Do progression rates of initial and moderate caries lesions and sound surfaces of primary teeth increase significantly after 7 years?

BACKGROUND: Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups. AIM: To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years. DESIGN: This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors. RESULTS: IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome. CONCLUSION: The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.

Short and long effects of the COVID-19 context on oral health-related quality of life of adolescents.

AIM: To assess the immediate and late effects of the COVID-19 pandemic on the oral health-related quality of life (OHRQoL) of adolescents. DESIGN: This is a longitudinal study performed with adolescents (11-15 years old) from Southern Brazil who were evaluated before the COVID-19 outbreak, and 3 (T2) and 15 (T3) months after the beginning of the pandemic. OHRQoL was assessed using the CPQ11-14. Sociodemographic and clinical variables were also collected. Changes in OHRQoL before, 3 and 15 months after the start of the pandemic were analyzed through multilevel Poisson regression models for repeated measures. RESULTS: A total of 290 adolescents were evaluated at T1, 207 were re-evaluated at T2, and 204 at T3. Overall CPQ11-14 scores over follow-ups were 11.0 (SD 8.0) at T1, 8.3 (SD 7.8) and 12.8 (SD 8.8) at T3. Compared to T1, adolescents presented 29% lower overall CPQ11-14 scores (IRR 0.71 95% CI 0.66-0.75) at T2, and 11% higher scores at T3 (IRR 1.11 95% CI 1.05-1 0.17), especially for the emotional and social well-being domains. CONCLUSION: COVID-19 pandemic impacted the adolescents' OHRQoL differently over time, indicating a reduction in impacts immediately after the beginning and worsening over long term exposure to this scenario.

Oral health literacy and its association with oral health-related quality of life amongst pregnant women: a cross-sectional study.

PURPOSE: This study aimed to evaluate the association of oral health literacy (OHL) and oral health-related quality of life (OHRQoL) of pregnant women. METHODS: This cross-sectional study evaluated a representative sample of pregnant women assisted in public health services in southern Brazil. Demographic, socioeconomic, psychosocial and behavioural data were collected through structured questionnaires. The Oral Health Impact Profile (OHIP-14) questionnaire was used to evaluate the OHRQoL. The Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) was used to measure OHL. Dental caries and gingival bleeding were evaluated by clinical examinations. Adjusted multilevel Poisson regression models with a hierarchical approach were used to assess the associations. The results are presented as rate ratio (RR) and 95% confidence interval (95% CI). RESULTS: A total of 520 pregnant women were evaluated. Pregnant women with lower levels of OHL presented overall OHIP-14 scores 14% higher (RR 1.14; 95% CI 1.07-1.22) than their counterparts. High household income and high education level were related to low overall OHIP-14 scores. Furthermore, less dental attendance, low social support, untreated dental caries and gingival bleeding were also associated with high overall OHIP-14 scores. CONCLUSION: Our findings reinforce that health literacy levels influence patient-reported outcomes. Pregnant women with lower OHL were more likely to present poorer OHRQoL.

Social capital and possible bruxism during the COVID-19 pandemic among Brazilian undergraduates.

This study investigated the prevalence of possible bruxism and its association with social capital among undergraduates during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was conducted at a private university in Southern Brazil. Data were collected through a self-administered electronic questionnaire (Google Forms). Possible bruxism was measured using the following question: "Do you grind your teeth or clench your jaws?". Social capital was evaluated using individual social networks. Data on self-perceived oral health, anxiety, sociodemographics, and information related to university graduates were also collected. Adjusted logistic regression models with a hierarchical approach were used to evaluate associations. The results are presented as odds ratios (ORs) and 95% confidence intervals (95%CIs). Altogether, 345 undergraduates participated in the study, with a mean age of 21.8 years (standard deviation = 5.21). The prevalence of bruxism in the sample was 57.1%. Undergraduates with low social capital had 2.06 times greater odds of bruxism than their counterparts (OR 2.06; 95%CI 1.11-3.83). Female undergraduates (OR 2.40, 95%CI 1.39-4.12), those who were in the final year of university (OR 1.13, 95%CI 1.04-1.21), and those who perceived they needed dental treatment (OR 1.91; CI: 1.21-3.02) also had greater odds of possible bruxism. In conclusion, the prevalence of possible bruxism was high among undergraduate students during the COVID-19 pandemic and associated with lower social capital levels. Knowledge of these factors is important to identify risk groups and plan strategies to control bruxism in this population.

Does the liner material influence pulpal vitality in deep carious cavities submitted to selective caries removal? A network meta-analysis review.

OBJECTIVES: To evaluate whether the restorative material in direct contact with the dentin influences pulp vitality in primary and permanent teeth with deep carious lesions restored after selective caries removal (SCR). MATERIAL AND METHODS: Systematic searches of databases MEDLINE via PubMed, Scopus and ISI Web of Science were performed for primary and permanent teeth. Inclusion criteria were applied for title and abstract reading of databases search results. After full texts review of included studies, those that did not meet exclusion criteria were excluded from meta-analysis. RESULTS: For meta-analysis, 2 studies were included for permanent teeth and 6 for primary teeth. The failure events reported were meta-analyzed using two statistical methods: standard pairwise meta-analysis (SPMA) and network meta-analysis (NMA). The SPMA identified similar failure occurrence of restorations performed with calcium hydroxide (CH) and other liner materials (RR 0.84, 95% CI 0.41, 1.74; p = 0.64), no significant difference between the use of alternative liners or CH regardless deciduous or permanent teeth (RR 0.79, 95% CI 0.36, 1.71; p = 0.55) and similar risk of failing at different follow-ups for all liner materials tested (RR 0.77, 95% CI 0.35, 1.70; p = 0.52). Probabilistic analysis indicated GIC as liner material with the highest probability of clinical success (SUCRA = 72.76%), and CH ranked as the worst liner material (SUCRA = 21.81%). CONCLUSION: Pulpal vitality was not affected by material used as liner after selective caries removal in deep carious cavities. CLINICAL RELEVANCE: Current clinical evidence supports the weak recommendation to not use calcium hydroxide as liner after SCR.

Uso de óxido nitroso como sedação consciente por profissionais de odontologia no Rio Grande do Sul: um estudo transversal / Prevalence of nitrous oxide use as conscious sedation by dentistry professionals in Rio Grande do Sul: a cross-sectional study

Objetivo: Avaliar fatores associados, percepção e prevalência do uso de óxido nitroso por cirurgiões-dentistas do Rio Grande do Sul, Brasil. Metodologia: Realizou-se um estudo transversal, de base eletrônica, com profissionais registrados no Rio Grande do Sul. A coleta de dados baseou-se no envio, por e-mails e campanhas no Instagram, de um questionário via plataforma Google Forms contendo 27 questões acerca do uso de óxido nitroso em atendimentos odontológicos, bem como o perfil e as percepções dos profissionais sobre a técnica. Resultados: Dos 220 participantes, apenas 12,3% utilizava o óxido nitroso em sua prática clínica, sendo as especialidades que mais utilizavam, cirurgia e odontopediatria. Dentre os que reportaram utilizar a técnica, 81,5% tinham mais de 29 anos (p<0,001) e possuíam curso de pós-graduação, sendo que destes, 55,6% realizou o curso de habilitação (p<0,01) e mais da metade (55,6%) relatou utilizar em pacientes adultos (p<0,001). O alto custo do equipamento, bem como a falta de interesse dos profissionais, foram as principais razões para o não uso da técnica. Conclusão: A técnica de sedação consciente com óxido nitroso é pouco usada pelos cirurgiões-dentistas no Estado do Rio Grande do Sul. É possível que a ampliação do conhecimento acerca da indicação e aplicação do óxido nitroso, ainda durante a graduação, possa expandir o uso e contribuir para uma melhor qualidade no atendimento de pacientes com medo e ansiedade odontológicos. (AU)

Objective: The aim of this study is to evaluate associated factors, perception and prevalence of nitrous oxide use by dental surgeons in Rio Grande do Sul, Brazil. Methodology: A cross-sectional, electronic-based study was carried out with professionals registered in Rio Grande do Sul. Data collection was based on sending, via emails and Instagram campaigns, a questionnaire via the Google Forms platform containing 27 questions about the use of nitrous oxide in dental care, as well as the profile and perceptions of professionals about the technique. Results: Of the 220 participants, only 12.3% used nitrous oxide in their clinical practice, the specialties they used most being surgery and pediatric dentistry. Among those who reported using the technique, 81.5% were over 29 years old (p<0.001) and had a postgraduate course, of which 55.6% completed the qualification course (p<0.01) and more than half (55.6%) reported using it in adult patients (p<0.001). The high cost of the equipment, as well as the lack of interest from professionals, were the main reasons for not using the technique. Conclusion: The conscious sedation technique with nitrous oxide is little used by dental surgeons in the State of Rio Grande do Sul. It is possible that expanding knowledge about the indication and application of nitrous oxide, even during graduation, can expand its use and contribute to a better quality of care for patients with dental fear and anxiety. (AU)

Dental caries prediction and the indication of pit and fissure sealant in children first permanent molars: A prospective study.

OBJECTIVES: To evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants. METHODS: This 7-y cohort study started in 2010 with a sample of 639 children (1-5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor. RESULTS: 449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars. CONCLUSIONS: Distal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant. CLINICAL RELEVANCE: Our findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.

The Different Roles of Structural and Cognitive Social Capital on Oral Health-Related Quality of Life among Adolescents.

This study evaluated the relationship of structural and cognitive dimensions of social capital with oral health-related quality of life (OHRQoL) among adolescents. This was a cross-sectional study nested in a cohort of adolescents from southern Brazil. OHRQoL was evaluated using the short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14). Structural social capital was measured by attendance of religious meetings and social networks from friends and neighbours. Cognitive social capital was evaluated through trust in friends and neighbours, perception of relationships in the neighbourhood, and social support during hard times. Multilevel Poisson regression analysis was performed to estimate the association between social capital dimensions and overall CPQ11-14 scores; higher scores corresponded to worse OHRQoL. The sample comprised 429 adolescents with a mean age of 12 years. Adolescents who attended religious meetings less than once a month or never presented higher overall CPQ11-14 scores. Adolescents who did not trust their friends and neighbours, those who believe that their neighbours did not have good relationships, and those reporting no support during hard times also presented higher overall CPQ11-14 scores. OHRQoL was poorer in individuals who presented lower structural and cognitive social capital, with the greatest impact related to the cognitive dimension.

Pathways to dental fear from childhood to adolescence: A 10-year cohort study.

BACKGROUND: Dental fear affects children's oral health; there is, however, no evidence regarding the pathways linking possible predictors for its occurrence. AIM: This study aimed at exploring the direct and indirect effects of sociodemographic, clinical, behavioural and psychosocial factors on the development of dental fear in schoolchildren over time. DESIGN: This is a prospective cohort study, with 10 years of follow-up. The first assessment started in 2010 (T1) with a sample of 639 children aged 1-5 years from Southern Brazil. For this study, the follow-up (T2) of these individuals was performed in 2020. Dental fear was assessed at T2 using the Brazilian version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). Socio-economic, demographic, psychosocial and oral health measures were collected in both assessments. A structural equation model was performed to assess the direct and indirect pathways among variables at T1 and T2 to predict the CFSS-DS scores at T2. RESULTS: Of the 639 children, 429 were re-evaluated at T2. Higher levels of untreated dental caries, younger individuals, dental visits for nonroutine reasons and low sense of coherence at T2 directly impacted dental fear at T2. Considering the indirect effects, the presence of dental caries and low household income at T1 indirectly impacted higher levels of dental fear over 10 years via dental caries at follow-up. CONCLUSION: Our findings suggest that socio-economic, demographic, clinical, psychosocial and behavioural conditions can influence dental fear from childhood to adolescence.

Sense of coherence moderates the relationship between perceived racial discrimination and oral health-related quality of life in schoolchildren.

AIM: To evaluate the moderating effect of the sense of coherence (SOC) in the relationship between racial discrimination and oral health-related quality of life (OHRQoL) in schoolchildren. METHODS: This is a cross-sectional study nested in a cohort performed in southern Brazil. OHRQoL was assessed using the short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14). The perception of racial discrimination was measured using a question contained in the Bullying Questionnaire by Olweus, and SOC through the shortened version of the 13-item Sense of Coherence Scale. Sociodemographic and dental caries following the International Caries Detection and Assessment System (ICDAS) characteristics were also collected. A simple slop test and Poisson regression analysis were performed to test the interaction effects of the predictors on OHRQoL. RESULTS: A total of 429 schoolchildren were included in this study. About 6.7% reported had perceived racial discrimination. The simple slope test indicated that the negative effects of racial discrimination on OHRQoL were significant under different SOC levels. Among schoolchildren who suffered racial discrimination, those who had higher SOC reported lower impact on OHRQoL when compared to those with low SOC. CONCLUSION: SOC can be considered a moderating variable in the relationship between racial discrimination and OHRQoL. CLINICAL SIGNIFICANCE: These findings highlight that psychosocial factors such as SOC could attenuate the impact of perceived discrimination on OHRQoL in adolescence.

Social capital and possible bruxism during the COVID-19 pandemic among Brazilian undergraduates

Abstract This study investigated the prevalence of possible bruxism and its association with social capital among undergraduates during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was conducted at a private university in Southern Brazil. Data were collected through a self-administered electronic questionnaire (Google Forms). Possible bruxism was measured using the following question: "Do you grind your teeth or clench your jaws?". Social capital was evaluated using individual social networks. Data on self-perceived oral health, anxiety, sociodemographics, and information related to university graduates were also collected. Adjusted logistic regression models with a hierarchical approach were used to evaluate associations. The results are presented as odds ratios (ORs) and 95% confidence intervals (95%CIs). Altogether, 345 undergraduates participated in the study, with a mean age of 21.8 years (standard deviation = 5.21). The prevalence of bruxism in the sample was 57.1%. Undergraduates with low social capital had 2.06 times greater odds of bruxism than their counterparts (OR 2.06; 95%CI 1.11-3.83). Female undergraduates (OR 2.40, 95%CI 1.39-4.12), those who were in the final year of university (OR 1.13, 95%CI 1.04-1.21), and those who perceived they needed dental treatment (OR 1.91; CI: 1.21-3.02) also had greater odds of possible bruxism. In conclusion, the prevalence of possible bruxism was high among undergraduate students during the COVID-19 pandemic and associated with lower social capital levels. Knowledge of these factors is important to identify risk groups and plan strategies to control bruxism in this population.

Conhecimento dos pais em relação à avulsão dentária em escolares: um estudo transversal / Parental knowledge on tooth avulsion in schoolchildren: a cross-sectional study

Objetivo: Avaliar o conhecimento dos pais em relação à avulsão dentária em escolares. Métodos: Os dados foram obtidos de um levantamento epidemiológico realizado com pais de escolares de 12 anos, por um questionário. Os participantes foram questionados sobre aspectos sociodemográficos da família, histórico de traumatismo dentário da criança e necessidade de tratamento, e condutas de urgência a serem adotadas em caso de avulsão. Análises descritivas e comparativas foram realizadas pelo programa estatístico STATA. Resultados: Participaram do estudo 354 pais, dentre os quais 32% relataram que seu filho já havia sofrido algum traumatismo dentário, e destes, 28% necessitou tratamento odontológico em função do trauma. Quando perguntados sobre a melhor conduta frente à avulsão, somente 2,8% identificou o reimplante imediato do elemento; para o transporte do dente avulsionado ao dentista, 19,6% respondeu que deveria ser imerso em saliva ou leite e, quando questionados sobre o tempo indicado para o atendimento de urgência, 70,6% apontou que deveria ser em até 30 minutos. Não houve diferença estatísticamente significante entre o conhecimento e fatores sociodemográficos (p > 0,05). Conclusão: Evidencia-se um conhecimento insuficiente dos pais sobre os procedimentos de urgência em caso de avulsão.

Aim: To assess parents' knowledge regarding tooth avulsion in schoolchildren. Methods: Data were obtained from an epidemiological survey conducted with parents of 12-year-old schoolchildren, using a questionnaire. Participants were questioned about sociodemographic aspects of the family, the child's history of traumatic dental injuries and the need for treatment, and urgent measures to be taken in case of tooth avulsion. Descriptive analyzes were performed using the STATA statistical program. Results: A total of 354 parents participated in the study, with 32% reporting that their child had already experienced some traumatic dental injury. Among these, 28% required dental treatment due to the injury. When asked about the best approach to tooth avulsion, only 2.8% identified immediate reimplantation of the tooth. Regarding transporting the avulsed tooth to the dentist, 19.6% responded that it should be immersed in saliva or milk. When asked about the recommended time for emergency care, 70.6% said it should be within 30 minutes. Conclusion: Parents' insufficient knowledge about emergency procedures in the case of tooth avulsion is evident.

Impact of community and individual social capital during early childhood on oral health-related quality of life: A 10-year prospective cohort study.

AIM: To evaluate the impact of community and individual social capital during early childhood on oral health-related quality of life (OHRQoL) over a 10-year follow-up period. METHODS: A prospective cohort study was conducted in the southern Brazil. Baseline (T1) data collection occurred in 2010 with preschool children aged 1-5 years. Participants were assessed in 2012 (T2), 2017 (T3), and 2020 (T4). OHRQoL was assessed using the B-ECOHIS at T1 and T2 and through CPQ8-10 at T3 and CPQ11-14 at T4. Community social capital was evaluated through the presence of formal institutions in the neighbourhood and individual social capital by social networks, both at T1. Demographic and socioeconomic characteristics were also evaluated. Multilevel Poisson regression analysis was performed to estimate the impact of social capital measures on OHRQoL. RESULTS: Of the 639 children assessed at T1, 469 were followed at T2 (73.3% response rate), 449 at T3 (70.3% response rate), and 429 at T4 (67.1% response rate). Individuals living in neighbourhoods with the presence of social class associations at T1 had higher OHRQoL at T3 and T4. Individuals whose families visit friends and neighbours less than once a month or never at T1 had lower OHRQoL at T1, T3 and T4. Attending religious meetings less than once a month or never at T1 was associated with lower OHRQoL at T2 and T4. CONCLUSION: Social capital at the community level had a long-term effect on OHRQoL, especially during adolescence, while individual social capital levels impacted OHRQoL across the assessments. CLINICAL SIGNIFICANCE: The findings indicate that psychosocial variables can impact OHRQoL, a fundamental aspect of clinical practice.

Sense of coherence moderates the relationship between social capital and oral health­related quality of life in schoolchildren: a 10-year cohort study.

BACKGROUND: This study aimed to evaluate the moderating effect of sense of coherence (SOC) on the relationship between social capital and oral health-related quality of life (OHRQoL) among schoolchildren. METHODS: A cohort study was conducted in the city of Santa Maria, Brazil, involving children aged 1-5 years at baseline who were reassessed after 10 years in adolescence (11-15 years-old). Social capital was assessed at baseline and follow-up through social networks and social trust. Sense of coherence scale (SOC-13) and the short form of the Child Perceptions Questionnaire 11-14 (CPQ11-14) were measured at 10-years follow-up. Demographic and socioeconomic characteristics, and dental caries were also evaluated. Moderating effect of SOC on the relationship between social capital and OHRQoL was tested using multilevel adjusted Poisson regression analysis and simple slope test. RESULTS: From the 639 subjects assessed at baseline, 429 were reassessed at follow-up (cohort retention rate 67.1%). Moderate and high levels of SOC demonstrated a moderating effect on the relationship between social capital and OHRQoL. Among individuals who presented low social capital at baseline and follow-up, those who had high SOC reported, respectively, an impact 63% and 70% lower on OHRQoL when compared to those with low SOC. The greatest margin effect was observed in individuals with low social capital and low SOC at follow-up (24.25; p < 0.05). CONCLUSION: Our findings suggest that SOC moderates the negative impact of low social capital on poor OHRQoL in schoolchildren.

Oral health-related quality of life determinants throughout adolescence: a cohort study in Brazil.

PURPOSE: Oral health-related quality of life (OHRQoL) is a complex construct that reflects the interaction among well-being, socioeconomic, oral health status, and also contextual factors. This study aimed to verify the association between poorer socioeconomic background and oral health condition on OHRQoL throughout adolescence. METHODS: A cohort study followed a random sample of 1134 participants aged 12 years in 2012 (T1), 770 adolescents with an average age of 14 years in 2014 (T2; retention rate, 67.9%), and 768 adolescents with an average age of 17.5 years in 2018 (T3; retention rate, 67.8%). OHRQoL was collected three times using the Brazilian short version of the Childhood Perception Questionnaire 11-14 (CPQ 11-14). At baseline, the adolescents were clinically assessed by dentists, and their demographic data, socioeconomic status, use of dental services, and toothache were evaluated. The mean income of the neighborhood was used as a proxy of contextual factors. This variable was obtained from an official municipal publication. Poisson multilevel regression analyses were performed using a hierarchical approach to assess the predictors of OHRQoL over time. RESULTS: Adolescents living in a neighborhood with low mean income, low household income, low education levels, girls, and nonwhite individuals reported poor OHRQoL. Clinical variables such as gingival bleeding and malocclusion were also associated with higher overall scores on CPQ11-14, indicating poor OHRQoL. CONCLUSION: Our results showed that the unfavorable contextual and individual socioeconomic environment, and oral disease negatively influenced OHRQoL during adolescence.

Associação entre idade na primeira consulta odontológica e tipo de tratamento dentário realizado em pacientes infantis: estudo transversal / Association between age of the first dental visit and type of dental treatment performed in infant patients: a cross-sectional study

Objetivo: Avaliar a associação entre idade na primeira consulta odontológica e o tipo de tratamento dentário realizado em pacientes infantis por meio de um estudo transversal que avaliou registros em prontuários odontológicos. Métodos: A coleta de dados foi realizada por meio de prontuários de pacientes de 0-5 anos atendidos em uma Clínica Escola de Odontologia, de março de 2014 a julho de 2018, com registro de informações referentes às características dos participantes e procedimentos odontológicos realizados. Para a análise dos dados, foram calculadas medidas descritivas e posteriormente os dados foram ajustados em um modelo de regressão logística; o desfecho foi o tipo de procedimento realizado, dicotomizado em tratamentos não-invasivos (fluorterapia e/ou restauração) e invasivos (endodontia e/ou exodontia). Resultados: Foram avaliados prontuários de 210 crianças, com média de idade na primeira consulta de 38 meses (DP=14,5). Fluorterpia e/ou restauração foram realizados em 74,8% das crianças, enquanto tratamentos invasivos foram realizados em 25,2% da amostra. A análise ajustada indicou um incremento (OR = 1,03, p = 0,027) na chance de realização de tratamentos invasivos com o aumento da idade das crianças na primeira consulta odontológica. Conclusão: Quanto maior a idade das crianças na primeira consulta, maior a chance de terem recebido um tratamento invasivo. Ressalta-se a importância da consulta odontológica nos primeiros meses de vida, com a finalidade de prevenção e manutenção da saúde bucal.(AU)

Objective: To evaluate the association between the age of the first dental visit and the type of dental treatment performed in infant patients through a cross-sectional study that examined dental records from the years 2014 to 2018. Methods: Data collection was conducted using medical records of patients aged 0 to 5 years treated at a Dental School Clinic, including information about participants' characteristics and the types of dental procedures performed. For data analysis, descriptive measures were calculated, and the data were subsequently fitted into a logistic regression model. The outcome was categorized into non-invasive treatments (fluoridation therapy and/or restoration) and invasive treatments (endodontics and/or extraction). Results: Medical records of 210 children were evaluated, with a mean age of the first dental visit being 38 months (SD = 14.5). Non-invasive treatments, including fluoride therapy and/or dental restoration, were performed in 74.8% of children, while invasive treatments were performed in 25.2% of the sample. Adjusted analysis indicated an increase (OR = 1.03, p = 0.027) in the odds of undergoing invasive treatments as the children's age at the first dental visit increased. Conclusion: Older age at the first appointment was associated with increased odds of receiving invasive treatment. The significance of early dental consultations within the first months of life is underscored, aiming to prevent and maintain oral health.(AU)

Dentists' Attitudes towards the Dental Ceramic Choice for Metal-Free Restorations: a Questionnaire Survey / Atitudes de Dentistas Frente à Escolha de Cerâmicas Dentárias para Restaurações Livres de Metal: uma Pesquisa de Questionário

A wide variety of dental ceramics is launched every year. Therefore, clinicians should constantly study and update themselves to correctly indicate these materials. This cross-sectional study aimed to assess the association of dentists' academic aspects with their knowledge and the indication of dental ceramics for metal free restorations. All the dentists from private clinics who affirmed to perform prosthetic treatments on their patients in a Southern Brazilian city were personally invited to this research to avoid dropouts. Participants answered questions related to their knowledge of different dental materials, their information sources and usage frequency of ceramic materials, and related to their academic training/education. Chi-square tests were performed to evaluate the association among the outcomes (knowledge of different materials, information sources considered for material selection and their frequencies of use) and exposure variables (time since graduation and post-graduation degree). Significant associations were also submitted to Chi-square residual analysis. A response rate of 73.3% was reached. The most known and used materials were Y-TZP and porcelain veneered zirconia, respectively, whereas the least known was leucite-based ceramic. The majority of the professionals with at least 25 years since graduation claimed not to know lithium disilicate or leucite-based ceramics, and a significant number of these professionals allow the laboratory prostheses technician to choose the restorative material. In addition, most of dentists with no post-graduation said they did not have knowledge about leucite and lithium disilicate. It was evidenced that continuing education plays an important role in the dentists' attitudes regarding ceramic materials. (AU)

Uma grande variedade de cerâmicas é lançada no mercado a cada ano. Portanto, os clínicos devem se manter em constante estudo e atualização para indicar corretamente o uso desses materiais. Assim, este estudo transversal teve por objetivo avaliar a associação entre aspectos acadêmicos de dentistas com seus conhecimentos e as indicações de cerâmicas dentárias para uso em restaurações livres de metal. Para isso, todos os dentistas de clínicas privadas que afirmaram realizar tratamentos protéticos em seus pacientes em uma cidade do sul do Brasil foram pessoalmente convidados a participar desta pesquisa para evitar desistências. Os participantes responderam a questões relacionadas ao seu conhecimento sobre diferentes materiais dentários, suas fontes de informação, a frequência de uso de materiais cerâmicos, e, também, sobre sua formação acadêmica. Testes qui-quadrado foram realizados para avaliar a associação entre os desfechos (conhecimento de diferentes materiais, fontes de informação consideradas para a seleção do material e sua frequência de uso) e as variáveis de exposição (tempo desde a graduação e grau de pós-graduação). As associações significativas foram submetidas à análise de resíduos do qui-quadrado. A taxa de resposta obtida foi de 73,3%. O material mais conhecido e usado foi a Y-TZP e zircônia recoberta por porcelana, respectivamente, enquanto que o material menos conhecido foi a cerâmica a base de leucita. A maioria dos profissionais com pelo menos 25 desde a graduação afirmaram não conhecer as cerâmicas a base de dissilicato de lítio ou leucita, e um significativo número desses profissionais permitem que o técnico em prótese dentária escolha o material restaurador. Ainda, a maioria dos dentistas sem pós-graduação disseram não conhecer as cerâmicas a base de dissilicato de lítio ou leucita. Concluiu-se que a educação continuada é um fator determinante nas atitudes de dentistas em relação aos materiais cerâmicos. (AU)

Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study.

OBJECTIVE: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). METHODS: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. RESULTS: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. CONCLUSION: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

The Impact of Early Childhood Factors on Dental Caries Incidence in First Permanent Molars: A 7-Year Follow-Up Study.

The development of dental caries in first permanent molars has been extensively investigated. However, studies are inconclusive in determining the influence of contextual and individual factors on dental caries incidence in this group of teeth. The aim of this study was to evaluate the influence of contextual and individual factors on dental caries incidence in first permanent molars. This 7-year cohort study was conducted with children (1-5 years of age) who had been assessed initially in a survey performed in 2010. Dental caries was assessed at the baseline through the International Caries Detection and Assessment System (ICDAS). Contextual and individual variables were collected at baseline and included the presence of cultural community centers in the neighborhood as well as demographic, socioeconomic, psychosocial, and biological characteristics. A multilevel Poisson regression model was used to investigate the influence of individual and contextual characteristics on dental caries incidence in first permanent molars (relative risk [RR] and 95% confidence interval [CI]). Of the 639 children examined at baseline, a total of 449 were reassessed after 7 years (70.3% retention rate). Children who lived in neighborhoods with cultural community centers had a lower risk of dental caries in first permanent molars at the follow-up (RR 0.78; 95% CI 0.62-0.99). Children from families with a low income (RR 1.34; 95% CI 1.03-1.76) and poor parental perception of children's oral health (RR 1.56; 95% CI 1.18-2.06) were associated with a higher risk of dental caries in first molars. In conclusion, individual and contextual determinants showed an important role in the incidence of caries in first permanent molars.

Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

RESUMO Objetivo: Avaliar a influência da má oclusão na primeira infância na qualidade de vida relacionada à saúde bucal (QVRSB). Métodos: Este estudo de coorte de 7 anos envolveu 639 pré-escolares (1 a 5 anos) que foram avaliados inicialmente em um levantamento transversal conduzido em 2010. As crianças completaram a versão brasileira do Child Perception Questionnaire (CPQ8-10) para avaliar sua QVRSB no período do acompanhamento. Variáveis exploratórias foram coletadas na linha de base, incluindo a presença e severidade de má oclusão (sobressaliência e cobertura labial). Características socioeconômicas, hábitos de saúde bucal e padrões de assistência odontológica também foram investigados. Um modelo de regressão de Poisson multinível foi utilizado para medir a associação entre má oclusão e QVRSB. Com essa abordagem, calculou-se a razão de taxa de incidência (IRR, incidence rate ratio) e o intervalo de confiança de 95% (IC 95%). Resultados: No total, 449 crianças foram reavaliadas (taxa de acompanhamento de 70,3%). A prevalência de sobressaliência acentuada e cobertura labial inadequada foi de 13,5% e 11,9%, respectivamente. A média±DP de pontuação do CPQ8-10 foi 10,57±10,32. A presença de selamento labial inadequado foi associada com maiores médias na pontuação total do CPQ8-10 (IRR 1,51; IC 95% 1,29-1,77) e nos domínios de bem-estar social, bem-estar emocional e limitação funcional. Crianças com sobressaliência acentuada (>3 mm) também demonstraram médias nas pontuações do CPQ8-10 total maiores do que suas contrapartes normais. A presença dessa condição também influenciou os domínios de sintomas bucais (IRR 1,29; IC 95% 1,08-1,53) e bem-estar emocional (IRR 1,30; IC 95% 1,02-1,66). Conclusão: Os resultados do presente estudo sugerem que a má oclusão na primeira infância é um fator de risco para baixa QVRSB no futuro.