Nocturnal sleep architecture is altered by sleep bruxism.

OBJECTIVE: Sleep is a complex behaviour phenomenon essential for physical and mental health and for the body to restore itself. It can be affected by structural alterations caused by sleep bruxism. The aim of this study was to verify the effects of sleep bruxism on the sleep architecture parameters proposed by the American Academy of Sleep Medicine. DESIGN: The sample comprised 90 individuals, between the ages of 18 and 45 years, divided into two groups: with sleep bruxism (n=45) and without sleep bruxism (n=45). The individuals were paired by age, gender and body mass index: a polysomnography was performed at night. RESULTS: Statistically significant differences were found between (P≤0.05) individuals with sleep bruxism and individuals without sleep bruxism during total sleep time (P=0.00), non-rapid eye movement (NREM) total sleep time (P=0.03), NREM sleep time stage 3 (P=0.03), NREM sleep latency (P=0.05), sleep efficiency (P=0.05), and index of microarousals (P=0.04). CONCLUSIONS: Sleep bruxism impairs the architecture of nocturnal sleep, interfering with total sleep time, NREM sleep latency, and sleep efficiency.

Avaliação do impacto de fatores socioeconômicos e acesso aos serviços de saúde bucal na prevalência de cárie dentária em crianças

Objetivo: esta pesquisa objetiva avaliar a relação dos fatores socioeconômicos na ocorrência de cárie dentá -ria e analisar o impacto da implantação da Equipe de Saúde Bucal (ESB), comparando a necessidade de tratamento odontológico para cárie dentária de crianças acompanhadas com crianças não adscritas pela ESB, em uma população de crianças de 1 a 70 meses (0 a 5 anos). Sujeitos e método: trata-se de um estudo quantitativo analítico que compreende o levantamento de dados socioeconômicos e de condições de saúde bucal de 150 crianças de 0 a 5 anos. Os sujeitos foram avalia-dos por um cirurgião-dentista calibrado os índices ceo-d e de necessidade de tratamento odontológico, bem como realizada entrevista com os pais ou responsáveis dos indivíduos para averiguação de dados acerca de alfabetização do chefe de família, abastecimento de água, renda familiar, número de pessoas no domicílio e renda per capita. Os indivíduos foram divididos em dois grupos, G1 (acesso à ESB) e G2 (não acesso). Resultados: a maioria das crianças avaliadas reside em domicílios com chefes de família alfabetizados e tem acesso ao abastecimento de água pela rede pública. O ceo-d médio de toda a amostra foi de 1,17 e a média do número de dentes com necessidade de tratamento foi de 0,74; 77% das crianças avaliadas apresentaram ceo-d igual a 0. Não houve diferenças estatisticamente significativas entre o ceo-d dos dois grupos, contudo, o G1 apresentou um menor índice de necessidade de tratamento odontológico. Conclusões: a inclusão de ESB diminui as necessidades de tratamento odontológico, sendo recomendada, especialmente, à crianças com piores índices socioeconômicos.

Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism.

OBJECTIVE: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. METHODS: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. RESULTS: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of "probable SB" were associated with the worst sensitivity (16%, 18%, 22%, respectively). CONCLUSIONS: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and--although they do not attain diagnostic values high enough to replace the current gold standard (PSG)--should be used as a screening tool to identify SB.

[The use of dental services among preschool children: a population-based study]. / Uso de serviços odontológicos entre pré-escolares: estudo de base populacional.

The prevalence and factors associated with the use of dental services in a representative, probabilistic, complex sample with two-stage clusters of preschoolers aged 18 to 36 months was estimated. Structured questionnaires were answered by parents/guardians and the preschoolers were assessed by trained and qualified dental surgeons. In the analysis the corrections for the design effect were considered and the magnitudes of the associations based on logistic regression (OR/IC 95%) were estimated. 809 preschool children were evaluated, 15.5% of which had used dental services. Being older (3.27/1.71-6.24), having higher per capita income (2.65/1.50-4.65), having their own house (1.83/104 -3.23), having access to preventive oral health information (5.44/3.00-9.86), flossing (2.75/1.50-5.02) established higher odds of the use of these service. Not having the experience of caries (0.22/0.13- 0.38) and not having basic lesions in soft tissues (0.10/0.01-0.77) reduced these odds. The prevalence of the use of dental services was low, indicating the need for greater provision of such services and the broadening of preventive actions and health promotion and the greater the odds of use among those with better socio-economic conditions suggests inequality.

Uso de serviços odontológicos entre pré-escolares: estudo de base populacional / The use of dental services among preschool children: a population-based study

Estimou-se a prevalência e fatores associados ao uso de serviços odontológicos, em uma amostra probabilística, complexa, por conglomerados em dois estágios de pré-escolares com 18 a 36 meses de idade. Questionários estruturados foram aplicados aos pais/responsáveis, os pré-escolares foram avaliados por cirurgiões-dentistas treinados e calibrados. Nas análises foram consideradas as correções pelo efeito de desenho e estimaram-se as magnitudes das associações a partir de regressão logística (OR/ IC95%). Foram avaliados 809 pré-escolares, 15,5% havia usado serviço odontológico. Ser mais velho (3,27/1,71-6,24), ter maior renda per capita (2,65/1,50-4,65), ter moradia própria (1,83/1,04-3,23), ter acesso a informações preventivas de saúde bucal (5,44/3,00-9,86), usar fio dental (2,75/1,50-5,02) ocasionaram chances mais elevadas de uso desses serviços. Não possuir experiência de cárie (0,22/0,13-0,38) e não apresentar lesões fundamentais em tecidos moles (0,10/0,01-0,77) ocasionaram menores chances. A prevalência do uso de serviços odontológicos foi baixa, indicando a necessidade de maior oferta desses serviços e a ampliação de ações preventivas e de promoção de saúde. A maior chance de usos entre aqueles com melhores condições socioeconômicas sugere iniquidade.

The prevalence and factors associated with the use of dental services in a representative, probabilistic, complex sample with two-stage clusters of preschoolers aged 18 to 36 months was estimated. Structured questionnaires were answered by parents/guardians and the preschoolers were assessed by trained and qualified dental surgeons. In the analysis the corrections for the design effect were considered and the magnitudes of the associations based on logistic regression (OR/IC 95%) were estimated. 809 preschool children were evaluated, 15.5% of which had used dental services. Being older (3.27/1.71-6.24), having higher per capita income (2.65/1.50-4.65), having their own house (1.83/104 -3.23), having access to preventive oral health information (5.44/3.00-9.86), flossing (2.75/1.50-5.02) established higher odds of the use of these service. Not having the experience of caries (0.22/0.13- 0.38) and not having basic lesions in soft tissues (0.10/0.01-0.77) reduced these odds. The prevalence of the use of dental services was low, indicating the need for greater provision of such services and the broadening of preventive actions and health promotion and the greater the odds of use among those with better socio-economic conditions suggests inequality.

Non syndromic cleft lip and palate: relationship between sex and clinical extension.

UNLABELLED: Cleft lip and/or palate represent the most common congenital anomaly of the face. AIM: To describe the correlation between non-syndromic cleft lip and/or palate and gender, and its severity in the Brazilian population. METHODS: Cross-sectional study, between 2009 and 2011, in a sample of 366 patients. The data was analyzed with descriptive statistics and multinomial logistic regression with a 95% interval to estimate the likelihood of the types of cleft lip and/or palate affecting the genders. RESULTS: Among the 366 cases of non-syndromic cleft lip and/or palate, the more frequent clefts were cleft lip and palate, followed respectively by cleft lip and cleft palate. The cleft palates were more frequent in females, while the cleft lip and palate and cleft lips only predominated in males. The risk of cleft li in relation the cleft palate was 2.19 times in males when compared to females; while the risk of cleft lip and palate in relation to cleft palate alone was 2.78 times in males compared to females. CONCLUSION: This study showed that there were differences in the distribution of the non-syndromic cleft lip and/or palate between males and females.

Fissuras lábio palatinas não sindrômicas: relação entre o sexo e a extensão clínica / Non sindromic cleft lip and palate: relationship between sex and clinical extension

A fenda labial e/ou palatina representa a anomalia congênita mais comum na face. OBJETIVO: Descrever a correlação existente entre a fenda labial e/ou palatina não sindrômica e gênero e sua gravidade na população brasileira. MÉTODO: Estudo transversal, conduzido entre 2009 e 2011, em uma amostra de 366 pacientes. Os dados foram analisados com estatística descritiva e regressão logística multinomial com intervalo de 95% para estimar a probabilidade dos tipos de fenda labial e/ou palatina afetar os gêneros. RESULTADOS: Entre os 366 casos de fenda labial e/ou palatina não sindrômica, as fendas mais frequentes foram a fenda lábio-palatina, seguida, respectivamente, pela fenda labial e fenda palatina. As fendas palatinas foram mais frequentes entre as mulheres e a fenda lábio-palatina e fenda labial apenas predominaram nos homens. O risco de fenda labial em relação à fenda palatina foi de 2,19 vezes maior em homens quando comparados às mulheres; enquanto o risco de fenda labial e palatina em relação à fenda palatina apenas foi 2,78 vezes em homens, quando comparados às mulheres. CONCLUSÃO: Este estudo mostrou que há diferenças na distribuição de fendas labiais e/ou palatinas não sindrômicas entre homens e mulheres.

Cleft lip and/or palate represent the most common congenital anomaly of the face. AIM: To describe the correlation between non-syndromic cleft lip and/or palate and gender, and its severity in the Brazilian population. METHODS: Cross-sectional study, between 2009 and 2011, in a sample of 366 patients. The data was analyzed with descriptive statistics and multinomial logistic regression with a 95% interval to estimate the likelihood of the types of cleft lip and/or palate affecting the genders. RESULTS: Among the 366 cases of non-syndromic cleft lip and/or palate, the more frequent clefts were cleft lip and palate, followed respectively by cleft lip and cleft palate. The cleft palates were more frequent in females, while the cleft lip and palate and cleft lips only predominated in males. The risk of cleft li in relation the cleft palate was 2.19 times in males when compared to females; while the risk of cleft lip and palate in relation to cleft palate alone was 2.78 times in males compared to females. CONCLUSION: This study showed that there were differences in the distribution of the non-syndromic cleft lip and/or palate between males and females.