Does the liner material influence pulpal vitality in deep carious cavities submitted to selective caries removal? A network meta-analysis review.

OBJECTIVES: To evaluate whether the restorative material in direct contact with the dentin influences pulp vitality in primary and permanent teeth with deep carious lesions restored after selective caries removal (SCR). MATERIAL AND METHODS: Systematic searches of databases MEDLINE via PubMed, Scopus and ISI Web of Science were performed for primary and permanent teeth. Inclusion criteria were applied for title and abstract reading of databases search results. After full texts review of included studies, those that did not meet exclusion criteria were excluded from meta-analysis. RESULTS: For meta-analysis, 2 studies were included for permanent teeth and 6 for primary teeth. The failure events reported were meta-analyzed using two statistical methods: standard pairwise meta-analysis (SPMA) and network meta-analysis (NMA). The SPMA identified similar failure occurrence of restorations performed with calcium hydroxide (CH) and other liner materials (RR 0.84, 95% CI 0.41, 1.74; p = 0.64), no significant difference between the use of alternative liners or CH regardless deciduous or permanent teeth (RR 0.79, 95% CI 0.36, 1.71; p = 0.55) and similar risk of failing at different follow-ups for all liner materials tested (RR 0.77, 95% CI 0.35, 1.70; p = 0.52). Probabilistic analysis indicated GIC as liner material with the highest probability of clinical success (SUCRA = 72.76%), and CH ranked as the worst liner material (SUCRA = 21.81%). CONCLUSION: Pulpal vitality was not affected by material used as liner after selective caries removal in deep carious cavities. CLINICAL RELEVANCE: Current clinical evidence supports the weak recommendation to not use calcium hydroxide as liner after SCR.

Social capital and possible bruxism during the COVID-19 pandemic among Brazilian undergraduates.

This study investigated the prevalence of possible bruxism and its association with social capital among undergraduates during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was conducted at a private university in Southern Brazil. Data were collected through a self-administered electronic questionnaire (Google Forms). Possible bruxism was measured using the following question: "Do you grind your teeth or clench your jaws?". Social capital was evaluated using individual social networks. Data on self-perceived oral health, anxiety, sociodemographics, and information related to university graduates were also collected. Adjusted logistic regression models with a hierarchical approach were used to evaluate associations. The results are presented as odds ratios (ORs) and 95% confidence intervals (95%CIs). Altogether, 345 undergraduates participated in the study, with a mean age of 21.8 years (standard deviation = 5.21). The prevalence of bruxism in the sample was 57.1%. Undergraduates with low social capital had 2.06 times greater odds of bruxism than their counterparts (OR 2.06; 95%CI 1.11-3.83). Female undergraduates (OR 2.40, 95%CI 1.39-4.12), those who were in the final year of university (OR 1.13, 95%CI 1.04-1.21), and those who perceived they needed dental treatment (OR 1.91; CI: 1.21-3.02) also had greater odds of possible bruxism. In conclusion, the prevalence of possible bruxism was high among undergraduate students during the COVID-19 pandemic and associated with lower social capital levels. Knowledge of these factors is important to identify risk groups and plan strategies to control bruxism in this population.

Oral health-related quality of life in Brazilian children, adolescents, and young adults undergoing cancer treatment.

Introduction: Cancer is considered a major public health problem worldwide and may have an important impact on oral health-related quality of life (OHRQoL). Thus, the present study aimed to assess OHRQoL in Brazilian patients aged 3 to 21 years undergoing cancer treatment. Materials and Methods: In total, 121 patients receiving cancer treatment and 363 healthy individuals (control group) were evaluated. OHRQoL was assessed using an age-specific questionnaire, that is, the Brazilian versions of the Early Childhood Oral Health Impact Scale (ECOHIS), the Child Perceptions Questionnaire (CPQ) 11-14-short version, the CPQ 8-10-short version, and the short-form of Oral Health Impact Profile Questionnaire-14 (OHIP-14). Results: Individuals from the control group who were evaluated by the ECOHIS presented more impact on the OHRQoL regarding the psychological and family function score, as well as those evaluated by CPQ 8-10, who presented more impact in general. However, considering CPQ 11-14, cancer patients had their OHRQoL more affected, as shown in both the total questionnaire score and oral symptoms score. Conclusion: Within the limitations of this Brazilian study, cancer treatment seems to be associated with decreased OHRQoL only in patients aged between 11 and 14 years. However, children without cancer aged between 8 and 10 years seem to experience worse OHRQoL.

Social capital and possible bruxism during the COVID-19 pandemic among Brazilian undergraduates

Abstract This study investigated the prevalence of possible bruxism and its association with social capital among undergraduates during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was conducted at a private university in Southern Brazil. Data were collected through a self-administered electronic questionnaire (Google Forms). Possible bruxism was measured using the following question: "Do you grind your teeth or clench your jaws?". Social capital was evaluated using individual social networks. Data on self-perceived oral health, anxiety, sociodemographics, and information related to university graduates were also collected. Adjusted logistic regression models with a hierarchical approach were used to evaluate associations. The results are presented as odds ratios (ORs) and 95% confidence intervals (95%CIs). Altogether, 345 undergraduates participated in the study, with a mean age of 21.8 years (standard deviation = 5.21). The prevalence of bruxism in the sample was 57.1%. Undergraduates with low social capital had 2.06 times greater odds of bruxism than their counterparts (OR 2.06; 95%CI 1.11-3.83). Female undergraduates (OR 2.40, 95%CI 1.39-4.12), those who were in the final year of university (OR 1.13, 95%CI 1.04-1.21), and those who perceived they needed dental treatment (OR 1.91; CI: 1.21-3.02) also had greater odds of possible bruxism. In conclusion, the prevalence of possible bruxism was high among undergraduate students during the COVID-19 pandemic and associated with lower social capital levels. Knowledge of these factors is important to identify risk groups and plan strategies to control bruxism in this population.

Endemic dental fluorosis in children from a brazilian slave-descendent community: a cross-sectional study / Fluorose dentária endêmica em crianças de uma comunidade quilombola brasileira: um estudo transversal

Although fluoride (F) is required for the normal growth and development of several human organs and tissues, excessive exposure to it may be potentially toxic. Groundwater may present ranging levels of F; however, the appearance, taste, and smell are not altered. Thus, the present study aimed to evaluate dental fluorosis in children from a Brazilian slave-descendent community, as well as to assess F levels in the drinking water supplies available in that area. For that, 21 children aged from 6 to 14 years living in Rincão dos Martimianos were invited to participate. Thylstrup and Fejerskov index (a 0­9 scale) was used to assess dental fluorosis on permanent teeth. Furthermore, the F concentration of two water samples (from the artesian well and a tank) was determined by using a potentiometric method. All children presented dental fluorosis to some degree, ranging from score 2 to 9. About 81% of them had dental fluorosis scores equal to or over 5. Scores lower than 5 were observed only in children younger than 8 years; on the other hand, all children older than 8 years presented scores higher than 5. Moreover, artesian well water had an F concentration of 5 mg/L and tank water 0.8 mg/L. It is suggested that the F-rich groundwater supply was most probably responsible for dental fluorosis in that area. Brazilian slave-descendent communities, therefore, should receive constant attention from their local authorities in order to guarantee a proper water supply for consumption, as well as to provide public health education(AU)

Embora o flúor (F) seja necessário para o crescimento e desenvolvimento normal de vários órgãos e tecidos humanos, a exposição excessiva pode ser potencialmente tóxica. As águas subterrâneas podem apresentar níveis variados de F; no entanto, a aparência, o sabor e o cheiro não são alterados. Desta forma, o presente estudo teve como objetivo avaliar a fluorose dentária em crianças de uma comunidade brasileira descendente de escravos, bem como avaliar os níveis de F na água potável disponível nessa área. Para isso, 21 crianças de 6 a 14 anos residentes no Rincão dos Martimianos foram convidadas a participar da pesquisa. O índice de Thylstrup e Fejerskov (uma escala de 0 a 9) foi usado para avaliar a fluorose dentária em dentes permanentes. Além disso, a concentração de F de duas amostras de água (do poço artesiano e de um tanque) foi determinada pelo método potenciométrico. Todas as crianças apresentaram algum grau de fluorose dentária, variando de 2 a 9. Cerca de 81% delas apresentaram escores de fluorose dentária iguais ou superiores a 5. Escores inferiores a 5 foram observados apenas em crianças menores de 8 anos; por outro lado, todas as crianças maiores de 8 anos apresentaram escores superiores a 5. Além disso, a água do poço artesiano tinha concentração de F de 5 mg/L e a água do tanque 0,8 mg/L. Desta forma, acredita-se que a fonte de água subterrânea rica em F foi provavelmente responsável pela fluorose dentária na região avaliada. As comunidades quilombolas brasileiras, portanto, devem receber atenção constante de suas autoridades locais, a fim de garantir o abastecimento adequado de água para consumo, bem como proporcionar educação em saúde pública(AU)

Associação entre idade na primeira consulta odontológica e tipo de tratamento dentário realizado em pacientes infantis: estudo transversal / Association between age of the first dental visit and type of dental treatment performed in infant patients: a cross-sectional study

Objetivo: Avaliar a associação entre idade na primeira consulta odontológica e o tipo de tratamento dentário realizado em pacientes infantis por meio de um estudo transversal que avaliou registros em prontuários odontológicos. Métodos: A coleta de dados foi realizada por meio de prontuários de pacientes de 0-5 anos atendidos em uma Clínica Escola de Odontologia, de março de 2014 a julho de 2018, com registro de informações referentes às características dos participantes e procedimentos odontológicos realizados. Para a análise dos dados, foram calculadas medidas descritivas e posteriormente os dados foram ajustados em um modelo de regressão logística; o desfecho foi o tipo de procedimento realizado, dicotomizado em tratamentos não-invasivos (fluorterapia e/ou restauração) e invasivos (endodontia e/ou exodontia). Resultados: Foram avaliados prontuários de 210 crianças, com média de idade na primeira consulta de 38 meses (DP=14,5). Fluorterpia e/ou restauração foram realizados em 74,8% das crianças, enquanto tratamentos invasivos foram realizados em 25,2% da amostra. A análise ajustada indicou um incremento (OR = 1,03, p = 0,027) na chance de realização de tratamentos invasivos com o aumento da idade das crianças na primeira consulta odontológica. Conclusão: Quanto maior a idade das crianças na primeira consulta, maior a chance de terem recebido um tratamento invasivo. Ressalta-se a importância da consulta odontológica nos primeiros meses de vida, com a finalidade de prevenção e manutenção da saúde bucal.(AU)

Objective: To evaluate the association between the age of the first dental visit and the type of dental treatment performed in infant patients through a cross-sectional study that examined dental records from the years 2014 to 2018. Methods: Data collection was conducted using medical records of patients aged 0 to 5 years treated at a Dental School Clinic, including information about participants' characteristics and the types of dental procedures performed. For data analysis, descriptive measures were calculated, and the data were subsequently fitted into a logistic regression model. The outcome was categorized into non-invasive treatments (fluoridation therapy and/or restoration) and invasive treatments (endodontics and/or extraction). Results: Medical records of 210 children were evaluated, with a mean age of the first dental visit being 38 months (SD = 14.5). Non-invasive treatments, including fluoride therapy and/or dental restoration, were performed in 74.8% of children, while invasive treatments were performed in 25.2% of the sample. Adjusted analysis indicated an increase (OR = 1.03, p = 0.027) in the odds of undergoing invasive treatments as the children's age at the first dental visit increased. Conclusion: Older age at the first appointment was associated with increased odds of receiving invasive treatment. The significance of early dental consultations within the first months of life is underscored, aiming to prevent and maintain oral health.(AU)

Oral health and happiness in adolescents: A cohort study.

OBJECTIVES: To investigate the influence of oral health conditions, socioeconomic status and dental care utilization on subjective happiness and identify the factors associated with changes in happiness among adolescents. METHODS: Data were collected in 2012 and 2014. Oral health conditions were evaluated by performing clinical examinations; socioeconomic status and dental care utilization were assessed by using a questionnaire. The participants answered the Child Perceptions Questionnaire 11-14 for the evaluation of the impact of these variables on oral health-related quality of life (OHRQoL). Happiness was assessed using the Brazilian version of the Subjective Happiness Scale. For longitudinal data analysis, a mixed-effect model of linear regression was used to assess the factors related to happiness and multinomial logistic regression to appraise prospective changes in happiness. RESULTS: A total of 1134 12-year-old adolescents were examined at baseline (response rate: 93%), and 770 were reevaluated after 2 years (retention rate: 68%). The adolescents who lived in households with lower equivalized income and greater overcrowding, had not visited the dentist in the later 6 months, had a higher number of cavitated carious lesions, and reported a higher impact on OHRQoL in 2012 presented lower happiness levels. Additionally, the adolescents with a higher number of decayed, missing or filled teeth and who reported a higher impact on OHRQoL were more likely to belong to the most unfavourable happiness trajectory categories. CONCLUSIONS: The presence of dental caries, socioeconomic conditions, dental care utilization and OHRQoL influence happiness in adolescents. Having more teeth affected by dental caries and worse self-perception in early adolescence can lead to a decrease in happiness.

Avaliação do nível de percepção de cirurgiões-dentistas das redes pública e privada de um município do norte do Rio Grande do Sul sobre atenção em saúde a pacientes com necessidades especiais / Assessment dentists level of perception in public and private service of a city in the north of Rio Grande do Sul about health care for patients with special needs

Objetivo: identificar a percepção de cirurgiões-dentistas das redes pública e privada do município de Erechim, RS, sobre atenção em saúde a pacientes com necessidades especiais, avaliando conhecimento, preparo e limitações para o atendimento odontológico. Métodos: este estudo de caráter transversal ocorreu no período de março a agosto de 2019, por meio da aplicação de questionário próprio semiestruturado para cirurgiões-dentistas. Resultados: participaram da pesquisa 82 cirurgiões-dentistas, sendo a maioria (58,54%) atuantes na rede privada; 56,10% não cursaram uma disciplina específica em sua graduação sobre cuidados a pacientes com necessidades especiais. Em contrapartida, dos que cursaram, para a maioria, a disciplina era obrigatória e teórico-prática. Conclusão: apesar de somente 42,68% se sentirem muito bem ou bem preparados, somente 10,98% nunca realizaram atendimentos. Mesmo não tendo cursado uma disciplina específica em sua graduação, os cirurgiões-dentistas de Erechim, RS, realizam o atendimento e, quando necessário, o encaminhamento desses pacientes. Por manifestarem o interesse em se manterem atualizados sobre o tema, ações de educação continuada serão de fundamental importância.(AU)

Objective: assess dentists perception, about oral health care for patients with special needs, of public and private service of Erechim, RS, evaluating their knowledge, preparation and limitations for dental care. Methods: this cross-sectional research was conducted from March to August 2019, using questionnaires for dentists. Results: eighty-two dentists participated in the research, the majority (58.54%) are from the private service, 56.10% did not attend a specific discipline, in their graduation, about dental care for patients with special needs. In contrast, for those who attended, the discipline was compulsory and theoretical- -practical. Conclusion: although only 42.68% feel very well, or well prepared, only 10.98% never attended dental care. Even though they did not attend a specific discipline in their graduation, the dentists of Erechim, RS, perform dental care and, when necessary, they referral these patients. As they express their interest in keeping up to date on the topic, continuing education actions will be of fundamental importance.(AU)

Efeito in vitro da laserterapia e da terapia fotodinâmica na redução de bactérias presentes em canais radiculares / In vitro effect of lasertherapy and photodynamic therapy in bacterial reduction presents in root canals

Este estudo tem por objetivo verificar in vitro o efeito bactericida da laserterapia e da terapia fotodinâmica com laser de baixa potência (660 nm e 808 nm) em bactérias presentes nos canais radiculares. Métodos: foram preparadas 60 placas de Petri com bactérias: 20 placas com Enterococcus faecalis, 20 placas com Staphylococcus aureus e 20 com Pseudomonas aeruginosa. Aleatoriamente, dividiu-se cada grupo em 10 subgrupos (duas placas cada): três subgrupos tratados com laserterapia 660 nm em doses de 150, 225 e 300J/ cm², três subgrupos tratados com terapia fotodinâmica (azul de metileno 0,2% e laser 660 nm) em doses de 150, 225 e 300J/cm²; um subgrupo tratado com laserterapia 808 nm na dose de 225J/cm², um subgrupo com terapia fotodinâmica e laser 808 nm, em dose 225J/cm²; um subgrupo tratado apenas com fotossensibilizante (FS), e um não tratado (controle). Os tratados com laserterapia e terapia fotodinâmica foram irradiados uma única vez e incubados por 24 horas. Os últimos dois não receberam irradiação. As culturas foram analisadas visualmente para verificação do halo de inibição. Nos grupos submetidos somente à laserterapia, para o grupo FS e para o grupo controle, não foram observados halos de inibição, já onde houve aplicação da TFD, tanto com L1 quanto com L2, observaram-se halos de inibição em todas as espécies bacterianas estudadas. Conclui-se que a laserterapia, não produziu efeitos bactericidas e/ou bacteriostáticos, enquanto a terapia fotodinâmica nos dois comprimentos de onda produziu halos significativos de inibição de crescimento nas três bactérias do estudo.(AU)

This study aims to verify in vitro the bactericidal effect of laser therapy and photodynamic therapy with low power laser (660 nm and 808 nm), in bacteria present in the root canals.Methods: 60 Petri dishes were prepared with bacteria: 20 plates with Enterococcus faecalis, 20 plates with Staphylococcus aureus and 20 with Pseudomonas aeruginosa. At random, each group was divided into 10 subgroups (two plates each): three subgroups treated with 660nm laser therapy at doses of 150, 225 and 300J / cm², three subgroups treated with photodynamic therapy, (0.2% methylene blue and laser 660nm) in doses of 150, 225 and 300J / cm²; a subgroup treated with 808nm laser therapy at a dose of 225J / cm², a subgroup with (photodynamic therapy and 808nm laser) at a dose of 225J / cm²; a subgroup treated only with photosensitizer(FS), and an untreated (control). Those treated with laser therapy and photodynamic therapy were irradiated only once and incubated for 24 hours. The last two received no radiation. The cultures were analyzed visually to check the inhibition zone. In the groups submitted to laser therapy only, for the FS group and for the Control group, no inhibition halos were observed, since PDT was applied, with both L1 and L2, inhibition halos were observed in all studied bacterial species. It was concluded that laser therapy did not produce bactericidal and / or bacteriostatic effects, while photodynamic therapy at both wavelengths produced significant growth inhibition halos in the three studied bacteria.(AU)

Fatores associados à experiência de cárie e qualidade de vida relacionada à saúde bucal em escolares / Factors associated with caries experience and oral health-related quality of life in schoolchildren

Objetivo: avaliar a associação do nível socioeconômico da família e o grau de conhecimento dos pais sobre saúde bucal e a experiência de cárie e qualidade de vida relacionada à saúde bucal de escolares de 12 anos no município de Estação, RS. Métodos: a partir de um levantamento epidemiológico, 50 crianças (taxa de resposta: 81%) foram avaliadas por meio de exame clínico bucal, utilizando como critério de diagnóstico o índice de dentes permanentes cariados, perdidos e obturados (CPO-D), e entrevista estruturada, utilizando a versão brasileira reduzida do Child Perceptions Questionnaire 11-14 (CPQ 11-14), para medir o impacto das condições de saúde bucal na qualidade de vida. Os responsáveis responderam um questionário sobre condição socioeconômica da família, procura por atendimento odontológico e conhecimentos sobre saúde bucal. Foram considerados três desfechos distintos: experiência de cárie, presença de cárie não tratada e a severidade do CPQ 11-14. Resultados: a prevalência de cárie foi de 46%; desses, 24% possuíam pelo menos um dente com cavidade de cárie não tratada. A experiência de cárie e presença de lesões não tratadas foram associadas a fatores psicológicos, como a autopercepção em saúde bucal, e fatores socioeconômicos (possuir plano de saúde e tipo de serviço odontológico utilizado). Além disso, a autopercepção também se mostrou associada a fatores socioeconômicos e ao conhecimento dos pais sobre saúde bucal. Conclusão: fatores psicossociais, nível econômico da família e conhecimentos dos pais sobre saúde bucal estão associados à ocorrência de cárie e ao maior impacto na qualidade de vida em escolares.(AU)

Objective: this study assessed the association of the socioeconomic status of families and the knowledge of parents regarding oral health in caries experience, as well as the oral health-related quality of life of 12-year-old schoolchildren in the city of Estação, RS, Brazil. Methods: an epidemiological survey included the assessment of 50 children (response rate: 81%) through clinical oral examinations using the index of permanent decayed, missed and filled teeth (DMF-T) as diagnostic criterion. Structured interviews were also conducted using the Brazilian short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14) to measure the impact of oral health conditions on quality of life. The parents answered a questionnaire about the socioeconomic status of the family, search for dental care, and oral health knowledge. Three different outcomes were considered: caries experience, presence of untreated caries, and severity of CPQ11-14. Results: The prevalence of caries was 46% from which 24% presented at least one tooth with an untreated cavity. Caries experience and the presence of untreated caries were associated with psychological factors (oral health self-perception) and socioeconomic factors (having health insurance and type of dental service used). In addition, oral health self-perception was associated with socioeconomic factors and the knowledge of parents on oral health. Conclusion: psychosocial factors, economic status of the family, and the knowledge of parents on oral health are associated with the occurrence of caries and the higher impact on the quality of life in schoolchildren.(AU)

Saúde bucal e grau de felicidade em adolescentes de uma cidade no sul do Brasil: análise longitudinal / Oral health and subjective happiness in adolescents of a Southern Brazilian town longitudinal analysis

Felicidade é um constructo multidimensional que pode ser definido como ograu em que uma pessoa avalia a qualidade geral de sua vida como favorável; ela tem sido associada com vários desfechos e medidas de saúde. A transição da infância para a adolescência envolve uma série de mudanças físicas e especialmente psicológicas, e oimpacto das doenças bucais pode ser percebido como um obstáculo para o desenvolvimento social dos indivíduos.Osobjetivos do presente trabalho foram estudar a influência das condições de saúde bucal, condição socioeconômica e uso de serviços no grau de felicidade durante o período de transição da infância para a adolescência;identificar os fatores associados à mudança do grau de felicidade e avaliar o incremento dos problemas de saúde bucal na amostra após 2 anos de acompanhamento. A coleta de dados ocorreu em 2 momentos, nos anos de 2012 e 2014. Foram feitos exames clínicos para avaliar as condições de saúde bucal (cárie dentária, má oclusão, traumatismo dentário e condição gengival), entrevistas para avaliar o grau de felicidade (medido com a Escala Subjetiva de Felicidade-SHS) e o impacto das condições de saúde bucal na qualidade de vida (medido com o Child Perceptions QuestionnaireCPQ11-14), além de questionários enviados aos responsáveis para avaliar a condição socioeconômica da família, variáveis demográficas e de uso de serviços dacriança. Para a análise dos fatores relacionados ao grau de felicidadefoi utilizado um modelo linear multinível para medidas repetidas ao longo do tempo, comentrada de variáveis hierarquizada de acordo com um modelo conceitual; para análise dos fatores associados à mudança no grau de felicidadefoi utilizada regressão logística multinomial.Das 1134 crianças examinadas no baseline, 770 foram reavaliadas após 2 anos(taxa de resposta de 67,9 por cento), e foi observado um aumento na prevalência de problemas bucais (experiência de cárie, prevalência de má oclusão, prevalência de sangramento e placa dental). O modelo multinível final foi composto por variáveis socioeconômicas da família, pelo uso de serviços e pelas condições clínicas de saúde bucal e autopercepção.Adolescentes de famílias com menor renda(p=0,030), que viviam em residências com maior aglomeração(p<0,001), cujas mães tinham um menor nível de escolaridade(p=0,014), que utilizavam o serviço odontológico por motivos de dor ou em busca de tratamentos(p=0,039), que possuíam um número maior de dentes com cavidades de cárie não tratada(p=0,010)e que relatavam maior impacto das condições de saúde bucal na qualidade de vida (p<0,001)apresentaram um pior grau de felicidade. O modelo multinomial final indicou uma associação entre experiência de cárie e autopercepção e a mudança no grau de felicidade: adolescentes com um maior número de dentes cariados, perdidos ou obturados (OR=1,16-1,19, p=0,018-0,037) e com escores mais altos no CPQ11-14 (OR=1,04-1,07, p=0,000-0,014) tinham uma maior chance de pertencer às categorias mais desfavoráveis de trajetória de felicidade. Esses resultados evidenciam a importância de políticas públicas inclusivas e promoção de saúde bucal para o desenvolvimento psicossocial de adolescentes

Happiness is a multidimensional construct and can be defined as the degree to which a person evaluates the quality of his life as a whole as favorably; It has been associated with several health outcomes and measures. The transition from childhood to adolescence involves a number of physical and especially psychological changes, and the impact of oral diseases can be perceived as an obstacle to the social development of individuals. The objectives of this paper were to investigate the influence of oral health conditions, socioeconomic status and use of dental services on subjective happiness during the transition from childhood to adolescence; to identify the factors associated with the change in the perception of happiness and to evaluate the incidence of oral health problems in the sample after 2 years of follow-up. Data collection was performed at two periods, in 2012 and 2014. Clinical examinations were performed to evaluate oral health conditions (dental caries, malocclusion, dental trauma and gingival condition), interviews were conducted to evaluate the subjective happiness (using the Subjective Happiness Scale -SHS ) and the impact of oral health conditions on quality of life (using the Child Perception Questionnaire -CPQ11-14), questionnaires were sent to the parents to assess socioeconomic family characteristics, demographic variables and the use of dental services. To analyse the factors associated with the subjective happiness, data were fitted into a linear multilevel model for repeated measures and hierarchical selection of variables; to analyze the factors associated with changes in happiness, data were fitted into a multinomial logistic model. From 1134 children examined in the baseline, 770 were reevaluated after 2 years (response rate of 67.9 per cent), and it was observed an increase in the prevalence of oral health conditions (experience of dental caries, prevalence of malocclusion, gingival bleeding and dental plaque). In the multilevel model, following adjustment, there was an association between the mean score of SHS and socioeconomic variables, the use of dental services, clinical conditions and self-perception. Adolescents from lower income families (p = 0.030), who lived in households with worse overcrowding (p<0.001), whose mothers had lower levels of education (p = 0.014), who used dental services due to pain or to seek dental treatment (p= 0.039), which had a higher number of cavitated caries lesions (p = 0.010) and who reported higher impact of oral health conditions on quality of life (p <0.001) presented to a worse degree of happiness. The multinomial final model indicated an association between dental caries experience and self-perception and the changes in happiness over time: adolescents with a greater number of teeth decayed, missng orfilled (OR = 1.16-1.19, p = 0.018-0.037), and with higher CPQ11-14 scores (OR = 1.04-1.07, p = 0.000-0.014) had a higher chance of being in the most unfavorable categories of happiness trajectory. These results highlight the importance of inclusive publicpolicies and oral health promotion for the psychosocial development of adolescents

The associations of socioeconomic status and social capital with gingival bleeding among schoolchildren.

OBJECTIVE: The aim of this study was to assess the associations of gingival bleeding with individual and community social variables among schoolchildren. METHODS: This cross-sectional study evaluated a representative, multistage, random sample of 1,134 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. The participants were examined clinically, and full-mouth gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding). The children's parents or guardians answered questions regarding their socioeconomic status and social capital, and an assessment of the associations was performed using multilevel Poisson regression models. RESULTS: The prevalence of gingival bleeding was 96.21 percent. The multilevel adjusted assessment revealed that socioeconomic, clinical, and social capital variables at the individual level were associated with higher levels of gingival bleeding. Children whose fathers had a low educational level, children who had dental plaque and dental crowding, and children who never/almost never attended religious meetings exhibited significantly higher levels of gingival bleeding than their counterparts. This social gradient remained significant even after adjusting for contextual-level covariates. CONCLUSION: The results indicate that the socioeconomic status and features of social capital are associated with the levels of gingival bleeding among schoolchildren.

Association of malocclusion, happiness, and oral health-related quality of life (OHRQoL) in schoolchildren.

OBJECTIVE: The aim of this study was to assess the impact of malocclusion on children's oral health-related quality of life (COHRQoL) and self-reported happiness. METHODS: A cross-sectional study was conducted in a representative sample of 12-year-old schoolchildren from Santa Maria, South Brazil. Four calibrated examiners carried out clinical exams to evaluate malocclusion [Dental Aesthetic Index (DAI)], dental caries (DMFT), and dental trauma (O'Brien classification, used in the Children's dental health survey in the UK, 1994). Participants answered the Brazilian versions of the Child Perceptions Questionnaire (CPQ11-14 ) and the Subjective Happiness Scale (SHS). Parents completed a structured questionnaire regarding socioeconomic status. Data analysis was conducted using multilevel Poisson regression models. RESULTS: A total of 1,134 adolescents (boys: 45.8 percent; girls: 54.1 percent) were enrolled in the study. The DAI overall score ranged from 13 to 63 (mean: 25.19, standard error: 0.19); 57.6 percent of the subjects had minor or no malocclusion and 24.4 percent had definite malocclusion. Severe malocclusion and handicapping malocclusion were found in 10.4 percent and 7.4 percent of the subjects, respectively. After adjustment, the severity of malocclusion was associated with high mean values of the CPQ11-14 overall score, and the emotional well-being and social well-being domains were the most affected. Lower levels of happiness were also associated with the severity of malocclusion: those with definite malocclusion presented lower scores on the SHS scale (Rate Ratio 0.97; 95 percent CI 0.94-0.99). CONCLUSION: Malocclusion had a negative impact on COHRQoL and happiness, mainly on the emotional and social domains.

The influence of normative and subjective oral health status on schoolchildren's happiness.

BACKGROUND: Traditional methods to measure oral health based on clinical standards are limited because they do not consider psychosocial and functional aspects of oral health. It has been recommended that these measures need to be supplemented by data obtained from patients regarding their individual perceptions on oral health-related quality of life (OHRQoL). Happiness is a multidimensional construct comprising both emotional and cognitive domains, and has been defined as "the degree to which an individual judges the overall quality of his or her life as a whole favorably". It has been associated with several health outcomes, including oral health. The aim of this study was to assess the impact of oral health conditions, oral health-related quality of life (OHRQoL), and socioeconomic factors on the subjective happiness of Brazilian adolescents. METHODS: A cross-sectional study was conducted in 2012 on a representative sample of 12-year-old schoolchildren in Santa Maria-RS, Brazil. The data were collected through dental examinations and structured interviews. The participants underwent an evaluation aimed at detecting dental caries, traumatic dental injuries, malocclusion, and gingival bleeding. They also completed the Brazilian versions of the Child Perceptions Questionnaire-short form (CPQ11-14-ISF: 16) and the Subjective Happiness Scale (SHS), which was our outcome variable. Socioeconomic conditions were evaluated through a questionnaire that was completed by the participants' parents. Poisson regression analysis was used to determine the association between the explanatory variables and the outcome. Moreover, a correlation analysis was performed to determine the relationship between the SHS scores and the overall and domain scores of the CPQ11-14-ISF: 16. RESULTS: A total of 1,134 children were evaluated. Unadjusted analyses showed that happiness was associated with socioeconomic indicators, the use of dental services, clinical status, and scores on the OHRQoL measure. After adjustment, household overcrowding (RR: 0.96; 95% CI: 0.93-0.98), dental caries (RR: 0.98; 95% CI: 0.97-0.99), malocclusion (RR: 0.98; 95% CI: 0.96-0.99), and the severity associated with the CPQ11-14 (RR: 0.95; 95% CI: 0.93-0.97) still showed a significant association with lower levels of the mean SHS score. CONCLUSIONS: Happiness is influenced by oral conditions, socioeconomic status, and OHRQoL.

Association of gingivitis with child oral health-related quality of life.

BACKGROUND: Child oral health-related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. METHODS: This cross-sectional study used multistage random sampling to enroll 1,134 12-year-old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full-mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-Year-Old Children (CPQ11-14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain-specific CPQ11-14 scores. RESULTS: In general, children with bleeding in ≥15% of sites had higher total CPQ11-14 scores and domain-specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11-14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low-level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). CONCLUSION: The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.

Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children.

BACKGROUND: Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents' socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children's use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1-5 years. METHODS: Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children's Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals. RESULTS: Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as "poor" used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child's oral health as "fair/poor" were less likely to have visited the dentist for preventive care. CONCLUSION: This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.