Health Professionals: Identifying and Reporting Child Physical Abuse-a Scoping Review.

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category.

Does religiosity impact binge drinking among early adolescents? A cross-sectional study in a city in Southeastern Brazil / A religiosidade impacta o binge drinking na adolescência precoce? Um estudo transversal em uma cidade do sudeste do Brasil

Abstract This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.

Resumo O objetivo do estudo foi avaliar a associação entre religiosidade e binge drinking no início da adolescência. Um estudo transversal realizado com adolescentes de 10 a 13 anos de Belo Horizonte, Brasil. Foi realizada uma amostragem aleatória estratificada considerando distrito administrativo e ano escolar. Os adolescentes preencheram um formulário com o AUDIT C, perguntas sobre religiosidade e perguntas sobre binge drinking pelos pais e melhor amigo. Um formulário sobre questões socioeconômicas foi respondido pelos responsáveis. Foi realizada análise descritiva, regressão logística univariada e multivariada. Participaram do estudo 650 adolescentes. A frequência de binge drinking foi de 13,7%. No modelo ajustado, a religiosidade não esteve associada ao binge drinking. As covariáveis associadas foram idade de 12-13 anos (OR: 1,94 IC95%: 1,06-3,56; p=0,030), binge drinking pela mãe (OR: 3,12; IC95%: 1,76-5,52; p<0,001) binge drinking pelo melhor amigo (OR: 6,01; IC95%: 3,40-10,62; p<0,001) e família não nuclear (OR: 1,80; IC95%: 1,01-3,23; p=0,045). Os achados revelaram que apesar dos adolescentes afirmarem serem religiosos, para o binge drinking, os principais fatores que influenciaram essa decisão foi o binge drinking pelo melhor amigo, mãe e família não nuclear.

Does religiosity impact binge drinking among early adolescents? A cross-sectional study in a city in Southeastern Brazil.

This study evaluated the association between religiosity and binge drinking in early adolescence. A cross-sectional study was conducted with adolescents aged 10-13 from Belo Horizonte, Brazil. Stratified random sampling was performed considering the administrative district and school year. Adolescents filled an AUDIT-C form, containing questions about religiosity and binge drinking by parents and their best friends. Adolescents' caregivers answered a form regarding socioeconomic issues. Descriptive analysis, univariate, and multivariate logistic regression were performed. A total of 650 adolescents participated in the study. The frequency of binge drinking was 13.7%. In the adjusted model, religiosity was not associated with binge drinking. The covariates associated were the age of 12-13 years (OR: 1.94; CI95%: 1.06-3.56; p=0.030), maternal binge drinking (OR: 3.12; CI95%: 1.76-5.52; p<0.001) best friend binge drinking (OR: 6.01; CI95%: 3.40-10.62; p<0.001) and nonnuclear family (OR: 1.80; CI95%: 1.01-3.23; p=0.045). The findings revealed that, for binge drinking, the main factors that influenced this decision were the best friend and maternal binge drinking and family structure, although the adolescents claimed to be religious.

Is Binge Drinking Associated with Suicidal Behaviors among Brazilian Adolescents?

OBJECTIVE: To evaluate the association between suicidal behaviors and binge drinking among Brazilian adolescents. METHODS: A cross-sectional study was conducted with 2,476 students 14 to 19 years of age from 26 public high schools in the city of Olinda, Brazil. Data collection occurred between March and June 2018 through the self-administered Youth Risk Behavior Survey. Descriptive analysis and Poisson regression (p < 0.05, 95%CI) were performed. RESULTS: The prevalence of suicidal ideation, planning and attempt in the previous 12 months was 23.7%, 17.4% and 13.5%, respectively. Suicidal ideation was associated with binge drinking one to two days (PR:1.053, 95%CI:1.011-1.096) and ≥ three days in the previous 30 days (PR:1.069, 95%CI:1.016-1.125), sadness/hopelessness in the previous 12 months (PR:1.313, 95%CI:1.267-1.360), a report of family physical aggression in the previous 12 months (PR:1.111, 95%CI:1.068-1.155), the female sex (PR:1.082, 95%CI:1.049-1.115) and a non-nuclear family (PR:1.037, 95%CI:1.004-1.071). Suicidal planning was associated with sadness/hopelessness in the previous 12 months (PR:1.257, 95%CI:1.214-1.302), report of family physical aggression in the previous 12 months (PR:1.110, 95%CI:1.065-1.156) and the female sex (PR:1.072, 95%CI:1.041-1.104). Suicide attempt was associated with binge drinking ≥ three days in the previous 30 days (PR:1.062, 95%CI:1.008-1.119), sadness/hopelessness in the previous 12 months (PR:1.202, 95%CI:1.161-1.244), report of family physical aggression in the previous 12 months (PR:1.105, 95%CI:1.060-1.153) and the female sex (PR:1.064, 95%CI:1.034-1.095). The Catholic (PR:0.938, 95%CI:0.899-0.979; PR:0.925, 95%CI:0.888-0.9865; PR:0.937, 95%CI:0.899-0.977) and Evangelical (PR:0.956, 95%CI:0.922-0.992; PR:0.954, 95%CI:0.919-0.991) religions acted as a possible protective factor against suicidal behaviors. CONCLUSIONS: Suicidal ideation and attempt were associated with binge drinking.

Avaliação comparativa entre terapia endodôntica convencional e técnica não instrumental: um relato de caso / Comparative evaluation between conventional endodontic therapy and a non-instrumental technique: a case report

Objetivo: A necrose da polpa dentária é uma complicação causada principalmente por cáries e lesões traumáticas. Não há consenso sobre a melhor técnica e materiais para o tratamento endodôntico na dentição decídua. O objetivo foi apresentar um relato de caso clínico em que foram realizadas diferentes abordagens endodônticas em dentes homólogos traumatizados e necróticos. Métodos: Um menino de um ano e oito meses sofreu traumatismo dento-alveolar após queda e procurou o projeto de extensão de traumatismos na dentição decídua da Faculdade de Odontologia da UFMG em outubro de 2018 para avaliação clínica e radiográfica. O incisivo central superior esquerdo apresentou fratura de esmalte e dentina sem exposição pulpar, enquanto o incisivo central superior direito apresentou luxação intrusiva leve. Ambos apresentaram o desenvolvimento de lesões periapicais. Resultados: Os dentes foram tratados respectivamente com a técnica não instrumental com pasta CTZ e com terapia endodôntica convencional com pasta Guedes-Pinto. Os acompanhamentos clínico e radiográfico após os tratamentos revelaram dentes assintomáticos e evidência de cicatrização periapical. Conclusão: O uso da pasta CTZ apresentou resultados satisfatórios e semelhantes à terapia tradicional em curto prazo no relato de caso apresentado.

Aim: Dental pulp necrosis is a complication caused mainly by dental caries and lesions. No consensus has been reached on the best technique and materials for endodontic treatment in the primary dentition. The objective was to present a clinical case report in which different endodontic approaches were performed in traumatized and necrotic homologous teeth. Methods: A one-year-and-eight-month-old boy suffered dentoalveolar trauma after a fall and sought out the Deciduous Trauma Dental Center of the Federal University of Minas Gerais in October 2018 for clinical and radiographic evaluation. The left maxillary central incisor presented enamel and dentin fracture without pulp exposure, while the right maxillary central incisor presented a small intrusive dislocation. Both presented the development of periapical lesions. Results: The teeth were treated respectively, using the non-instrumental technique with CTZ paste and the conventional endodontic therapy with Guedes-Pinto paste. Clinical and radiographic follow-ups after treatments revealed asymptomatic teeth and evidence of periapical healing. Conclusion: The use of CTZ paste in this case report presented satisfactory and similar results to traditional therapy in the short term.

Prevalence of oral health-related shame and associated factors among Brazilian schoolchildren.

The aim of the present study was to investigate the prevalence of oral health-related shame and the associated factors among 8-to-10-year-old Brazilian schoolchildren. A cross-sectional study was conducted with 388 children randomly selected from public and private schools of Diamantina, southeastern Brazil. In order to identify the feeling of shame, self-reports were collected through a single question, "In the last month, did you feel ashamed because of your teeth or mouth? Two calibrated examiners performed the clinical examination for dental caries (DMFT/dmft index), traumatic dental injuries (O' Brien), and malocclusion (Dental Aesthetic Index). Sociodemographic indicators were obtained through a questionnaire answered by the children's caregivers. Descriptive analysis, chi-square test, and hierarchical Poisson regression models were performed (95%CI; p < 0.05). The prevalence of shame was 38.1% (n = 148). The adjusted regression analysis demonstrated a significant association between shame and untreated dental caries (PR: 1.34; 95%CI: 1.04-1.74; p = 0.02), age of 10 years (PR: 1.36; 95%CI: 1.05-1.76; p = 0.01), and with parents with less than eight years of schooling (PR: 1.30; 95%CI: 1.00-1.68; p = 0.04). Older children with untreated dental caries and whose parents had lower education level presented a higher prevalence of oral health-related shame.

Determinant factors for immediate care seeking after traumatic dental injury among Brazilian children.

The present study aimed to evaluate the frequency of immediate care seeking after traumatic dental injury (TDI) in primary dentition and its association with the children's characteristics, socioeconomic status, and TDI characteristics. This was a cross-sectional study with dental records of children aged 9 months to 6 years who attended a reference center in TDI in primary dentition between 2007 and 2018. Immediate care seeking after TDI, child's characteristics, sociodemographic conditions and TDI characteristics were collected. Descriptive statistics and Poisson regression analysis with robust variance were performed (p < 0.05; 95%CI). Among the 493 dental records, 61.1% (n = 301) were of males and 50.5% (n = 249) were from children aged 2 years or less. More than one third of the sample (36.9%; n = 182) sought immediate care after TDI. Among the types of TDI, the prevalence of soft tissue injuries was 59.0% (n = 291), while 51.7% (n = 255) were hard tissue injuries and 54.0% (n = 266) were supporting tissue injuries. Immediate care seeking after TDI was higher in children who needed suture (PR: 1.39; 95%CI: 1.01-1.92. p = 0.039), had luxation (lateral, intrusion, or extrusion) (PR: 2.36; 95%CI: 1.36-4.08. p = 0.002) or avulsion (PR: 2.18; 95%CI: 1.28-3.70. p = 0.004). The need for suture, luxation (lateral, intrusion and extrusion), and avulsion were determinant factors for the immediate care seeking after TDI, regardless of the child's characteristics and socioeconomic status.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors.

Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors / Prevalência de identificação e notificação de abuso físico infantil por dentistas e fatores associados

Abstract Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.

Resumo Estudos que avaliem os fatores associados à subnotificação e às dificuldades dos dentistas para identificar e notificar abuso físico infantil são escassos e necessários. Este estudo teve como objetivo investigar a prevalência de identificação e de notificação de abuso físico infantil (AFI) e fatores associados por dentistas da atenção primária. Trata-se de um estudo transversal com amostra representativa dos dentistas da Estratégia Saúde da Família de Belo Horizonte. Para a coleta de dados foi utilizado um questionário autoaplicável, validado para uso no Brasil. A análise estatística incluiu análise univariada e múltipla pela regressão de Poisson. Um total de 181 profissionais participaram do estudo. Destes, 73 (40,3%) já identificaram algum caso de AFI, mas apenas 11 (6,1%) realizaram a notificação. Dentistas com seis a 19 anos de trabalho no município apresentaram probabilidade 2,38 vezes [RP = 2,38 (CI 95%: 1,29-4,41)] maior de identificar casos de AFI do que aqueles com menos de seis anos de atuação. Possuir pós-graduação com foco em crianças [PR = 4,50(CI 95%: 1,08-18,68)] esteve positivamente associado a um maior número de notificações. O tempo de trabalho no município esteve associado à identificação de casos de AFI. A prevalência de notificação encontrada foi baixa.

LGB prevalence in schools is associated with unhealthy weight-control behaviors in lesbian, gay, and bisexual youth: a multilevel analysis.

BACKGROUND: Previous studies have found that a school climate of more heteronormativity is associated with adverse effects on the mental health of LGB students. Accordingly, our aim was to assess the association between lower LGB prevalence in schools and unhealthy weight-control behaviors among LGB youth. METHODS: A cross-sectional, multilevel study based in public high schools in the city of Olinda, Northeast Brazil. A multilevel logistic regression was performed, including 2500 adolescents enrolled in 27 schools. The contextual variable was the prevalence of LGB youth in each school (as a proxy for heteronormativity in schools), while the outcome was unhealthy weight-control behaviors (fasting, purging, and taking diet pills). We controlled for socioeconomic characteristics (age, sex, receiving a family allowance), obesity, and self-reported happiness. RESULTS: Lower LGB prevalence in schools was associated with higher odds of engaging in unhealthy weight-control behaviors (OR: 1.5, 95%CI: 1.0, 2.2) among all youth, regardless of sexual orientation. No cross-level interactions between school context and individual characteristics were statistically significant. CONCLUSION: Lower LGB prevalence in schools was associated with a higher risk of unhealthy weight-control behaviors in youth regardless of sexual orientation, which may reflect either the contextual influence of school climate, or may be due to residual confounding.

Complications following replantation of primary teeth: a case report / Complicações após reimplante de dentes decíduos: um relato de caso clínico

Abstract Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.

Resumo Introdução: a avulsão de dentes decíduos é um evento perturbador e inesperado. Descrição: o presente relato descreve o caso clínico de uma criança de três anos que sofreu avulsão e reimplante dos incisivos centrais superiores decíduos no local do acidente. Os responsáveis procuraram atendimento para a criança na Universidade Federal de Minas Gerais após reimplante. Quatro meses depois, a criança sofreu novo trauma e os dentes reimplantados apresentavam mobilidade avançada, reabsorção radicular e fístula. A conduta clínica foi extração e reabilitação com mantenedor estético fixo. Discussão: a literatura descreve duas opções de tratamento para avulsão de incisivos decíduos: o reimplante e o não reimplante. De acordo com revisão sistemática recente, a dificuldade de se obter um consenso sobre a melhor conduta clínica se deve, em parte, à escassez de publicações que apresentem não apenas acompanhamentos com sucesso clínico, mas também com falhas. O reimplante pode ser influenciado por vários fatores. O tempo decorrido entre o reimplante e a contenção, e o novo episódio de trauma, influenciaram negativamente o prognóstico do presente caso, levando ao insucesso. O reimplante de incisivos decí- duos ainda não é um tratamento baseado em evidências. Portanto, essa opção deve ser escolhida com cautela e em situações ideais. Requer monitoramento clínico e radiográfico para constante avaliação do desfecho.

Spatial density of adolescents aged 14 years old, victims of dental: A longitudinal study.

BACKGROUND/AIM: Knowledge about the spatial density of the domiciles of dental trauma victims can assist in the identification of the most vulnerable areas and contribute to the planning of prevention, promotion, control, and treatment actions, focusing on the most affected areas. The aim of this study was to analyze the spatial density of domiciles of 14-year-old adolescent victims of dental trauma, in the city of Diamantina, Brazil, after a two-year follow-up period. MATERIAL AND METHODS: This longitudinal study was carried out with 584 adolescents between 2013 and 2015. Dental trauma, overjet, and lip protection were assessed by two trained and calibrated examiners (K > 0.70). Information about binge drinking was collected among the adolescents through the Alcohol Use Disorders Identification Test and sociodemographic indicators were obtained through a questionnaire answered by the caregivers of the adolescents. Spatial analyses were performed to evaluate the spatial density of adolescents with dental trauma and the independent variables of interest according to the domicile using Ripley's K function and the Kernel Map. RESULTS: Ripley's K function revealed spatial aggregation of the domiciles of adolescent victims of dental trauma in relation to males, binge drinking and overjet, with a confidence interval of 95%. The higher density of domiciles with adolescents with two or more traumatized teeth was found in the north-east region of the city. Boys were the most affected, their homes were located in the north, north-west, and south-east regions at baseline and follow-up. The largest density of domiciles of adolescents with overjet greater than 5 mm and inadequate lip protection was in the north-east region. Similar spatial distribution was identified for binge drinking for both years. CONCLUSION: The majority of adolescents with dental trauma lived in the north-east and south-east regions, characterized by high population density and greater social vulnerability.

Determinant factors for immediate care seeking after traumatic dental injury among Brazilian children

Abstract The present study aimed to evaluate the frequency of immediate care seeking after traumatic dental injury (TDI) in primary dentition and its association with the children's characteristics, socioeconomic status, and TDI characteristics. This was a cross-sectional study with dental records of children aged 9 months to 6 years who attended a reference center in TDI in primary dentition between 2007 and 2018. Immediate care seeking after TDI, child's characteristics, sociodemographic conditions and TDI characteristics were collected. Descriptive statistics and Poisson regression analysis with robust variance were performed (p < 0.05; 95%CI). Among the 493 dental records, 61.1% (n = 301) were of males and 50.5% (n = 249) were from children aged 2 years or less. More than one third of the sample (36.9%; n = 182) sought immediate care after TDI. Among the types of TDI, the prevalence of soft tissue injuries was 59.0% (n = 291), while 51.7% (n = 255) were hard tissue injuries and 54.0% (n = 266) were supporting tissue injuries. Immediate care seeking after TDI was higher in children who needed suture (PR: 1.39; 95%CI: 1.01-1.92. p = 0.039), had luxation (lateral, intrusion, or extrusion) (PR: 2.36; 95%CI: 1.36-4.08. p = 0.002) or avulsion (PR: 2.18; 95%CI: 1.28-3.70. p = 0.004). The need for suture, luxation (lateral, intrusion and extrusion), and avulsion were determinant factors for the immediate care seeking after TDI, regardless of the child's characteristics and socioeconomic status.

Reporting of child physical abuse by a group of Brazilian primary care health professionals and associated factors.

BACKGROUND: Evidences points to the importance of health professionals to recognize child abuse, but also to a high frequency of underreporting, even in countries where reporting is mandatory, like Brazil. OBJECTIVE: To evaluate the frequency of non-reporting behavior of child physical abuse (CPA) among Brazilian primary care health professionals who recognized some cases in their careers and associated factors with reporting. METHODS: Cross-sectional study conducted with a representative sample of dentists, nurses, family physicians, and pediatricians from the Family Health Strategy network in the city of Belo Horizonte, Brazil. A validated self-administered questionnaire for use in Brazil was applied in-person to professionals in 2014 and 2015. Pearson's chi-squared test (p < 0.05) and a binary logistic regression model was used. RESULTS: A total of 715 professionals participated (response rate: 98.89%), 414 (57.3%) recognized cases, of which 171 (41.3%) reported. Reporting was associated with the type of profession, as pediatricians reported cases more than dentists [OR = 6.05 (95% CI: 1.24-29.50)], with the willingness to become involved [OR = 2.01 (95% CI: 1.02-3.97)] and knowledge regarding where to report cases [OR = 2.68 (95% CI: 1.25-5.74)]. Confidentiality was the barrier associated with a lower probability of reporting CPA cases [OR = 0.22 (95% CI: 0.08-0.66)]. CONCLUSIONS: There is a high frequency of non-reporting behavior. Pediatricians reported more CPA cases, followed by family doctors and nurses. Dentists were those who reported fewer cases. Reporting was also associated with a willingness to be involved in detecting/reporting abuse and knowing where to report CPA.

Amelogenesis imperfecta: use of cyanoacrylate as a desensitizing agent and its impact on oral health-related quality of life.

Amelogenesis imperfecta (AI) is a rare hereditary condition characterized by abnormal enamel formation and increased tooth sensitivity. There are no defined therapeutic recommendations for tooth sensitivity in patients with AI. The aim of the present case report of a 5-year-old girl with AI is to describe the use of cyanoacrylate as a desensitizing agent on the patient's permanent molars and report the impact of this treatment on her oral health-related quality of life (OHRQoL). After 4 sodium fluoride varnish applications were unsuccessful in relieving sensitivity affecting the molars, cyanoacrylate was applied 5 times (at intervals of 7, 15, 30, and 180 days after the first application). Pain scores were recorded on a visual analog scale before and after each intervention, and the OHRQoL was measured using a questionnaire (Early Childhood Oral Health Impact Scale [ECOHIS]) administered prior to the first cyanoacrylate application and on the last day of the protocol. In this patient, cyanoacrylate seemed to be effective at decreasing tooth sensitivity in immature permanent molars affected by AI, as demonstrated by reductions in the frequency of complaints of dental pain, difficulty in drinking cold beverages, and difficulty in eating some foods.

School academic climate and oral health (tooth loss) in adolescents.

BACKGROUND: Preventing tooth loss depends on oral health maintenance behaviors. This study hypothesized that adolescents with educational aspirations have greater motivation to invest in the future, including maintenance of oral health status. AIM: To analyze the association between a school academic climate of educational aspirations and tooth loss (first permanent molars) among adolescents. METHODS: A cross-sectional study was designed to include 2,500 adolescents (aged 14-19 years) enrolled in public high schools of Olinda located in Northeast Brazil. Multilevel Poisson regression random intercept models were conducted with tooth loss (first permanent molars) as the outcome. The primary cohort of interest was school academic climate, as measured by the proportion of students taking the national high school exams. RESULTS: Tooth loss of the first permanent molars (assessed by clinical exam) was more prevalent in adolescents from more disadvantaged backgrounds (receiving family allowance, low maternal education). However, after controlling for a wide range of individual characteristics, adolescents enrolled in schools with lower academic climate had a higher prevalence of tooth loss (PR 1.42, 95%CI: 1.09,1.85). CONCLUSION: The school academic climate is associated with tooth loss, suggesting that educational aspirations are linked to adolescent oral health maintenance behaviors.

Association between cigarette use and adolescents' behavior.

OBJECTIVE: To determine the prevalence of cigarette use among adolescents and to identify associated health risk behaviors. METHODS: This is a cross-sectional study with a representative sample, composed of 1059 adolescents between 13 and 19 years old, enrolled in primary and secondary public schools of Olinda, Pernambuco, in 2014. Information was obtained through self-administered questionnaires (validated version of YRBS 2007). Cigarette experimentation was defined as smoking at least once in life. Adolescents who smoked at least one day within 30 days prior to the survey were considered current smokers. Most students were female and 16 years old or older. RESULTS: Almost 30% used it in life and about 10% smoked within the 30 days before the survey. Suicidal ideation (PR = 1.51, 95%CI 1.25-1.82), alcohol use (PR = 1.41, 95%CI 1.03-1.92), marijuana (PR = 1.64, 95%CI 1.37-1.96), excessive alcohol consumption (PR = 1.57, 95%CI 1.15-2.16) and sexual experience (PR = 1.78, 95%CI 1.43-2.21) have increased the risk of using cigarettes. Feelings of sadness (PR = 1.70, 95%CI 1.22-2.36), alcohol use (PR=2.40, 95%CI 1.12-5.12), excessive alcohol consumption (PR = 2.5, 95% CI 1.24-5.38), marijuana (PR = 2.31, 95%CI.57-3.39) and cocaine (PR = 1.99, 95%CI.32-3.01) increased the risk of cigarette use within the 30 days before the survey. CONCLUSIONS: Cigarette use among adolescents from Olinda was high, being considered higher than the national prevalence. Possible factors associated with cigarette use were drug use (alcohol, marijuana, and cocaine) and behaviors related to sexual experience, feelings of sadness and suicidal ideation.

Unusual exophytic gingival lesion in a newborn treated with diode laser.

Gingival lesions rarely occur in newborns. However, when present, they commonly worry the parents and impair the infant's feeding, thus affecting growth. Such lesions are usually nonneoplastic in nature, although malignancies may develop; therefore, specimens must be submitted for histopathologic examination. A 2-month-old girl presented with a 10-mm nodule on the anterior lower alveolar ridge in association with natal tooth extraction and neonatal tooth eruption. The lesion was excised with high-power laser under local anesthesia, and a histopathologic diagnosis of a peripheral ossifying fibroma was made. In addition to peripheral ossifying fibromas being rare in newborns, the use of high-power lasers for surgical procedures in newborns have been proven to be safe, comfortable, and efficient.

Binge drinking, alcohol outlet density and associated factors: a multilevel analysis among adolescents in Belo Horizonte, Minas Gerais State, Brazil / Consumo excessivo episódico de álcool, densidade de locais de venda de bebidas alcoólicas e fatores associados: uma análise multinível entre adolescentes em Belo Horizonte, Minas Gerais, Brasil / Consumo de alcohol compulsivo, densidad de locales de venta de alcohol y factores asociados: un análisis multinivel entre adolescentes procedentes de Belo Horizonte, estado de Minas Gerais, Brasil

Our study sought to evaluate the prevalence of binge drinking in adolescents and its association with density of alcohol outlets around schools. This cross-sectional study was conducted in Belo Horizonte, Minas Gerais State, Brazil, with 436 high-school students aged between 17 and 19 and enrolled in 18 public and private schools. The students completed the Alcohol Use Disorder Identification Test (AUDIT-C), consisting of questions about alcohol consumption by parents and siblings, and socioeconomic status (type of school, mother's education level). Data from geographic information systems were used to estimate the density of alcohol outlets around schools participating. The association between exploratory variables and binge drinking was investigated using multilevel logistic regression analysis (p < 0.05) with random intercepts and fixed slopes. A three-step sequential modeling strategy was adopted. The prevalence of binge drinking was 39.9%. The alcohol consumption among adolescents was lower for those studying in areas with low density of alcohol outlets around schools (OR = 0.32; 95%CI: 0.14; 0.73) and the consumption of alcohol by mothers was associated with binge drinking among adolescents (OR = 1.94; 95%CI: 1.14; 3.30). Our study concluded that binge drinking among adolescents was associated with density of alcohol outlets around the schools and mother's alcohol consumption.

O estudo teve como objetivo avaliar a prevalência de consumo excessivo episódico de álcool entre adolescentes e a associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas. Um estudo transversal foi realizado em Belo Horizonte, Minas Gerais, Brasil, com 436 estudantes de segundo grau entre 17 e 19 anos de idade matriculados em 18 escolas públicas e privadas. Os estudantes responderam perguntas do Alcohol Use Disorder Identification Test (AUDIT-C) sobre consumo de álcool pelos pais e irmãos, além de características socioeconômicas (tipo de escola, escolaridade materna). Foram utilizados dados de sistemas de informações geográficas para calcular a densidade de locais de venda de bebidas alcoólicas em torno das escolas participantes. A associação entre variáveis independentes e consumo excessivo episódico de álcool foi investigada por análise de regressão logística multivariada (p < 0,05) com interceptos randômicos e inclinações fixas. Foi adotada uma estratégia de modelagem sequencial em três passos. A prevalência de consumo excessivo episódico de álcool foi de 39,9%. O consumo de álcool entre adolescentes foi mais baixo naqueles que estudavam em áreas com baixa densidade de locais de venda de bebidas alcoólicas em torno das escolas (OR = 0,32; IC95%: 0,14; 0,73), e o consumo de álcool pelas mães esteve associado ao consumo excessivo episódico de álcool pelos adolescentes (OR = 1,94; IC95%: 1,14; 3,30), Em conclusão, consumo excessivo episódico de álcool por adolescentes mostrou associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas e com o consumo materno de álcool.

El objetivo de este estudio fue evaluar la prevalencia del consumo compulsivo de alcohol por parte de adolescentes y su asociación con la densidad de establecimientos de venta de alcohol próximos a escuelas. Este estudio transversal se realizó en Belo Horizonte, Minas Gerais, Brasil, con 436 estudiantes de escuelas secundarias con edades comprendidas entre los 17-19 años, inscritos en 18 escuelas públicas y privadas. Los estudiantes completaron con Alcohol Use Disorder Identification Test (AUDIT-C) preguntas sobre el consumo de alcohol por parte de padres y hermanos, así como de su estatus socioeconómico (tipo de escuela, nivel de escolarización de la madre). Los datos del sistema de informaciones geográficas se usaron para calcular la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas participantes. La asociación entre las variables exploratorias y el consumo compulsivo de alcohol fue investigado usando un análisis de regresión logística multinivel (p < 0,05) con intersecciones aleatorias y curvas fijas. Se adoptó una estrategia de modelado secuencial en tres pasos. La prevalencia de consumo compulsivo de alcohol fue de 39,9%. El consumo de alcohol entre adolescentes fue más bajo entre quienes estudiaban en áreas con baja densidad de establecimientos de venta de alcohol alrededor de las escuelas (OR = 0,32; IC95%: 0,14; 0,73), además el consumo de alcohol en madres estuvo asociado con el consumo de alcohol en adolescentes (OR = 1,94; IC95%: 1,14; 3,30). La conclusión fue que el consumo compulsivo de alcohol en adolescentes estaba asociado con la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas y el consumo de alcohol por parte de la madre.

Association between cigarette use and adolescents' behavior

ABSTRACT OBJECTIVE To determine the prevalence of cigarette use among adolescents and to identify associated health risk behaviors. METHODS This is a cross-sectional study with a representative sample, composed of 1059 adolescents between 13 and 19 years old, enrolled in primary and secondary public schools of Olinda, Pernambuco, in 2014. Information was obtained through self-administered questionnaires (validated version of YRBS 2007). Cigarette experimentation was defined as smoking at least once in life. Adolescents who smoked at least one day within 30 days prior to the survey were considered current smokers. Most students were female and 16 years old or older. RESULTS Almost 30% used it in life and about 10% smoked within the 30 days before the survey. Suicidal ideation (PR = 1.51, 95%CI 1.25-1.82), alcohol use (PR = 1.41, 95%CI 1.03-1.92), marijuana (PR = 1.64, 95%CI 1.37-1.96), excessive alcohol consumption (PR = 1.57, 95%CI 1.15-2.16) and sexual experience (PR = 1.78, 95%CI 1.43-2.21) have increased the risk of using cigarettes. Feelings of sadness (PR = 1.70, 95%CI 1.22-2.36), alcohol use (PR=2.40, 95%CI 1.12-5.12), excessive alcohol consumption (PR = 2.5, 95% CI 1.24-5.38), marijuana (PR = 2.31, 95%CI.57-3.39) and cocaine (PR = 1.99, 95%CI.32-3.01) increased the risk of cigarette use within the 30 days before the survey. CONCLUSIONS Cigarette use among adolescents from Olinda was high, being considered higher than the national prevalence. Possible factors associated with cigarette use were drug use (alcohol, marijuana, and cocaine) and behaviors related to sexual experience, feelings of sadness and suicidal ideation.