Assessment of the developmental defects of the enamel in children and adolescents with sickle cell disease: A comparative study.

BACKGROUND: Sickle cell disease (SCD) is the most important hemoglobinopathy in terms of frequency and social impact and can affect the stomatognathic system. AIM: To assess and compare the developmental defects of the enamel (DDE) in children and adolescents with and without SCD. DESIGN: This was a cross-sectional, analytical, and comparative study of 210 children and adolescents aged 5-18 years, who visited the Hematology and Hemotherapy Hospital of Pernambuco. RESULTS: Developmental defects of the enamel were observed in 55.2% of the SCD patients and 35.2% of the non-SCD patients (healthy group; p < .05). In the SCD group, DDE were more common in females than in males (69.1% vs. 40.0%; p < .05). The incidence of DDE in the permanent teeth was higher in the upper arch than in the lower arch (SCD group, 13.1% vs. 4.6%; healthy group, 8.9% vs. 3.6%; p < .05). CONCLUSION: Compared with the healthy group, the SCD patients were almost twice as likely to develop DDE, mostly affecting females and the permanent teeth. These findings suggest that individuals with SCD need early dental care to avoid future oral problems.

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.

Sociodemographic and behavioral factors associated with dental caries in preschool children: Analysis using a decision tree.

BACKGROUND: Untreated dental caries can result a negative impact on oral health-related quality of life. AIMS: The aim of the present study was to determine the prevalence of dental caries and associated factors in children enrolled in public preschools in the city of Recife, Brazil. SETTINGS AND DESIGN: A descriptive, analytical, cross-sectional study was conducted with a representative random sample of 556 children aged 3-5 years. MATERIALS AND METHODS: Data were collected through clinical examinations using the International Caries Detection and Assessment System. The parents answered a questionnaire addressing sociodemographic and behavioral characteristics. Two examiners underwent training and calibration exercise for the calculation of interexaminer agreement (Kappa index of 0.83). STATISTICAL ANALYSIS USED: In addition to descriptive data, an inductive decision tree was constructed to analyze the results (Algorithm J48; α = 5%). RESULTS: The prevalence of dental caries was 92.1%. The following factors were associated with dental caries: brushing performed by the child (prevalence ratio [PR] = 4.39, 95% confidence interval [CI]: 2.57-7.51 P < 0.001), household income less than the minimum wage (PR = 1.79; 95% CI: 1.18-2.72, P = 0.005), brushing frequency (PR = 1.50; CI 95%: 0.50-4.49; P = 0.001), and parent's/caregiver's school equal to an incomplete elementary school education (PR = 1.65, 95% CI: 1.56-1.74, P < 0.001). CONCLUSIONS: The occurrence of dental caries in children was high and was associated with brushing performed by the child, household income less than the monthly minimum wage, low brushing frequency, and low parent's/caregiver's schooling.

Enamel defects and tooth eruption disturbances in children with sickle cell anemia.

Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Enamel defects and tooth eruption disturbances in children with sickle cell anemia

Abstract Sickle cell anemia, a genetic disease caused by a mutation in the beta-globin gene, can present oral manifestations such as delayed tooth eruption and hypomineralized enamel and dentin. The aim of the present study was to evaluate the prevalence and severity of developmental defects of enamel (DDE) and delayed tooth eruption in children with sickle cell anemia. The sample comprised 56 male and female children with sickle cell anemia aged 6 to 12 years and treated at the Hematology and Hemotherapy Center of Pernambuco, Brazil. The data were collected according to the WHO criteria for DDE and tooth eruption. The prevalence of DDE was 58.2% and increased with age, affecting 43.8% of children aged 6 to 8 years and 66.7% of those aged 10 to 12 years (p>0.05; Pearson's chi-square test). There was no significant association between DDE and sex; the most prevalent type of DDE was diffuse opacity (6.2%). Tooth eruption was delayed in 18 children (32.1%). The delay increased with age and was detected in 11.8% of children aged 6 to 8 years, in 20.0% of those aged 8 to 10 years and in 54.2% of those aged 10 to 12 years (p<0.05; Pearson's chi-square test). Delayed tooth eruption was higher in males (36.7%, p>0.05). The prevalence of DDE was high, increased with age and was similar between sexes, while delayed eruption was higher in males and showed a significant association with age.

Physical violence and alcohol drinking consumption among teenagers / Violencia física e consumo de álcool entre adolescentes

INTRODUCTION: Adolescence is a period of transition, between childhood and adulthood marked by biological, psychological and social changes. These changes characterize the situations of vulnerability to which these individuals are exposed. OBJECTIVE: The aim of this study was to examine the association between alcohol consumption and involvement in physical violence among adolescent students in the city of Olinda, Pernambuco, Brazil METHODS: This was a pilot, cross-sectional, study conducted with adolescents enrolled in high school. The Youth Risk Behavior Survey questionnaire was applied in the classroom and questions were taken from the modules on alcohol consumption, violence and socioeconomic data. Analysis of associations was performed using the Chi-square test, or Fisher's exact test when the Chi-square parameters were not met. RESULTS: Involvement in physical altercations was associated with male gender (p = 0.001), alcohol consumption in the last 30 days (p = 0.019), binge drinking (p = 0.022) and higher maternal education (p = 0.037). CONCLUSION: There was an association between the consumption of alcohol by adolescents and physical violence. These results are an indication of the vulnerability to which this population is exposed and is a warning of the need for further studies to investigate this issue

INTRODUÇÃO: A adolescência é um período de transição, compreendido entre a infância e a vida adulta marcado por alterações biológicas, psicológicas e sociais. Essas alterações caracterizam as situações de vulnerabilidade as quais esses indivíduos estão expostos. OBJETIVO: Analisar a existência de associação entre o consumo de bebidas alcoólicas e envolvimento em situações de violência física entre adolescentes escolares do município de Olinda, PE MÉTODO: Trata-se de um estudo piloto, do tipo transversal, realizado com adolescentes matriculados no ensino médio. O questionário Youth Risk Behavior Survey foi aplicado em sala de aula e foram adotadas questões referentes aos módulos consumo de bebidas alcoólicas, violência e dados socioeconômicos. Para análise de associação foi utilizado o teste Qui-quadrado de Pearson ou o teste de Exato de Fisher quando os parametros de utilização do Qui-quadrado não eram atendidos. RESULTADOS: O envolvimento em luta corporal esteve associado ao sexo masculino (p=0,001), ao consumo de álcool nos ultimos trinta dias (p=0,019), ao binge drinking (p=0,022) e a maior escolaridade materna (p=0,037). CONCLUSÃO: Houve associação entre o consumo de bebidas alcoólicas por adolescentes e o envolvimento em brigas. Esses resultados são um indício da vulnerabilidade a qual a esta população está exposta e faz um alerta à necessidade de estudos que aprofundem a temática abordada.

Malocclusion and treatment need in children and adolescents with sickle cell disease.

OBJECTIVE: To assess the prevalence of malocclusion and treatment need in children and adolescents with sickle cell disease (SCD). MATERIALS AND METHODS: In this cross-sectional study, the sample size comprised 35 five-year-old children and 36 adolescents of both sexes, aged between 12 to 18 years, with SCD. Dental occlusion was assessed using two indexes: the Malocclusion Index (World Health Organization) and the Dental Aesthetic Index (DAI). RESULTS: The prevalence of malocclusion in the preschool children was 62.9%. The main malocclusions observed in this age group were Class II (37.1%), increased overjet (28.6%), reduced overbite (28.6%), and open bite (17.1%). In the 12- to 18-year-old subjects, the prevalence of malocclusion was 100%, and the most prevalent types of malocclusion were maxillary overjet (63.9%) and maxillary misalignment (58.3%). It is noteworthy that the majority of adolescents (80.6%) had very severe or disabling malocclusions. CONCLUSION: The results revealed a high prevalence of malocclusion in children and adolescents with SCD. According to DAI score, the majority of the sample presented with very severe malocclusion and a compulsory treatment need.

Caries removal in primary teeth--a systematic review.

OBJECTIVE: This systematic review addressed what the ideal limit is for removing carious tissue to address a caries lesion. METHOD AND MATERIALS: The Medline, Cochrane, and PubMed databases were searched for abstracts of English-language articles published between 2000 and 2010 as well as randomized clinical trials about the total, partial, and/or nonmechanical removal of carious tissue in primary teeth. The analysis of the abstracts was performed individually by two reviewers. The full text of potentially relevant studies was obtained, analyzed based on criteria for quality assessment of a randomized clinical trial, and placed in an evidence-based table. RESULTS: After reading the abstracts, 151 articles were excluded. Six references met the inclusion criteria and were selected for full reading. After the reviewers consulted with one another, three papers were considered potentially relevant to this review. CONCLUSION: This analysis suggests that minimally invasive procedures for dental tissue are viable choices for stopping caries lesions. Partial or nonmechanical removal of carious tissue favors the arrest of dental caries lesions.

Traumatic dental injuries and associated factors among Brazilian preschool children aged 1-5 years.

The aim of this study was to evaluate the prevalence of dental trauma in children aged 1 to 5 years old and its associated factors (gender, age group, malocclusion and labial-closing), interviewing parents and guardians for additional information on the trauma occurrence. A transversal study of 820 preschool children from the City of Caruaru, Pernambuco, Brazil was conducted. Data were collected by means of a clinical examination and a structured interview. The statistical analysis included a distribution of frequencies, a bi- and a multi-variate analysis at a significance level of 5%. Trauma prevalence was 20.1%, tooth 61 was the most often affected, and enamel fractures followed by the fractures of the enamel and the dentine were the most frequent alterations. Trauma prevalence was highest in 3- to 5-year-old males with malocclusion (open bite and protrusion) (p < 0.05). According to most parents and/or guardians, the most usual etiology was falling and the place most often cited was home. All the variables studied, except for lip coverage, were associated with dental trauma. The outcome of the present study showed high prevalence of dental trauma in a pediatric population under the age of 5 years. Falls and accidental collisions were the etiological factors most often cited. The front upper incisors were the teeth most often affected, and enamel fracture was the trauma most often observed.

[Orofacial aspects of childhood abuse and dental negligence]. / Aspectos orofaciais dos maus-tratos infantis e da negligência odontológica.

The aim of this paper was to identify the main oral and dental aspects of childhood abuse and dental neglect, contributing to the identification of these victims in a dental office. A bibliographic research was carried out, in ADOLEC, MEDLINE, LILACS and BBO databases. The following key words were used: child abuse, oral manifestations, dentists; role; liability, legal. It was verified that violence against children happens in general at home and the resulting orofacial injuries encompass: injuries, burns and lacerations on soft and hard tissues, bite marks and gradually-healed wounds. It can have wounds in other parts of the body next to the oral cavity, such as periorbital wound and nasal injury. Regarding sexual abuse, many victims do not present any associated physic signs; therefore, behavioral indicators must be observed. The immediate recognition and report of childhood abuse and dental negligence by dental surgeon are essential for children protection. Therefore, it is critical to define more effective action from those professionals, by registration and denunciation of suspect cases to child protection agencies.

Dental avulsion: experience, attitudes, and perception of dental practitioners of Caruaru, Pernambuco, Brazil / Avulsão dentária: experiência, atitudes e percepção de cirurgiões-dentistas de Caruaru, Pernambuco, Brasil

Purpose: To evaluate the level of knowledge of Brazilian dental practitioners on dental avulsion and replantation.Methods: A 14-item structured interview was used to collect data from 148 dentists, members of a dental association in the city of Caruaru, Pernambuco, in the Northeast region of Brazil. Data were analyzed by descriptive and inferential statistics (Fisher's exact test and Pearson's chi-square test) at the 0.5 level of significance.Results: In this sample, 49.3% of the dentists had up to 10 years of professional experience, 46.1% worked in public and private institutions, and 50.7% reported graduate education. For avulsed deciduous teeth, 40.3% of the dentists would not perform dental replantation, but most practitioners (92.3%) would do it for permanent teeth, and the professional experience was not a significant factor. Semi-rigid wiring was the most frequent type of dental splinting indicated by dentists with short- and long-term professional experience (74.7% and 64.1%, respectively).Conclusion: In this sample, most dentists were aware of the basic procedures to be followed in case of dental avulsion of deciduous and permanent teeth independently from their professional experience.

Objetivo: Avaliar o conhecimento sobre avulsão e reimplante dentário entre cirurgiões-dentistas brasileiros.Metodologia: A amostra foi constituída por 148 cirurgiões-dentistas, membros de uma entidade de classe do município de Caruaru, Pernambuco. Para a coleta dos dados utilizou-se um questionário estruturado com 14 itens. Os dados foram analisados por estatística descritiva e inferencial (Teste exato de Fisher e teste qui-quadrado de Pearson), ao nível de significância de 5%. Resultados: Nesta amostra, 49,3% dos cirurgiões-dentistas possuíam até 10 anos de experiência profissional, 46,1% trabalhavam em instituições públicas e privadas e 50,7% eram pós-graduados. Quanto à avulsão de dentes decíduos, 40,3% dos dentistas não realizariam reimplante; a maioria dos profissionais (92,3%) optaria pelo reimplante no caso de dentição permanente, não sendo a experiência profissional fator significativo. A contenção semi-rígida foi citada por 74,7% e 64,1% dos entrevistados com menor e maior experiência profissional, respectivamente.Conclusão: A maioria dos cirurgiões-dentistas desta amostra tem conhecimento dos procedimentos básicos a serem seguidos em caso de avulsão de dentes decíduos e permanentes, independentemente de sua experiência profissional.

Fatores associados ao desmame precoce no município de São José dos Bezerros/PE / Factors associated to early wean in the city of São José dos Bezerros/PE

Objetivos: Verificar as causas do desmame precoce na UnidadeMista de São José dos Bezerros/PE, observando se há associação entre a ocorrênciadesse fenômeno e as variáveis: faixa etária, grau de escolaridade da mãe,renda mensal e uso de chupeta. Material e Método: Foram entrevistadas 70mães de crianças egressas (0 a 6 meses) de uma Unidade Hospitalar Pública dereferência. A análise estatística envolveu distribuição de freqüências e o testede Qui-quadrado de Pearson e Exato de Fisher com nível de significância de5%. Resultados: O percentual de desmame precoce foi de 41,4% e a idade dacriança mais freqüente, no período do desmame, foi até um mês (55,0%). Oalimento substituto ao leite humano foi o leite em pó industrializado (53,9%). Ajustificativa de que o leite era fraco foi o principal motivo que levou ao desmame(56,9). Não houve associação entre o desmame precoce e a faixa etária da mãe, ograu de escolaridade e a renda mensal. Houve associação entre o uso de chupetae o desmame precoce (p<0,05). Conclusões: O percentual de desmame precocefoi elevado, e a crença popular do ?leite fraco? foi a principal justificativa. A sucçãode chupeta foi a única variável que apresentou associação significativa como desmame precoce. Dessa forma, fica evidente a importância das políticas deincentivo ao aleitamento materno, sendo essa prática, na atualidade, associada àqueda na taxa de natalidade, de mortalidade infantil e de desnutrição, além dosinúmeros benefícios para a saúde em geral e para a vida emocional do bebê.

Influence of socio-economic and demographic factors in determining breathing patterns: a pilot study.

UNLABELLED: Breathing represents one of the vital functions of the organism, and its unbalance causes some series of alterations in several organs and systems. AIM: Verify the influence of socio-economic and demographic factors in determining breathing patterns. STUDY DESIGN: cross-sectional. MATERIALS AND METHODS: there were 143 students in the sample, with ages ranging from 9 and 10 years, from two schools, public and private, in the city of Recife, Pernambuco. Breathing patterns were established through two tests: Glatzel Plate (Steam) and water time in the mouth. Socio-economic factors were evaluated through questionnaires with nine questions each. Statistics were carried out by means of the Chi-Squared test or Fishers Exact test and the significance level used was of 5%. RESULTS: Oral breathing prevalence was of 55.2%, higher among females (57.7%) and in public schools (67.2%). Lack of medical care (62%), less use of medications (56.6%), parents with educational levels lower than high school, divorced parents (66%), students that do not live with their parents (68.7%) and homes with only one room (72%), in all of those situations, oral breathing signs were more prevalent. Only school type had significant association with the breathing pattern. CONCLUSION: High levels of oral breathing without differences concerning gender and age. With the exception of school type, there was no association between breathing pattern and socio-economic factors.

Prevalence and factors related to mouth breathing in school children at the Santo Amaro project-Recife, 2005.

AIM: To determine the prevalence of mouth breathing children at the santo amaro project/ esef/ upe, and study their main facial and behavior alterations. STUDY DESIGN: transversal study. MATERIAL AND METHODS: there were 150 children in the sample, with ages ranging from 8 to 10 years. Data was collected by means of a questionnaire and clinical examinations. As for their breathing assessment, two tests were carried out: test 1- breath steam against a mirror; and test 2 -water remains in the mouth with lips closed for 3 minutes. RESULTS: mouth breathing prevalence was of 53.3%. There was no significant difference between gender, age and type of breathing. Facial alterations were:incomplete lip closure ( 58.8%X5,7%), fallen eyes ( 40.0%X1.4%), High palate ( 38.8%X2.9%), Anterior open bite ( 60.0% Versus 30.0%), Hypotonic lips ( 3.8%X0.0%), Circles under the eyes (97.5% Versus 77.1%). CONCLUSION: high mouth breathing prevalence without significant statistical difference between genders,age and type of mouth breathing. There was no association between behavior characteristics and type of breathing. There were significant differences between physical traits and breathing pattern.

Dental trauma and associated factors in Brazilian preschoolers.

This study aims to determine the prevalence of dental trauma and its relation to associated factors among preschool children in both private and state schools in the city of Recife, Brazil. A cross-sectional study was conducted in which a total of 2651 preschool children were examined; out of this total, 1313 were enrolled in private schools and 1338 in state schools. The associated factors analyzed were: type of school, gender, age group and nutritional status. After a dental exam, the anthropometric measurements of weight and height were registered. Children that presented weight values above two Z scores were considered overweight/obese. The total prevalence of trauma was 36.8%. The most frequent type of trauma was enamel fractures (58.1%); the most affected subjects were the overweight/obese children; the males and the children in private schools. With regard to age group, the risk of trauma increases as children get older (P < 0.001). The high prevalence of dental trauma in preschoolers and its possible harm for permanent dentition, suggest that public health policies need to be implemented with a view to its prevention.