Prenatal, neonatal and postnatal factors and the developmental defects of dental enamel / Fatores pré-natais, neonatais e pós-natais e defeitos de desenvolvimento do esmalte dentário

ABSTRACT Objective: To estimate the prevalence of developmental defects in dental enamel and its possible association with prenatal, neonatal and postnatal conditions in six-year-old schoolchildren in a southern Brazilian municipality. Methods: A cross-sectional study was conducted involving 655 six-year-old schoolchildren. Sociodemographic and health data were collected through interviews with mothers and children's oral examinations at schools. Multivariate analyses were performed using Poisson regression with robust estimator. Results: The prevalence of developmental defects of enamel was 44.0%. Demarcated opacities were the most prevalent, followed by diffuse opacities. Late pregnancy, maternal schooling less than eight years, female gender and child's white skin color were independently associated with the prevalence of demarcated opacities. Conclusions: The prevalence of developmental defects in dental enamel was 44.0%. Late pregnancy, maternal schooling less than eight years, female gender and child's white skin color were associated with the prevalences.

RESUMO Objetivo: Estimar a prevalência de defeitos de desenvolvimento do esmalte dentário e sua possível associação com fatores pré-natais, neonatais e pós-natais em escolares de seis anos de idade em um município do sul do Brasil. Métodos: Foi conduzido um estudo transversal envolvendo 655 escolares de seis anos de idade. Os dados sociodemográficos e de saúde foram coletados por meio de entrevistas com as mães e exames bucais das crianças nas escolas. As análises multivariadas foram realizadas por meio de regressão de Poisson com estimador robusto. Resultados: A prevalência de defeitos de desenvolvimento do esmalte foi de 44,0%. As opacidades demarcadas foram as mais prevalentes, seguidas das difusas. Gravidez tardia, escolaridade materna inferior a oito anos, sexo feminino e cor da pele branca da criança foram independentemente associados à prevalência de opacidades demarcadas. Conclusões: A prevalência de defeitos de desenvolvimento do esmalte dentário foi de 44,0%. Gravidez tardia, escolaridade materna inferior a oito anos de estudo, sexo feminino e cor da pele branca da criança estiveram associados às prevalências.

Prenatal, neonatal and postnatal factors and the developmental defects of dental enamel.

OBJECTIVE: To estimate the prevalence of developmental defects in dental enamel and its possible association with prenatal, neonatal and postnatal conditions in six-year-old schoolchildren in a southern Brazilian municipality. METHODS: A cross-sectional study was conducted involving 655 six-year-old schoolchildren. Sociodemographic and health data were collected through interviews with mothers and children's oral examinations at schools. Multivariate analyses were performed using Poisson regression with robust estimator. RESULTS: The prevalence of developmental defects of enamel was 44.0%. Demarcated opacities were the most prevalent, followed by diffuse opacities. Late pregnancy, maternal schooling less than eight years, female gender and child's white skin color were independently associated with the prevalence of demarcated opacities. CONCLUSIONS: The prevalence of developmental defects in dental enamel was 44.0%. Late pregnancy, maternal schooling less than eight years, female gender and child's white skin color were associated with the prevalences.

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

ABSTRACT Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child's life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions.

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

ABSTRACT Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted.

The Influence of the First Thousand Days of Life on Establishing Determinant Behaviors for Dental Caries in Childhood

ABSTRACT Objective: To study the influence of the first thousand days of life on establishing determinant behaviors for dental caries in childhood. Material and Methods: Longitudinal retrospective study involving 664 children born in 2009 living in a southern Brazilian municipality was carried out. Data was collected through interviews with mothers and through child's health card. Dependent variables were 1) tooth brushing onset after two years of age; 2) absent tooth brushing or once a day; 3) tooth brushing without adult supervision; 4) not having gone to the dentist until the age of 6; and 5) seek for dental services due to toothache at 6 years of age, over the last 30 days. Bivariate and multivariate analyses were performed using Poisson Regression to estimate relative risks (RR) and respective confidence intervals at the 95% accuracy level. Results: Mothers with lower schooling at child's birth presented a higher risk of "child's tooth brushing onset only after two years of age", "brushing the teeth once a day only or not brushing" and with "child not having gone to the dentist until the age of 6". Mothers who did not have a job when the child was born were associated with "not having gone to the dentist until the age 6". Children with gastroesophageal reflux who underwent hospitalization for more than 2 days under age 2 were associated with "seeking dental services because of pain at 6 years of age over the last 30 days". Conclusion: Higher risks of some determinant behaviors related to dental caries were associated with variables of the period of the first thousand days of life.

Dental trauma and oral health-related quality of life in schoolchildren from public schools of a southern Brazilian city / Trauma dental e o impacto na qualidade de vida de escolares da rede pública em uma cidade no sul do Brasil

ABSTRACT Objective: To study the impact of dental trauma on the oral health-related quality of life among Brazilian students. Methods: A cross-sectional study involving a representative sample of students of the public schools (n = 435) in a city in southern Brazil was carried out. Data on dental trauma were collected through oral examinations using the O'Brien's criteria (1993) restricted to fractures and avulsions. The Brazilian version of the Oral Impacts on Daily Performances (OIDP) was used in order to collect data on the impact of oral health-related quality of life. Bivariate and multivariate analysis were performed through Poisson log-linear regression with robust estimator with significance levels set at p <0.05. Prevalence ratios (PR) and confidence intervals (95%) were estimated. Results: The prevalence of dental trauma was 7.2%, and it was associated with the following dimensions: performing daily activities [(PR = 3.52 (95% CI, 1.06-11.75)] (p = 0.040), and speaking [(PR = 3.67 (95% CI, 1.24-10.86)] (p = 0.019) after adjusting for sex, age, dental caries and malocclusion. Conclusion: The prevalence of dental trauma found among this population was low, but significantly associated with oral health-related quality of life.

RESUMO Objetivo: Estudar o impacto do trauma dental na qualidade de vida relacionada a saúde oral entre escolares brasileiros. Métodos: Foi realizado estudo transversal envolvendo uma amostra representativa de escolares (n = 435), em uma cidade no sul do Brasil. Os dados sobre trauma dental foram coletados através de exames orais utilizando os critérios do O'Brien (1993), restritas a fraturas dentais e avulsões. A versão brasileira dos impactos no desempenho diário (OIDP) foi utilizado para recolher dados sobre o impacto na qualidade de vida relacionada à saúde bucal. O teste do qui-quadrado foi utilizado para a análise bivariada com níveis de significância de p <0,05. As razões de prevalência (RP) e intervalos de confiança (95%) foram estimados utilizando regressão de Poisson log-linear com um estimador robusto. Resultados: A prevalência de trauma dental foi de 7,2%, e foi associado com as seguintes dimensões: realização de atividades cotidianas [(RP = 3,52 (IC 95%, 1,06-11,75)] (p = 0,040), e falar [(PR = (IC 95%, 1,24-10,86) 3,67] (p = 0,019) após o ajuste para sexo, idade, cárie dentária e maloclusão. Conclusão: A prevalência de traumatismo dentário encontrado entre esta população era baixa, mas significativamente associada à qualidade relacionada à saúde bucal de vida.

Malocclusion in Brazilian Schoolchildren: High Prevalence and Low Impact.

PURPOSE: To estimate the prevalence and severity of malocclusion and test a possible association with negative impacts on quality of life of schoolchildren in Tubarão, Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted on a representative sample (n = 389) of schoolchildren. Data on oral health-related quality of life were obtained through the Oral Impacts on Daily Performance (OIDP) scale. The malocclusion indicator was the Dental Aesthetic Index (DAI). Prevalence ratios were estimated using log-linear Poisson regression with a robust estimator. RESULTS: The prevalence of class II, III, and IV malocclusion was 57.3%. The most common dental condition was overjet greater than 3 mm. Girls and older schoolchildren showed statistically significantly higher prevalence of all classes of malocclusion. There were no statistically significant associations between the most frequent malocclusions and dimensions of the impact indicator, except for the presence of overjet greater than 3 mm that was associated the 'cleaning teeth' dimension. CONCLUSION: The prevalence of malocclusion was high, but was not statistically significantly associated with impact on oral health-related quality of life.

Autoestima e cárie dentária em adolescentes: um estudo seccional / Self-esteem and dental caries in adolescents: a cross sectional study

Introdução: A cárie dentária na adolescência continua sendo um importante problema de saúde pública; entretanto, a sua relação com os fatores psicológicos é pouco estudada. Objetivo: Estudar a possível associação entre aspectos de autoestima e cárie dentária em adolescentes. Material e método: Estudo transversal envolvendo amostra de 409 adolescentes de 13 municípios do sul do Brasil. A cárie foi avaliada segundo critérios da Organização Mundial da Saúde e a autoestima, pela Escala de Rosenberg. O teste do qui-quadrado foi utilizado para determinar a significância estatística das associações. Para ajustar para variáveis de confusão, foi utilizada a regressão loglinear de Poisson com estimativa robusta. Resultado: Foram observadas associações positivas entre presença de dentes cariados e alguns aspectos da escala de autoestima: Às vezes, eu acho que não presto para nada; (p <0,001); Eu gostaria de poder ter mais respeito comigo mesmo (p=0,016), e Eu, com certeza, me sinto inútil, às vezes (p=0,022). Associação negativa foi observada com: “No conjunto, eu estou satisfeito comigo” (p=0,022). Na análise ajustada, os adolescentes com dentes cariados apresentaram maior prevalência de respostas positivas para a questão Às vezes, eu acho que não presto para nada [RP= 1,23 (IC 95% 1,05; 1,44)] e maior prevalência de respostas negativas para a questão No conjunto, eu estou satisfeito comigo [RP= 1,12 (IC 95% 1,02; 1,24)]. Conclusão: Aspectos da autoestima foram, independente e significativamente, associados com a presença de dentes cariados.

Abstract Introduction Dental caries in adolescents remains an important public health problem, but its relationship with psychological factors are poorly studied. Objective To study the possible association between aspects of self-esteem and dental caries in adolescents. Material and method A cross-sectional study involving a sample of 409 adolescents from 13 Southern Brazilian municipalities was carried out. Dental caries status was assessed through the World Health Organization criteria. For questions related to self-esteem the Rosenberg Self-Esteem Scale was used. The outcomes were each question of the scale. The chi-square test was used to determine statistical significance of associations. To adjust for confounding variables, the Poisson loglinear with robust estimator was used. Result Positive associations were observed for the presence of decayed teeth and “At times, I think I am no good at all (p < 0.001), “I wish I could have more respect for myself (p= 0.016), I certainly feel useless at times (p= 0.022) and negative association with On the whole, I am satisfied with myself (p= 0.022). In the adjusted analysis, adolescents with decayed teeth had a higher prevalence of positive responses to At times, I think I am no good at all [(PR= 1.23 (CI 95% 1.05; 1.44)], and negative responses for On the whole, I am satisfied with myself [(PR= 1.12 (CI 95% 1.02; 1.24)]. Conclusion Aspects of self-esteem were significantly and independently associated with the presence of decayed teeth.

Impact of Dental Caries on Quality of Life of School Children

Objective: To estimate the impact of dental caries on the oral health-related quality of life of school children of public schools of Tubarão, Santa Catarina, Brazil. Material and Methods: A cross-sectional study on a sample of 42310-15 years old students was carried out. The prevalence of dental caries, dental trauma and malocclusion was observed by oral examination based on WHO criteria. The Oral Impact on Daily Performance indicator was used to collect data about the impact on quality of life related to children's oral health. The Chi-square test was used for bivariate analysis with significance levels set at p<0.05. Prevalence ratios (PR) and confidence intervals (95%) were estimated using log-linear Poisson regression with a robust estimator. Results: The prevalence of dental caries was 55.5%. The prevalence of impact on oral health related quality of life was 45.6%. OIDP dimensions significantly associated with dental caries were eating [PR = 1.45 (95%CI 1.06; 2.00)] (p = 0.021), sleeping [(PR = 2.29 (95%CI 1.15; 4.56)] (p = 0.018) and performing daily activities [PR = 2.57 (95%CI 1.06; 6.22)] (p = 0.036) after adjusting for gender, age and presence of dental trauma and malocclusion. Conclusion: Dental caries was found to be significantly associated with oral health-related quality of life of children in activities such as eating, sleeping, and performing daily activities.

Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children.

PURPOSE: The purpose of this study was to examine the association between developmental defects in the enamel (DDE) of the primary teeth and low birth weight or prematurity. METHODS: A case-control study was carried out in Itajaí, Southern Brazil, involving 3- to 5-year-old children. The case group was composed of 102 children presenting at least 1 dental surface with DDE. The control group comprised 113 children without DDE matched by sex and age and enrolled in the same day care centers. All teeth were clinically examined using the Modified Index of Developmental Defects of Enamel. The outcome variable of the study was DDE in at least 1 dental surface, and the independent variables were: (1) birth weight; (2) gestational age; and (3) breast-feeding. Maternal schooling and health problems of the mother during pregnancy and of the child during the first year of life were collected as potential confounding factors. Simple and conditional multiple logistic regression analyses were performed, providing crude and adjusted odds ratio and 95% confidence intervals. RESULTS: Prematurity (OR=2.6; 95% CI=1.0-6.4) and children who did not breast-feed (OR=3.2; 95% CI=1.2-8.4) were associated with defects in tooth enamel after adjusting for possible confounding variables. CONCLUSIONS: In this study, premature children and those who did not breast-feed could be considered at risk for developing defects in tooth enamel.

Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children.

Developmental defects of the enamel (D.D.E.) are changes in the deciduous dentition that have been little studied in Brazil, although they lead to aesthetic problems, dental sensitivity and may be predictors of dental caries. The objective of this study was to estimate the prevalence and distribution of D.D.E. in the deciduous dentition of pre-school children in the municipality of Itajaí, Santa Catarina, in 2003. A cross-sectional study was carried out with a sample of 431 children aged 3 to 5 enrolled in public day care centres. All of the teeth were examined and the enamel defects were assessed according to the Modified DDE Index (FDI, 1992). The prevalence of D.D.E. was 24.4% (CI 95% 20.3-28.5). Diffuse opacities were the most common defects found (17.9%), followed by hypoplasia (11.1%) and demarcated opacities (6.1%). The most affected teeth were the second molars (44.4%), followed by the first molars (23.5%). Defects were observed more frequently in the upper arch (58.2%). Assessing enamel hypoplasia separately, a prevalence of 15.1% (CI 95% 11.7-18.5) was observed, with the most affected teeth being the canines (33.6%) and second molars (33.6%). One quarter of the pre-school children presented enamel defects, with diffuse opacities being the most prevalent ones.

Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children

No Brasil, os defeitos de desenvolvimento de esmalte (D.D.E.) são alteracões pouco estudadas na denticão decídua apesar de acarretarem problemas estéticos, de sensibilidade dentária e serem fatores predisponentes da cárie dental. O objetivo deste estudo foi estimar a prevalência e distribuicão de D.D.E. na denticão decídua de pré-escolares do município de Itajaí, Santa Catarina em 2003. Foi realizado um estudo transversal com uma amostra de 431 criancas de 3 a 5 anos de idade matriculadas em creches públicas. Todos os dentes foram examinados e os defeitos de esmalte foram avaliados segundo o "Modified DDE Index" (FDI, 1992). A prevalência de D.D.E. foi 24,4% (IC 95% 20,3-28,5). As opacidades difusas foram os defeitos mais encontrados (17,9%), seguidos das hipoplasias (11,1%) e opacidades demarcadas (6,1%). Os dentes mais acometidos foram os segundos molares (44,4%); seguidos pelos primeiros molares (23,5%). Os defeitos foram observados com maior freqüência na arcada superior (58,2%). Avaliando isoladamente as hipoplasias de esmalte, observou-se uma prevalência de 15,1% (IC 95% 11,7-18,5); sendo que os dentes mais atingidos foram os caninos (33,6%) e segundos molares (33,6%). Um quarto dos pré-escolares apresentou defeitos de esmalte, sendo que as opacidades difusas foram os mais prevalentes.