Dental students' satisfaction with their course and how it is associated to their satisfaction with life and career outlook / Satisfação com o curso de Odontologia e suas associações com a satisfação com a vida e perspectiva de carreira

ABSTRACT Identifying factors that influence the satisfaction of undergraduate dental students can contribute to establishing strategies for improving the educational process, furthering student development, and enhancing students' academic and professional achievements. Aim: the present study investigated associations between undergraduate students' satisfaction with the dental course and their satisfaction with life, perception of professional career and sociodemographic factors. Materials and method: this was a cross-sectional study on 512 dental students from a Brazilian School of Dentistry. Students were asked to respond to three questionnaires about sociodemographic characteristics, academic, and professional perceptions. Satisfaction with life was measured using the Brazilian version of the Satisfaction with Life Scale, which comprises five statements with responses scored on a seven-point Likert scale ranging from "I strongly disagree" to "I strongly agree". Unadjusted and adjusted multiple logistic regression analyses were performed to test associations between satisfaction with the dental course and key variables. Results: most participants were female (73.2%), single (99.8%) and with mean age 21.77 (±2.71) years. Approximately three quarters had a family income over three times higher than the national monthly minimum wage. Higher satisfaction with the course was associated with more optimistic perception of the job market (OR=2.44; 95% CI: 1.36-4.40), better academic performance (OR=1.65; 95% CI: 1.00-2.74) and greater satisfaction with life (OR=1.10; 95% CI: 1.06-1.15). Students' sex and family income did not have significant impact on satisfaction with the dental course. Conclusions: satisfaction with the dental course is related to an optimistic perception of the job market, academic performance and satisfaction with life.

RESUMO Identificar os fatores que influenciam na satisfação dos estudantes de odontologia pode contribuir para o estabelecimento de estratégias que aprimorem o processo educacional, favorecendo o desenvolvimento dos alunos e potencializando suas conquistas acadêmicas e profissionais. Objetivo: o presente estudo investigou as associações entre a satisfação de estudantes de graduação com o curso de odontologia e sua satisfação com a vida, percepção da carreira profissional e fatores sociodemográficos. Materiais e método: um estudo transversal foi realizado com 512 estudantes de Odontologia de uma Faculdade Brasileira de Odontologia. Três questionários foram aplicados aos alunos, com o objetivo de avaliar as características sociodemográficas, percepções acadêmicas e profissionais. A satisfação com a vida foi mensurada pela versão brasileira da Escala de Satisfação com a Vida, que compreende cinco afirmações com respostas pontuadas em uma escala Likert de sete pontos, variando de "discordo totalmente" a "concordo totalmente". A análise de regressão logística foi realizada para testar associações entre a satisfação com o curso de Odontologia e as demais variáveis. Análises de regressão logística múltipla não-ajustada e ajustada foram realizadas para testar associações entre a satisfação com o curso de odontologia e variáveis-chave. Resultados: A maioria dos participantes era do sexo feminino (73,2%), solteiros (99,8%) e com média de idade de 21,77 (±2,71) anos. Aproximadamente três quartos tinham renda familiar três vezes superior ao salário-mínimo nacional. A maior satisfação dos alunos com o curso foi associada a maior percepção otimista do mercado de trabalho (OR=2,44; IC 95%: 1,36-4,40), desempenho acadêmico (OR=1,65; IC 95%: 1,00-2,74) e satisfação com a vida (OR =1,10; IC 95%: 1,06-1,15). O sexo dos alunos e a renda familiar não apresentaram impacto significativo na satisfação com o curso de odontologia. Conclusão: a satisfação com o curso de odontologia está relacionada com a percepção otimista do mercado de trabalho, desempenho acadêmico e satisfação com a vida.

Dental students' satisfaction with their course and how it is associated to their satisfaction with life and career outlook.

Identifying factors that influence the satisfaction of undergraduate dental students can contribute to establishing strategies for improving the educational process, furthering student development, and enhancing students' academic and professional achievements. AIM: the present study investigated associations between undergraduate students' satisfaction with the dental course and their satisfaction with life, perception of professional career and sociodemographic factors. MATERIALS AND METHOD: this was a cross-sectional study on 512 dental students from a Brazilian School of Dentistry. Students were asked to respond to three questionnaires about sociodemographic characteristics, academic, and professional perceptions. Satisfaction with life was measured using the Brazilian version of the Satisfaction with Life Scale, which comprises five statements with responses scored on a seven-point Likert scale ranging from "I strongly disagree" to "I strongly agree". Unadjusted and adjusted multiple logistic regression analyses were performed to test associations between satisfaction with the dental course and key variables. RESULTS: most participants were female (73.2%), single (99.8%) and with mean age 21.77 (±2.71) years. Approximately three quarters had a family income over three times higher than the national monthly minimum wage. Higher satisfaction with the course was associated with more optimistic perception of the job market (OR=2.44; 95% CI: 1.36-4.40), better academic performance (OR=1.65; 95% CI: 1.00-2.74) and greater satisfaction with life (OR=1.10; 95% CI: 1.06-1.15). Students' sex and family income did not have significant impact on satisfaction with the dental course. CONCLUSIONS: satisfaction with the dental course is related to an optimistic perception of the job market, academic performance and satisfaction with life.

Identificar os fatores que influenciam na satisfação dos estudantes de odontologia pode contribuir para o estabelecimento de estratégias que aprimorem o processo educacional, favorecendo o desenvolvimento dos alunos e potencializando suas conquistas acadêmicas e profissionais. Objetivo: o presente estudo investigou as associações entre a satisfação de estudantes de graduação com o curso de odontologia e sua satisfação com a vida, percepção da carreira profissional e fatores sociodemográficos. Materiais e método: um estudo transversal foi realizado com 512 estudantes de Odontologia de uma Faculdade Brasileira de Odontologia. Três questionários foram aplicados aos alunos, com o objetivo de avaliar as características sociodemográficas, percepções acadêmicas e profissionais. A satisfação com a vida foi mensurada pela versão brasileira da Escala de Satisfação com a Vida, que compreende cinco afirmações com respostas pontuadas em uma escala Likert de sete pontos, variando de "discordo totalmente" a "concordo totalmente". A análise de regressão logística foi realizada para testar associações entre a satisfação com o curso de Odontologia e as demais variáveis. Análises de regressão logística múltipla não-ajustada e ajustada foram realizadas para testar associações entre a satisfação com o curso de odontologia e variáveis-chave. Resultados: A maioria dos participantes era do sexo feminino (73,2%), solteiros (99,8%) e com média de idade de 21,77 (±2,71) anos. Aproximadamente três quartos tinham renda familiar três vezes superior ao salário-mínimo nacional. A maior satisfação dos alunos com o curso foi associada a maior percepção otimista do mercado de trabalho (OR=2,44; IC 95%: 1,36-4,40), desempenho acadêmico (OR=1,65; IC 95%: 1,00-2,74) e satisfação com a vida (OR =1,10; IC 95%: 1,06-1,15). O sexo dos alunos e a renda familiar não apresentaram impacto significativo na satisfação com o curso de odontologia. Conclusão: a satisfação com o curso de odontologia está relacionada com a percepção otimista do mercado de trabalho, desempenho acadêmico e satisfação com a vida.

Dental caries remains as the main oral condition with the greatest impact on children's quality of life.

PURPOSE: The objective of this study was to assess the negative impact of dental caries on the OHRQoL of 8- to 10-year-old Brazilian children. METHODS: This population-based case-control study involved 546 children (8-10 years old), 182 cases with a high negative impact on OHRQoL and 364 controls with a low negative impact on OHRQoL. Children's OHRQOL was measured using the Child Perceptions Questionnaire (CPQ8-10). Cases and controls (1x2 ratio) were individually matched by school and gender. Dental caries experience, malocclusion, and traumatic dental injuries were used as independent variables. Dental examinations were carried out at school during daytime hours by two calibrated examiners (Kappa = 0.93-interexaminer and 0.95- intraexaminer). The data were analyzed by descriptive statistics, conditional bivariate and multiple logistic regression, with the significance level set at 5%. RESULTS: There was no significant difference in traumatic dental injuries and malocclusion between the case and control groups (p>0.05). Children with DMFT/dmft ≥3 had a 2.06-fold (95%CI = 1.28-3.31, p = 0.003) greater chance of experiencing a high negative impact on OHRQoL than those with DMFT/dmft = 0. CONCLUSION: Children with high dental caries experience are more likely to present a high negative impact on OHRQoL than those with no dental caries experience.

Clinical factors and socio-demographic characteristics associated with dental trauma in children: a systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the factors associated with traumatic dental injury (TDI) in the primary dentition. METHODOLOGY: An electronic search addressing factors associated with TDI was conducted in the PubMed, ISI, LILACS, Cochrane Library, and Embase databases. Data were extracted and analyzed regarding risk factors, statistical test, effect measures, and study design. RESULTS: The online search strategy led to the initial retrieval of 2566 articles. After evaluating the titles and abstracts, 24 papers were selected for complete review and data collection. TDI was associated with males (OR: 1.24; 95%CI: 1.09-1.41), inadequate lip coverage (OR: 1.81; 95%CI: 1.50-2.17), overbite (OR: 1.438; 95%CI: 0.94-2.19), and age (1 vs 2 years - OR: 0.47; 95%CI: 0.38-0.58; 2 vs 3 years - OR: 0.78; 95%CI: 0.67-0.91; 3 vs 4 years - OR: 0.82; 95%CI: 0.71-0.95). Overjet and anterior open bite were associated with TDI in the majority of studies. CONCLUSIONS: Males, older children, and those with inadequate lip coverage, overbite, or overjet are more likely to have TDI in the primary dentition.

Impact of wearing fixed orthodontic appliances on quality of life among adolescents: Case-control study.

OBJECTIVE: To investigate the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among adolescents. MATERIALS AND METHODS: A case-control study (1 ∶ 2) was carried out with a population-based randomized sample of 327 adolescents aged 11 to 14 years enrolled at public and private schools in the City of Brumadinho, southeast of Brazil. The case group (n  =  109) was made up of adolescents with a high negative impact on OHRQoL, and the control group (n  =  218) was made up of adolescents with a low negative impact. The outcome variable was the impact on OHRQoL measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ 11-14) - Impact Short Form (ISF:16). The main independent variable was wearing fixed orthodontic appliances. Malocclusion and the type of school were identified as possible confounding variables. Bivariate and multiple conditional logistic regressions were employed in the statistical analysis. RESULTS: A multiple conditional logistic regression model demonstrated that adolescents wearing fixed orthodontic appliances had a 4.88-fold greater chance of presenting high negative impact on OHRQoL (95% CI: 2.93-8.13; P < .001) than those who did not wear fixed orthodontic appliances. A bivariate conditional logistic regression demonstrated that malocclusion was significantly associated with OHRQoL (P  =  .017), whereas no statistically significant association was found between the type of school and OHRQoL (P  =  .108). CONCLUSIONS: Adolescents who wore fixed orthodontic appliances had a greater chance of reporting a negative impact on OHRQoL than those who did not wear such appliances.

Survival of Adhesive Restorations for Primary Molars: A Systematic Review and Metaanalysis of Clinical Trials.

PURPOSE: The purpose of this study was to assess the scientific evidence regarding the survival and clinical performance of adhesive materials for primary molars, comparing composite resin (CR), conventional glass ionomer cement (GIC), resin-modified glass ionomer (RMGIC), silver-reinforced glass ionomer cement, and compomer. METHODS: Six databases were searched without restrictions regarding language or year of publication. Meta-analysis was conducted; risk ratios (RRs) and 95 percent confidence intervals (95% CI) were calculated. RESULTS: Eleven clinical trials were included. Two studies found that the median survival time (MST) of SRGIC was less than that of GIC and RMGIC (P<0.005), and two studies found that the GIC had a lower MST than both RMGIC and compomer (P<0.05). Meta-analysis for CR, compomer, and RMGIC was conducted. These materials did not differ significantly regarding the number of restorations that survived over 24 months: CR versus RMGIC (RR equals 1.12, 95% CI equals 0.96 to 1.31); CR versus compomer (RR equals 1.04; 95% CI equals 0.96 to 1.13); and compomer versus RMGIC (RR equals 1.03; 95% CI equals 0.84 to 1.27). CONCLUSIONS: Silver-reinforced glass ionomer cement has the worst survival rate among ionomers, and adhesive materials with a resin component have similar survival rates.

Breast and Bottle Feeding as Risk Factors for Dental Caries: A Systematic Review and Meta-Analysis.

Understanding the role that breastfeeding and bottle feeding play in the development of dental caries during childhood is essential in helping dentists and parents and care providers prevent the disease, and also for the development of effective public health policies. However, the issue is not yet fully understood. The aim of this systematic review and meta-analysis was to search for scientific evidence in response to the question: Do bottle fed children have more dental caries in primary dentition than breastfed children? Seven electronic databases and grey literature were used in the search. The protocol number of the study is PROSPERO CRD 42014006534. Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment. A random effect model was used for meta-analysis, and the summary effect measure were calculated by odds ratio (OR) and 95% CI. Seven studies were included: five cross-sectional, one case-control and one cohort study. A meta-analysis of cross-sectional studies showed that breastfed children were less affected by dental caries than bottle fed children (OR: 0.43; 95%CI: 0.23-0.80). Four studies showed that bottle fed children had more dental caries (p<0.05), while three studies found no such association (p>0.05). The scientific evidence therefore indicated that breastfeeding can protect against dental caries in early childhood. The benefits of breastfeeding until age two is recommended by WHO/UNICEF guidelines. Further prospective observational cohort studies are needed to strengthen the evidence.

Absence of an association between socioeconomic indicators and traumatic dental injury: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to perform a systematic review and search for scientific evidence on the association between socioeconomic indicators and traumatic dental injury (TDI) in the primary dentition. METHODOLOGY: The PubMed, ISI, LILACS, Cochrane Library, and Embase databases were searched for articles addressing possible associations between socioeconomic indicators and TDI in the primary teeth in journals dating from the inception of the databases through to December 2013. Two independent reviewers performed data extraction and analyzed the quality of the studies. Meta-analysis was undertaken. Pooled estimates were calculated with a 95% confidence interval (CI) and odds ratios (OR). RESULTS: Sixteen articles were included in the systematic review. Children from families with household income less than two times average salary (U$ 592) (OR: 0.77; 95% CI: 0.66-0.90) or more than three times the average salary (U$ 888) (OR: 0.76; 95% CI: 0.65-0.89) had a significantly lower chance of having TDI in the primary dentition. TDI was not associated with socioeconomic status (high vs low - OR: 0.77; 95% CI: 0.43-1.36; high vs medium - OR: 1.03; 95% CI: 0.72-1.48; medium vs low - OR: 0.70; 95% CI: 0.42-1.19), house ownership (owned vs rented - OR: 1.28; 95% CI: 0.98-1.66), mother's schooling (OR: 0.89; 95% CI: 0.74-1.08), or father's schooling (OR: 1.01; 95% CI: 0.62-2.74). CONCLUSION: The scientific evidence demonstrates that socioeconomic indicators are not associated with TDI in the primary dentition. The evidence of an association between a low income and TDI is weak. In general, studies had low risk of bias. Further prospective cohort studies are needed to confirm this association.

Breastfeeding, bottle feeding practices and malocclusion in the primary dentition: a systematic review of cohort studies.

The World Health Organization recommends exclusive breast feeding for at least six months. However, there is no scientific evidence of the benefits of breast feeding for oral health in children under primary dentition. This study aimed to search for scientific evidence regarding the following question: is bottle feeding associated with malocclusion in the primary dentition compared to children that are breastfed? An electronic search was performed in seven databases. The systematic review included 10 cohort studies. It was not possible to conduct meta-analysis; therefore a qualitative analysis was assessed. The majority of studies evaluated feeding habits by means of questionnaires and conducted a single examination. Three studies observed that bottle feeding was significantly associated with overjet and posterior crossbite. Studies reported several cut-off times for breastfeeding (varying from 1 month up to 3 years of age) and several types of malocclusion. Controlling for non-nutritive sucking habits was reported for only half of the studies and this may have led to biased results. The scientific evidence could not confirm a specific type of malocclusion associated with the feeding habits or an adequate time of breastfeeding to benefit the children against malocclusion. Further cohort studies are needed to confirm this evidence.

Anxiety and worry when coping with cancer treatment: agreement between patient and proxy responses.

PURPOSE: Assess agreement between proxy respondents (caregivers) and children/adolescents related to the impact of cancer on children's/adolescents' health-related quality of life, with respect to anxiety and worry issues. METHODS: A cross-sectional study was conducted among 83 Brazilian children/adolescents, of both genders, diagnosed with cancer, aged 5-18 years and their proxy respondents. Anxiety and worry were assessed through items of the instrument Pediatric Quality of Life Inventory™ Cancer Module Scale. Participants were recruited from the pediatric hematology/oncology centers at two public hospitals. All individuals were receiving medical care. Descriptive statistics were performed as well as a weighted kappa coefficient, Spearman's correlation coefficient, Wilcoxon signed-rank test and Bland-Altman plots. The magnitude of the difference between the mean scores obtained from children/adolescents and that of their proxy respondents was evaluated through effect size. RESULTS: The proxy respondents underestimated the feelings of worry among children (8-12 years) (p < 0.001; effect size 0.71) and overestimated adolescents' (13-18 years) treatment anxiety (p < 0.05; effect size 0.57). The comparison between the three age groups (5-7, 8-12, 13-18 years) showed a tendency for children/adolescents to report increasing feelings of worry as they got older. In the 'treatment anxiety' subscale, there was a tendency for proxy respondents to present higher mean scores, revealing that proxy respondents believed the children's/adolescents' treatment anxiety decreased as they aged. CONCLUSIONS: Discrepancies between the reports of children/adolescents and their proxy respondents were observed. Children's/adolescents' reports should not be ignored nor replaced by proxy reports; both reports should be analyzed together.

The oral health of seniors in Brazil: addressing the consequences of a historic lack of public health dentistry in an unequal society.

OBJECTIVE: National epidemiological data on the oral health of elders was analysed to examine relationships between the need for oral treatment and external environment, the dental care delivery system, personal characteristics and subjective conditions of oral health. BACKGROUND: Brazil's universal public healthcare system is theoretically responsible to provide dental care to Brazilians of all ages. However, as dentists were integrated into public primary care facilities only in 2000, Brazilian seniors have accumulated needs. MATERIALS AND METHODS: Seniors (65-74 years old) were examined and interviewed by calibrated professionals. The association of overall need for oral treatment and component factors were analysed. Associations with socio-demographic factors and self-reported attitudes and behaviours were also calculated. RESULTS: A total of 85.9% of Brazilian seniors demonstrated a need for some oral treatment, 83.8% of the dentate needed periodontal treatment and 57.3% of all seniors needed full or partial prostheses. Social inequalities were also evident as Brazilians using free oral care services demonstrated a higher degree of need, as did elders who had not previously accessed dental services, nonwhites and males. CONCLUSIONS: Our findings demonstrate that the elderly population in Brazil has a very high degree of need in general and that certain subgroups have been especially vulnerable to oral disease.

Tooth erosion and eating disorders: a systematic review and meta-analysis.

BACKGROUND: Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. OBJECTIVES: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? METHODS: An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained. RESULTS: Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1-37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6-68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2-41.7). CONCLUSION: The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.

Impact of treated/untreated traumatic dental injuries on quality of life among Brazilian schoolchildren.

BACKGROUND/AIM: The joint evaluation of oral health-related quality of life and traumatic dental injury (TDI) is an important tool for setting priorities in public oral health programs. The purpose of the present study was to compare the impact of treated TDI, untreated TDI, and absence of TDI on the quality of life of schoolchildren aged 11-14 years. MATERIAL AND METHODS: A cross-sectional study was carried out with 668 schoolchildren from the city of Diamantina, Brazil. The clinical examination involved the determination of the presence and type of TDI based on the criteria proposed by O'Brien. Malocclusion was evaluated using the criteria of the Dental Aesthetic Index, and dental caries was diagnosed using the DMFT/dmft index. The impact of TDI on quality of life was assessed using the Child Oral Impact on Daily Performances (Child-OIDP). The outcome was the absence (Child-OIDP = 0) or presence (Child-OIDP ≥ 1) of impact on quality of life. RESULTS: The prevalence of TDI was 34.3%. Schoolchildren with untreated TDI experienced a greater impact on eating (P = 0.016) and smiling (P < 0.001) in comparison with those without TDI. No significant differences were found in the Child-OIDP score between schoolchildren with treated TDI and those without trauma. The unadjusted and adjusted results of the Poisson regression analysis of the Child-OIDP demonstrated that schoolchildren with untreated TDI were more likely to experience an impact on 'eating and enjoying food', 'smiling and showing teeth', and 'overall score'. CONCLUSIONS: Untreated TDI was associated with a negative impact on the quality of life of schoolchildren, whereas treated TDI and absence of TDI were not associated with impact on quality of life.

Impact of untreated dental caries on quality of life of preschool children: different stages and activity.

OBJECTIVE: The aim of the present population-based cross-sectional study was to evaluate the association between untreated dental caries, considering stages and activity, and the impact on OHRQoL among preschool children and their parents/caregivers. METHODS: A randomly selected sample of 451 Brazilian preschool children aged three to 5 years underwent a clinical oral examination for the assessment of dental caries using the ICDAS II criteria. Parents/caregivers were asked to answer two questionnaires: one on the OHRQoL of the children (ECOHIS) and another on the demographic and socioeconomic characteristics of the children and families. Statistical analysis involved descriptive statistics, the chi-square test, Mann-Whitney test and hierarchically adjusted Poisson regression models. RESULTS: The prevalence of early childhood caries was 51.2%. The majority of teeth with caries exhibited severe decay (60.6%). Untreated severe decay, such as active lesions within visible dentin (P < 0.001), extensive active and inactive cavity without pulp exposure or fistula (P < 0.001 and P = 0.001, respectively), extensive cavity with pulp exposure and absence of fistula (P = 0.003) and root remnant (P = 0.002), were associated with a negative impact on quality of life. CONCLUSION: Active and inactive untreated severe carious lesions were associated with a negative impact on the quality of life of preschoolers and their parents/caregivers.

Cross-cultural adaptation and validation of a Brazilian version of an instrument to assess impairments related to oral functioning of people with Down syndrome.

BACKGROUND: An instrument was developed in Canada to assess impairments related to oral functioning of individuals with four years of age or older with Down syndrome (DS). The present study attempted to carry out the cross-cultural adaptation and validation of the instrument for the Brazilian Portuguese language and to test its reliability and validity. FINDINGS: After translation and cross-cultural adaptation, the instrument was tested on caregivers of people with DS. Clinical examination for malocclusion was carried out in people with DS by two calibrated examiners. Inter and Intra examiner agreement was assessed by Intraclass Correlation Coefficient (ICC) and ranged from 0.92 to 0.97 respectively. Total of 157 people with DS and their caregivers were able to compose the sample. They were selected from eight institutions for people with DS in five cities of southeastern Brazil. The mean age of people with DS was 20.7 [±13.1] and for caregivers was 53.1 [±13.7]. The mean instrument score was 18.6 [±9.0]. Internal reliability ranged from 0.49 to 0.80 and external reliability ranged from 0.78 to 0.88. Construct validity was verified by significant correlations identified between malocclusion and the total instrument; and caregivers' educational level and the instrument (p<0.05). Discriminant validity was proved as the instrument presented different mean comparing people with DS and non-DS (p<0.05). CONCLUSIONS: Initial validity tests indicated that the instrument related to the oral health for people with DS may be a valid instrument to this segment of the population in Brazil.

Development of a short form of the Brazilian Parental-Caregiver Perceptions Questionnaire using exploratory and confirmatory factor analysis.

PURPOSE: This study presents the Brazilian short form of the P-CPQ. METHODS: Data from a representative sample of 702 parents/caregivers of children were randomly divided in two subsamples. A development sample (n = 502) was used for exploratory factor analysis (EFA), and a validation sample (n = 200) was used for confirmatory factor analysis (CFA). The EFA was used to determine the hypothetical factor structure and internal consistency. The CFA was applied to test the factor structure of the original P-CPQ, alternative models and the validity and reliability of the Brazilian short form of the P-CPQ. RESULTS: A 3-factor model (alternative model 2) had a factor structure with high factor loadings, acceptable fit indices (χ(2)/df = 2.38; GFI = 0.90; CFI = 0.90; TLI = 0.87; AGFI = 0.85; SRMR = 0.07) and both convergent and discriminant validity (Pearson bivariate zero order correlations among factors <0.85). CONCLUSIONS: The Brazilian P-CPQ with three subscales and 13 items appears to be a valid short version to be used in further studies to evaluate parents/caregivers' perceptions of children's oral health-related quality of life.

Malocclusion and oral health-related quality of life in Brazilian school children.

OBJECTIVE: To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. MATERIALS AND METHODS: A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05). RESULTS: Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. CONCLUSIONS: Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

The association between occlusal factors and noncarious cervical lesions: a systematic review.

OBJECTIVES: This study aimed to systematically review the scientific evidence for the association between noncarious cervical lesions (NCCL) and occlusal risk factors (ORF) [occlusal interferences in excursive movements; occlusal force; premature contacts; type of guidance; skid of centric occlusion to maximum intercuspidation] in adults. SOURCES: Pubmed, Web of Science, Cochrane, Lilacs, Clinical Trials, National Research Register and National Institute for Health were searched. STUDY SELECTION: From 1082 potentially eligible studies, 106 were selected for full text analysis. Two independent reviewers (Kappa=0.8; p<0.001) selected the studies, abstracted information and assessed quality based on standardised scales. Six cross-sectional, two case-controls and one clinical trial were included. Several occlusal variables were analysed among the studies, but there was no standardisation of the units used in the analysis of occlusal factors. The majority of studies did not find significant associations between NCCL and ORF. Three studies found associations between NCCL and some variables (occlusal contact area, right canine guidance, premature contacts in centric relation and working side) (p<0.05). The methodological quality varied across studies, and there was high heterogeneity among them. CONCLUSION: Current scientific evidence does not support an association between ORF and NCCL. Further prospective studies with standardised methods are vital to strengthen the evidence. CLINICAL SIGNIFICANCE: Understanding the risk factors for NCCL is important to control the causes and to help the dentist choose the best approach for the patient. The evidence does not support intervention to alter some occlusal factors for the prevention or control of the progression of NCCL.

A systematic review of socioeconomic indicators and dental caries in adults.

Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject's education, subject's income, subject's occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries.

Association among stress, personality traits, and sleep bruxism in children.

PURPOSE: The purpose of this study was to determine the association among stress levels, personality traits, and sleep bruxism in children. METHODS: A population-based case control study (proportion=1:2) was conducted involving 120 7- to 11-year-olds with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from schools in Belo Horizonte, Minas Gerais, Brazil. The following instruments were used for data collection: questionnaire administered to parents; child stress scale; and neuroticism and responsibility scales of the big five questionnaire for children. Psychological tests were administered and evaluated by psychologists. Sleep bruxism was diagnosed from parents' reports. The chi-square test, as well as binary and multivariate logistic regression, was applied for statistical analysis. RESULTS: In the adjusted logistic model, children with a high level of stress, due to psychological reactions (odds ratio=1.8; confidence interval=1.1-2.9) and a high sense of responsibility (OR=1.6; CI=1.0-2.5) vs those with low levels of these psychological traits, presented a nearly 2-fold greater chance of exhibiting the habit of sleep bruxism. CONCLUSION: High levels of stress and responsibility are key factors in the development of sleep bruxism among children.