Early Introduction of Total Sugar Foods and Early Childhood Caries.

Purpose: To evaluate the association between the introduction of total sugar foods (TSF) in the first six months of age and the prevalence of early childhood caries (ECC) and its consequences for dental pulp in preschool children. Methods: A representative cross-sectional study was conducted with 533 preschool children (four to six years old) in Ribeirão das Neves, Brazil. The decayed, missing, and filled teeth (dmft) index was used for determining ECC. The visible pulp, oral mucosa ulceration due to root fragments, fistula, and abscess (pufa) index was used for the pulp consequences of dental caries. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the children's diet. Statistical analysis was performed using multiple logistic regression (P<0.05). Results: The multiple logistic regression model adjusted for family income and breastfeeding showed that preschool children who were introduced to TSF prior to six months of age were 1.58 times more likely to have ECC (95 percent confidence interval equals 1.09 to 2.30). The multiple logistic regression model, adjusted for family income, breastfeeding, and brushing behaviors, showed that preschool children who were introduced to TSF prior to six months of age were 2.30 times more likely to have pulp consequences (95 percent confidence interval equals 1.35 to 3.91). Conclusion: The early introduction TSF is associated with a higher prevalence of early childhood caries and pulp consequences in preschool children. The negative effects on oral health may be greater when the introduction of TSF occurs prior to six months of age.

Psychosocial associated factors of early childhood caries and oral health-related quality of life: Structural equation model approach.

OBJECTIVE: To identify a structural model for the identification of psychosocial associated factors of early childhood caries (ECC) and oral health-related quality of life (OHRQoL) in preschool children and their families. METHODS: A population-based cross-sectional study was conducted with 533 preschool children from 4 to 6 years-old public and private preschools, from Ribeirão das Neves, MG. Parents/caregivers self-completed the Brazilian versions of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and Resilience Scale as well as a structured questionnaire addressing socioeconomic status and child's oral health behavior. Two dentists who had undergone training and calibration exercises for ICDAS­epi and pufa index (Kappa≥0.95) performed the examinations for ECC. Stages of ECC were classified as free of visible carious lesion, initial caries, moderate caries, extensive caries without pulp consequences and extensive caries with pulp consequences. Data were analyzed using structural equation modeling, using Mplus version 8.6. RESULTS: Lower socioeconomic status (b=-0.250; p<0.001) and higher frequency of free sugar consumption (b = 0.122; p = 0.033) were directly associated with a more severe stage of ECC. Lower parental resilience had an indirect impact on more severe stage of ECC which was mediated by the variable 'frequency of free sugar consumption' (b=-0.089; p = 0.048). ECC was associated with lower child's OHRQoL (b = 0.587; p<0.001) and lower family's OHRQoL (b = 0.506; p<0.001). CONCLUSION: Structural modeling revealed that the severity of ECC negatively impacted the OHRQoL of preschoolers and their families. The main associated factors of the severity of ECC were lower socioeconomic status, higher frequency of free sugar consumption and lower parental resilience. CLINICAL SIGNIFICANCE: T The findings indicate that psychosocial and behavior variables can be associated with the severity of ECC, and ECC can be associated with negative impact on wellbeing and ability to perform daily activities of preschoolers and their families.

Association Between Attention-Deficit/Hyperactivity Disorder Symptoms and Sleep, Bruxism and Dental Trauma in Pediatric Population: A Preliminary Study.

Purpose: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms reported by parents and the variables sleep problems, possible sleep bruxism, possible awake bruxism and dental trauma (DT), and its mode of occurrence in children and adolescents.
Methods: A cross-sectional study was conducted with the parents of 144 four- to 16-year-old subjects through a questionnaire on demographics, subjects' sleep, self-reported bruxism and DT mode of occurrence. The Swanson, Nolan and Pelham scale IV was used to assess ADHD signs and subtypes. Bivariate and multivariate analysis were performed (P <0.05).
Results: The subjects' mean age was 7.9 years (±2.8 years) and 50.7 percent were boys. DT was reported in 80 percent of those with the hyperactive/impulsive subtype (ADHD-HI) and 72.7 percent of those with the combined subtype (ADHD-C). DT was caused solely by falls in the ADHD-C and inattention subtypes (ADHD-I). ADHD-C was associated with somniloquy (prevalence ratio [PR]=1.075; P =0.010). ADHD-HI was associated with bad sleep quality (PR=1.194; P =0.005), possible sleep bruxism (PR=1.088, 95% confidence interval=1.006 to 1.176; P =0.034), possible awake bruxism (PR=1.146; P =0.024) and sleep duration (PR=0.88; P =0.02).
Conclusion: ADHD-C and -HI subtypes were associated with sleep characteristics. Possible sleep and awake bruxism were associated with symptoms of ADHD-HI. Despite no significant association, DT was present in most ADHD subjects, mostly due to falls.

Qualidade de preenchimento de prontuários clínicos por estudantes de uma Faculdade de Odontologia brasileira / Calidad del llenado de fichas clínicas por estudiantes de una Facultad de Odontología brasileña / Quality in filling out clinical records by students of a Brazilian Dentistry school

O prontuário odontológico é um documento médico-legal importante para o registro adequado dos serviços prestados pelo profissional, sendo fundamental para o melhor acompanhamento longitudinal da saúde bucal. A competência para seu adequado preenchimento deve ser desenvolvida pelos alunos desde o início de sua atuação clínica, no ambiente de ensino. Este estudo avaliou a qualidade de preenchimento de prontuários odontológicos por alunos em diferentes níveis de formação, nas atividades clínicas de Odontopediatria, da Faculdade de Odontologia da Universidade Federal de Minas Gerais, Brasil. Os dados foram coletados através dos prontuários de pacientes atendidos entre o segundo semestre de 2013 e o segundo semestre de 2019. A qualidade de preenchimento foi analisada descritivamente, categorizando as seções do prontuário como totalmente, parcialmente ou não preenchidas. Posteriormente, uma análise bivariada avaliou a qualidade de preenchimento por alunos do 3º e 6º períodos (p< 0,05). Dos 296 prontuários analisados, nenhum apresentou o preenchimento adequado de todas as seções. As principais falhas observadas foram: dados incompletos no termo de consentimento livre e esclarecido (75%), no índice de sangramento gengival (72,9%) e no diagnóstico da condição bucal (68,6%). Adicionalmente, 51% dos prontuários tinham os dados da identificação dos pacientes parcialmente preenchidos. Não houve diferença estatisticamente significativa na qualidade de preenchimento dos prontuários entre alunos do 3º e 6º períodos. Os presentes resultados evidenciam falhas no preenchimento dos prontuários odontológicos, que se mantiveram ao longo da formação dos alunos. Sendo assim, ressaltam a necessidade de estratégias de sensibilização dos corpos discente e docente, objetivando a manutenção adequada destes registros, por sua relevância ética, legal e científica (AU).

La ficha odontológica es un documento médico-legal importante para el adecuado registro de los servicios prestados por el profesional y es fundamental para el mejor seguimiento longitudinal de la salud oral. La competencia para llenarla adecuadamente debe ser desarrollada por los estudiantes desde el inicio de su práctica clínica, en el ámbito docente. Este estudio evaluó la calidad del llenado de fichas odontológicas por estudiantes de diferentes niveles de formación en prácticas clínicas de Odontología Pediátrica de la Facultad de Odontología de la Universidad Federal de Minas Gerais, Brasil. Los datos se recolectaron a través de fichas clínicas de pacientes atendidos entre el segundo semestre de 2013 y el segundo semestre de 2019. La calidad del llenado se analizó de forma descriptiva, categorizando las secciones de la ficha clínica como completas, parciales o no llenadas. Posteriormente, un análisis bivariado evaluó la calidad del llenado por estudiantes del 3.º y del 6.º período (p< 0,05). De las296 fichas clínicas analizadas, ninguna presentó un llenado adecuado de todas las secciones. Las principales fallas observadas fueron: datos incompletos en el consentimiento informado (75 %), en el índice de sangrado gingival (72,9 %) y en el diagnóstico de la afección bucal (68,6 %). Además, el 51 % de las fichas tenían datos de identificación de los pacientes parcialmente llenados. No hubo diferencia estadísticamente significativa en la calidad del llenado de fichas entre los estudiantes del 3.º y 6.º período. Los presentes resultados resaltan fallas en el llenado de fichas odontológicas que continuaron durante toda la formación de los estudiantes. Por lo tanto, se enfatiza la necesidad de estrategias de sensibilización de estudiantes y docentes, visando el adecuado mantenimiento de estos registros, debido a su relevancia ética, jurídica y científica (AU).

The dental record is an important medical and legal document for the proper registration of the services provided by the dental professional and it is essential for better longitudinal monitoring of the patients' oral health condition. The skills necessaryfor its adequate completion should be developed by students from the start of their clinical practice in professional training centers. This study evaluated the quality of filling out dental clinical records by students from different stages of clinical practice at the Pediatric Dentistry clinic, Dentistry School from UFMG (Federal University of Minas Gerais) in Brazil. Data were collected through dental records of patients assisted between the second semester of 2013 and the second semester of 2019. The registration quality was analyzed descriptively and characterized as fully, partially,or not filled out. Then, a bivariate analysis assessed the completion quality by students from third and sixth semesters (p< 0.05). Of the 296 dental records analyzed, none showed adequate completion of all sections. The main failures observed were incomplete data in the free and informed consent form (75%), in the gingival bleeding index (72.9%) and in the oral condition diagnosis (68.6%). Additionally, patient identification was incomplete in 51% of the dental records. There was no statistically significant difference when comparing students from thirdand sixthsemesters. These results highlight failures in filling out dental records, which continued throughout the students' formation. Therefore, they emphasize the need for awareness-raising strategies among students and teachers, aiming at the adequate maintenance of these records due to their ethical, legal, and scientific relevance (AU).

Development and validation of a questionnaire on the feelings of undergraduate dental students regarding child dental care.

OBJECTIVES: This study aimed to develop and test a questionnaire's validity and reliability to evaluate undergraduate dental students' feelings regarding child dental care. METHODS: The questionnaire was developed using a focus group of 10 undergraduate dental students. This questionnaire was then structured and applied digitally via Google Forms to 90 dental students aged 22.95 years (±0.89) who had already completed or were enrolled in a pediatric dentistry discipline. The test-retest was conducted with 15 students. Descriptive analysis, exploratory factorial analysis (EFA), and intraclass correlation coefficient were performed to evaluate the test-retest reliability, Cronbach's alpha (α) to measure the internal consistency, and Mann-Whitney test was used to determine the discriminant validity (p < 0.05). RESULTS: The final version of the questionnaire concerning the feelings of dental students when faced with pediatric dental treatment comprised three items, which evaluated anxiety, fear, and insecurity. The visual analog scale was used to evaluate the answer for each item. The questionnaire resulted in a total score that varied from 0 to 10. The higher the score on the questionnaire, the greater the negative feelings regarding pediatric dental treatment. The results of the EFA were satisfactory (Bartlett's sphericity = 0.001; Kayser-Meyer-Olkin measure = 0.725). The EFA extracted a single dimension with an eigenvalue of 2.4 and a total explained variance of 80%. The internal consistency of the questionnaire was satisfactory (α = 0.877), and the test-retest reliability was good (intraclass correlation coefficient = 0.691). Students who felt confident about carrying out invasive procedures in children demonstrated more positive feelings related to the pediatric dental treatment (average = 3.50 ± 2.73) than those who did not feel such confidence (average = 5.00 ± 2.35; p = 0.007). CONCLUSIONS: The unidimensional questionnaire proposed by this study is valid and reliable in evaluating the feelings of undergraduate dental students regarding child dental care.

The relationship between temperament and dental fear and anxiety: a systematic review.

OBJECTIVE: To investigate the relationship between temperament traits and dental fear and anxiety (DFA) in children and adolescents by the means of a systematic review (PROSPERO #CRD42020207578). METHODS: The PEO (Population, Exposure, and Outcome) strategy was followed using children and adolescents as the population, temperament as the exposure, and DFA as the outcome. A systematic search for observational studies (cross-sectional, case-control, and cohort) without restrictions on year or language of publication was performed in seven databases (PubMed, Web of Science, Scopus, Lilacs, Embase, Cochrane, and PsycINFO) in September 2021. Grey literature search was performed in OpenGrey, Google Scholar, and in the reference list of included studies. Study selection, data extraction, and risk of bias assessment were carried out independently by two reviewers. The Fowkes and Fulton Critical Assessment Guideline was used to assess methodological quality of each study included. The GRADE approach was performed to determine the certainty of evidence of relationship between temperament traits. RESULTS: This study recovered 1362 articles, of which 12 were included. Despite the high heterogeneity of methodological aspects, qualitative synthesis by subgroups showed a positive association/correlation between emotionality, neuroticism, and shyness with DFA in children and adolescents. Different subgroups analysis showed similar results. Eight studies were classified as having low methodological quality. CONCLUSION: The main shortcoming of the included studies is the high risk of bias and a very low certainty of evidence. Within its limitations, children and adolescents with a temperament-like emotionality/neuroticism and shyness are more likely to present higher DFA.

Determination of dental caries, molar-incisor hypomineralization, and oral health-related quality of life in schoolchildren: A structural equation modeling approach.

BACKGROUND: Some oral conditions can have psychosocial consequences that affect children's daily life and well-being. AIM: To create a structural model for the determination of dental caries, molar-incisor hypomineralization (MIH), and the impact of these conditions and socioeconomic status on schoolchildren's oral health-related quality of life (OHRQoL). DESIGN: A representative cross-sectional study was conducted in Lavras, Brazil, with 1181 female and male schoolchildren 8-9 years of age. OHRQoL was measured using the Brazilian version of the CPQ8-10. Clinical examinations were performed by a calibrated dentist for the diagnosis of dental caries (WHO) and MIH (EAPD). Parents/caregivers answered questionnaires addressing the child's medical history and socioeconomic status. Data were analyzed using structural equation modeling. RESULTS: The model revealed that greater MIH severity (ß = .874; p < .001) and worse socioeconomic status (ß = -.060; p = .001) were associated with a greater number of teeth with caries experience. The higher the number of teeth with caries experience (ß = .160; p = .007) and worse socioeconomic status (ß = -.164; p < .001), the greater the negative impact on OHRQoL. CONCLUSION: The model created showed that dental caries and socioeconomic status had a direct negative impact on the OHRQoL of schoolchildren and MIH had an indirect impact mediated by the occurrence of caries experience.

Development and validation of a short form of the BOHLAT-P.

The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

Cárie dentária em molares decíduos, doenças comuns na infância e condição socioeconômica: estudo representativo de escolares brasileiros / Dental caries in deciduous molars, common childhood diseases and socioeconomic status: a representative study of brazilian schoolchildren

Objetivo: verificar a experiência de cárie em molares decíduos e a sua associação com doenças comuns na infância, uso de medicamentos, condições socioeconômicas. Materiais e Métodos: foi realizado um estudo transversal representativo com uma amostra de 1181 crianças entre 8 e 9 anos, de ambos os sexos. O exame clínico foi realizado em ambiente escolar por uma dentista calibrada para diagnóstico de cárie dentária através do índice de dentes cariados, extraídos ou com extração indicada e obturados (Índice ceo-d). Os responsáveis responderam questionários sobre a história médica da criança e condições socioeconômicas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa Local. Os dados foram analisados através da Regressão de Poisson, sendo que as variáveis com p<0,20 foram introduzidas em um modelo multivariado e hierárquico (p<0,05). Razão de Prevalência (RP) e Intervalo de Confiança (IC) de 95% foram calculados. Resultados: a maioria das crianças apresenta cárie em molares decíduos (54,6%). Doenças comuns na infância e uso medicamentos não apresentaram associação estatisticamente significativa com cárie dentária (p>0,05). Estudantes de escolas públicas tiveram uma prevalência 27% maior de (IC95%=1,05-1,59) experiência de cárie em molares decíduos quando comparados aos estudantes de escolas particulares. Menor escolaridade materna também se mostrou associada à experiência de cárie em molares decíduos, sendo que crianças cujas mães tinham até 4 anos de estudo tinham uma prevalência 60% maior de cárie dentária (IC95%:1,19-2,16). Conclusão: a maioria das crianças apresentou experiência de cárie em molares decíduos, mas esta condição não foi associada com doenças e medicamentos utilizados até os 4 anos de idade. Entretanto, crianças de escola pública e cujas mães possuíam menor escolaridade apresentaram maior experiência de cárie.

Objective: to verify the caries experience in deciduous molars and its association with common childhood diseases, medication use, socioeconomic conditions. Materials and Methods: a representative cross-sectional study was carried out with a sample of 1181 children between 8 and 9 years old, of both sexes. The clinical examination was performed in a school environment by a dentist calibrated for the diagnosis of dental caries through the index of decayed teeth, extracted or with the indicated and filled samples (ceo-d index). Those responsible for the child answered about the child's medical history and socioeconomic conditions. The project was approved by the Research Ethics Committee Local. The data were analyzed using an analysis model, and as p<0.20, varied with variables were evaluated in a model and hierarchical. Prevalence Ratio (PR) and 95% Confidence Interval (CI) were calculations. Results: 54.6% of the children had caries experience in the deciduous molars. Common childhood diseases and medication use were not significantly associated with dental caries (p>0.05). Public school students had a prevalence of 27% of students (95%CI=1.05-1.59) of caries experience in deciduous molars when compared to school students. Lower maternal schooling was also associated with caries experience in deciduous molars, with mothers with up to 4 years of schooling having a 60% higher probability of having children with dental caries (95%CI:1.19-2.16). Conclusion: most children had caries experience in deciduous molars, but it was not associated with diseases and medications used between 0 and 4 years old. However, school children and whose mothers had less schooling had a greater experience of caries.

Prevalence of ankyloglossia according to different assessment tools: A meta-analysis.

BACKGROUND: Prevalence of ankyloglossia may vary depending on the assessment tool. This systematic review aimed to evaluate the prevalence of ankyloglossia in distinct age groups according to different assessment tools. TYPES OF STUDIES REVIEWED: Nine electronic databases were searched from inception through November 2021 without restrictions of language or year of publication. Paired independent reviewers selected cross-sectional and cohort studies reporting the diagnosis of ankyloglossia, extracted data, and assessed methodological quality. The number of patients with ankyloglossia and the sample were extracted to calculate the overall prevalence of ankyloglossia and 95% CI. The authors calculated the prevalence of ankyloglossia per assessment tool, age group, and sex. They assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Seventy-one studies were included. Seven different diagnostic tools were used. The overall prevalence of ankyloglossia was 5% (95% CI, 4.0% to 5.0%) and ranged from 2% (using an unspecific tool) to 20% (Coryllos classification). The prevalence per age group was higher in infants (7%). The prevalence ratio was 1.34 (95% CI, 1.17 to 1.54) for boys, with very low certainty of evidence. PRACTICAL IMPLICATIONS: The prevalence of ankyloglossia is higher among infants and differs depending on the assessment tool used for the diagnosis. It is uncertain whether boys are more affected by ankyloglossia than girls.

Validation of the Brazilian Oral Health Literacy-Adults Questionnaire.

BACKGROUND: Recognizing that a deficit of reading and numeracy skills is associated with poorer oral health, contemporary researchers have identified additional components as important attributes of oral health literacy (OHL). So, the use of comprehensive functional OHL tools is crucial. The Oral Health Literacy-Adults Questionnaire (OHL-AQ) evaluates reading comprehension, numeracy, listening and decision-making skills. OBJECTIVE: Describe the validation process of the OHL-AQ Brazilian version (BOHL-AQ). METHODS: The cross-culturally adapted version, BOHL-AQ, was applied to 180 employees age 18 to 71 years (mean = 37.2; standard deviation [SD] = 11.7) from a private university located in the Southeast of Brazil. Psychometric properties were evaluated through the analysis of internal consistency (Cronbach's alpha), reproducibility (test-retest), convergent validity (BREALD-30; education level), discriminant validity (family income; dental services), predictive validity (self-perception; literacy questions) and construct validity (Exploratory Factor Analysis). Confirmatory Factor Analysis (CFA) evaluated the dimensionality of the BOHL-AQ, with Promax method for rotation. Data were analyzed using SPSS Statistics software and the Mplus program. KEY RESULTS: BOHL-AQ mean score = 11.84 (SD = 3.1); administration mean time = 8 minutes (SD = 1.6); good internal reliability (Cronbach's alpha = 0.73) and excellent reproducibility (kappa = 0.89; intraclass correlation coefficient = 0.97). Preliminary tests showed that data were suitable for PCA (Kayser-Meyer-Olkin measure = 0.75; Barlett's Test of Sphericity significant [p < .001]). CFA showed that the instrument had a four-factor solution with excellent model fit estimates (χ2 = 636.587154.16, p value = .00117, Comparative Fit Index = 0.9787, Tucker Lewis index = 0.97, and Root Mean Square Error of the Approximation = 0.03). BOHL-AQ high scores significantly correlated to high education level, dental visit within the last year and for preventive reason, more independence and self-confidence on reading and filling out health forms, and better oral health self-perception (p < .05). CONCLUSIONS: The BOHL-AQ showed to be a fast and reliable instrument to assess a comprehensive functional OHL at Brazilian community and clinical settings. [HLRP: Health Literacy Research and Practice. 2022;6(3):e224-e231.] Plain Language Summary: Recognizing the need of advancing knowledge related to OHL, this study aimed to describe the validation process of the BOHL-AQ. Cross-cultural adaptation and psychometric properties evaluation presented satisfactory results. The BOHL-AQ proved to be a fast and valid instrument to measure comprehensive functional OHL in the Brazilian context.

Responsiveness of the B-ECOHIS to detect changes in OHRQoL following dental treatment of children with autism spectrum disorder.

The Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) is an oral health-related quality of life (OHRQoL) questionnaire. This paper aims to investigate the responsiveness of the B-ECOHIS to dental treatment in individuals diagnosed with autism spectrum disorder (ASD) and determine if dental treatment has an impact on OHRQoL. The survey targeted 27 ASD individuals aged 4 to 14 years attending the Acolher Project of the University Federal Fluminense. This project provides children and adolescents with disabilities with oral health services. A group of randomly selected caregivers self-completed the B-ECOHIS before and 14 days after their children's dental treatment. The dental treatment included meticulous screening, preventive treatment, and restorative treatment. Responsiveness was assessed by investigating the effect size (ES) and standardized response mean (SRM). Wilcoxon test was used to evaluate internal responsiveness (distribution-based approach). The B-ECOHIS showed significant changes in the total score (p<0.001) and in all domains. The ES of the total B-ECOHIS after treatment was 1.28 and ranged between 0.70 and 1.14 for the domains. The SRM for each of the domains was large, except for the symptom domain. The B-ECOHIS is sensitive and responsive to ASD individuals undergoing dental treatment. Individuals with ASD showed improvement in their OHRQoL score after dental treatment.

Adolescents' and Parents' Perspective on Impact of Dental Caries and Malocclusion on Quality of Life.

Purpose: To evaluate the impact of malocclusion and dental caries on oral health- related quality of life (OHRQoL) in adolescents and the differences between adoles- cents' self-reports and caregiver's proxy reports. Methods: A population-based cross-sectional study was conducted with 1,612 Brazil- ian adolescents and 1,168 caregivers. Adolescents completed the Child Perceptions Questionnaire and caregivers completed the Parental-Caregiver Perceptions Question- naire. Malocclusion (dental esthetic index) and dental caries (DMFT) were documented. Multiple Poisson regression was conducted. Results: A self-reported model demonstrated that adolescents with malocclusion had an impact on emotional (PR=1.14; 95 percent confidence interval [95% CI=1.03 to 1.26) and social domains (PR=1.35; 95% CI=1.20 to 1.50). Dental caries had an impact on the emotional domain (prevalence ratio [PR]=1.34; 95% CI=1.21 to 1.48). The caregiver model showed that malocclusion had an impact on oral symptoms (PR=1.12; 95% CI=1.03 to 1.21), functional limitations (PR=1.18; 95% CI= 1.05 to 1.33), and emotional (PR=1.23; 95% CI=1.10 to 1.54) and social domains (PR=1.22; 95% CI=1.02 to 1.45). Those with dental caries felt an impact on oral symptoms (PR=1.09; 95% CI=1.01 to 1.19), functional limitations (PR=1.18; 95% CI=1.05 to 1.33) and social domains (PR=1.24; 95% CI=1.04 to 1.45). Conclusions: Adolescents reported a negative impact on OHRQoL both in relation to dental caries and malocclusion. Caregivers observed the impact of oral conditions on more domains than the adolescents reported.

Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach.

BACKGROUND: Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries. AIM: To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis. DESIGN: This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05). RESULTS: Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS. CONCLUSION: Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.

Risk Factors for the Incidence of Dental Caries in Low, Very Low, and Extremely Low Birth Weight Children: A Cohort Study

Abstract Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries (AU).

Development and validation of a short form of the BOHLAT-P

Abstract: The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

The importance of full text screening when judging eligibility criteria in a systematic review: a systematic survey / A importância da avaliação do texto completo ao julgar os critérios de elegibilidade em uma revisão sistemática: uma revisão de métodos

Aim: To evaluate if statistically significant results are more likely to be reported in title/abstracts compared to non-significant outcomes. Methods: In this methodological survey, we reanalyzed 59 observational studies from a previous systematic review. The PECO question was: Patient (P): children with primary teeth; Exposure (E): low birth weight and/or preterm; Comparison (C): normal birth weight and/or full-term; Outcome (O): dental caries. We analyzed the presence of key terms in the titles and abstracts, such as gestational age, preterm, full-term, birth weight, low/normal birth weight. Full texts were analyzed for "positive outcomes" (statistically significant association, p < 0.05 or 95% CI not crossing the null effect line) related to the association between the outcome and the exposure; and "negative outcomes" (when the outcome had statistically similar occurrence between the exposure and the comparison group). The odds ratio (OR) was calculated between the presence of key terms in titles/abstracts and the type of outcome (positive or negative). Results: Of 59 studies, 66% cited the key terms in titles/abstracts, and 75% reported negative outcomes. Studies with positive outcomes were more likely to report key terms in the titles/abstracts compared to studies with negative outcomes (OR: 4.5; 95% CI: 0.9-22.4; Chi-square test: p = 0.06). Studies with statistically significant outcomes, favoring the exposure or the comparison, were more likely to report these data in the titles/abstracts. Conclusion: When conducting a systematic review, the final decision related to the inclusion of a study must be based on a full-text level.

Objetivo: Avaliar se os resultados estatisticamente significativos são mais prováveis de serem relatados nos títulos/resumos dos artigos do que os resultados não significativos. Métodos: Neste levantamento metodológico, foram reanalisados 59 estudos observacionais de uma revisão sistemática anterior. A questão PECO foi: Paciente (P): crianças com dentes decíduos; Exposição (E): baixo peso ao nascer e/ou pré-termo; Comparação (C): peso normal ao nascer e/ou a termo; Resultado (O): cárie dentária. Foi analisada a presença de termos-chave nos títulos/resumos, como idade gestacional, pré-termo, a termo, peso ao nascer, baixo/peso normal ao nascer. Textos completos foram analisados para "desfechos positivos" (associação estatisticamente significativa, p < 0,05 ou IC 95% não cruzando a linha de efeito nulo) relacionados à associação entre o desfecho e a exposição; e "desfechos negativos" (quando o desfecho teve ocorrência estatisticamente semelhante entre a exposição e o grupo de comparação). Foi calculada a odds ratio (OR) entre a presença de termos-chave nos títulos/resumos e o tipo de resultado (positivo ou negativo). Resultados: Dos 59 estudos, 66% citaram os termos-chave nos títulos/resumos e 75% relataram resultados negativos. Estudos com resultados positivos foram mais propensos a relatar os termos-chave nos títulos/resumos em comparação com estudos com resultados negativos (OR: 4,5; IC 95%: 0,9-22,4; teste do qui-quadrado: p = 0,06). Estudos com significância estatística os desfechos, favorecendo a exposição ou a comparação, foram mais propensos a relatar esses dados nos títulos/resumos. Conclusão: Ao realizar uma revisão sistemática, a decisão final quanto à inclusão de um estudo deve ser baseada por meio da análise do texto completo.

Responsiveness of the B-ECOHIS to detect changes in OHRQoL following dental treatment of children with autism spectrum disorder

Abstract The Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS) is an oral health-related quality of life (OHRQoL) questionnaire. This paper aims to investigate the responsiveness of the B-ECOHIS to dental treatment in individuals diagnosed with autism spectrum disorder (ASD) and determine if dental treatment has an impact on OHRQoL. The survey targeted 27 ASD individuals aged 4 to 14 years attending the Acolher Project of the University Federal Fluminense. This project provides children and adolescents with disabilities with oral health services. A group of randomly selected caregivers self-completed the B-ECOHIS before and 14 days after their children's dental treatment. The dental treatment included meticulous screening, preventive treatment, and restorative treatment. Responsiveness was assessed by investigating the effect size (ES) and standardized response mean (SRM). Wilcoxon test was used to evaluate internal responsiveness (distribution-based approach). The B-ECOHIS showed significant changes in the total score (p<0.001) and in all domains. The ES of the total B-ECOHIS after treatment was 1.28 and ranged between 0.70 and 1.14 for the domains. The SRM for each of the domains was large, except for the symptom domain. The B-ECOHIS is sensitive and responsive to ASD individuals undergoing dental treatment. Individuals with ASD showed improvement in their OHRQoL score after dental treatment.

Association of deleterious sucking habits with the occurrence of otitis in newborns, infants, preschool children, and children: a systematic review protocol.

OBJECTIVE: The objective of this review is to determine whether deleterious sucking habits contribute to otitis in newborns, infants, preschool children, and children. INTRODUCTION: Otitis is one of the most prevalent diseases in infants. Diverse studies have suggested that deleterious sucking habits, such as pacifier use, bottle-feeding, and finger-sucking, may be risk factors for the development of otitis in young individuals. INCLUSION CRITERIA: This systematic review will include observational studies in which the association between deleterious sucking habits and otitis was assessed in newborns, infants, preschool children, and children. Studies will compare caregiver reporting of sucking habits in this population to those with no deleterious sucking habits or those who exclusively breastfeed. The primary outcome will be the presence of otitis. METHODS: The searches will be carried out in six electronic databases, and gray literature will also be screened. A three-step search strategy will be used, with no date or language restrictions. Studies whose full text meets the eligibility criteria will be included in the systematic review. Study screening and selection, critical appraisal, and data extraction will be performed by two independent reviewers. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to assess the certainty of the evidence. Meta-analysis will be performed if there is relative homogeneity among included studies. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020197162.

Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study.

BACKGROUND AND AIM: Ankyloglossia is a congenital anomaly that can affect breastfeeding. The aim was to evaluate the prevalence of ankyloglossia in newborns and breastfeeding difficulties reported by mothers; assess possible factors that may interfere with breastfeeding. METHODS: A cross-sectional study was conducted with 391 pairs of mothers/newborns at a university hospital. A pediatric dentist examined the oral cavity of the newborns for the occurrence of ankyloglossia. We analyzed medical records and the mothers answered a self-administered questionnaire to assess birth variables, breastfeeding difficulties, and sociodemographic factors. We calculated prevalence ratios (PRs) of breastfeeding difficulties according to the independent variables. RESULTS: The mean age of the newborns was 2.5±2.9 days and 52% were male. The prevalence of ankyloglossia was 15% and 91.4% of mothers reported not having breastfeeding difficulties. Ankyloglossia was not associated with breastfeeding difficulties (PR: 0.5; 95% CI: 0.2-1.4). Mothers with a low income (PR: 0.5; 95% CI: 0.3-0.8), those who received instructions on breastfeeding (PR: 0.4; 95% CI: 0.2-0.9), and those who breastfed exclusively (PR: 0.3; 95% CI: 0.1-0.8) had fewer breastfeeding difficulties. CONCLUSION: Successful breastfeeding was more dependent on being born at full term, the family income, receiving guidance with regard to breastfeeding, and exclusive breastfeeding. Although ankyloglossia was not associated with breastfeeding, future prospective studies should evaluate the long-term factors that may interfere with breastfeeding. RELEVANCE FOR PATIENTS: This study brings a new perspective on the importance of assessing ankyloglossia and breastfeeding difficulties, reinforces the benefits of exclusive breastfeeding and the need for breastfeeding instructions, as well as the need to evaluate breastfeeding before making a decision regarding frenectomy.