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.

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.

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

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.

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.

#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.

Oral mucosal lesions' impact on oral health-related quality of life in preschool children.

OBJECTIVES: The aim of this study was to assess the prevalence of oral mucosal lesions and their impact on oral health-related quality of life (OHRQoL) in children aged 5 years. METHODS: A sample of 1118 children from Pelotas' birth cohort, born in 2004 (response rate of 85.8%), were selected to participate in the study. Data were collected using a questionnaire applied to mothers and from the oral examinations of the children. OML were identified by type, site, and size. Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess caregivers' perception on children's OHRQoL. Descriptive, bivariate, and multivariate Poisson regression analyses were carried out, considering the impact on OHRQoL (total ECOHIS score) as the outcome. RESULTS: The prevalence of the OML was 30.1% (95% CI 27.5-32.9). Ulcers were the more prevalent type of lesion (29.4%), and the most affected site was the gums (31.0%). In bivariate analysis, there was a positive association between the presence of OML and OHRQoL impact measured by the following: mean overall score of ECOHIS (P < 0.001); extent (P < 0.001); prevalence (P = 0.030); and intensity (P = 0.010). After adjustments for sociodemographic and oral health variables, children with OML presented higher impact on OHRQoL [rate ratio (RR) 1.38 95% CI 1.11; 1.72] comparing with their counterparts. Analyzing specific domains, children with OML also presented higher impact on children symptoms (RR 1.46 95% CI 1.20; 1.66) and family functional (RR 3.14 95% CI 1.59; 6.22) domains. CONCLUSION: Almost one-third of children presented with oral mucosal lesions, and these lesions impaired children's oral health-related quality of life.

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.

Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil.

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.

[Inequalities in oral health: are schoolchildren receiving the Bolsa Família more vulnerable?]. / Iniquidades em saúde bucal: escolares beneficiários do Bolsa Família são mais vulneráveis?

OBJECTIVE: To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren. METHODS: A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval). RESULTS: Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools. CONCLUSIONS: Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

Uso e necessidade de prótese dentária em idosos brasileiros segundo a Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): prevalências e fatores associados / 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 y necesidad de prótesis dentales en ancianos brasileños, según la Encuesta Nacional de Salud Bucal (SBBrasil 2010): prevalencias y factores asociados

Resumo: O objetivo deste estudo foi avaliar o uso e a necessidade de prótese dentária entre os idosos brasileiros (65-74 anos) e verificar fatores associados. Foram analisados dados de 7.496 idosos participantes do Pesquisa Nacional de Saúde Bucal realizado em 2010 (SBBrasil, 2010). O uso e a necessidade de prótese dentária foram usados como desfechos. As variáveis de exposição incluíram características demográficas, socioeconômicas, de uso de serviços e de autopercepção da saúde bucal. Análises descritiva, bivariada e multivariada foram realizadas. A prevalência de uso e necessidade de prótese dentária foi de 78,2% e 68,7%, respectivamente. A Região Nordeste foi a que apresentou a menor prevalência de uso (71,3%) e a maior de necessidade prótese dentária (82,9%). As análises multivariadas por meio de regressão de Poisson revelaram maior uso de prótese dentária em mulheres, naqueles com 5 a 7 anos de estudos e nos que foram a serviço particular, e houve menor uso em indivíduos pretos e com necessidade autorreferida de prótese dentária. Menor necessidade de prótese dentária foi observada em mulheres e nos usuários de serviço particular, e maior naqueles que autorreferiram necessidade de prótese dentária. Diferenças regionais foram observadas na distribuição do uso e da necessidade de prótese dentária. Ainda assim, os achados revelaram altas prevalências de ambos os desfechos em todas as regiões. Variáveis socioeconômicas, demográficas e de uso de serviços influenciaram a ocorrência de uso e de necessidade de prótese dentária.

Abstract: 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.

Resumen: El objetivo de este estudio fue evaluar el uso y la necesidad de prótesis dentales entre los ancianos brasileiros (65-74 años) y verificar sus factores asociados. Se analizaron datos de 7.496 ancianos participantes en la Encuesta Nacional de Salud Bucal, realizada en 2010 (SBBrasil 2010). El uso y la necesidad de prétesis dentales se usaron como resultados. Las variables de exposición incluyeron características demográficas, socioeconómicas, de uso de servicios y de autopercepción de salud bucal. Se realizaron análisis descriptivos, bivariados y multivariados. La prevalencia de uso y necesidad de prótesis dentales fue de un 78,2% y 68,7%, respectivamente. La región nordeste fue la que presentó la menor prevalencia de uso (71,3%) y la mayor de necesidad prótesis dentales (82,9%). Los análisis multivariados, mediante la regresión de Poisson, revelaron un mayor uso de prótesis dentales en mujeres, en aquellos con 5 a 7 años de estudios y en los que fueron a servicios privados, y hubo un menor uso en individuos negros y con necesidad autorreferida de prótesis dentales. Se observó una menor necesidad de prótesis dentales en mujeres y en los usuarios de servicios particulares, y mayor en aquellos que autoinformaron una necesidad de prótesis dentales. Se observaron diferencias regionales en la distribución del uso y necesidad de prótesis dentales. Incluso así, los hallazgos revelaron altas prevalencias de ambos en los resultados en todas las regiones. Variables socioeconómicas, demográficas y de uso de servicios influenciaron la ocurrencia de uso y necesidad de prótesis dentales.

Influência da vestimenta do cirurgião-dentista e do ambiente do consultório odontológico na ansiedade de crianças pré-escolares durante consulta odontológica: resultados de um estudo piloto

O medo e a ansiedade em odontopediatria podem ser uma barreira para a realização do tratamento odontológico. Objetivo: avaliar a influência da alteração da vestimenta do cirurgião-dentista e da modificação do ambiente do consultório odontológico na ansiedade odontológica de crianças entre 3 e 6 anos de idade. Sujeitos e método: este estudo clínico randomizado controlado cruzado incluiu doze pré-escolares da cidade de Pelotas, no Rio Grande do Sul. Cada criança foi submetida a dois procedimentos odontológicos iguais realizados sob a forma convencional (controle) e com alterações lúdicas no ambiente do consultório odontológico e na vestimenta do profissional (intervenção). O nível de ansiedade das crianças foi avaliado por meio do Venham Picture Test (VPT) modificado. Aos pais/responsáveis foi aplicado um questionário para avaliar a percepção sobre o comportamento de seu filho durante o atendimento odontológico, para analisar a autopercepção de ansiedade foi utilizada a escala de ansiedade odontológica (DAS). A diferença entre o controle e a intervenção foi avaliada pelo teste de Wilcoxon (P < 0,05). Resultados: antes do início da consulta, grande parte dos pais/responsáveis classificou a ansiedade do filho como moderadamente baixa e a própria como alta. Na análise da DAS, a maioria apresentou grau moderado de ansiedade. Não houve diferença nas médias do VPT com relação às duas formas de atendimento (P = 0,8697). Conclusão: este estudo piloto observou que não houve influência na ansiedade odontológica da criança quando o ambiente do consultório e a vesti-menta do CD foram modificados. Mais estudos são necessários a fim de confirmar esse resultado preliminar.