The influence of different dimensions of oral health literacy on parental attitudes and comprehension of an information leaflet about permanent tooth avulsion.

BACKGROUND/AIM: Permanent tooth avulsion requires proper management at the time of the accident and parental oral health literacy (OHL) may influence decision-making with regards to dental trauma. The aim of this study was to investigate the influence of OHL on: (1) self-rated comprehension of an information leaflet (IL), (2) self-rated capacity to execute the tasks proposed on the IL, and (3) attitudes regarding the avulsion of a permanent tooth in children. MATERIAL AND METHODS: A longitudinal study was conducted involving the reading of an IL by 466 parents/caregivers. Evaluations were performed prior to the IL (Phase I), immediately after the application of the IL (Phase II) and 60 days after the application of the IL (Phase III). Self-rated comprehension and capacity to execute the proposed tasks were analyzed in Phase II. Attitude was evaluated in all three phases. Functional OHL was measured using the BREALD-30 and interactive OHL was measured using HeLD-14. RESULTS: Correlations were found between self-rated comprehension and both the OHL/BREALD-30 score (rs = 0.179; p = .012) and OHL/HeLD-14 score (r = 0.258; p < .001). Correlations were also found between the self-rated capacity to execute the proposed tasks and both the OHL/BREALD-30 score (rs = 0.133; p = .047) and the OHL/HeLD-14 score (rs = 0.225; p < .001). Higher BREALD-30 and HeLD-14 scores were associated with a better performance regarding parental attitudes toward permanent tooth avulsion comparing Phases I and II and Phases II and III (p < .05). CONCLUSIONS: Higher levels of OHL were associated with better parental self-rated comprehension of the IL and the capacity to execute the tasks proposed therein as well as more adequate attitudes regarding the avulsion of a permanent tooth.

Are technology-based health education methods able to reduce oral health inequalities between the sexes in adolescents? A cluster randomized trial.

PURPOSE: Determine if different technology-based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. METHODS: A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14-19 years of age. Phase I (n = 288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI-S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n = 147) or oral counselling (OR; n = 141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n = 66/OR without App; n = 71/VD + App; n = 63/VD without App; n = 63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. RESULTS: In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI-S (p = 0.039) and GBI (p = 0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI-S. However, males had a higher mean GBI compared with females in the OR group (p = 0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p = 0.007). CONCLUSION: This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents.

Unexpected formation of root-like structures subsequent to the avulsion of immature permanent teeth: Case report.

This report describes the unexpected formation of root-like structures following the avulsion of immature permanent teeth without replantation. A 6-year-old female patient had avulsed the four permanent mandibular incisors and the two deciduous mandibular canines. The patient was seen in an emergency healthcare unit but did not receive specialized treatment for tooth replantation. As follow-up treatment, she received a removable prosthesis. After 4 years of follow-up, an image obtained by panoramic radiography showed formations similar to four root structures in the alveolus of the previously avulsed permanent teeth. This finding was confirmed by periapical radiography and computed tomography. This case report demonstrates that in teeth with incomplete root development, even after avulsion without replantation, cells from the pulp stump may have the capacity to form mineralized structures that appear radiographically comparable to root dentin.

How much does household food insecurity explain income inequalities in untreated dental caries?

BACKGROUND: The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear. AIM: To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI). DESIGN: A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PRc ) for dental caries and this measure adjusted by HFI (PRa ). RESULTS: The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI. CONCLUSIONS: Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families.

Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: A hierarchical approach.

BACKGROUND: Molar incisor hypomineralization (MIH) is associated with unfavourable dental conditions such as dental caries and may consequently impact oral health-related quality of life (OHRQoL). OBJECTIVE: To assess the impact of MIH on OHRQoL in children with early mixed dentition. METHOD: A population-based cross-sectional study of 728 8-year-old children from the public school system in Curitiba, Brazil, was conducted. The Child Perception Questionnaire for 8- to 10-year-olds (CPQ8-10 ) was used to evaluate OHRQoL. MIH was diagnosed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The assessments of MIH, dental caries, and malocclusion were performed by four calibrated examiners (κ ≥ 0.80). Demographic and socioeconomic data (DSE) were obtained from the children's parents/caregivers using a structured questionnaire. The analysis of OHRQoL determinants was performed through a three-level hierarchical approach: mesial (DSE), intermediate (clinical conditions), and distal (child's oral self-perception), using Poisson regression with robust variance (α = 0.05). RESULTS: The prevalence of MIH was 12.1% (95% CI: 10-15). An association was found between MIH and OHRQoL in the "oral symptoms" domain of the CPQ8-10 (PR: 1.07, 95% CI: 1.03-1.11, P < 0.001) after adjusting for other clinical variables and DSE. CONCLUSION: Molar incisor hypomineralization was associated with a greater impact on OHRQoL in children's oral symptoms.

Knowledge of parents/caregivers about the sleep bruxism of their children from all five Brazilian regions: A multicenter study.

BACKGROUND: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists. AIM: To investigate parents' knowledge about SB among their children. DESIGN: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05). RESULTS: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05). CONCLUSION: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge.

Healthy and cariogenic foods consumption and dental caries: A preschool-based cross-sectional study.

OBJECTIVE: To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. MATERIALS AND METHODS: A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. RESULTS: The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p = 0.05), whereas the latter maintained an association with lower caries rates (p = 0.01). CONCLUSION: A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.

Is parental oral health literacy a predictor of children's oral health outcomes? Systematic review of the literature.

BACKGROUND: The scientific evidence regarding the association between parental oral health literacy (OHL) and children's oral health is unclear. AIM: To evaluate the scientific evidence concerning the association between parental OHL and children's oral health outcomes. DESIGN: Eight databases were searched. Studies that evaluated oral health outcomes among children and measured parental OHL through a validated tool were included. Two independent reviewers selected studies, extracted data and analysed the risk of bias. RESULTS: Eleven studies were included. Most (n = 6) had a high risk of bias. Most studies evaluating dental caries found association between lower parental OHL and higher prevalence/experience of dental caries. Poor oral health-related quality of life was associated with decreased parental OHL (P < 0.05). Studies diverged on the association between OHL and the number of filled, extracted teeth, and dental visits. There was no association between children's tooth brushing frequency, use of toothpaste, oral health claim, oral health expenditures and parental OHL. The literature was inconclusive regarding the association between night bottle feeding, negative parental perception of the child's oral health and OHL. CONCLUSION: Low parental OHL was associated with dental caries among their children. It is too soon to assume an association between OHL and the remaining outcomes.

Improving adolescents' periodontal health: evaluation of a mobile oral health App associated with conventional educational methods: a cluster randomized trial.

BACKGROUND: Adolescence is a decisive period in the construction of new conduits. OBJECTIVE: The influence of an App associated with conventional educational methods in adolescents' oral health. STUDY DESIGN: Randomized controlled trial including 291 participants (mean age = 16.1 years) in baseline. The study consisted of four phases. Interventions were evaluated through the knowledge score (KS) and oral indexes (OHI-S/GBI). KS was obtained through five affirmations about periodontal diseases applied in different moments (pre-test, post-test, and follow-up test). Phase I included pre-test and oral clinical examination. Sample was randomly divided into two groups: oral (OG) and video orientation (VG) and post-test (phase II). Phase III characterized the formation of groups: OG + App/OG without App/VG + App/VG without App. App consisted of reinforcement messages which was sent during 30 days. Phase IV comprised follow-up test and clinical evaluation. RESULTS: There was no significant difference in KS between OG/VG. Overall, App improved KS (P < 0.001). VG + App showed a significant increase in KS in the follow-up test compared to the post-test (P = 0.046). There was a significant reduction in oral indexes for all methods. CONCLUSION: App was effective in increasing knowledge, especially associated with video. The different methods were equally effective for a better standard in oral hygiene.

Association of parental attitudes at mealtime and snack limits with the prevalence of untreated dental caries among preschool children.

Eating behavior of parents exerts an influence on eating practices among their children, including the consumption of cariogenic products. The aim of this study was to determine the relationship between the snack limits established by parents/caregivers and the prevalence of untreated dental caries (UDC) among their children. A cross-sectional study was conducted with a representative sample of 686 children aged four and five years enrolled at public schools in the city of Curitiba, Brazil, and their parents/caregivers. The children were examined for dental caries and visible plaque. Parents/caregivers answered the Brazilian version of the Parent Mealtime Action Scale (PMAS). Data were analyzed using nonparametric tests and Poison regression analysis. The prevalence of UDC was 45.6%. The Snack Limits subscale of the PMAS was associated with a lower prevalence rate of UDC (PR: 0.83; 95%CI: 0.72-0.96), independently of the other variables. UDC was also associated with a greater prevalence of visible plaque (PR: 1.29; 95%CI: 1.08-1.54), a lower tooth brushing frequency (PR: 1.46; 95%CI: 1.22-1.77) and greater age of the child (PR: 1.31; 95%CI: 1.08-1.59). Snack limits established by parents/caregivers were associated to a lower prevalence rate of UDC among preschool children.

Profile of orofacial dysfunction in Brazilian children using the Nordic Orofacial Test-Screening.

OBJECTIVE: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children. MATERIALS AND METHODS: A population-based cross-sectional study was conducted involving 531 schoolchildren (8-10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S). Poisson multiple regression analysis with robust variance was used to estimate adjusted NOT-S rate ratios (ratio of arithmetic means) among the different categories of covariables and their respective 95% confidence interval (RR: 95%CI). RESULTS: The mean NOT-S score was 2.1 (SD 1.4, median: 2.0; range: 0-8). The majority of children (87.6%) had at least one domain of the scale affected. The most affected were Chewing and Swallowing (50.5%), Habits (41.4%) and Breathing (26.4%). NOT-S scores were lower among children from higher income families (RR = 0.73; 95% CI: 0.61-0.87) and higher among those with difficulty regarding access to dental services (RR = 1.14; 95% CI: 1.01-1.28), those with sleep bruxism (RR = 1.18; 95% CI: 1.04-1.32) and those with open bite (RR = 1.65; 95% CI: 1.42-1.93). CONCLUSIONS: The prevalence of OFD was high and both socioeconomic and clinical factors exerted an influence on NOT-S scores.

A population-based study on the impact of orofacial dysfunction on oral health-related quality of life among Brazilian schoolchildren.

OBJECTIVE: The aim of the present study was to assess the impact of orofacial dysfunction on oral health-related quality of life (OHRQoL) among Brazilian schoolchildren. MATERIAL AND METHODS: A population-based study was conducted with 531 children aged eight to 10 years at schools in the city of Campo Magro, Brazil. The Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) was the outcome variable used to measure the impact on OHRQoL. The main independent variable was orofacial function, which was diagnosed using the Nordic Orofacial Test-Screening (NOT-S). Descriptive, bivariate and multiple Poisson regression analyses were performed using a multilevel approach, with the significance level set to 5%. RESULTS: The mean (±SD) total CPQ8-10 score was 13.95 ± 0.5. The multilevel Poisson regression model revealed that the mean CPQ8-10 score was higher among girls (RR: 1.38, 95% CI: 1.17-1.63; p < 0.001) than boys and that children from families with a higher income had lower CPQ8-10 scores (RR: 0.67, 95% CI: 0.51-0.88; p = 0.004) than those from families with a lower income. Children who sought dental care due to pain or factors other than prevention (RR: 1.41; 95% CI: 1.18-1.68), those with orofacial dysfunction (RR: 1.62; 95% CI: 1.30-2.02) and those with a history of traumatic dental injury (RR: 1.39; 95% CI: 1.15-1.69) also experienced a greater impact on OHRQoL. CONCLUSIONS: Schoolchildren with orofacial dysfunction experience a greater negative impact on OHRQoL.

The Association of Oral Health Literacy and Oral Health Knowledge with Social Determinants in Pregnant Brazilian Women.

The aim of the present study was to assess oral health literacy (OHL) in pregnant women and its association with social determinants and knowledge regarding eating habits and oral hygiene in infants. This cross-sectional study assessed 175 pregnant women in a hospital in southern Brazil. Socioeconomic and demographic data were obtained using a questionnaire, and OHL was determined by the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Eating habits and oral hygiene knowledge were assessed by statements on a 3-point Likert scale. The data were analyzed using Spearman correlations and the Mann-Whitney U test (α = 0.05). The mean (SD) age was 26.2 (6.17) years. Most of the participants had up to 8 years of education (60.0 %) and belonged to socioeconomic class "C" or lower (56.0 %). The mean (SD) score on the BREALD-30 was 22.4 (4.66). A positive correlation was found between BREALD-30 scores and knowledge (r s  = 0.370, p < 0.001), income (r s  = 0.374, p < 0.001), and the age at which infants first consumed sugar in their diets (r s  = 0.370, p < 0.001). A negative correlation was found between BREALD-30 scores and domicile agglomeration (r s  = -0.237, p = 0.020). BREALD-30 scores were higher among pregnant women who had more than 8 years of education (p < 0.001), who belonged to higher socioeconomic classes (p < 0.001), and who were employed (p = 0.025). A significant correlation was found between OHL and knowledge. Lower social determinants were associated with lower OHL. Oral health literacy should be considered in health education practices to facilitate adherence to health recommendations in pregnant women.

Impact of Oral Health Status on the Oral Health-Related Quality of Life of Brazilian Male Incarcerated Adolescents.

PURPOSE: To assess the impact of oral health status on the oral health-related quality of life (OHRQoL) of incarcerated Brazilian male adolescents. MATERIALS AND METHODS: A cross-sectional survey with 102 male adolescents incarcerated at the São Francisco Juvenile Detention Facility, Piraquara, Brazil in 2010 was carried out. Dental caries, oral hygiene, periodontal status, malocclusion, dental fluorosis and dental trauma were analysed. The Oral Health Impact Profile (OHIP-14) was administered to measure OHRQoL, along with a questionnaire addressing sociodemographic variables, health-related aspects and dental experience. Descriptive statistical analysis and univariate and multiple Poisson regression with robust variance were performed. RESULTS: The prevalence of adolescents who reported an impact on OHRQoL was 64% (95% CI: 54-73) and the mean OHIP-14 score was 6.69 (SD = 8.79; median = 3.00). In the multiple regression model, the prevalence of a negative impact on OHRQoL was significantly higher among individuals with untreated caries (PR = 1.74; 95% CI: 1.10-2.77), those who reported having discomfort in the teeth or mouth (PR = 1.33; 95% CI: 1.03-1.73), using tobacco prior to internment (PR = 1.53; 95% CI: 1.04-2.24) and maintaining a stable relationship (PR = 1.31; 95% CI: 1.01-1.70) in comparison to individuals who did not exhibit these conditions. Moreover, each month of internment represented an increase in the prevalence of an impact on OHRQoL (PR = 1.03; 95% CI: 1.01-1.06). CONCLUSION: Incarcerated male adolescents reported that oral health problems exerted an influence on quality of life, with untreated caries exhibiting the greatest impact.

Performance of distant diagnosis of dental caries by teledentistry in juvenile offenders.

BACKGROUND: Telehealth has been considered a practical and potentially cost-effective method of providing healthcare to the underprivileged population. The aim of this study was to determine whether a teledentistry system is a valid tool to screen for the presence of dental caries in a cohort of 102 Brazilian juvenile offenders. MATERIALS AND METHODS: Clinical examinations were performed to evaluate the decayed, missing, and filled teeth (DMFT) index and oral conditions of each adolescent, documented using a digital camera. For distant diagnosis, two methods of image transmission were tested. In the first, images were uploaded on a file-sharing service, and the link was sent via e-mail to one distant consultant. The other consultant received the images recorded on a compact disc. Both assessed the files and calculated the DMFT index for each case. The degree of agreement between the traditional examination and distant consultant assessments was measured by the kappa coefficient of agreement. Sensitivity and specificity were also calculated. RESULTS: According to the traditional clinical examination, 93.1% of the adolescents had at least one instance of dental caries with a mean DMFT index of 5.9. Kappa statistics ranged from "strong" to "almost perfect." Sensitivity ranged from 48% to 73%, and specificity was either 97% or 98%. CONCLUSIONS: Adolescent inmates could benefit from oral health screening using digital photography. Teledentistry appears to be a reliable alternative to the traditional oral examination for dental caries assessment.

Hypohidrotic ectodermal dysplasia: a clinical case with a longitudinal approach.

AIM: This paper describes a clinical case of a male with hypohidrotic ectodermal dysplasia submitted to rehabilitation and occlusal dental interventions with follow-up from 3 to 14 years of age. BACKGROUND: Due to the severe effects on function and esthetics, the clinical manifestations of ectodermal dysplasia exert a negative impact on quality of life. However, oral rehabilitation in childhood poses a challenge due to growth and development. CASE DESCRIPTION: A male with hypohidrotic ectodermal dysplasia began dental intervention at the age of 3 years. The clinical and radiographic exams revealed the absence of several primary and permanent teeth and abnormal shape of the primary maxillary incisors. The facial characteristics were compatible with hypohidrotic ectodermal dysplasia, such as a prominent brow, everted lips, fattened bridge of the nose and small vertical facial height. The treatment proposed involved rehabilitation through successive temporary partial dentures, functional orthopedics of the jaws, esthetic reconstruction of the anterior teeth, timely occlusal intervention and preventive actions for the control of dental caries and plaque. CONCLUSION: The present case demonstrates that early care plays a fundamental role in minimizing the biopsychosocial consequences of hypohidrotic ectodermal dysplasia and preparing the patient for future oral rehabilitation. CLINICAL SIGNIFICANCE: Although, the literature offers a number of papers describing dental treatment for ectodermal dysplasia, few cases include long-term follow-up and the use of a functional orthopedic appliance in combination with removable dentures in such patients.

Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: A systematic review and meta-analysis.

OBJECTIVES: To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH have greater likelihood of presenting DH/toothache than controls. DATA: Studies evaluating DH/toothache in patients with MIH were included. Studies focusing on other enamel defects were excluded. SOURCES: Eight databases, including grey literature, were searched in January 2024. STUDY SELECTION: The methodological quality of studies was assessed using the Joanna Briggs Institute checklist for Cross-sectional studies. Proportion and association meta-analyses, subgrouped by diagnostic methods, were conducted. The certainty of evidence was assessed using GRADE approach. RESULTS: Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses. Two studies fulfilled all items of the methodological quality checklist. The overall prevalence of DH/toothache among patients with MIH was 45 %. Prevalence rates of 30 %, 47 %, and 55 % were estimated based on proxy reports, self-reports, and air stimulation, respectively. The overall prevalence of DH/toothache per tooth was 22 %, ranging from 16 % to 29 % according to the diagnostic method. Patients with MIH demonstrated higher likelihood of presenting proxy reports of DH/toothache compared to those without MIH (OR: 1.51, 95 % CI [1.23-1.85], P < 0.01, I2: 0 %). The certainty of evidence was very low, mainly due to the low methodological quality of included studies and high inconsistency. CONCLUSIONS: The global prevalence of DH/toothache was 22 %, per tooth, and 45 % per patient. Estimates vary according to diagnostic methods. Patients with MIH showed higher likelihood of presenting proxy reports of DH/toothache than controls. CLINICAL SIGNIFICANCE: This systematic review contributes valuable information to the dental literature by assessing the prevalence and associated factors of DH/toothache in patients with MIH. The findings can guide future research, inform clinical practices and public policy makers, and ultimately improve the management of oral health of patients with MIH. REGISTRATION: PROSPERO CRD42023432805.

Quality of life in children and adolescents with blood coagulation disorders and hemoglobinopathies.

The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.

Parental oral health literacy influences preschool children's utilization of dental services.

Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered questionnaire about their perception of their children's oral health and whether their children had already been to a dental visit. Parental OHL level was assessed by the validated version of the Oral Health Literacy Adult Questionnaire (OHL-AQ) translated into Brazilian Portuguese. Univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis (α = 0.05). Most children had already been to a dental visit (73%). Overall, 31.7% of the parents or guardians reported that their children had experienced dental pain or dental caries. Parental OHL level was classified by tercile as low, medium, and high. The final model showed independent associations between children who had already been to a dental visit and higher parental OHL level (PR = 1.16; 95%CI = 1.00-1.35) when compared to the lowest OHL level, higher parental educational level (PR = 1.39; 95%CI = 1.03-1.87) when compared to lower educational level, the report of children's pain and dental caries (PR = 1.22; 95%CI = 1.09-1.36) and married parents or parents in a common-law marriage (PR = 1.17; 95%CI = 1.03-1.93). The prevalence of children who had already been to a dental visit was higher among those parents with a higher OHL level when compared to those with a lower OHL level.

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.