Dental pain in Brazilian preschool children: association with the severity of dental caries and impact on oral health-related quality of life.

PURPOSE: This study aimed to verify the association between dental pain and severity of dental caries (caries morbidity stages) and the impact on oral health-related quality of life (OHRQoL) in preschool children. METHODS: A cross-sectional study with 199 children (2-5 years old) enrolled at preschools in Capão do Leão-RS, Brazil. The self-report of mothers of children with a history of dental pain in the last 6 months and perception of their child's OHRQoL (ECOHIS) were obtained through a structured questionnaire. This questionnaire also collected independent variables. Children's oral examination was performed using the CAST instrument to determine caries morbidity stage. Crude and adjusted Poisson regression analysis was performed. RESULTS: The prevalence of dental pain was 14.57%. The chance of the occurrence of dental pain was higher among children diagnosed in morbidity [Prevalence ratio-PR: 5.29 (95% confidence interval-95% CI 1.91-14.61); p = 0.001] and severe morbidity [RP = 6.12 (95 CI% 2.25-16.64); p < 0.001] stages. Children with dental pain presented higher scores in the total ECOHIS [rate ratio = 7.11 (95% CI 4.55-11.09); p < 0.001] and in all of the domains of this instrument. Furthermore, children with a history of dental trauma [PR = 2.41 (95% CI 1.15-5.04); p < 0.001] and those whose reason for last visit to the dental office was for restorative/endodontic/extraction treatment [PR = 1.29 (95% CI 1.01-6.19); p = 0.049] had a higher prevalence of dental pain. CONCLUSION: A substantial prevalence of dental pain in the last 6 months and negative impact on children's OHRQoL was identified in this sample. Children diagnosed with carious dentin lesions and abscess and fistula were more likely to have dental pain.

Splinting in the management of dental trauma in the primary dentition: a systematic review.

PURPOSE: The purpose of this study was to gather existing data on the efficacy of tooth splinting (TS) in patients with traumatized primary teeth, evaluating their overall prognosis and reported complications. METHODS: Electronic searches were performed in seven databases up to Februray/2023. Clinical studies published in the last two decades and presenting the following characteristics were included: (a) reporting on children with traumatized primary teeth; (b) describing the efficacy of splinting those teeth. Studies describing imobilization of dental avulsion were excluded. RESULTS: A total of 163 potentially relevant studies were initially found. After title/abstract screening, and full-text evaluation, three retrospective studies with moderate to high risk of bias were included. The studies described the outcomes of TS in primary teeth with luxation (intrusion, extrusion, lateral displacement), intra-alveolar root fracture, and/or alveolar fracture. High clinical success rate was observed for teeth with root fracture. Benefits of spliting teeth with lateral luxation were not identified, although it may be a reccomended approach. No study was found evaluating TS for alveolar fracture. CONCLUSION: Based on a low level of evidence, the findings highlight a better clinical success rate of the use of TS in the management of deciduous teeth with root fractures.

The influence of clinical and psychosocial characteristics on children behaviour during sequential dental visits: a longitudinal prospective assessment.

PURPOSE: This is the first study to adopt a multilevel approach to assess the impact of the order of dental visits on child's behaviour. The aim was to investigate which factors directly interfere with child's behaviour regardless of the order of sequential dental visits. METHODS: In this prospective longitudinal study, children aged 7-12 years were invited to participate. Child behaviour was assessed using the Frankl Scale during four sequential dental visits. Chi-square test was used to analyse the effect of dental fear on children's non-cooperative behaviour according to the presence of dental fear. Multilevel mixed logistic regression model was used to assess the association between predictor variables and the outcome (child behaviour) during the sequential dental visits. RESULTS: Overall, 111 children participated in this study. Maternal dental anxiety, dental pain and complexity of the treatment were associated with the non-cooperative behaviour in children aged 7-12 years. When stratified by dental fear, the complexity of the treatment remained associated with non-cooperative behaviour. CONCLUSIONS: The results provide evidence that, even with the familiarization of child with the dental environment, maternal dental anxiety, dental pain in the last month, and the complexity of dental treatment negatively affect the children's behaviour aged 7-12 years.

Factors associated with children's perception of pain following dental treatment.

PURPOSE: To assess children's perception of pain during routine dental procedures and associated factors. METHODS: A cross-sectional study was performed including 192 children aged 6-13 years, who visited a university paediatric dental clinic. Mothers were interviewed to obtain information about demographic and socioeconomic data, and psychosocial characteristics. During dental treatment, children's behaviour was assessed using Frankl's Behaviour Scale. Dental procedures were recorded according to complexity of treatment from dental records. Immediately after the dental procedure, perception of pain was assessed using the Faces Pain Scale-Revised. Poisson regression analysis was used to assess the association between potential predictor variables and perception of pain (P < 0.05 was considered significant). RESULTS: Overall, the mean pain score was 1.5 (SD 2.4). Higher levels of pain were reported by children who demonstrated non-cooperative behaviour during the treatment (RR = 2.39, 95% CI = 1.23-4.64), who were administered local analgesia (RR = 2.36, 95% CI = 1.31-4.27), and who reported dental pain during the previous 4 weeks (RR = 1.60, 95% CI = 1.04-2.47). CONCLUSION: Perception of pain may be influenced by pre-operative pain and use of local analgesia, and is associated with non-cooperative behaviour during treatment.

Representation of dental care and oral health in children's drawings.

BACKGROUND: Paediatric dentistry requires knowledge of preventive measures, restorative skills and an understanding of child development. AIM: This exploratory, descriptive and qualitative study has analysed children's drawings regarding their perception of dental treatment and oral health. METHOD: Children aged from six to ten years attending a dental school for treatment were randomly invited to create a drawing about 'dental treatment' and 'oral health'. Verbal expressions made by the children whilst drawing were also recorded and attached to the drawings. These representations were analysed and categorised using Vygotsky postulations for context reading. DISCUSSION: During the drawing analysis different themes emerged. Five categories regarding perceptions of dental treatment were identified: personal relationship; power relation; trauma; childhood resistance; and contextualisation of dental care in the child's life. Three categories relating to oral health were determined: dichotomy of health/sickness; ludic representation of health; and sickness seen as a process. CONCLUSION: Drawing can be used to understand children's emotions and expectations about dental treatment. Besides possessing technical skills and scientific knowledge, dentists have an obligation to pay attention to children's feelings.

Traumatic dental injuries in primary teeth: severity and related factors observed at a specialist treatment centre in Brazil.

AIM: This retrospective study aimed to analyse demographic data and the severity of traumatic dental injuries (TDIs) to the primary dentition based on children's dental records at a university clinic. STUDY DESIGN: A cross-sectional retrospective study. METHODS: The records of all patients were analysed according to gender, age, aetiology, teeth involved, number of affected teeth, place of occurrence, witness to the trauma, time elapsed between trauma occurrence and care-seeking, type of trauma and severity of injury. RESULTS: A total of 576 children aged 8-89 months suffered injuries to 1,043 teeth. Severe injuries were the most prevalent (45.5%). These occurred at all ages, but their frequency was higher in children aged between 13 and 24 months. The prevalence of mild injury was higher when the cause was a fall from one's own height. No differences were detected in severity according to the place of occurrence and witnesses of the accident. The prevalence of severe injury was higher in cases where three or more teeth were involved. CONCLUSIONS: In this specialist treatment centre, severe injuries were the most common TDIs, which occurred in children aged 13-24 months, mainly due to falls and most occurred at home. Professionals must be prepared to deliver the best and most efficient care to this population.

Influence of anxiety on temporomandibular disorders--an epidemiological survey with elders and adults in Southern Brazil.

The socio-economic and psychological factors and the use of and need for dental prostheses have been associated with prevalence and severity of temporomandibular disorders (TMD). The aim of this study was to evaluate the association of socio-economic and psychological factors, use of and need for dental prostheses with the prevalence and severity of signs and symptoms of temporomandibular disorders (TMD). A cross-sectional study was conducted in Luzerna/Brazil. All individuals aged 35-44 (adults) and 65-74 (elders) were invited to participate in this study. The measuring instrument included a questionnaire application and the clinical evaluation regarding signs and symptoms of TMD. Descriptive analyses, chi-squared test, unadjusted and adjusted Poisson regression were used for the statistic analysis. The level of statistical significance was given when P ≤ 0·05. In total, 568 individuals (338 adults and 230 elders) were included; among them, 43·5% had absent, 42·6% mild, 11·3% moderate and 2·6% severe TMD. The presence of higher TMD rates was found in females (P = 0·001), and the TMD occurrence increased with anxiety level (P = 0·001). Other socio-economic factors, such as colour (P = 0·115), family structure (P = 0·478), age (P = 0·143), social class (P = 0·935) and education (P = 0·678) showed no influence. In conclusion, the female gender and individuals with higher levels of anxiety had increased prevalence of signs and symptoms of TMD. Additionally, was not founded association between TMD and use of and need for dental prostheses.

Influence of maternal dental anxiety on the child's dental caries experience.

This study assessed the influence of maternal dental anxiety-related behavior on the child's caries experience. A cross-sectional study with 608 mother-child dyads during the Children's National Immunization Campaign in Pelotas, Brazil was performed. Mothers were asked to answer a questionnaire and dental examination of the children was performed (dmft). The association assessment used Poisson regression. Children from anxious mothers were more likely to present untreated caries even after covariate adjustment. Boys, older children and low-income family children presented a higher dmft mean. Preventive strategies should focus not only on child and family characteristics, but also on maternal dental anxiety-related behaviors.