Prevalence of negative behaviour in the dental setting and association with sociodemographic, oral health-related and psychosocial factors amongst Brazilian preschool children.

PURPOSE: To investigate the prevalence of negative behaviour in preschool children attending dental clinics and its association with sociodemographic, oral health-related and parental psychosocial factors. METHODS: A cross-sectional study was carried out with 145 parents/guardians and their children aged 4-6 years attending paediatric dentistry training programmes in a capital city of Midwest Brazil. Data were obtained from children's dental records, interviews, and questionnaires for parents/guardians. The outcome was negative child behaviour, based on the dentists' use or indication of behavioural control measures during the dental appointments, as registered in the children's dental records. Covariates were sociodemographic, clinical and parent/guardian psychosocial factors religiosity (DUREL index) and Sense of Coherence (SOC-13 scale). Bivariate analyses and Poisson regression with robust variance were performed. RESULTS: The prevalence of negative behaviour was 24.1% (95% CI = 17.9-31.7). In the bivariate analyses, the variables initially selected for the regression models (p < 0.25) were the parent/guardians' number of children and religiosity, and the children's dental pain and caries status in deciduous teeth. After adjustment, the prevalence of negative behaviour was 2.12 higher in children with teeth extracted due to caries. CONCLUSION: The prevalence of negative behaviour was high and associated with the presence of missing teeth due to caries, regardless of sociodemographic, psychosocial, and other oral health factors.

Quality of education and adolescents' oral health-related behaviours: a multilevel analysis.

PURPOSE: The school environment may positively influence student health behaviours and learning. This study aimed to investigate the association between cities' quality of education and adolescent students' oral health-related behaviours. METHODS: Cross-sectional study using data of the 2015 Brazilian National Adolescent School-Based Health Survey and other public databases. The sample was composed of adolescents (N = 23,674) from public schools of the 27 Brazilian state capitals. Outcomes were four oral health-related behaviours: toothbrushing, sweets and soft-drink consumption, and dental visits. The explanatory variable was the cities' quality of education, measured by the Brazilian Basic Education Development Index. Covariates were individual (sociodemographic) and contextual (socioeconomic, oral health coverage and oral health-promoting schools). Multilevel logistic regression was performed considering two levels: individual (adolescents) and contextual (city). RESULTS: The prevalence of the outcomes were: low daily toothbrushing frequency 6.7% (95% CI 6.0-7.4); high weekly sweets consumption 41.5% (95% CI 40.3-42.7); high weekly soft-drink consumption 28.5% (95% CI 27.2-29.9); and low frequency of annual dental visits 31.2% (95% CI 30.1-32.3). In the adjusted models, cities whose schools had higher scores of education quality were more likely to have students with low toothbrushing frequency and high frequency of sweets consumption. CONCLUSION: The cities' quality of education was associated with unhealthy oral health-related behaviours, particularly the frequency of toothbrushing and sweets consumption. Therefore, appropriate health promotion strategies as well as high-quality education are needed in schools.

Modulation of expressivity in PDGFRB-related infantile myofibromatosis: a role for PTPRG?

Infantile myofibromatosis is a rare genetic disorder characterized by the development of benign tumors in the skin, muscle, bone, and viscera. The molecular pathogenesis is still incompletely known. An autosomal dominant form had been reported as causally related with mutations in the gene for platelet-derived growth factor receptor beta (PDGFRB). We report here two siblings with infantile myofibromatosis and with a PDGFRB mutation identified by exome sequence analysis. However, the unaffected mother also had the same PDGFRB mutation. We showed that both children had also inherited from their healthy father a heterozygous mutation in the gene for receptor protein tyrosine phosphatase gamma (PTPRG), an enzyme known to dephosphorylate PDGFRB. We suggest that in this family, the additional mutation in PTPRG may explain the full phenotypic penetrance in the siblings affected, in comparison with the unaffected mother.

An exploratory survey of diagnostic methods for bone quality assessment used by Brazilian dental implant specialists.

Bone quality (BQ) has been described as an important predictor for the outcome of dental implant treatment. It is, however, unclear how this factor is assessed in the dental practice routine. The aim of this study was to investigate what Brazilian dental implant specialists know and understand about BQ, if they include BQ assessments in their treatment planning and which methods they use to assess BQ. A questionnaire was posted to Brazilian dental implant specialists, containing open and closed questions about their knowledge and understanding of BQ assessment, and 221 answered the questionnaire. Data were gathered and methods for BQ assessment were grouped using hierarchical cluster analysis. Answers about BQ knowledge and understanding were categorized into quantity of cortical and marrow bone (n = 72), density (n = 55), type of bone (n = 35), bone height (n = 30), bone thickness (n = 27), primary stability (n = 24) and other less common categories. BQ assessment was judged relevant to be considered a selection criterion for implant treatment. Overall frequency analysis showed that methods were roughly divided into usual (n > 170) and unusual methods (n < 9). Cluster analysis grouped BQ assessment methods into four clusters: unusual methods (DEXA, resonance frequency, Periotest and occlusal radiography), perioperative methods (peak insertion torque and tactile perception), sectional imaging (computed tomography) and plain films (periapical and panoramic radiographs). No consensus on BQ understanding or the clinical application of methods to assess BQ was found in this survey. The selection of methods shows a clear natural grouping from basic to advanced strategies for BQ assessment by Brazilian specialists in dental implants.

Assessing perceived potential outcomes of prosthodontic treatment in partial and fully edentulous patients.

The aim was to develop an instrument to measure and to explore the perception of potential outcomes of prosthodontic treatment in partial and fully edentulous patients, including benefits, risks and consequences of non replacement of missing teeth. It was also aimed to assess the influence of clinical and socio-demographic variables on the perception of potential outcomes. Using a two-phase data collection (open-ended and closed-form), a scale was developed containing 41 statements to measure subject's perception scores in a 5-point Likert-type scale (1, strongly disagree; 2, disagree; 3, neutral; 4, agree; 5, strongly agree). In the second phase 126 partially or fully edentulous subjects were interviewed. Influence of age, gender and clinical variables on perceived outcomes were tested using one-way anova, independent t-test and two-way anova (general linear model). Respondents' mean age was 51.8 years (s.d.=12.3), and 74% were female. Cronbach's alpha coefficient of the scale and subscales ranged from 0.70 to 0.90. Patients' mean scores ranged from 2.37 to 4.88 (mean=4.25; s.d.=0.65), indicating that subjects tended to agree with the proposed affirmatives (scores 4 and 5). Perception scores were influenced by age, gender, edentulous spaces and use of prosthodontics. Older subjects, female, those with higher number of missing teeth and who have been previously treated had greater perception of benefits and risks of prosthodontic treatment. It was concluded that the proposed instrument was suitable for measuring subjects' perception of potential outcomes of prosthodontic treatment.

Relationship between height and dental caries in adolescents.

Taller stature is associated with better health status. The objective of this study was to test the hypothesis that taller Brazilian adolescents have lower levels of caries experience. Data were collected through questionnaires, clinical examinations for oral health and anthropometric measures from a cross-sectional study conducted in Goiânia, Brazil, on 664 randomly selected 15-year-old schoolchildren. Variables analyzed were adolescents' caries experience (DMFT and DMFS index) as outcome variables, height as an explanatory variable and social class, school performance, exposure to fluoride, frequency of sugar consumption and pattern of dental attendance as possible confounders. Polytomous ordered regression was used in the data analysis. A decreased risk of having higher DMFT levels was found among taller adolescents in quintile 3 (OR = 0.63, CI 0.40-0.99) and in the highest quintile (OR = 0.54, CI 0.35-0.82), while an increased risk was found among those from low social class compared with those from high social class (OR = 1.45, CI 1.10-1.91) and those who had at least one school failure compared with those who had never failed (OR = 1.57, CI 1.17-2.10). A decreased risk of having higher DMFS levels was found among the tallest adolescents (OR = 0.55, CI 0.36-0.83), while an increased risk was found among those from low social class compared with those from high social class (OR = 1.57, CI 1.20-2.07) and those who had at least one school failure compared with those who had never failed (OR = 1.66, CI 1.24-2.23). The hypothesis that taller adolescents have lower levels of caries experience was confirmed in the sample of the present study.

Quality of life of public health service dental hygienists in Goiânia, Brazil.

The aim of this study was to assess quality of life (QoL) and related factors among dental hygienists. A cross-sectional study was conducted in a sample of dental hygienists working in the public health service of Goiânia, Central-West Region, Brazil, in 2004. All active dental hygienists received a mailed questionnaire containing the shortened version of the World Health Organization instrument to measure quality of life (WHOQOL-Bref), demographic and job-related data, and questions about self-rated general health status and QoL. Response rate was 58.5% (n = 93). Descriptive statistics, simple and multiple logistic regressions were used in the analysis of data. The WHOQOL-Bref instrument revealed that the Social Relationships domain had the highest mean score (70.56), followed by the Physical (65.49), Psychological (61.3) and Environment domains (56.25). Most of the dental hygienists had a high QoL in the Social Relationships domain and a low QoL in the Physical, Psychological and Environment domains. There was an association between self-rated health status and the Physical domain; satisfaction with health and the Physical, Psychological and Social Relationships domain and self-rated QoL and the Psychological and Social Relationships domains. The conclusion is that a low QoL was common among the dental hygienists and has perceptible effects on their perceptions of their health status and QoL.

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.