Prevalence of Temporomandibular Disorders in an Adult Brazilian Community Population Using the Research Diagnostic Criteria (Axes I and II) for Temporomandibular Disorders (The Maringá Study).

PURPOSE: The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. MATERIALS AND METHODS: Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. RESULTS: The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. CONCLUSION: The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.

Self-perception and malocclusion and their relation to oral appearance and function.

The aim of this study was to evaluate the relationship between malocclusion and self-perception of oral appearance/function, in 12/15-year-old Brazilian adolescents. The cluster sample consisted of 717 teenagers attending 24 urban public (n=611) and 5 rural public (n=107) schools in Maringá/PR. Malocclusion was measured using the Dental Aesthetic Index (DAI), in accordance with WHO recommendations. A parental questionnaire was applied to collect information on esthetic perception level and oral variables related to oral health. Univariate and multiple logistic regression analyses were performed. Multiple logistic regression confirmed that for 12-year-old, missing teeth (OR=2.865) and presence of openbite (open occlusal relationship) (OR=2.865) were risk indicators for speech capability. With regard to 15-year-old, presence of mandibular overjet (horizontal overlap) (OR=4.016) was a risk indicator for speech capability and molar relationship (OR=1.661) was a risk indicator for chewing capability. The impact of malocclusion on adolescents' life was confirmed in this study. Speech and chewing capability were associated with orthodontic deviations, which should be taken into consideration in oral health planning, to identify risk groups and improve community health services.

Self-perception and malocclusion and their relation to oral appearance and function / Auto-percepção e má oclusão relacionadas à aparência e a função bucal

The aim of this study was to evaluate the relationship between malocclusion and self-perception of oral appearance/function, in 12/15-year-old Brazilian adolescents. The cluster sample consisted of 717 teenagers attending 24 urban public (n=611) and 5 rural public (n=107) schools in Maringá/PR. Malocclusion was measured using the Dental Aesthetic Index (DAI), in accordance with WHO recommendations. A parental questionnaire was applied to collect information on esthetic perception level and oral variables related to oral health. Univariate and multiple logistic regression analyses were performed. Multiple logistic regression confirmed that for 12-year-old, missing teeth (OR=2.865) and presence of openbite (open occlusal relationship) (OR=2.865) were risk indicators for speech capability. With regard to 15-year-old, presence of mandibular overjet (horizontal overlap) (OR=4.016) was a risk indicator for speech capability and molar relationship (OR=1.661) was a risk indicator for chewing capability. The impact of malocclusion on adolescents' life was confirmed in this study. Speech and chewing capability were associated with orthodontic deviations, which should be taken into consideration in oral health planning, to identify risk groups and improve community health services.

Este estudo objetivou avaliar a relação entre a má oclusão e a autopercepção da aparência/função bucal em adolescentes brasileiros de 12/15 anos de idade. A amostragem foi probabilística, constituída por 717 adolescentes de escolas públicas, sendo 24 urbanas (n=611) e 5 rurais (n=107), em Maringá/PR. A má oclusão foi medida por meio do Índice de Estética Dental (DAI), de acordo com os critérios da OMS. Foi aplicado um questionário aos pais para coletar informações sobre o nível de percepção estética e as variáveis relacionadas à saúde bucal. Análises univariada e de regressão logística múltipla foram realizadas. A regressão logística múltipla confirmou que para 12 anos, os dentes ausentes (OR=2,865) e a presença de mordida aberta (OR=2,865) foram indicadores de risco na capacidade de fala. Com relação aos 15 anos, a presença de overjet mandibular (OR=4,016) foi um indicador de risco para a capacidade de expressão e a relação molar (OR=1,661) foi um indicador de risco para a capacidade mastigatória. O impacto da má oclusão na vida dos adolescentes foi confirmado neste estudo. A capacidade da fala e da mastigação esteve associada às alterações ortodônticas, as quais devem ser levadas em consideração no planejamento de saúde bucal, para identificar grupos de risco e para melhorar os serviços de saúde.

[Prevalence of overweight and obesity, and associated factors in adolescents, at the central west area of the state São Paulo (SP, Brazil)]. / Prevalência de sobrepeso e obesidade e fatores associados em adolescentes na região centro-oeste do estado de São Paulo (SP, Brasil).

The aim of the study was to evaluate the relationship between the Body Mass Index (BMI) and the DMFT index, in 207 adolescents aged 12 years old, from 8 public and private schools of the central west area of São Paulo State. From a sample of 380 12 year-old adolescents, both genders, 207 were examined. We used the index DMFT, CBI for weight, measured of stature and applied a questionnaire about alimentary habits, characteristic anthropometrics and physical activity. Regarding body weight, 55.93% was normal, 35.59% had low weight, and 8.47% were pre-obese in private schools. In the public schools, 52.03% had normal weight, 41.22% had low weight, 4.73% were pre-obese and 2.03% were obese, without significant difference (p=0.45). The DMFT of public schools was 2.16, compared to 0.23 in private schools (p<0.05), with 39.2% of caries-free individuals in public schools and 88.1% in private schools. There was no correlation between the increase in BMI and the increase in DMFT. There was negative correlation between socioeconomic conditions and dental caries. It was concluded that, even though the pre-obese and obese groups presented a higher frequency of food ingestion, obesity was not correlated with the increase in dental caries. However, the socioeconomic conditions were determinant for this occurrence.

Prevalência de sobrepeso e obesidade e fatores associados em adolescentes na região centro-oeste do estado de São Paulo (SP, Brasil) / Prevalence of overweight and obesity, and associated factors in adolescents, at the central west area of the state São Paulo (SP, Brazil)

Objetivou-se avaliar a relação entre o Índice de Massa Corporal (IMC) e o índice CPOD em 207 adolescentes de 12 anos, de 8 escolas públicas e particulares da região centro-oeste do estado de São Paulo. A amostra foi constituída por 380 adolescentes aos 12 anos, de ambos os gêneros, sendo examinados 207. Utilizou-se o índice CPOD, IMC para peso, medida de estatura, e aplicou-se questionário sobre hábitos alimentares, características antropométricas e atividade física. Quanto ao peso corpóreo, 55,93 por cento apresentaram normal (G4), 35,59 por cento de baixo peso (G3), 8,47 por cento de pré-obesos (G2), nas escolas particulares. Nas públicas, 52,03 por cento apresentaram normal, baixo peso 41,22 por cento, pré-obesos 4,73 por cento e obesos (G1) 2,03 por cento; não houve diferença significativa (p=0,45). Verificou-se que o CPOD nas escolas públicas foi 2,16 e nas particulares, 0,23 (p<0,05), sendo que 39,2 por cento das crianças estavam livres de cárie nas municipais e nas particulares, 88,1 por cento. Não houve correlação do maior IMC com o incremento de CPOD. Houve correlação negativa entre condições socioeconômicas e índice de cárie dentária. Concluiu-se que os grupos pré-obesos e obesos, embora houvesse maior frequência de ingestão de alimentos, não apresentaram correlação com o incremento de cárie dentária, mas as condições socioeconômicas foram determinantes para essa ocorrência.

The aim of the study was to evaluate the relationship between the Body Mass Index (BMI) and the DMFT index, in 207 adolescents aged 12 years old, from 8 public and private schools of the central west area of São Paulo State. From a sample of 380 12 year-old adolescents, both genders, 207 were examined. We used the index DMFT, CBI for weight, measured of stature and applied a questionnaire about alimentary habits, characteristic anthropometrics and physical activity. Regarding body weight, 55.93 percent was normal, 35.59 percent had low weight, and 8.47 percent were pre-obese in private schools. In the public schools, 52.03 percent had normal weight, 41.22 percent had low weight, 4.73 percent were pre-obese and 2.03 percent were obese, without significant difference (p=0.45). The DMFT of public schools was 2.16, compared to 0.23 in private schools (p<0.05), with 39.2 percent of caries-free individuals in public schools and 88.1 percent in private schools. There was no correlation between the increase in BMI and the increase in DMFT. There was negative correlation between socioeconomic conditions and dental caries. It was concluded that, even though the pre-obese and obese groups presented a higher frequency of food ingestion, obesity was not correlated with the increase in dental caries. However, the socioeconomic conditions were determinant for this occurrence.

Efficacy of an oral health promotion program for infants in the public sector%Adaptação marginal na interface intermediário-cilindro antes e após as sobrefundições

O objetivo do trabalho foi comparar o índice de cárie (ceo), presença de hábitos de sucção e alterações faciais em crianças atendidas no programa de atendimento preventivo a bebês, com crianças atendidas por demanda espontânea, na mesma idade, no serviço público de Maringá-PR. Foram avaliadas 100 crianças (1-5 anos), divididas em 2 grupos: GI-crianças atendidas no programa de bebês com atendimento educativo-preventivo e retornos bimestrais, desde o 1º ano de vida; GII-crianças atendidas para tratamento convencional (preventivo e curativo) de acordo com a necessidade, sendo o retorno responsabilidade dos familiares. A coleta dos dados foi realizada por meio de entrevista com os pais e através de exame clínico, para avaliação do ceo e alterações faciais. A análise dos dados (Teste de Mann-Whitney para comparações de ceo e teste qui-quadrado para todas outras comparações) mostrou diferença significante (p<0,05) em relação ao índice ceo (GI: 0,2; GII:3,0), componente livre de cárie (GI:88%; GII:57%) e hábitos de sucção não nutritiva (GI:47%; GII:75%). As práticas de amamentação e uso da mamadeira foram semelhantes nos grupos. Constatou-se maior presença de alterações faciais (p<0,05) no GII (48%) do que no GI (8,4%), destacando-se as variáveis (p<0,05) palato ogival (GI: 10,2%; GII:35,4%), mordida aberta anterior (GI:14,2%; GII:35,4%) e respiração bucal (GI: 6,1%; GII: 29,1%). Concluiu-se que o programa de atendimento a bebês é mais efetivo que o atendimento de demanda espontânea, cumprindo o objetivo de manutenção da saúde bucal na população infantil

Efficacy of an oral health promotion program for infants in the public sector

O objetivo do trabalho foi comparar o índice de cárie (ceo), presença de hábitos de sucção e alterações faciais em crianças atendidas no programa de atendimento preventivo a bebês, com crianças atendidas por demanda espontânea, na mesma idade, no serviço público de Maringá-PR. Foram avaliadas 100 crianças (1-5 anos), divididas em 2 grupos: GI-crianças atendidas no programa de bebês com atendimento educativo-preventivo e retornos bimestrais, desde o 1º ano de vida; GII-crianças atendidas para tratamento convencional (preventivo e curativo) de acordo com a necessidade, sendo o retorno responsabilidade dos familiares. A coleta dos dados foi realizada por meio de entrevista com os pais e através de exame clínico, para avaliação do ceo e alterações faciais. A análise dos dados (Teste de Mann-Whitney para comparações de ceo e teste qui-quadrado para todas outras comparações) mostrou diferença significante (p<0,05) em relação ao índice ceo (GI: 0,2; GII:3,0), componente livre de cárie (GI:88%; GII:57%) e hábitos de sucção não nutritiva (GI:47%; GII:75%). As práticas de amamentação e uso da mamadeira foram semelhantes nos grupos. Constatou-se maior presença de alterações faciais (p<0,05) no GII (48%) do que no GI (8,4%), destacando-se as variáveis (p<0,05) palato ogival (GI: 10,2%; GII:35,4%), mordida aberta anterior (GI:14,2%; GII:35,4%) e respiração bucal (GI: 6,1%; GII: 29,1%). Concluiu-se que o programa de atendimento a bebês é mais efetivo que o atendimento de demanda espontânea, cumprindo o objetivo de manutenção da saúde bucal na população infantil.

Efficacy of an oral health promotion program for infants in the public sector.

This study compared the caries index (dmft), presence of sucking habits and facial alterations in children attended by the preventive program for infants and children assisted by spontaneous demand, at the same age, at the public sector of Maringá, PR. A total of 100 children were evaluated (1-6 years), who were divided into 2 groups: GI - children attended by the infant program with educational and preventive care and bimonthly follow-up, since the 1st year of age; GII - children assisted for conventional treatment (preventive and restorative) according to the needs, and follow-up as requested by the parents. Data collection was performed by interview with the parents and clinical examination for evaluation of the dmft and facial alterations. Analysis of data (Mann-Whitney test for dmft comparison and chi-square test for all other comparisons) demonstrated a significant difference (p<0.05) in relation to the dmft index (GI: 0.2; GII: 3.0), percentage of caries-free children (GI: 88%; GII: 57%) and non-nutritive sucking habits (GI: 47%; GII: 75%). The breastfeeding and bottle utilization practices were similar for both groups. Facial alterations were more frequently observed (p<0.05) in GII (48%) than GI (8.4%), especially for the variables (p<0.05) high arched palate (GI: 10.2%; GII: 35.4%), anterior open bite (GI: 14.2%; GII: 35.4%) and mouth breathing (GI: 6.1%; GII: 29.1%). It was concluded that the infant program is more effective than the spontaneous demand program, reaching the goal of oral health maintenance in the child population.