95 % CI 22.0-26.9) of the children had never visited a dentist. Multivariate Poisson regression analysis showed that the outcome was associated with children from mothers with little education (≤0.001), from public schools (≤0.001), from crowded households (≤0.001), who had no caries (≤0.001), who had dental fear (≤0.001), and who started oral hygiene later (0.04). CONCLUSIONS: Despite the extensive increase in oral health coverage, especially in the public system in the last years in Brazil, there is still an unassisted portion of the population of schoolchildren. It was observed that socioeconomic, behavioral, and clinical factors influenced the nonuse of dental services.

Longevity of posterior restorations in primary teeth: results from a paediatric dental clinic.

OBJECTIVES: The aim of this retrospective study was to evaluate the longevity of restorations in the posterior primary teeth of children attending to a public paediatric dental clinic and to test the factors associated with failures. METHODS: Patient records of 329 children (162 boys and 166 girls) were used for collecting and analyzing data. A total of 565 restorations in primary teeth were included in the study. All children enrolled in the study were classified as high caries risk. The longevity of restorations from their placement until failure (up to 4 years of follow-up) was assessed using the Kaplan-Meier survival curves with log-rank test. Multivariate Cox regression analysis with shared frailty (p<0.05) was used to assess the factors associated with failures. RESULTS: Up to 4 years of follow-up, the annual failure rates were 9.5% for composite fillings, 12.2% for light-cured glass ionomer restorations, and 12.9% for conventional glass ionomer restorations with statistical difference between the materials (p=0.014). Glass ionomer restorations had a higher risk of failure over time compared with composites (HR 1.86, 95% CI 1.17-2.97). In crude analysis, Class II restorations showed lower survival rate than Class I restorations (p=0.031) but lost significance after adjustments. CONCLUSIONS: Our findings suggested that the material influenced the survival rate of primary posterior restorations, with composite presenting the best performance. CLINICAL SIGNIFICANCE: Differences were observed between restorative materials with different properties in primary teeth up to 4 years of follow-up. This study provides valuable information regarding the primary teeth posterior restoration longevity in a paediatric population with restorations performed under daily life clinical environment.

Accuracy of partial protocol to assess prevalence and factors associated with dental caries in schoolchildren between 8-12 years of age / Acurácia de um protocolo parcial para avaliar a prevalência da cárie dentária e fatores associados em escolares entre 8 e 12 anos de idade / Precisión del protocolo parcial para evaluar la prevalencia y factores asociados a la caries dental en escolares entre 8 y 12 años de edad

Abstract: The aim of this study was to test accuracy and reliability of a partial protocol (PP) of oral examination involving the permanent first molars. This cross-sectional study was carried out in two stages. First, a cross-sectional study was performed in a representative sample of 1,211 children using DMFT-index in a full-mouth protocol (FM). A PP was simulated from FM data using only data from the permanent first molars. A second part was performed with 202 children examined by a gold standard examiner (FM) and three dentists using the PP to assess its reliability. Accuracy of PP was assessed by sensitivity/specificity/predictive positive and negative values. Inter-examiner reliability in comparison with gold standard examiner was assessed using weighted kappa. The prevalence of dental caries observed using DMFT index was 32.4% and was 30.2% for PP . The PP presented high sensitivity (93.1%; 95%CI: 91.5-94.5), showing similar magnitude of association's measures for all associated factors investigated. When compared with the gold standard FM examination, all examiners obtained high parameters of sensitivity and specificity (around 90%). Predictive negative values were higher than predictive positive values for the examiners. This study showed that this partial protocol involving the permanent first molars is accurate and reliable as a screening tool to assess dental caries prevalence and associated factors in schoolchildren.

Resumo: O estudo teve como objetivo testar a acurácia e a confiabilidade de um protocolo parcial (PP) para exame oral, envolvendo os primeiros molares permanentes. O estudo transversal foi realizado em duas etapas. Primeiro, foi feito um estudo transversal em uma amostra representativa de 1.211 crianças, usando o índice CPOD com um protocolo de boca completa (BC). O PP foi simulado a partir de dados de BC, usando apenas os dados dos primeiros molares permanentes. A segunda etapa foi realizada em 202 crianças examinadas por um examinador de padrão de ouro (BC) e três odontólogos usando o PP para avaliar a confiabilidade do mesmo. A acurácia do PP foi avaliada pela sensibilidade, especificidade e valores preditivos positivos e negativos. A confiabilidade inter- examinador, comparada com o examinador de padrão de ouro, foi avaliada através do índice kappa ponderado. A prevalência de cárie dentária, medida pelo índice CPOD, foi 32,4%, comparado com 30,2% para o PP. O PP apresentou sensibilidade alta (93,1%; IC95%: 91,5-94,5), com magnitude semelhante nas medidas de associação dos fatores investigados. Quando comparados com o exame de BC (padrão de ouro), todos os examinadores obtiveram níveis altos de sensibilidade e especificidade (em torno de 90%). Os valores preditivos negativos foram mais altos do que os valores preditivos positivos para os examinadores. O estudo mostrou que o protocolo parcial envolvendo os primeiros molares permanentes é acurado e confiável enquanto ferramenta de triagem para avaliar a prevalência de cárie dentária e fatores associados em escolares.

Resumen: El objetivo de este estudio fue probar la precisión y fiabilidad de un protocolo parcial (PP) de exámenes orales, incluyendo los primeros molares permanentes. Este estudio transversal se llevó a cabo en dos etapas. En primer lugar, se desarrolló un estudio transversal con una muestra representativa de 1.211 niños, usando el DMFT-index en un protocolo para toda la boca (FM por sus siglas en inglés). El PP se simuló con datos del FM, usando solo información de los primeros molares permanentes. La segunda parte se realizó con 202 niños examinados por un examinador ideal (FM) y tres dentistas, usando el PP para evaluar su fiabilidad. La precisión del PP se evaluaron por sensibilidad/especificidad/valores predictivos positivos y negativos. La fiabilidad interexaminadores, en comparación con el examinador ideal, fue evaluada usando un índice kappa ponderado. La prevalencia de caries dental observada, usando el índice DMFT fue de un 32,4% y un 30,2% respecto al PP. El PP presentó una alta sensibilidad (93,1%; IC95%: 91,5-94,5), mostrando una magnitud similar de medidas de asociación para todos los factores asociados investigados. Cuando se comparó con el estándar ideal de examen para la FM, todos los examinadores obtuvieron parámetros altos de sensibilidad y especificidad (sobre un 90%). Los valores predictivos negativos eran más altos que los valores predictivos positivos para los examinadores. Este estudio mostró que este protocolo parcial, incluyendo los primeros molares permanentes, es preciso y fiable como herramienta de detección para evaluar la prevalencia de caries dental y sus factores asociados en niños con edad escolar.