Dental caries are more likely to impact on children's quality of life than malocclusion or traumatic dental injuries.

AIM: To measure the impact of dental caries, malocclusion, and traumatic dental injuries (TDI) on the oral health-related quality of life (OHRQoL) of Brazilian children. STUDY DESIGN: population-based cross-sectional study. MATERIALS AND METHODS A representative sample of 1,204 8-to-10-year-old children randomly selected from 19 public and private schools in Belo Horizonte (Brazil) was evaluated. The Decayed, Missing and Filled Teeth Index (DMFT), the Dental Aesthetic Index (DAI), and Andreasen's classification were used by two calibrated examiners to diagnose dental caries, malocclusion, and TDI, respectively. Children were clinically examined at school. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years (CPQ8-10) was used to assess the impact on OHRQoL. RESULTS: There were statistically significant differences (p<0.001) between groups (dental caries, malocclusion, and TDI) in all subscales and the CPQ8-10 total score. The presence of dental caries alone and its association with TDI and malocclusion were associated with all CPQ8-10 subscales (p<0.05). STATISTICS: the Poisson regression model with a robust variance estimator was utilised for the multivariate analysis. Adjusted prevalence ratios were obtained for the association between oral conditions and the total score on the CPQ8-10 and its subscales. CONCLUSION: Dental caries seems to be the oral condition most commonly associated with a higher impact on the OHRQoL of Brazilian 8-to-10-year-olds.

Influence of negative dental experiences in childhood on the development of dental fear in adulthood: a case-control study.

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear.

Factors associated with dental caries in Brazilian children: a multilevel approach.

OBJECTIVES: The aims of the present study were to assess caries experience among Brazilian children aged eight to 10 years and determine social factors of this disease, through a multilevel approach. METHODS: This is a cross-sectional study in which a representative sample of 1204 eight-to-ten-year-old children were randomly selected from 19 public and private schools in the city of Belo Horizonte, Brazil. After formal authorization from the parents, the children were clinically examined at school by two calibrated examiners (Kappa=0.78). Individual socioeconomic status was determined using household income, number of residents in the home and parents'/caregivers' schooling. The social vulnerability index and type of school were used as contextual variables. The outcome variables were severity score of dental caries in permanent teeth (DMFT index), dental caries experience in permanent teeth (DMFT = 0 or ≠ 0), severity score of dental caries in primary teeth (dmft index) and dental caries experience in primary teeth (dmft = 0 or ≠ 0). RESULTS: The minority of children (37.2%) had dental caries experience. Chi-squared and Mann-Whitney tests showed that age, parents'/caregivers' schooling, household income and type of school were associated with dental caries experience in permanent and primary teeth (P < 0.05). Mann-Whitney, Kruskal-Wallis tests and Spearman correlation coefficient showed that age, parents'/caregivers' schooling, household income, and type of school were associated with severity score of dental caries in permanent and primary teeth (P < 0.05). In multilevel approach, the individual variables, age and household income demonstrated association with dental caries experience and with severity score of dental caries in primary teeth (P < 0.05). Type of school was also associated with dental caries experience and with severity score of dental caries in these teeth (P < 0.05). In the Poisson multilevel approach, the analysis of the final estimation of variance components of the null model revealed a significant difference among the 19 schools with regard to severity score of dental caries in permanent teeth too (P < 0.001). Younger children and attending private schools showed lower severity score of dental caries in permanent teeth. CONCLUSION: Dental caries experience and severity score of dental caries in primary teeth was influenced by age, household income, and the type of school The dental caries experience in permanent teeth was influenced by age, parents'/caregivers' schooling, household income, and type of school, whereas the severity score of dental caries in permanent teeth was influenced by age and type of school.

Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors.

AIM: To assess the impact of dental pain on the daily living of 5-year-old preschool children using reports from parents/guardians. DESIGN AND METHODS: A cross-sectional study was carried out involving 549 five-year-old children randomly selected from preschools in the city of Belo Horizonte, Brazil. Data were collected using a previously validated parent-reported questionnaire. The children received dental examinations from a single calibrated examiner. The following outcome variables were selected: age, gender, dental caries, filled teeth, missing teeth, caries involving pulp and social class. Simple and multiple logistic regression analyses were performed on the data. RESULTS: According to parents' reports, 11.1% of children were affected by dental pain in the previous 4 months and of these 72.6% had their daily activities hampered by pain. The majority of these children had difficulty in eating, brushing teeth, sleeping, playing and going to school. The impact of dental pain had a statistically significant association with gender (p=0.001), social class (p=0.009), dental caries (p<0.001), missing teeth (p<0.001), filled teeth (p<0.001) and caries involving pulp (p<0.001). CONCLUSION: The prevalence of difficulties performing tasks of daily living due to dental pain was relatively high among the children studied.

Parents' perceptions of oral health conditions depicted in photographs of anterior permanent teeth.

AIM: The aim of this study was to evaluate parents' perceptions of dental fluorosis and other oral health conditions depicted in photographs of anterior teeth. MATERIALS AND METHODS: The sample comprised 120 parents (average age 39.3 years) whose children were undergoing dental treatment at the School of Dentistry of the Federal University of Minas Gerais. Seven photographs were selected: P1, open bite; P2, dental fluorosis TF 1 associated with open bite; P3, dental fluorosis TF 1; P4, midline deviation and crowding; P5, dental hypoplasia; P6, teeth without oral problems; P7, dental fluorosis TF 3. All photographs were randomly shown to all the parents, who classified the conditions observed based on a numeric scale: 0-19 (very unsatisfactory), 20-39 (unsatisfactory), 40-59 (neutral), 60-79 satisfactory and 80-100 (very satisfactory). The reasons for dissatisfaction and the possible treatment choice were examined. RESULTS: P6 (normal teeth) was the most satisfactory photograph according to the parents (mean 61.2), and all photographs were statistically significantly different from one another (Mann-Whitney test, p ≤ 0.05), except the following pairs: P1 (mean 52.9) and P7 (mean 50.2) (p 0.537); P2 (mean 32.6) and P3 (mean 39.0) (p 0.073); and P5 (mean 18.9) and P4 (mean 18.4) (p 0.923). Alignment and crowding were considered the most prevalent problem in all cases (27.5 to 90.8% of parents) and orthodontic treatment was the most frequently cited option for treating all conditions (34.2 to 89.2% of parents). CONCLUSION: In general, parents were dissatisfied with the oral conditions depicted in all photographs. Midline deviation associated to crowding (P4) and dental hypoplasia (P5) were considered the most unsatisfactory conditions. The most frequently cited oral problems by the parents were alignment and crowding. Orthodontic treatment was considered the best option by the majority of parents.

Preliminary validation of the Brazilian version of the Child Perceptions Questionnaire 8-10.

AIM: The aim of the study was to perform a preliminary validation of the Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ 8-10). METHODS: The sample used to test the measurement equivalence was made up of 59 children from 8 to 10 years of age at the Federal University of Minas Gerais, Brazil. The CPQ 8-10 was administered, and clinical exams were performed by a single examiner, calibrated for the diagnosis of dental caries (Kappa= 0.98) and malocclusion (weighted Kappa and intraclass correlation coefficient = 0.66-1.00). The children were divided into three groups according to their clinical condition (22 with cavitated carious lesions; 20 with malocclusion; 17 with both oral conditions). STATISTICS: The internal consistency of the instrument was assessed by Cronbach's alpha Coefficient. The Intraclass correlation coefficient (ICC) was used for the test-retest reliability (40 children). Discriminant validity was determined using the Kruskal-Wallis test. RESULTS: An assessment of the psychometric properties revealed the instrument to be reliable (Cronbach's alpha=0.92 for the total scale and 0.63-0.85 for the subscales), exhibiting excellent stability (ICC=0.96 for the total scale and 0.79-0.95 for the subscales). Construct validity was demonstrated through the significant correlations between the global indicators and subscales. There were statistically significant differences between the clinical groups regarding the total scale, thereby demonstrating discriminant validity (p=0.03). CONCLUSIONS: The preliminary validation of the Brazilian version of the CPQ 8-10 showed valid and reliable for use on Brazilian children.