Oral habits, sociopsychological orthodontic needs, and sociodemographic factors perceived by caregivers impact oral health-related quality of life in children with and without autism?

BACKGROUND: Caregivers play a crucial role in assessing the oral health-related quality of life (OHRQoL) of young individuals with autism spectrum disorder (ASD). AIM: This study assessed the impact of sociodemographic and oral conditions on OHRQoL and family dynamics in young individuals with and without autism, as perceived by guardians. DESIGN: This comparative cross-sectional study included young individuals aged 6 to 14 years and their guardians. Data were collected at a specialized institution and dental schools. Guardians completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS), and sociodemographic and oral habits questionnaires. The sociopsychological need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). RESULTS: The sample included 144 youths and caregivers. The ASD group had higher P-CPQ and FIS scores. Factors associated with poorer perceived OHRQoL included higher youth age, lower caregiver education, higher IOTN scores, teeth clenching (RR = 1.20; 95% CI: 1.01-1.41), and lip sucking. Lower parental education (RR = 1.75; 95% CI: 1.10-2.80) and higher IOTN scores from the caregiver's perspective impacted family dynamics. CONCLUSION: Caregivers of young individuals with ASD perceived a lower OHRQoL, and families in this group were more affected by sociodemographic and oral conditions.

Use of Photobiomodulation to Reduce Postoperative Pain, Edema, and Trismus After Third Molar Surgery: A Systematic Review and Meta-Analysis.

PURPOSE: Third molar extraction can cause surgical trauma, which is associated with pain, edema, trismus, and functional limitations. The aim of the present systematic review was to investigate the effects of photobiomodulation (PBM) following the extraction of impacted mandibular third molars. METHODS: An electronic search was conducted in 10 databases from inception up to October 2021 and the grey literature, with no restrictions regarding language or year of publication. Randomized controlled clinical trials (RCT) were included. Studies that were not RCTs were excluded. Reviewers independently analyzed titles and abstracts, followed by full-text analysis. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The exposure variable was the use of PBM and the outcomes were pain, edema, and trismus. Meta-analysis was performed using a random-effects model. The estimate was calculated considering standardized mean differences (SMD) and respective 95% confidence intervals (CI) obtained for each outcome on the first, second, third and seventh postoperative days. The level of evidence was assessed using the GRADE approach. RESULTS: The search resulted in the 3,324 records. Thirty-three RCTs were included in the systematic review and 23 of these were included in the meta-analyses. The studies involved a total of 1,347 participants (56.6% female and 43.4% male) between 16 and 44 years of age. A greater reduction in pain was found in the PBM group compared to the control group on the third postoperative day (SMD: -1.09; 95% CI: -1.63; -0.55; P < .001; low certainty). Edema was discretely lower in the PBM group on the second postoperative day (SMD: -0.61; 95% CI: -1.09; -0.13; P < .001; low certainty) and trismus was discretely lower in the PBM group on the seventh postoperative day (SMD: 0.48; 95% CI: 0.00; 0.96; P < .001; very low certainty). CONCLUSION: The evidence of the effect of PBM regarding the control of pain, edema, and trismus following third molar extractions is low or very low.

Attention-deficit/hyperactivity disorder and oral health literacy exert an influence on the occurrence of dental caries in early adolescence.

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Validation for Brazilian Portuguese language of the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P).

BACKGROUND: Oral health literacy (OHL) is associated with oral health outcomes. AIM: To validate the Brazilian Portuguese version of the Hong Kong OHL Assessment Task for Paediatric Dentistry (HKOHLAT-P). DESIGN: We performed cross-cultural adaptation of the HKOHLAT-P. A sample of 200 pre-schoolers and caregivers from Campina Grande, Brazil completed the Brazilian HKOHLAT-P (BOHLAT-P), sociodemographic questionnaire, the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Child dental caries was assessed. Instrument reliability was measured by internal consistency (Cronbach's alpha) and test-retest (ICC). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) evaluated dimensionality. Regression models tested associations between BOHLAT-P and exploratory variables (P < .05). RESULTS: BOHLAT-P demonstrated excellent reliability (Cronbach's alpha = 0.92; ICC = 0.95). BOHLAT-P and BREALD-30 scores (r = .71), number of schooling years (r = .60), and reading hours (r = .34) were positively correlated. BOHLAT-P and B-ECOHIS scores (r = -.22), and BOHLAT-P scores and number of cavitated teeth (r = -.15) were negatively correlated. After controlling for confounding variables, BOHLAT-P scores were not associated with caries or number of teeth with cavitated caries. CONCLUSION: BOHLAT-P is a valid and reliable instrument to assess the OHL of Brazilian parents.

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.

Impact of oral health problems on the quality of life of preschool children: a case-control study.

BACKGROUND: There is a need for investigations into the impact of oral problems on OHRQoL with study designs that offer greater strength of evidence. AIM: To evaluate the impact of dental caries and traumatic dental injury (TDI) on the OHRQoL of Brazilian preschool children. DESIGN: A population-based, matched, case-control study was conducted involving 415 children aged 3-5 years enrolled at public and private preschools. The case group (impact on OHRQoL) and control group (no impact on OHRQoL) were matched for age, sex, and monthly household income at a 1 : 4 ratio (83 cases and 332 controls). Impact on OHRQoL was assessed using the B-ECOHIS. Dental caries and TDI were determined through clinical oral examinations. Data analysis involved descriptive statistics and conditional logistic regression analysis (P ≤ 0.05; 95% CI). RESULTS: The most frequent responses on the B-ECOHIS were 'felt pain' (79.7%) and 'difficulty in eating' (35.0%). The following variables were significantly associated with impact on OHRQoL: caries severity (OR = 12.58; 95% CI: 5.31-29.79) and TDI (OR: 2.11; 95% CI: 1.23-3.62). CONCLUSIONS: Caries severity and TDI impacted the OHRQoL of preschool children.

Effect of an Educational Programme on the Knowledge Level Among an Emergency Service Medical Team Regarding Tooth Avulsion.

PURPOSE: To evaluate the effectiveness of an educational intervention in improving the level of knowledge of tooth avulsion among non-dental healthcare professionals of an emergency medical service in Brazil and the maintenance of this knowledge after a 6-month period. MATERIALS AND METHODS: An intervention study was carried out involving the administration of a questionnaire and presentation of a lecture to 73 healthcare professionals (11 physicians, 41 nurses and 21 paramedics) of an emergency medical service in Brazil. The questionnaire was administered before (T0), immediately after (T1) and 6 months after the lecture (T2). McNemar's test was used to compare the responses, with the significance level set at 5% (p < 0.05). RESULTS: A general improvement was found regarding the concept of tooth avulsion, replantation, conduct in cases of avulsion, ideal time for replantation, ability to perform replantation and storage medium prior to replantation between baseline (T0) and the post-lecture evaluations (p < 0.05). However, an increase in insecurity regarding replantation was found between T1 and T2 (p < 0.001). CONCLUSION: The educational intervention led to a significant increase in the number of correct answers regarding the measures to be taken in cases of tooth avulsion. The professionals' knowledge level remained high 6 months after the lecture. However, a certain degree of insecurity was found regarding the ability to perform replantation.

Is thermography an effective screening tool for differentiating benign and malignant skin lesions in the head and neck? A systematic review.

The aim of this study was to assess, through a systematic review, the status of infrared thermography (IRT) as a diagnostic tool for skin neoplasms of the head and neck region and in order to validate its effectiveness in differentiating benign and malignant lesions. A search was carried out in the LILACS, PubMed/MEDLINE, SCOPUS, Web of Science and EMBASE databases including studies published between 2004 and 2024, written in the Latin-Roman alphabet. Accuracy studies with patients aged 18 years or over presenting benign and malignant lesions in the head and neck region that evaluated the performance of IRT in differentiating these lesions were included. Lesions of mesenchymal origin and studies that did not mention histopathological diagnosis were excluded. The systematic review protocol was registered in the PROSPERO database (CRD42023416079). Reviewers independently analyzed titles, abstracts, and full-texts. After extracting data, the risk of bias of the selected studies was assessed using the QUADAS - 2 tool. Results were narratively synthesized and the certainty of evidence was measured using the GRADE approach. The search resulted in 1,587 records and three studies were included. Only one of the assessed studies used static IRT, while the other two studies used cold thermal stress. All studies had an uncertain risk of bias. In general, studies have shown wide variation in the accuracy of IRT for differentiating between malignant and benign lesions, with a low level of certainty in the evidence for both specificity and sensitivity.

Individual and contextual determinants associated with bullying in schoolchildren eight to ten years of age.

Investigate individual and contextual determinants associated with bullying in schoolchildren eight to ten years of age. A cross-sectional study was conducted with 739 schoolchildren, who answered a question about episodes of bullying related to oral health and questionnaires addressing childhood anxiety and orofacial dysfunction. The guardians provided information on sociodemographic characteristics, sleep disorders, and oral health literacy. Trained examiners assessed the children for the diagnosis of dental caries using the International Caries Detection and Assessment System, malocclusion using the Dental Aesthetic Index, orofacial dysfunction using the Nordic Orofacial Test-Screening and traumatic dental injury (Andreasen criteria) (Kappa> 0.80). The contextual variables were the type of school and the monthly income of the school neighborhood. Descriptive statistics was performed to characterize the sample and unadjusted and adjusted (p <0.05) multilevel Poisson regression models were run. The prevalence of bullying was 13.3%. After the adjusted analysis, malocclusion (PR=1.59; 95%CI:1.03-2.44) and anxiety (PR=1.79; 95%CI:1.10-2.93) remained associated with bullying. In terms of context, the monthly income of the neighborhood of the school was associated with bullying (PR=1.75; 95%CI:1.12-2.72). Malocclusion and anxiety influenced the occurrence of bullying. A lower average income in the school neighborhood was an important contextual determinant for the increase in the prevalence of bullying.

External root thermal analysis of three different obturation techniques.

Background: The purpose of this study was to assess the external root surface thermal behavior when submitted to three different obturation techniques. Material and Methods: Forty-five single-rooted premolars were selected, prepared and randomly divided into three groups according to the studied obturation techniques: lateral condensation (LC), single cone technique (SCT) and injectable thermoplasticized technique (IT). Each tooth was placed in a customized apparatus and connected to a thermocouple. A FLIR T650sc infrared thermal camera was used to assess root temperature in a room under controlled temperature and humidity. Temperature values were recorded using the thermal camera and thermocouples before, during and 30, 60, 90, 120, 150s after obturation. Shapiro-Wilk, QQ-plot, Levene's, ANOVA-three-way, Mauchly's sphericity, Box's M and Bonferroni tests were used to assess data. The significance level was set at 5%. Results: Infrared assessment showed significant temperature changes between time intervals, obturation techniques and root thirds. Temperature increase was observed 30s after obturation for STL, LC and IT, followed by a gradual temperature decline, with temperature values similar to the initial temperature at 150s for LC and IT. SCT temperature values only returned to normal 60s after obturation in the apical third and 90s in the middle and cervical thirds. In all techniques, the temperature did not rise above the critical limit of 10°C. Conclusions: All studied obturation techniques increased root surface temperature with IT showing the highest temperature increase. However, the temperature increase does not exceed the acceptable limits, not causing damage to the surrounding tissues. Key words:Endodontics, changes in body temperature, root canal filling, thermography.

Oral cancer: analysis of the clarity of publications in Instagram profiles of official health agencies in Brazil.

This article aims to analyze the clarity and engagement measures of publications on oral cancer in the Instagram profiles of official health agencies in Brazil. An infodemiological study was conducted with 81 profiles. Data collected concerned content classification, account and media, manner of addressing the topic, number of posts, likes, comments, views and hashtags. The clarity of the educational publications was assessed with the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis involved Spearman's correlation and the Mann-Whitney test (α = 5%). A total of 775 publications on oral cancer were found. The average BR-CDC-CCI score was 69.8 (SD = 15.5). The clarity of the information was adequate in 9.5% of the educational publications. Positive correlations were found between the number of likes and engagement (comments [r = 0.49], views [r = 0.96]), number of hashtags (r = 0.13) and year of publication (r = 0.21). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score compared to the other profiles. Publications on oral cancer were correlated with engagement, year of publication and number of hashtags. Public agencies increased publications to reach the population, but the clarity of the content was low.

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment.

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Comparative cross-sectional study of socio-psychological orthodontic needs and oral habits in Autism Spectrum Disorder.

OBJECTIVE: This cross-sectional study analyzed the socio-psychological need for orthodontic treatment in children and adolescents with and without Autism Spectrum Disorder (ASD) and its association with deleterious oral habits. METHODS: Children/adolescents aged 6-14 years old, with and without ASD, and their respective caregivers were included. Caregivers completed a questionnaire addressing children and adolescents' deleterious oral habits. To assess the socio-psychological need for orthodontic treatment, we utilized the aesthetic component of the Index of Orthodontic Treatment Needs (IOTN). Caregivers and an orthodontist independently used the standardized IOTN aesthetic attractiveness scale containing ten intraoral photographs and compared them with the most similar condition of the child/adolescent. Data collection occurred at two universities in northeastern Brazil and at an ASD referral center. Statistical analyses encompassed descriptive statistics, Shapiro-Wilk, Kruskal-Wallis, Mann-Whitney, and Chi-squared tests with linear trend (α5%). RESULTS: The study involved 144 participants, evenly divided into two groups (ASD and non-ASN). The ASD group showed higher average IOTN-AC scores as evaluated by both professionals (mean score = 4.78 [± 2.34], p = .182) and caregivers (mean score = 4.31 [± 2.71], p = .992). Caregivers reported notably elevated IOTN-AC scores in cases where onychophagy was absent (p = .049). CONCLUSIONS: Patients with ASD are indicated as having a relatively higher socio-psychological need for orthodontic treatment.

Clarity of publications on HPV in Instagram profiles of official health agencies in Brazil.

The study analyzed the clarity of publications on human papillomavirus (HPV) in the Instagram profiles of official Brazilian health agencies. An infodemiological study analyzed publications on HPV in the 81 Instagram profiles selected from the Health Ministry, States' Health Departments, and dental councils and associations. The following data were collected: classification of content, type of profiles, type of media, how the content was addressed, number of posts, frequency, likes, comments, viewings, and hashtags, and how the HPV vaccine was addressed. The clarity of the educational publications was assessed using the Brazilian version of the Clear Communication Index (BR-CDC-CCI). Data analysis was performed with Spearman's correlation and the Mann-Whitney test (p < 0.05). A total of 504 publications on HPV were found. The average number of likes was 528.3 (SD = 2388.2) and the average BR-CDC-CCI score was 67.1 (SD = 14.1). The quality and clarity of the information was considered adequate (BR-CDC-CCI score ≥ 90) in 6.9% of the publications. A weak positive correlation was found between the number of likes and both the BR-CDC-CCI score (r = 0.195) and number of posts (r = 0.124). Publications from the Health Ministry had a significantly higher BR-CDC-CCI score (72.9) compared to the other profiles analyzed (p = 0.01). Most publications concerned government actions, had low engagement, and written educational information was of low clarity and quality. However, the effort to reach the population was evident, with an increase in publications over the years.

The impact of the COVID-19 pandemic in Brazil: a study in tertiary dental care.

The pandemic caused by coronavirus has resonated throughout different levels of health care in Brazil and, in this context, the present research aimed to evaluate this impact on tertiary dental care provided by the Unified Health System (SUS). Therefore, an ecological study was conducted with data obtained from the Hospital Information System processed by the Portal of the Department of Informatics of SUS. The sample consisted of patients of all sexes and age groups, whose Hospital Admission Authorizations (AIHs) were approved for dental tertiary care procedures from January 2015 to December 2020. Descriptive analyses and the ANOVA test with a significance level set at p < 0.05 were used. When the annual mean numbers of AIHs approved were evaluated, findings showed that on an average, the Southeast region authorized a higher number of procedures (p-value < 0.001), however, in the pandemic year (2020), a reduction of approximately 24.5% of these hospitalizations occurred throughout Brazil, with the Midwest being the region most affected (32.12%). A percentage increase occurred in the Surgical Treatment of Oral sinus/Oral nasal Fistula (16.1%), in addition to a significant decrease in performing procedures for Resection of Mouth Lesion (33.4%). In the pandemic year, there was a reduction of 14% in expenditures related to hospital services and 23.26% related to professional services. It was concluded that the data presented demonstrated a significant reduction in AIHs for tertiary dental care in the pandemic year.

Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review.

OBJECTIVE: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). METHODOLOGY: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). RESULTS: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. CONCLUSION: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.

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 the Brazilian Oral Health Literacy-Adults Questionnaire.

BACKGROUND: Recognizing that a deficit of reading and numeracy skills is associated with poorer oral health, contemporary researchers have identified additional components as important attributes of oral health literacy (OHL). So, the use of comprehensive functional OHL tools is crucial. The Oral Health Literacy-Adults Questionnaire (OHL-AQ) evaluates reading comprehension, numeracy, listening and decision-making skills. OBJECTIVE: Describe the validation process of the OHL-AQ Brazilian version (BOHL-AQ). METHODS: The cross-culturally adapted version, BOHL-AQ, was applied to 180 employees age 18 to 71 years (mean = 37.2; standard deviation [SD] = 11.7) from a private university located in the Southeast of Brazil. Psychometric properties were evaluated through the analysis of internal consistency (Cronbach's alpha), reproducibility (test-retest), convergent validity (BREALD-30; education level), discriminant validity (family income; dental services), predictive validity (self-perception; literacy questions) and construct validity (Exploratory Factor Analysis). Confirmatory Factor Analysis (CFA) evaluated the dimensionality of the BOHL-AQ, with Promax method for rotation. Data were analyzed using SPSS Statistics software and the Mplus program. KEY RESULTS: BOHL-AQ mean score = 11.84 (SD = 3.1); administration mean time = 8 minutes (SD = 1.6); good internal reliability (Cronbach's alpha = 0.73) and excellent reproducibility (kappa = 0.89; intraclass correlation coefficient = 0.97). Preliminary tests showed that data were suitable for PCA (Kayser-Meyer-Olkin measure = 0.75; Barlett's Test of Sphericity significant [p < .001]). CFA showed that the instrument had a four-factor solution with excellent model fit estimates (χ2 = 636.587154.16, p value = .00117, Comparative Fit Index = 0.9787, Tucker Lewis index = 0.97, and Root Mean Square Error of the Approximation = 0.03). BOHL-AQ high scores significantly correlated to high education level, dental visit within the last year and for preventive reason, more independence and self-confidence on reading and filling out health forms, and better oral health self-perception (p < .05). CONCLUSIONS: The BOHL-AQ showed to be a fast and reliable instrument to assess a comprehensive functional OHL at Brazilian community and clinical settings. [HLRP: Health Literacy Research and Practice. 2022;6(3):e224-e231.] Plain Language Summary: Recognizing the need of advancing knowledge related to OHL, this study aimed to describe the validation process of the BOHL-AQ. Cross-cultural adaptation and psychometric properties evaluation presented satisfactory results. The BOHL-AQ proved to be a fast and valid instrument to measure comprehensive functional OHL in the Brazilian context.

Development and validation of a short form of the BOHLAT-P.

The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

Use of electronic devices, practice of sports, and awake bruxism in schoolchildren aged eight to ten years.

The aim of the present study was to investigate whether possible awake bruxism (AB) is associated with the use of electronic devices and the practice of sports in schoolchildren aged eight to ten years. A cross-sectional study was conducted with 739 students in public and private schools in the city of Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing sociodemographic data. The children answered questions about use of electronic devices, practice of sports, and AB. Statistical analysis involved robust logistic regression for complex samples (α = 5%). The prevalence of possible AB was 14.9%. Being female (OR = 1.71, 95%CI: 1.11-2.63), being the middle child (OR = 2.19, 95%CI: 1.14-3.88), having unmarried parents (OR = 1.73, 95%CI: 1.13-2.65), daily use of a cell phone/tablet/computer (OR = 1.82, 95%CI: 1.19-2.80), use of electronic devices for two or more hours per day (OR = 1.97, 95%CI: 1.35-2.86), and playing sports in and/or out of school (OR = 1.60, 95%CI: 1.18-2.52) remained associated with possible AB in the final model. The presence of possible AB was influenced by the use of electronic devices and the practice of sports among schoolchildren aged eight to ten years.