Influence of school environment on occurrence of traumatic dental injuries in 12 years old children.

BACKGROUND/AIM: Since children spend most of their time in school, some environmental characteristics of the schools may influence the occurrence of traumatic dental injuries (TDI). Therefore, the aim of this cross-sectional study was to assess the prevalence of TDI in 12 years old children in Quito, Ecuador, and its association with some school environmental aspects. MATERIAL AND METHODS: Six calibrated examiners evaluated 998 children from 31 public schools of Quito, to evaluate the occurrence of TDI in anterior teeth. School coordinators answered questionnaires on school physical conditions, promotion of health practices and the occurrence of negative episodes in school. The occlusion and socioeconomic status of the participants were also evaluated. Prevalence of TDI, unadjusted and adjusted by the design effect was calculated. Association between individual and contextual explanatory variables and presence of TDI were evaluated using multilevel Poisson regression analysis (P < .05). RESULTS: TDI prevalence adjusted by design effect was 20.7%. Children studying in schools with patio floor of grass and with access ramps had significantly lower prevalence of TDI than children studying in schools with patio floor of cement and with only stairs, respectively. The prevalence of TDI was also lower in children from schools that offered healthy meals or that had a proper place for oral hygiene. CONCLUSIONS: Schools with adequate physical structures and that promote health practices to their students have a lower prevalence of TDI.

Oral health of 12-year-old children in Quito, Ecuador: a population-based epidemiological survey.

BACKGROUND: There is a paucity of population-based surveys on oral health conditions in Ecuador. Thus, the aim of this study was to conduct an epidemiological survey with a representative sample of children aged 12 years from public schools of Quito, Ecuador. The aim of this initial report was to describe the methodology used in the survey, as well to present results regarding calibration procedures and prevalence of oral-health related outcomes. METHODS: We invited 33 public schools' coordinators from the urban area of Quito, and 1100 children (12 years old) to take part in this study. Six trained and calibrated examiners conducted clinical examinations using oral mirrors and ball-ended probes to assess: dental caries, traumatic dental injuries, malocclusion, gingival bleeding, presence of calculus and fluorosis. Children also responded a questionnaire on Oral Health-Related Quality of Life (OHRQoL). Individual sociodemographic data was collected through a questionnaire sent to parents. Moreover, some contextual data on school environment (infrastructure conditions, promotion of health practices and negative episodes) were also evaluated. Prevalence values, crude and weighted by sampling weights, and 95% confidence intervals (95%CI) were calculated. RESULTS: Nine hundred and ninety-eight children from 31 schools were examined from March to May 2017. The adjusted prevalence values (95%CI) for the six outcomes evaluated were: dental caries = 60.3% (55.3 to 65.0%); traumatic dental injuries = 20.7% (17.2 to 24.8%); dental fluorosis = 63.7% (58.5 to 68.5%); gingival bleeding = 92.0% (87.1 to 95.2%); presence of calculus = 69.9 (60.5 to 77.9%); and malocclusion = 25.8% (21.8 to 30.3%). Adjusted mean of number of decayed, missed or filled permanent teeth (DMF-T) was 1.61 (1.37 to 1.84). Results on OHRQoL and other contextual variables will be reported in other articles. CONCLUSION: The prevalence of the majority of oral health problems in 12-year-old children from public schools in Quito-Ecuador was compatible with those observed in other similar cities. However, periodontal health and fluorosis seem to be highly prevalent in children from Quito.

Periodontal status among 12-year-old schoolchildren: a population-based cross-sectional study in Quito, Ecuador.

This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.

Association of children's oral health and school environment on academic performance in 12-year-old schoolchildren of Quito, Ecuador.

OBJECTIVES: The primary aim of this study was to evaluate if children's oral health and oral health-related quality of life (OHRQoL) were associated with school performance. Moreover, the study aimed to examine whether school environment factors influenced this association. METHODS: This cross-sectional study was based on a population-based sample of 998 12-year-old schoolchildren from 31 public schools in Quito, Ecuador. Trained and calibrated examiners conducted clinical exams for dental caries, dental trauma and malocclusion. Furthermore, children completed the Spanish version of the Child Perception Questionnaire (CPQ11-14 ), and their parents answered questions about socio-economic status. School coordinators provided information on the physical environment, promotion of health practices and the occurrence of negative episodes in the school. There were three outcomes: grades obtained in Spanish language and mathematics and the number of missed school days. Multilevel linear and Poisson regression models were conducted using a hierarchical approach to include the variables guided by a previously created direct acyclic graph. RESULTS: Children with dental trauma and higher CPQ11-14 scores showed lower grades and school attendance. Schoolchildren from schools with episodes of vandalism had more school days missed. CONCLUSION: The school performance of 12-year-old children is affected by dental trauma and by a worse OHRQoL, as well as a negative school environment. Therefore, supportive environments and promoting health measures in schools could overcome this worse academic performance in children with oral health problems.

Does the school environment exert influence on quality of life related to traumatic dental injury in children?

The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

Periodontal status among 12-year-old schoolchildren: a population-based cross-sectional study in Quito, Ecuador

Abstract This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.

Does the school environment exert influence on quality of life related to traumatic dental injury in children?

Abstract The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

Evaluación de la microdureza del esmalte afectado por caries incipiente y tratados por dos tipos de barnices fluorados: Estudio in vitro / Avaliação da microdureza do esmalte afetado por cárie incipiente e tratada por dois tipos de vernizes fluoretados: Estudo in vitro / Evaluation of the microhardness of enamel affected by incipient caries and treated by two types of fluoride varnishes: In vitro study

El flúor ha demostrado su efectividad en la terapia de lesiones iniciales de caries. En la actualidad, existen nuevos barni-ces de flúor con agentes remineralizantes adicionales, con la finalidad de tratar las lesiones de caries no cavitadas de una forma no invasiva, promoviendo la remineralización del esmalte. Objetivo: Determinar la microdureza del esmalte con lesiones de caries incipientes tratados con dos barnices fluorados. Materiales y métodos: Estudio experimental in vitro. La muestra estuvo constituida por 35 bloques de esmalte, que fueron divididos de manera aleatoria en 3 grupos. G1(n=5): control negativo; G2 (n=15): Barniz de Flúor (Flúor protector- Ivoclar Vivadent) y G3(n=15): Barniz de flúor con Fosfato Tricálcico (Clinpro White Varnish- 3M ESPE). Se realizaron 3 indentaciones mediante un microdurómetro, con el fin de obtener la dureza inicial, luego se desmineralizaron las muestras con la finalidad de producir lesiones incipientes, donde se realizaron nuevamente 3 indentaciones para obtener la microdureza del esmalte desmineralizado, concluida esta fase se colocó el remineralizante en cada muestra y se siguió un régimen de pH cíclico durante 7 días para simular las condiciones bucales, transcurrido este periodo se realizaron 3 indentaciones en cada muestra para obtener la dureza final del esmalte remineralizado, llegando a un total de 9 indentaciones por muestra. Los datos se analizaron mediante el test de Scheffé y la prueba T de Student con un nivel de significancia del 5%. Resultados: Existió diferencia significativa entre el barniz fluorado con Fosfato Tricálcico (TCP) con el grupo control (p=0,03). No se encontraron diferencias significativas entre los diferentes barnices fluorados (p=0,09). Fue observada una mejora significativa de la microdureza postratamiento de ambos barnices de flúor (p<0.001). Conclusión: Los dos tipos de barnices de flúor incrementaron de manera eficiente la microdureza del esmalte con lesión de caries incipiente, sin existir diferencia significativa entre estos dos.

Fluoride has shown its effectiveness in the therapy of initial lesions of caries. Currently, there are new fluoride varnishes with additional remineralizing agents, to treat lesions of non-cavitated caries in a non-invasive way, promoting the remineralization of the enamel. Objective: To determine the microhardness of enamel with incipient caries lesions treated with two fluoride varnishes. Materials and methods: In vitro experimental study. The sample consisted of 35 enamel blocks, which were randomly divided into 3 groups. G1 (n=5): negative control; G2 (n=15): Fluorine varnish (Flúor protector - Ivoclar Vivadent) and G3 (n=15): Fluorine varnish with Tricalcium Phosphate (Clinpro White Varnish - 3M ESPE). Three indentations were made by means of a microhardness meter, in order to obtain the initial hardness, then the samples were demineralized with the purpose of producing incipient lesions, where 3 indentations were made again to obtain the microhardness of the demineralized enamel, after this phase the remineralizing solution in each sample and a cyclical pH regime was followed during 7 days to simulate the oral conditions, after this period 3 indentations were made in each sample to obtain the final hardness of the remineralized enamel, reaching a total of 9 indentations per sample. The data were analyzed using the Scheffé test and the Student's T test with a level of significance of 5%. Results: There was a significant difference between the fluoride varnish with Tricalcium Phosphate (TCP) and the control group (p=0.03). No significant differences were found between the different fluorinated varnishes (p=0.09). A significant improvement of the microhardness after treatment of both fluoride varnishes was observed (p<0.001). Conclusion: The two types of fluoride varnishes efficiently increased the microhardness of enamel with incipient caries lesion, without significant difference between these two.

O flúor tem mostrado sua efetividade na terapia das lesões iniciais de cárie. Atualmente, existem novos vernizes de flúor com agentes remineralizantes adicionais, a fim de tratar lesões de cárie não cavitadas de forma não invasiva, promovendo a remineralização do esmalte. Objetivo: Determinar a microdureza do esmalte com lesões de cárie incipientes tratadas com dois vernizes de flúor. Materiais e métodos: Estudo experimental in vitro. A amostra consistiu em 35 blocos de esmalte, que foram divididos aleatoriamente em 3 grupos. G1 (n=5): controle negativo; G2 (n=15): Verniz de flúor (Fluor protector - Ivoclar Vivadent) e G3 (n=15): Verniz de flúor com fosfato tricálcico (Clinpro White Varnish -ESPE 3M). Três indentações foram feitas por meio de um microdurômetro para obter a dureza inicial, depois as amostras foram desmineralizadas com o objetivo de produzir lesões incipientes, onde foram feitas novamente três indentações para obter a microdureza do esmalte desmineralizado, após essa fase foi colocado a solução remineralizante em cada amostra e um regime de pH cíclico foi fei-to durante 7 dias para simular as condições bucais, após esse período foram feitas 3 indentações em cada amostra para obter a dureza final do esmalte remineralizado, atingindo um total de 9 indentações por amostra. Os dados foram analisados uti-lizando o teste Scheffé e o teste T de Student com um nível de significância de 5%. Resultados: Houve diferença significa-tiva entre o verniz fluoretado com fosfato tricálcico (TCP) e o grupo controle (p=0,03). Não foram encontradas diferenças significativas entre os diferentes vernizes fluoretados (p=0,09). Observou-se uma melhoria significativa da microdureza após o tratamento de ambos os vernizes de flúor (p<0,001). Conclusão: Os dois tipos de vernizes de flúor aumentaram de forma eficiente a microdureza do esmalte com lesão de cárie incipiente, sem existir diferença significativa entre estes dois.

Influência do ambiente escolar na ocorrência de traumatismos dentários e qualidade de vida relacionada à saúde bucal em crianças de 12 anos da cidade de Quito, Equador / Influence of school environment on the occurrence of dental traumatic injuries and oral health-related quality of life in 12-year-old children from Quito, Ecuador

O objetivo geral deste estudo transversal foi realizar um levantamento epidemiológico de traumatismos dentários em crianças de 12 anos de Quito, no Equador e investigar a associação de fatores relacionados ao ambiente escolar e a ocorrência de traumatismos e na qualidade de vida relacionada a saúde bucal dessas crianças. Para isso, um levantamento epidemiológico em escolares de escolas públicas de Quito foi realizado para avaliar diferentes agravos de saúde bucal. A tese foi dividida em dois capítulos, com os seguintes objetivos: avaliar se alguns fatores relacionados ao ambiente escolar possuem associação com a ocorrência de traumatismos (Capítulo I), e avaliar se fatores positivos relacionados ao ambiente físico, social e de práticas de atividades relacionadas à saúde em escolas exercem efeito no impacto na qualidade de vida relacionada à ocorrência de traumatismos dentários (Capítulo II). O estudo foi realizado com uma amostra representativa de crianças de 12 anos de idade em escolas públicas da zona urbana de Quito, no Equador. Seis examinadores calibrados avaliaram as crianças com relação à presença de traumatismos dentários, cárie dentária e maloclusão. Um inquérito relacionado às condições socioeconômicas da família foi respondido. Os diretores das escolas também responderam a questões relacionadas à estrutura física da escola, à promoção de práticas de promoção de saúde e à ocorrência de episódios negativos na escola. O Child Perceptions Questionnaire (CPQ11-14) foi respondido pelas crianças. Para as análises, regressão de Poisson de multinível foi utilizada, e as razões de taxas (RT) e intervalos de confiança a 95% (95%IC) foram calculados (p < 0,05). A prevalência de traumatismo foi de 20,7%. Escolas com pátio de piso de grama e com rampas de acesso tiveram menor prevalência de traumatismos do que as escolas com pátio de piso de cimento e com apenas com escadas, respectivamente. A prevalência de traumatismo também foi menor em escolas que ofereciam refeições saudáveis ou local apropriado para escovação dentária. Já com relação à qualidade de vida, a ocorrência de traumatismos severos foi associada à maiores escores do CPQ11-14, mesmo no modelo múltiplo ajustado por outros problemas de saúde bucal, sexo, variáveis socioeconômicas e variáveis contextuais. As crianças de escolas que promoviam a escovação dos dentes de seus alunos apresentaram menor impacto na qualidade de vida, mesmo quando ajustada pela presença de traumatismos e outras variáveis. Conclui-se que escolas com um ambiente mais favorável apresentam menor prevalência de traumatismos e exercem efeito positivo na qualidade de vida relacionada à saúde bucal, mesmo na ocorrência de traumatismos dentários.