Oral health and depressive symptoms: findings from the English Longitudinal Study of Ageing.

Aim We assessed the cross-sectional association between depressive symptoms and oral health using a nationally representative sample of older adults aged 50 years and older living in England.Methods Data came from wave 7 (2014-2015) of the English Longitudinal Study of Ageing. Multiple logistic regression analyses were conducted to assess the association between depressive symptoms, measured through the eight-item Centre for Epidemiologic Studies Depression Scale and three oral health outcomes, namely self-rated oral health, edentulousness and oral impacts.Results The analytical sample comprised 3,617 individuals. The proportion of participants that reported poor self-rated oral health, being edentate and having at least one oral health impact in the last six months was 19.8%, 7.7% and 8.9%, respectively. Around a tenth of the participants reported having depressive symptoms (10%). All unadjusted associations between depressive symptoms and the oral health measures were statistically significant. However, after accounting for potential confounders, only the relationship between depressive symptoms and self-rated oral health remained significant (OR = 1.38; 95% CI 1.01-1.89). Socioeconomic and general health-related variables appeared to influence the associations between depressive symptoms and oral health, particularly edentulousness and oral impacts.Conclusion Depressive symptoms were associated with poor self-rated oral health in older English adults.

Relación entre el tipo de alimentación de los lactantes y la edad de gateo: AMI Pediátrico: Ciudad Bolívar, Estado Bolívar / Relationship between the type of feeding of infants and the age of crawling: Pediatric AMI: Bolivar City, Bolivar State

INTRODUCCIÓN: Cuando se evalúa el desarrollo neurocognitivo de bebes alimentados exclusivamente con leche humana en relación a sucedáneos, se encuentra que el desarrollo neuroconductual de los niños alimentados exclusivamente al pecho es superior. OBJETIVO: determinar la relación existente entre el tipo de alimentación de los lactantes y la edad de gateo, en la unidad de atención médica inmediata de pacientes pediátricos del Hospital Julio Criollo Rivas. Octubre 2018 ­ febrero 2019. Ciudad Bolívar, Estado Bolívar. METODOLOGÍA: fue un estudio de campo, de corte transversal, analítico, comparativo de casos y controles no experimental, conformado por el 30% de los lactantes menores aparentemente sanos entre 5 meses y un año de edad, que consumen lactancia materna exclusiva y lactancia artificial, atendidos en la unidad de atención médica inmediata del hospital "Julio Criollo Rivas" de Ciudad Bolívar, estado Bolívar. RESULTADOS: Durante el período de estudio, fueron evaluados 200 pacientes y se obtuvo que, de 43 pacientes que recibieron lactancia materna exclusiva hasta los 6 meses, el 51,16% (n=22) adquirieron la habilidad de gateo a los 7 meses, y de 157 pacientes que tuvieron ablactación precoz sólo el 32,48% (n=51) adquirieron la habilidad de gateo a los 7 meses. CONCLUSIONES: existe influencia de la lactancia materna en la adquisición de la habilidad de gateo, observándose adquisición precoz de la misma en el grupo que recibió lactancia materna exclusiva hasta los 6 meses de edad.

INTRODUCTION: When evaluating the neurocognitive development of babies exclusively fed with human milk in relation to substitutes, it is found that the neurobehavioral development of children fed exclusively to the breast is superior. OBJECTIVE: to determine the relationship between the type of feeding of the infants and the age of crawling, in the unit of immediate medical attention of pediatric patients of the Hospital Julio Criollo Rivas. October 2018 - February 2019. Ciudad Bolívar, Bolívar State. METHODOLOGY: was a field study, cross-sectional, analytical, non-experimental comparative cases and controls, consisting of 30% of apparently healthy younger infants between 5 months and 1 year of age, who consume exclusive breastfeeding and artificial lactation, attended in the immediate medical care unit of the "Julio Criollo Rivas" hospital in Ciudad Bolívar, Bolívar state. RESULTS: it was obtained that of 43 patients who received breastfeeding exclusive until 6 months, 51.16% (n = 22), acquired the ability to crawl at 7 months, and of 157 patients who had early ablation only 32.48% (n = 51) acquired the ability to I crawl at 7 months. CONCLUSIONS: there is an influence of breastfeeding in the acquisition of the ability to crawl, observing precocious acquisition of it in the group that received exclusive breastfeeding until 6 months of age.

How peoples' ratings of dental implant treatment change over time?

OBJECTIVES: Dental implant treatment (DIT) improves peoples' oral health-related quality of life (OHQoL). Assessment of longitudinal changes in OHRQoL may be undermined by response shift (RS). RS is the process by which quality of life changes, independent of health status as a result recalibration, reprioritization or reconceptualization. Thus, this study aimed to describe RS in the OHRQoL and perceived oral health of individuals receiving DIT and to compare the then-test, a self-anchored scale and the classification and regression trees (CRT) approaches for assessing RS. METHODS: OHRQoL was assessed in 100 patients receiving DIT using the OHIP-Edent (n = 100) and a self-anchored scale (n = 45) before placement of the final restoration and 3 to 6 months after treatment was completed. The OHIP-Edent was also used as a retrospective assessment at follow-up. CRT examined changes in the OHIP-Edent total score as a dependent variable with global changes in oral health and each OHIP-Edent subscale score as independent variables. RESULTS: OHRQoL and perceived oral health improved after treatment. The OHIP-Edent score decreased from 36.4 at baseline to 12.7 after treatment. On average, participants recalibrated their internal standard downwards (- 4.0 OHIP-Edent points). CRT detected downwards recalibration in 5% of participants and upwards in 15%. Reprioritization was observed in the social disability and psychological discomfort aspects of OHRQoL. CONCLUSIONS: RS affects longitudinal assessments of OHRQoL in DIT, reducing the apparent magnitude of change. The then-test and CRT are valid and complementary methods to assess RS.

Socioeconomic inequality in the provision of health advice in dental setting in England, Wales and Northern Ireland.

OBJECTIVE: To assess socioeconomic inequalities in health advice provided in dental setting. METHODS: Data were from the Adult Dental Health Survey, 2009 of England, Wales and Northern Ireland. Index of Multiple Deprivation, occupational classification and education were used to assess differences in advice on diet, oral hygiene and dental visits using logistic regression. RESULTS: The analysis included 6279 participants with complete data. There were significant socioeconomic inequalities in all health advice provided in dental setting. Those with a higher level of education had significant odds ratios of 1.36 (1.06-1.75), 1.40 (1.15-1.70), and 1.82 (1.47-2.25) for having advice on diet, dental visits and oral hygiene, respectively compared to those with lower education. CONCLUSION: Inequalities in health advice in the dental setting resemble inequalities in oral health. This implies that those who are most likely to need behaviour-related advice do not receive it. Health policies should address the underpinning causes of inequalities in health advice. PRACTICE IMPLICATIONS: Growing evidence supports the importance of health advice given in dental practice. More time and greater resources should be allocated for comprehensive health advice particularly to the socially disadvantaged to reduce inequalities and subsequently promoting health-related behaviours.

Socio-economic status, social support, social network, dental status, and oral health reported outcomes in adolescents.

This study explored the relationships between sex, socio-economic status, social support, social network, dental clinical status, dental pain, oral health-related quality of life (OHRQoL), and self-rated oral health (SROH) in adolescents. A cross-sectional study involving 542 adolescents, aged 12-14 yr, was conducted in Dourados, Brazil, to collect dental clinical measures (dental caries, missing teeth, and dental trauma), as well as measures of social support, social network, dental pain, OHRQoL, and SROH. Information on family income and parental education were collected from participant's parents. Structural equation modeling showed that higher income predicted better dental status and better SROH. Greater social support was linked to better dental status and better OHRQoL. Having more social networks was directly linked to better dental status. Poor dental status was linked to dental pain and poor OHRQoL. Dental pain predicted poor OHRQoL and worse SROH. Poor OHRQoL predicted worse SROH. Family income, social support, and social networks indirectly predicted dental pain via dental status. The latter was indirectly linked to OHRQoL and SROH via dental pain. Social support and social networks indirectly predicted OHRQoL and SROH via dental status and dental pain. Socio-economic factors and social relationships should be considered when planning health promotion and dental care provision to improve an adolescent's oral health.

Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile.

PURPOSE: Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. METHODS: In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments. RESULTS: Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. CONCLUSION: Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.

Using classification and regression tree modelling to investigate response shift patterns in dentine hypersensitivity.

BACKGROUND: Dentine hypersensitivity (DH) affects people's quality of life (QoL). However changes in the internal meaning of QoL, known as Response shift (RS) may undermine longitudinal assessment of QoL. This study aimed to describe patterns of RS in people with DH using Classification and Regression Trees (CRT) and to explore the convergent validity of CRT with the then-test and ideals approaches. METHODS: Data from an 8-week clinical trial of mouthwashes for dentine hypersensitivity (n = 75) using the Dentine Hypersensitivity Experience Questionnaire (DHEQ) as the outcome measure, were analysed. CRT was used to examine 8-week changes in DHEQ total score as a dependent variable with clinical status for DH and each DHEQ subscale score (restrictions, coping, social, emotional and identity) as independent variables. Recalibration was inferred when the clinical change was not consistent with the DHEQ change score using a minimally important difference for DHEQ of 22 points. Reprioritization was inferred by changes in the relative importance of each subscale to the model over time. RESULTS: Overall, 50.7% of participants experienced a clinical improvement in their DH after treatment and 22.7% experienced an important improvement in their quality of life. Thirty-six per cent shifted their internal standards downward and 14.7% upwards, suggesting recalibration. Reprioritization occurred over time among the social and emotional impacts of DH. CONCLUSIONS: CRT was a useful method to reveal both, the types and nature of RS in people with a mild health condition and demonstrated convergent validity with design based approaches to detect RS.

Income inequality and traumatic dental injuries in 12-year-old children: A multilevel analysis.

BACKGROUND/AIM: Contextual socio-economic factors have been associated with traumatic dental injuries (TDIs). However, evidence concerning the role of income inequality on TDIs in children is scarce. The aim of this study was to investigate the association between contextual income inequality over a 10-year period and TDIs in Brazilian children. SUBJECTS AND METHODS: The study population comprised a representative sample of 5027 children aged 12 years who participated in the Brazilian oral health survey in 2010. City-level Gini Index was used to measure contextual income inequality in the years 2000 and 2010, as well as the variation in income inequality between 2000 and 2010. Covariates were gender, ethnicity, family income, number of people per room and incisal overjet. Clinical examinations were used to assess TDIs. Multivariable multilevel ordered multinomial logistic regression was used to estimate cumulative Odds Ratio (OR) and 95% confidence intervals between income inequality and TDIs. RESULTS: The prevalence of children who had one tooth with TDI and two or more teeth with TDIs was 15.2% and 6.4%, respectively. The maxillary central and left lateral incisors were the teeth most affected by TDIs. Gini coefficient reduction between the years 2000 and 2010 decreased the odds of TDIs even after adjustment for demographic and socio-economic characteristics, and incisal overjet. The likelihood of more TDIs decreased 21% for each 0.05 unit decrease in the Gini coefficient between the years 2000 and 2010. Boys, brown skin colour, overcrowding and incisal overjet greater than 5 mm remained statistically associated with TDIs in the final model. CONCLUSIONS: The decrease in income inequality over a 10-year period was inversely associated with TDIs among Brazilian children aged 12 years.

Multimorbidity patterns of oral clinical conditions, social position, and oral health-related quality of life in a population-based survey of 12-yr-old children.

The aim of this study was to describe the patterns of multimorbidities of oral clinical conditions in children. The association between social position and number of oral clinical conditions, and the relationship of social position and number of oral clinical conditions with oral health-related quality of life [OHRQoL, measured using the Brazilian Child-Oral Impacts on Daily Performance (Child-OIDP)] were also investigated. The study analysed data on 7,208 children, 12 yr of age, from the Brazilian Oral Health Survey (SBBrasil Project). Cluster analysis based on the observed/expected (O/E) ratios identified six significant clusters of oral clinical conditions: (i) dental caries and missing teeth; (ii) dental caries and dental trauma; (iii) dental trauma and gingivitis; (iv) dental caries, missing teeth, and dental trauma; (v) dental caries, dental trauma, and gingivitis; and (vi) all oral clinical conditions. Ordinal regression showed that poor social position was associated with a large number of oral clinical conditions. Poisson regression demonstrated that low social position and greater number of oral clinical conditions increased the likelihood of poor OHRQoL (Child-OIDP extent). The four oral clinical conditions clustered into six distinct clusters among Brazilian children. Multimorbidity of oral clinical conditions predicted poor OHRQoL. Social position was of high relevance to multimorbidity of oral clinical conditions and children's OHRQoL.

Síndrome de Moebius. A propósito de un caso / Moebius Syndrome: A Case Report

Anomalía congénita caracterizada por afectación del VI y VII par craneano que determina una parálisis facial, uni o bilateral, aunque el compromiso puede ser más extenso. Se describe paciente masculino de 4 años de edad, obtenido por cesárea, con antecedentes de amenaza de aborto en cuatro oportunidades a partir de la décima semana de gestación; en el período de lactancia presentó dificultad para la succión y deglución. Al examen físico, facies inexpresiva, boca en carpa, parálisis facial bilateral, estrabismo, nistagmos, puente nasal ancho, micronagtia, paladar hendido, pie equino varo bilateral y sindactilia en mano derecha. Se relaciona con eventos y fármacos (misoprostol) que puedan producir una disrupción vascular e insuficiencia placentaria. Se sugiere como causa, la afección hipóxico/isquémica transitoria del feto debido a alteraciones en la circulación materno-fetal durante primer trimestre de embarazo, por amenaza de aborto y probablemente exposición a teratógenos como el misoprostol.

Congenital anomaly characterized by involvement of the VI and VII cranial nerve that causes a bilateral facial paralysis, or uni, but the commitment may be longer. Is described, male patient aged 4, obtained by cesarean section with a history of threatened abortion four times from the tenth week of pregnancy; in lactancy, presented difficulty in sucking and swallowing. On physical examination, expressionless face, mouth in tents, bilateral facial paralysis, strabismus, nystagmus, broad nasal bridge, micrognathia, cleft palate, clubfoot and bilateral syndactyly in right hand. It relates to events and drug (misoprostol) that produce vascular disruption and placental insufficiency. In this patient had been suggested as a cause transient hypoxic / ischemic disease of the fetus due to alterations in maternal-fetal circulation during early pregnancy, threatened abortion and likely exposure to teratogens such as misoprostol.

Derivation of a short form of the Dentine Hypersensitivity Experience Questionnaire.

AIM: To derive and evaluate a short form of the Dentine Hypersensitivity Experience Questionnaire. METHODS: Data from three previous studies of dentine hypersensitivity (n = 353) were pooled and randomly divided into half. Ten- and 15-item short forms were derived in the first half of the data using the item impact and regression methods. The four short forms were evaluated in the second half. RESULTS: The 10 and 15-item versions of the regression short form detected impacts in 37% and 61% of participants, respectively, compared to 68% and 93% using the item impact method. All short forms had internal consistency (Cronbach's α) >0.84 and test-retest reliability (ICC) >0.89. All correlated with the long form (all r > 0.93, p < 0.001) and with the effect of the mouth on everyday life (all r ≥ 0.73, p < 0.001). None of the short forms detected a treatment effect in two trials although all four showed a tendency to detect an effect in a trial where the long form had done so. CONCLUSIONS: The 15-item short form derived with the item impact method performed better than other short forms and appears to be sufficiently robust for use in individual patients.