A proposed community caries index of treatment need derived from the international caries detection and assessment system.

OBJECTIVE: To examine the accuracy of a short version of the International Caries Detection and Assessment System (ICDAS) in predicting caries treatment need for children. METHODS: The study is a validation study using data from three previously published cross-sectional studies. Participants were children with different dentitions from Kuwait, Brazil, and Spain. Children were clinically examined using ICDAS criteria. Children were classified into preventive, non-operative, and operative categories. Sensitivity and specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic (ROC) curve were used to measure the discriminative and diagnostic accuracy of the proposed short version of ICDAS compared to the full ICDAS. RESULTS: Clinical dental examination data from a total of 3076 children aged 1-15 years were used. The proposed short ICDAS and the full ICDAS showed a very good agreement on caries treatment need determination with Kappa scores of more than 0.833 in all dentitions. The short ICDAS showed excellent operating characteristics in all dentitions. The area under the ROC was more than 90% in primary dentition, 89% in permanent dentition, and 86% in mixed dentition in different populations. Lowest area under ROC and sensitivity values were observed when discriminating between non-operative and operative treatment categories. CONCLUSIONS: The proposed short version of the ICDAS showed good diagnostic accuracy in classifying children according to their caries treatment need. By reducing the number of surfaces examined and the time needed for clinical assessment, the short version of the ICDAS is a convenient alternative to the full ICDAS to be used in community settings.

Trends in use of dental services by Brazilian pre-school children considering Age-Period-Cohort Effect.

BACKGROUND: Besides the growth in Brazilian public oral health investments, no pre-school children preventive policies were done, and surveys demonstrated lower prevalences of use of dental service. AIM: To verify trends in the use, type, and reason for seeking dental services among pre-school children considering time variations. METHODS: This study used data of clinical examinations and structured interviews of three cross-sectional surveys of southern pre-school children in Brazil, from 2008, 2010, and 2013. Chi-square test for trends and hierarchical age-period-cohort (HAPC) analysis using the multilevel Poisson regression model assessing the influence of social and clinical variables in the use, type, and reason for seeking dental services were performed. RESULTS: A total of 1765 pre-school children participated in all surveys. At least, one time-related variation affected one of three assessed outcomes. There was no significant change in prevalence of the use of dental services (75.8%, 77.4%, and 74.9%, respectively, for each year; P = 0.750). In the HAPC analysis, younger children and from low socio-economic backgrounds were less likely to have visited the dentist. CONCLUSION: The prevalence of use of oral health services did not change and socio-economic inequalities persisted through the years, indicating a need of reviewing the policies to promote public health.

Sensitivity of an oral health-related quality-of-life questionnaire in detecting oral health impairment in preschool children.

AIM: This two-year cohort study evaluated whether the Early Childhood Oral Health Impact Scale (ECOHIS) is responsive to detect changes related to dental caries. DESIGN: Preschool children were examined in 2010 regarding dental caries, and their parents responded to the ECOHIS. After 2 years, 352 children (response rate = 73.6%) were re-examined and a new ECOHIS was responded. Children were categorized according to caries increment (no new caries, 1-3 surfaces with new lesions, and four or more decayed surfaces). The outcome variables were related to the decline of quality of life as determined via ECOHIS: decline, severe decline, and differences between baseline and follow-up scores. Effect sizes (ES) were calculated, and the associations were evaluated through Poisson regression. RESULTS: ES was small for children with 1-3 new lesions (ES = 0.19) and moderate for children with four or more new carious lesions (ES = 0.61). Children who developed 1-3 new lesions were significantly associated with all outcome variables compared to children with no new lesions, but the associations were stronger for children with four or more new carious lesions. CONCLUSIONS: The ECOHIS is sensitive to the deterioration of quality of life due to caries increments in preschool children.

Presence of Initial Caries Lesions as a Risk Factor for Caries in Preschool Children: A Cohort Study.

The aim of this study was to evaluate the influence of initial noncavitated caries lesions on cavitated caries increment in preschool children. A 2-year cohort study was designed to include the participants of a survey on dental caries performed in 2010. Preschool children (12-59 months old) were examined for dental caries and classified as children with no caries lesions, with only initial lesions, with at least 1 moderate caries lesion, and with extensive lesions. Socioeconomic data were also collected. After 2 years, 466 children were re-examined (follow-up rate of 72.9%) only for cavitated lesions. Association between caries incidence at 2 levels of severity and caries experience and other variables was evaluated using hierarchical Poisson regression analysis. The children with moderate and extensive caries lesions at baseline presented a higher risk of presenting both outcomes than the children with no caries lesions. Nevertheless, the children with only initial lesions had a higher risk of developing at least 1 new cavitated carious lesion, but not for a more severe increment in caries. Subgroup analysis stratified by the children's age showed that the influence of the presence of initial caries lesions on cavitated caries increment was only observed in children aged 12-35 months. In conclusion, although the presence of moderate and extensive lesions at baseline is a significant predictor for cavitated caries increment after 2 years in preschool children at all ages, the presence of only initial caries lesions is also associated, but with less severe caries incidence.

Identifying a Potential Summary Measure for Overall Caries Level in Children Examined with the International Caries Detection and Assessment System.

OBJECTIVE: To identify a potential summative summary measure that reflects a patient's overall caries level in children examined with the International Caries Detection and Assessment System (ICDAS). SUBJECTS AND METHODS: Participants were 1- to 15-year-old children from Kuwait, Brazil, and Spain. Children's teeth were examined using the ICDAS. Multiple measures of central tendency and dentition-specific indices were considered as potential summative measures. The relationship between the summative measures and number of caries lesions was evaluated considering degrees of caries severity using Spearman's correlation analysis. The results were generated using the Kuwaiti sample and were cross-validated using the Brazilian and Spanish samples. RESULTS: A total of 2,808 children participated in the present study. Total ICDAS score and mean ICDAS score showed a strong correlation with the number of caries lesions at different caries severity levels in primary, mixed, and permanent dentitions. The total ICDAS score of 51 buccal (B), 61B, 54 occlusal (O), 55O, 64O, 65O, 74O, 75O, 84O, and 85O surfaces in primary dentition and the total ICDAS score of 14O, 16 lingual (L), 16O, 24O, 26L, 26O, 36B, 36O, 37O, 46O, 46B, and 47O surfaces in permanent dentition or mixed dentition (if present) showed strong correlations with the number of caries lesions at different caries severity levels. CONCLUSIONS: Total ICDAS and mean ICDAS scores were the best summary measures of overall caries level at different dental stages. Total ICDAS scores of selectively examined 10 surfaces in primary dentition and 12 surfaces in permanent dentition can give an excellent summary measure for a patient's overall caries level with high diagnostic accuracy.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

Abstract The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children’s Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children’s dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers’ associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children’s ages, family income, parents’ schooling, mothers’ participation in their children’s school activities, dental caries, and presence of workers’ associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Trend of traumatic crown injuries and associated factors in preschool children.

The aim of this study was to assess trends in traumatic crown injuries (TCIs), their prevalence, and association with socioeconomic and clinical factors in preschool children over a 5-year period. A series of cross-sectional surveys was conducted in Santa Maria, Brazil, on children attending a National Day of Children's Vaccination. The same protocol was used in all surveys conducted in 2008, 2010, and 2013. Clinical examinations were performed to evaluate types of traumatic crown injuries using the O'brien index. A semi-structured questionnaire was answered by the parents. It provided information about several socioeconomic factors as well as the parents' perception of their child's oral health. The chi-square for trends test was used to verify changes in TCI prevalence throughout the years. The association between socioeconomic and clinical factors with TCI was assessed by the Poisson regression analysis. A total of 1,640 children were examined. The prevalence of TCIs decreased significantly from 2008 to 2013 (10.12%; p < 0.001). Central incisors were the most vulnerable to injury, independent of the year. Moreover, older children and those with inadequate lip coverage were more likely to present with some traumatic dental injury (p < 0.001). prevalence of traumatic crown injuries decreased following the years, however TCI remain an important subject to consider when planning oral health policies.

Influence of initial caries lesions on quality of life in preschool children: a 2-year cohort study.

OBJECTIVES: We aimed to assess the impact of the presence of initial and other stages of dental caries on the impairment of oral health-related quality of life in preschool children (COHRQoL) through a cohort study. METHODS: During an epidemiological survey, 478 children (12-59 months old) were examined for dental caries using the International Caries and Detection Assessment System (ICDAS), and their parents answered the Early Childhood Oral Health Impact Scale (ECOHIS). Children were categorized based on the presence of dental caries as follows: children with no caries lesions, children with only initial lesions (ICDAS scores 1 and 2), children with at least one moderate lesion (ICDAS scores 3 and 4) and children with extensive lesions (ICDAS scores 5 and 6). After 2 years, 352 children were re-examined for the presence of dentine cavitations, and their parents completed a new ECOHIS questionnaire. Multilevel Poisson regression analysis was performed to evaluate the impact of the presence of different stages of caries lesions at the baseline on COHRQoL impairment at the follow-up, considering two outcome variables: worsening and severe worsening of COHRQoL. Relative risk values (RR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS: Worsening or severe worsening of the COHRQoL at the follow-up were observed only in children with moderate lesions (RR = 2.00; 95% CI = 1.30-3.08 and RR = 2.38; 95% CI = 1.31-4.34, respectively) or children with extensive lesions (RR = 1.59; 95% CI = 1.10-2.30 for worsening and RR = 1.88; 95% CI = 1.13-3.12 for severe worsening). On the other hand, the presence of only initial caries lesions was not a significant predictor of COHRQoL impairment. CONCLUSIONS: The presence of only initial caries lesions does not impair COHRQoL of preschool children; however, moderate and extensive lesions are risk factors for worsening of the COHRQoL.

In vitro performance of QLF system and conventional methods for detection of occlusal caries around tooth-colored restorations in primary molars.

BACKGROUND: Secondary caries is the main reason for restoration replacement, and therefore, an accurate detection of this type of condition is fundamental. AIM: To compare in vitro the performance of different conventional and quantitative light-induced fluorescence-based (QLF) methods in detecting occlusal caries around resin composite restorations in primary molars. DESIGN: Two examiners evaluated independently 42 sites adjacent to tooth-colored restorations using visual inspection (ICDAS-CARS), radiographic examination, and QLF. Histological examination was used as reference standard method. Area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentin caries (D3) lesions thresholds. Intra- and interexaminer reproducibility were calculated using intraclass correlation coefficient (ICC) and kappa statistics. RESULTS: There was no difference among the methods considering Az at D1 threshold. Visual inspection, radiograph, and QLF (scores) methods presented similar sensitivities and significantly higher than those obtained with the QLF (∆F%). At D3 threshold, there were no differences among the methods regarding sensitivities, specificities, and accuracy, except for the examiner 2 with the QLF (∆F%) who achieved a very low sensitivity value. CONCLUSION: Conventional methods are similar to QLF methods for detecting caries around tooth-colored restorations in primary teeth.

Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation: a 2-year cohort study.

AIM: To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children. DESIGN: A cohort study was designed with 639 children (12-59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years, 469 children were re-examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were calculated using multilevel Poisson regression analysis. Association with explanatory variables, including caries experience of the children, was also investigated. RESULTS: The higher the initial score attributed to the dental surface, the more likely was the progression. Moreover, children with severe lesions at baseline had higher risk of having a sound surface or a non-cavitated caries lesion progressing to cavitation when compared with caries-free children; however, this increased risk was not observed in children with only initial caries lesions. CONCLUSIONS: Initial caries lesions present a low frequency of progression. Moreover, sound surfaces and initial caries lesions in children already presenting cavitations are more likely to progress to more severe conditions.

Trend of traumatic crown injuries and associated factors in preschool children

Abstract The aim of this study was to assess trends in traumatic crown injuries (TCIs), their prevalence, and association with socioeconomic and clinical factors in preschool children over a 5-year period. A series of cross-sectional surveys was conducted in Santa Maria, Brazil, on children attending a National Day of Children's Vaccination. The same protocol was used in all surveys conducted in 2008, 2010, and 2013. Clinical examinations were performed to evaluate types of traumatic crown injuries using the O'brien index. A semi-structured questionnaire was answered by the parents. It provided information about several socioeconomic factors as well as the parents' perception of their child's oral health. The chi-square for trends test was used to verify changes in TCI prevalence throughout the years. The association between socioeconomic and clinical factors with TCI was assessed by the Poisson regression analysis. A total of 1,640 children were examined. The prevalence of TCIs decreased significantly from 2008 to 2013 (10.12%; p < 0.001). Central incisors were the most vulnerable to injury, independent of the year. Moreover, older children and those with inadequate lip coverage were more likely to present with some traumatic dental injury (p < 0.001). prevalence of traumatic crown injuries decreased following the years, however TCI remain an important subject to consider when planning oral health policies.

Impact of malocclusion on oral health-related quality of life of preschool children / Impacto da maloclusão na qualidade de vida relacionada à saúde bucal em pré-escolares

OBJECTIVE: This study assessed the relationship of dental malocclusion with COHRQoL considering socioeconomic backgrounds and clinical factors. METHODS: A survey was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day. The sample comprised 478 children aged 12 to 59 months. Fifteen trained and calibrated examiners evaluated the presence of anterior malocclusion traits (AMT) - anterior open bite, overjet and sealing lip. COHRQoL was measured through overall scores of the Brazilian version of ECOHIS (Early Childhood Oral Health Impact Scale). The assessment of association used adjusted Poisson regression models. RESULTS: The unadjusted assessment observed age, untreated dental caries and anterior open bite as the main covariates of the overall ECOHIS score. After the adjustment, the presence of anterior open bite had a negative impact on COHRQoL. There was no association between overjet and sealing lip with COHRQoL. CONCLUSION: In conclusion, anterior open bite present a negative impact on COHRQoL. .

OBJETIVOS: Este estudo avaliou o impacto da maloclusão dentária na qualidade de vida relacionada à saúde bucal, considerando fatores socioeconômicos e condições clínicas. METODOS: Um estudo foi realizado em Santa Maria, Brasi, durante a Campanha Nacional de Multivacinação Infantil. A amostra compreendeu 478 crianças na faixa etária de 12 a 59 meses. Quinze examinadores treinados e calibrados avaliaram a presença de maloclusão na região anterior - mordida aberta anterior, overjet e selamento labial. na qualidade de vida relacionada à saúde bucal foi mensurada por meio de escores totais da versão em português do questionário ECOHIS (Early Childhood Oral Health Impact Scale). Para verificar as possíveis variáveis associadas foram aplicados modelos de regressão de Poisson. RESULTADOS: O modelo não ajustado revelou associação da idade, cárie dentária não tratada e e mordida aberta anterior aos escores totais do ECOHIS. Após o ajuste, verificou-se que mordida aberta anterior teve um impacto negativo na qualidade de vida relacionada à saúde bucal. Não houve associação entre a presença de overjet e elamento labial à qualidade de vida relacionada à saúde bucal. CONCLUSÃO: Pode-se concluir que que mordida aberta anterior teve um impacto negativo na qualidade de vida relacionada à saúde bucal. .

Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions: a systematic review.

Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection.

Prevalence of dental caries in preschool children by icdas diagnostic methodology

To evaluate the prevalence of caries with the ICDAS index (International Caries Detection and Assessment System) using different cut-off points in children from public and private institutions as well as to associate the presence of caries with socioeconomic indicators, sex, age, type of school (urban or rural) and also family health program with dentist's presence at the school. Material and Methods:An analytical cross-sectional study with a stratified sample (n = 612) in children ranging from three to six years old, in public and private institutions of the city of Barras, State of Piaui, Brazil. The clinical examination was based on ICDAS criteria, and a questionnaire for socioeconomic and educational level data was also applied. Different cut-offpoints were used, as follows: cut-off point 1 (scores 0 and 1 considered as healthy and scores 2-6 classified as decayed); cut-off point 2 (scores from 0 to 2 classified as healthy, scores 3 to 6 as decayed) and cut-off point 3 (0 to 3 healthy, 4 to 6 decayed). Univariate and Multiple Poisson regression analysis were performed, with 5% significance level.Results:For cut-off point 1, the prevalence was 68.8%; Cut-off point 2, 67.9% and at the cut-off point 3, 60.6%. An association was found in the prevalence of caries with the child's age (p = 0.004), school zone (urban or rural) (p = 0.004) and the presence of the dentist at school (p = 0.001).Conclusion:Taking into account the various cut-off points, the prevalence of caries in preschool children was considered high. The presence of caries lesions is more likely to occur in five year-old boys living in the countryside...

Toothache, Associated Factors, and Its Impact on Oral Health-Related Quality of Life (OHRQoL) in Preschool Children

The aim of this study was to assess the prevalence of toothache, associated factors and impact of this condition on the Child Oral Health Related Quality of Life (COHRQoL) in preschoolers. The study was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 534 children aged 0 to 5 years were included. Clinical variables included dental caries and dental trauma. A questionnaire was responded by the parents and provided information about several socioeconomic indicators, dental service use and toothache. Toothache was collected by the question: "Has your child ever had a toothache - Yes or no?". Data on COHRQoL were assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). Multivariable Logistic regression models were performed to assess the association between the predictor variables and outcomes. The prevalence of toothache was 10.11% (95% CI: 7.55% - 12.68%). Older children had a higher chance of presenting dental pain (OR 2.72; 95% CI: 1.01 - 7.56), as well as children with caries experience (OR 3.43; 95% CI: 1.81 - 6.52). Moreover, children who had not visited the dental service in the last 6 months were less likely to present toothache (OR 0.51; 95% CI: 0.28 - 0.95). The presence of dental pain negatively affects the COHRQoL; those with toothache presented a higher chance of having higher impact on the total scores of ECOHIS (OR 4.18; 95% CI: 1.76 - 9.95) than those without toothache. Similar observation was found for the child section of the questionnaire (OR 5.54; 95% CI: 2.15 - 14.24). Toothache negatively affects COHRQoL and is associated with caries experience, age and use of dental service.

O objetivo deste estudo foi avaliar a prevalência de dor dentaria, os fatores associados e seu impacto na qualidade de vida relacionada a saúde bucal de crianças pré-escolares. Esse estudo foi realizado em Santa Maria, Brasil, durante o dia nacional de vacinação infantil, e 534 crianças de 0 a 5 anos foram incluídas. As variáveis clinicas incluídas foram carie dental e traumatismo dentário. Um questionário foi respondido pelos pais, fornecendo informações sobre as condições socioeconômicas, uso de serviços odontológicos e dor dentaria. Dor de dente foi coletada através da pergunta: "Seu filho já teve dor de dente - Sim ou Não?". Os dados sobre qualidade de vida relacionada a saúde bucal foram obtidos através da versão brasileira do questionário "Early Childhood Oral Health Impact Scale" (ECOHIS). Modelos multivariáveis de regressão logística foram utilizados para avaliar a associação entre as variáveis preditoras e os desfechos. A prevalência de dor dentaria foi 10,11% (95% IC: 7,55% - 12,68%). Crianças mais velhas apresentaram uma maior chance de ter tido dor dentaria (OR 2,72; 95% IC: 1,01 - 7,56), assim como crianças com experiência de carie (OR 3,43; 95% IC: 1,81 - 6,52). Além disso, as crianças que não tinham visitado o dentista nos últimos 6 meses foram menos propensas a apresentar dor dentária (OR 0,51; 95% IC: 0,28 - 0,95). A presença de dor dentária afeta negativamente a qualidade de vida relacionada a saúde bucal das crianças; aquelas que tiveram dor de dente apresentaram uma maior chance de ter piores impactos nos escores totais do ECOHIS (OR 4,18; 95% IC: 1,76 - 9,95) quando comparadas àquelas que não tiveram dor dentária. O mesmo se pode observar para a seção do questionário correspondente aos impactos na criança (OR 5,54; 95% IC: 2,15 - 14,24. Dor dentaria afeta negativamente a qualidade de vida relacionada a saúde bucal e esta associada com experiência de carie, idade e uso de serviços odontológicos.

Self-perceived oral health influences tooth brushing in preschool children.

This study assessed the influence of socioeconomic and clinical factors, as well as parent's perception of child's oral health on the toothbrushing frequency of 0-5-year-old children. The study was carried out in Santa Maria, RS, Brazil, during the National Children's Vaccination Day, and 478 children aged 0-5 years were included. Data were collected by clinical examinations and a structured questionnaire, conducted by 15 calibrated examiners and 30 supports. A questionnaire was filled out by the parents with information about several socioeconomic indicators, perception of child's oral health and frequency of tooth brushing. The main outcome was collected by the question: "How many times a day do you brush your child's teeth?". Multivariable Poisson regression model taking into account the cluster sample was performed to assess the association between the predictors and outcome. Children whose parents related worse perception of child's oral health showed less tooth brushing frequency (PR 1.23; 1.06 - 1.43). Young children brush their teeth less than the older ones (PR 0.90; 0.84 - 0.96); and lack of visit to a dentist was predictor for less tooth brushing frequency (PR 1.29; 1.05 - 1.59). Parent's perception of child oral health influence children's healthy behaviors, supporting the evidence that psychosocial factors are strong predictors of children's oral health.

Expectativas de escolares de uma comunidade vulnerável: qualidade de vida e esperança sobre profissionais/governantes / Expectations of students of a vulnerable community: quality of life and hope in professional/rulers

Objetivou-se conhecer as expectativas/anseios de escolares sobre mudanças pessoais que possibilitariam melhorias na sua qualidade de vida e o que esperam dos profissionais da saúde e governantes. Estudo transversal, realizado com 435 escolares, de dez anos ou mais, matriculados do quinto ano do ensino fundamental até o último ano do ensino médio. Utilizou-se um questionário com questões fechadas e após a análise estatística descritiva. 45,3% dos pesquisados responderam que gostariam de estudar mais; 26,7%, de valorizar mais os pais. Praticamente metade dos sujeitos gostaria que os profissionais de saúde lhes dessem mais atenção e orientações. Destes, 19,7% consideravam importante o profissional de saúde na escola. 40% dos estudantes esperam honestidade dos governantes e 34,9%, que estes pensem mais no povo. Os escolares têm noção dos seus direitos de cidadania, expressam de forma consciente as expectativas/anseios em relação às mudanças pessoais e o que esperam de profissionais da saúde e governantes.

This study aimed to describe students’ expectations about personal changes that would bring improvements to their quality of life and also about their hope in health professionals and governments. Cross-sectional study, conducted with 435 students, ten years old or more, enrolled in the fifth year of elementary school to the last year of high school. We used a questionnaire with closed questions and after the descriptive statistical analysis. 45.3% of respondents said they would like to study more; 26.7% would like to give parents more value. Nearly half of the subjects would like health professionals to give them more attention and guidance. Among them, 19.7% considered important the presence of health professional in school. 40% of students expect honesty from rulers and 34.9% expect they think more in people. The students are aware of their rights of citizenship, they have conscience to express the expectations / aspirations regarding personal changes and what they expect from health professionals and government.

Este estudio tuvo como objetivo conocer expectativas/aspiraciones de estudiantes acerca de los cambios personales que permitan la mejora de su calidad de vida y lo que esperan de los profesionales de la salud y responsables políticos. Estudio transversal con 435 estudiantes, de diez años de edad o más, en el quinto año de la escuela primaria hasta el último año de la escuela secundaria. Se utilizó un cuestionario con preguntas cerradas y después del análisis estadístico descriptivo. El 45,3% de los encuestados dijo que les gustaría estudiar más; el 26,7% de dar más valor a los padres. A casi la mitad de los sujetos les gustaría que profesionales de la salud les dieran más atención y orientación. De éstos, el 19,7% considera que es importante tener en la escuela el profesional de la salud. El 40% de los estudiantes espera honestidad de los gobernantes y el 34,9% espera que pensaran más en las personas. Los estudiantes son conscientes de sus derechos de ciudadanía, expresan conscientemente expectativas/aspiraciones con respecto a los cambios personales y lo que esperan de los profesionales de la salud y responsables políticos.

Self-Perceived Oral Health Influences Tooth Brushing in Preschool Children

This study assessed the influence of socioeconomic and clinical factors, as well as parent's perception of child's oral health on the toothbrushing frequency of 0-5-year-old children. The study was carried out in Santa Maria, RS, Brazil, during the National Children's Vaccination Day, and 478 children aged 0 - 5 years were included. Data were collected by clinical examinations and a structured questionnaire, conducted by 15 calibrated examiners and 30 supports. A questionnaire was filled out by the parents with information about several socioeconomic indicators, perception of child's oral health and frequency of tooth brushing. The main outcome was collected by the question: "How many times a day do you brush your child's teeth?". Multivariable Poisson regression model taking into account the cluster sample was performed to assess the association between the predictors and outcome. Children whose parents related worse perception of child's oral health showed less tooth brushing frequency (PR 1.23; 1.06 - 1.43). Young children brush their teeth less than the older ones (PR 0.90; 0.84 - 0.96); and lack of visit to a dentist was predictor for less tooth brushing frequency (PR 1.29; 1.05 - 1.59). Parent's perception of child oral health influence children's healthy behaviors, supporting the evidence that psychosocial factors are strong predictors of children's oral health.

O estudo avaliou a influência de fatores socioeconômicos, clínicos e a percepção dos pais quanto à saúde de seus filhos na frequência de escovação de pré-escolares de 0 a 5 anos de Santa Maria-RS, Brasil. O estudo foi realizado em Santa Maria, Brasil, durante o Dia Nacional de Vacinação das Crianças e 478 crianças de 0 - 5 anos foram incluídas. Os dados foram coletados por meio de exames clínicos e por um questionário estruturado, realizados por 15 examinadores calibrados e 30 auxiliares. Os responsáveis forneceram informações sobre diversos indicadores socioeconômicos, auto-percepção de saúde bucal e frequência de escovação dentária. O principal desfecho foi coletado pela pergunta "Quantas vezes por dia você escova os dentes de seu filho?". Os dados foram analisados utilizando modelo de regressão de Poisson, considerando pesos relativos à amostragem complexa. Pais que relataram pior percepção de saúde bucal dos seus filhos em relação às outras crianças apresentavam uma menor frequência de escovação (RP 0,23; IC: 1,06 - 1,43). Crianças mais novas escovavam menos os dentes que as de idade mais elevada (RP 0,90; IC: 0,84 - 0,96) e a não-procura pelo dentista foi preditor para menor frequência de escovação (RP 1,29; IC: 1,05 - 1,59). A percepção dos pais influencia hábitos saudáveis da criança, suportando a evidência de que aspectos psicossociais são fortes preditores de saúde bucal na infância.

Assessing individual and neighborhood social factors in child oral health-related quality of life: a multilevel analysis.

PURPOSE: It has been suggested that subjective measures of oral health are influenced by both individual and contextual characteristics. This study assessed the relationship between neighborhood and individual social networks and child oral health-related quality of life (COHRQoL). METHODS: This study followed a cross-sectional design using a multistage sample of 478 children aged 1-5 years old. Caregivers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions related to socioeconomic status and social network. The dental examination provided information on the prevalence of dental caries, dental trauma, and occlusion. Contextual social determinants included the presence of cultural community centers and of workers' association in the neighborhood. Data analysis considered the total ECOHIS scores as the outcome and neighborhood/individual social networks as the independent variables. A multilevel Poisson regression model was used to investigate the association among individual and contextual characteristics and COHRQoL. RESULTS: Total ECOHIS scores ranged from 0 to 41 (possible range 0-52). The mean ECOHIS score was low (mean = 1.8, SD = 3.9), and the functional domain presented the highest mean impact on COHRQoL (mean = 0.5, SD = 1.4). Following adjusted analysis, low household income, visiting a neighbor less than once a month, the presence of anterior open bite, dental trauma, and dental caries were identified as individual determinants of negative impact on a child's quality of life. These variables remained associated with the outcome even after adding the contextual-level variables in the model. At the contextual level, the presence of community cultural centers was associated with overall mean ECOHIS score; higher impacts on COHRQoL were observed in those living in neighborhoods without cultural community centers. CONCLUSION: There is a significant association between individual and contextual social determinants and COHRQoL; unfavorable social conditions and poor socioeconomic status have a negative impact on caregiver reports of children's oral health-related quality of life.