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1.
Qual Life Res ; 28(9): 2491-2500, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31203563

RESUMO

PURPOSE: Socioeconomic inequalities are recognized as a major problem with people in low socioeconomic groups having worse subjective oral health outcomes, including oral health-related quality of life (OHRQoL). However, only a few longitudinal studies assessed the impact of contextual and individual socioeconomic determinants in adolescents' OHRQoL. We estimate the impact of socioeconomic inequalities on adolescents' OHRQoL over a 2-year period. METHODS: This study followed up a random sample of 1134 12-year-old schoolchildren for 2 years in Brazil. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-year-old Children (CPQ11-14) at baseline and follow-up. Participants were clinically examined for dental caries, gingival bleeding, and malocclusion. The schoolchildren's parents answered a questionnaire regarding socioeconomic status, social capital, and adolescents' use of dental service. Socioeconomic contextual variables were collected from official city publications. Multilevel linear regression models fitted the associations between socioeconomic factors and overall CPQ11-14 scores over time. RESULTS: A total of 747, 14-year-old adolescents were reassessed for OHRQoL (follow-up rate of 66%). Adolescents with lower mean income school's neighborhood (P < 0.05), household income (P < 0.05), and maternal schooling (P < 0.05) had higher overall CPQ11-14 scores. Female sex, attending a dentist by toothache, dental caries, and malocclusion were also associated with higher overall CPQ11-14 scores. CONCLUSIONS: Adolescents from low socioeconomic background reported worse OHRQoL at 2-year follow-up compared to those from high socioeconomic background. Actions toward health inequalities need to address socioeconomic factors in adolescence.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/diagnóstico , Disparidades nos Níveis de Saúde , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Classe Social , Adolescente , Brasil , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico , Análise Multinível , Pais , Índice Periodontal , Características de Residência , Instituições Acadêmicas , Fatores Socioeconômicos , Inquéritos e Questionários
2.
Community Dent Oral Epidemiol ; 47(2): 177-184, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30569569

RESUMO

OBJECTIVES: To explore the pathways through which the socioeconomic inequalities may influence gingival bleeding in adolescents, assessing the direct and indirect effects of material and psychosocial variables. METHODS: This cohort study followed a multistage, random sample of 1134 12-year-old adolescents from 20 public schools of Santa Maria, a city in southern Brazil. The percentage of teeth with gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding) at baseline and at 2-year follow-up. Biological (dental plaque, caries, and dental crowding), material (socioeconomic position [SEP] operationalized as family income and parents' education), psychosocial (parents' religiosity, self-rated health, and happiness) and behavioural (use of dental service by adolescents) factors were collected at baseline. Structural equation modelling (SEM) was guided by the adapted Commission on the Social Determinants of Health model linking material, psychosocial, biological, and behaviour variables to health. The SEM was employed to estimate standardized direct, indirect, and total effects of material and psychosocial factors on gingival bleeding at follow-up. RESULTS: A total of 770 14-year-old adolescents were reassessed (follow-up rate of 68%). The lower SEP at baseline had a higher direct effect (standard coefficient [SC] = -0.17, P < 0.01) than a mediated effect on percentage of teeth with gingival bleeding at 2-year follow-up. The lower indirect effect (SC = -0.06, P < 0.01) from SEP to gingival bleeding at follow-up ran through biological factors-dental plaque (baseline and follow-up) and gingival bleeding at baseline. The lower religiosity of the parents as a psychosocial aspect had only a small direct effect (SC = -0.10, P = 0.03) on gingival bleeding at follow-up. CONCLUSIONS: Material factors such as SEP contributed most to explanations on inequalities in adolescents' periodontal health because of their higher direct effect and additional shared (indirect) effect (through biological factors) on gingival bleeding. Religious practice as a psychosocial factor only explained part of percentage of teeth with gingival bleeding at follow-up.


Assuntos
Hemorragia Gengival/epidemiologia , Saúde Bucal , Adolescente , Brasil , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores Socioeconômicos
3.
Caries Res ; 52(1-2): 32-41, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29232677

RESUMO

The aim of this study was to evaluate the influence of initial noncavitated caries lesions on cavitated caries increment in preschool children. A 2-year cohort study was designed to include the participants of a survey on dental caries performed in 2010. Preschool children (12-59 months old) were examined for dental caries and classified as children with no caries lesions, with only initial lesions, with at least 1 moderate caries lesion, and with extensive lesions. Socioeconomic data were also collected. After 2 years, 466 children were re-examined (follow-up rate of 72.9%) only for cavitated lesions. Association between caries incidence at 2 levels of severity and caries experience and other variables was evaluated using hierarchical Poisson regression analysis. The children with moderate and extensive caries lesions at baseline presented a higher risk of presenting both outcomes than the children with no caries lesions. Nevertheless, the children with only initial lesions had a higher risk of developing at least 1 new cavitated carious lesion, but not for a more severe increment in caries. Subgroup analysis stratified by the children's age showed that the influence of the presence of initial caries lesions on cavitated caries increment was only observed in children aged 12-35 months. In conclusion, although the presence of moderate and extensive lesions at baseline is a significant predictor for cavitated caries increment after 2 years in preschool children at all ages, the presence of only initial caries lesions is also associated, but with less severe caries incidence.


Assuntos
Cárie Dentária/etiologia , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Masculino , Distribuição de Poisson , Fatores de Risco , Fatores Socioeconômicos
4.
Int J Paediatr Dent ; 28(2): 207-216, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28833769

RESUMO

AIM: This two-year cohort study evaluated whether the Early Childhood Oral Health Impact Scale (ECOHIS) is responsive to detect changes related to dental caries. DESIGN: Preschool children were examined in 2010 regarding dental caries, and their parents responded to the ECOHIS. After 2 years, 352 children (response rate = 73.6%) were re-examined and a new ECOHIS was responded. Children were categorized according to caries increment (no new caries, 1-3 surfaces with new lesions, and four or more decayed surfaces). The outcome variables were related to the decline of quality of life as determined via ECOHIS: decline, severe decline, and differences between baseline and follow-up scores. Effect sizes (ES) were calculated, and the associations were evaluated through Poisson regression. RESULTS: ES was small for children with 1-3 new lesions (ES = 0.19) and moderate for children with four or more new carious lesions (ES = 0.61). Children who developed 1-3 new lesions were significantly associated with all outcome variables compared to children with no new lesions, but the associations were stronger for children with four or more new carious lesions. CONCLUSIONS: The ECOHIS is sensitive to the deterioration of quality of life due to caries increments in preschool children.


Assuntos
Cárie Dentária/diagnóstico , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Brasil/epidemiologia , Pré-Escolar , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Sensibilidade e Especificidade , Inquéritos e Questionários
5.
Health Qual Life Outcomes ; 15(1): 182, 2017 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-28931398

RESUMO

BACKGROUND: The responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children. METHODS: Preschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses. RESULTS: Of the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively). CONCLUSIONS: Parents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.


Assuntos
Assistência Odontológica/normas , Saúde Bucal/normas , Qualidade de Vida , Inquéritos e Questionários/normas , Criança , Pré-Escolar , Assistência Odontológica/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais , Extração Dentária , Dente não Vital
6.
Community Dent Oral Epidemiol ; 45(5): 427-433, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28585271

RESUMO

OBJECTIVE: To compare the performance of partial-mouth periodontal examination (PMPE) protocols with different cut-off points to the full-mouth examination (FME) in the assessment of the prevalence and extent of gingival bleeding in adolescents. METHODS: A cross-sectional study was conducted involving 12-year-old adolescents. Following a systematic two-stage cluster sampling process, 1134 individuals were evaluated. Different PMPE protocols were compared to the FME with six sites per tooth. Sensitivity, specificity, area under the ROC curve (AUC), intraclass correlation coefficient (ICC), relative and absolute biases and the inflation factor were assessed for each PMPE protocol with different cut-off points for the severity of gingival bleeding. RESULTS: The highest AUC values were found for the six-site two-diagonal quadrant (2-4) (0.97), six-site random half-mouth (0.95) and Community Periodontal Index (0.95) protocols. The assessment of three sites [mesiobuccal (MB), buccal (B) and distolingual (DL)] in two diagonal quadrants and the random half-mouth protocol had higher sensitivity and lower specificity than the same protocols with distobuccal (DB) sites. However, the use of DB sites led to better specificity and improved the balance between sensitivity and specificity, except for the two-diagonal quadrant (1-3) protocol. The ≥1 cut-off point led to the most discrepant results from the FME. CONCLUSION: Six-site two-diagonal quadrant (2-4) and random half-mouth assessments perform better in the evaluation of gingival bleeding in adolescents. However, when a faster protocol is needed, a two-diagonal quadrant assessment using only MB, B and DL sites can be used with no important loss of information.


Assuntos
Diagnóstico Bucal/métodos , Hemorragia Gengival/diagnóstico , Hemorragia Gengival/epidemiologia , Índice Periodontal , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Sensibilidade e Especificidade
7.
Braz Dent J ; 27(1): 72-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27007350

RESUMO

This study aimed to assess the association between dental caries, socioeconomic individual and contextual factors in 12-years-old children. A representative sample of 1,134 children enrolled in public schools from Santa Maria, RS, Brazil, was obtained from a multistage random sampling. Four calibrated dentists examined participants at schools. Data about dental caries (DMF-T index) and dental plaque (present or absent) were assessed. Children's parents or guardians answered questions regarding their demographics and socioeconomic status. Context variables were also collected from official publications of the city. Data analyses were performed using multilevel logistic regression models. Caries prevalence in this sample (DMF-T≥1) was 49.9% (95%CI: 45.05% - 54.77%), and mean DMF-T was 1.15 (95%CI: 1.01-1.29) with 0.068 standard error. Children of the 3rd and 2nd tertile of income represented by the rich and intermediate categories, showed, respectively, a 50% (OR 0.50: CI95 % 0.35-0.71) and 39% (OR 0.61: CI95% 0.45-0.82) lower chance to present untreated caries compared with the poorest portion of the sample represented by the 1st tertile of income. Regarding the context covariates, children from lower income neighborhood presented a higher chance for having untreated dental caries compared with their counterpart (OR 1.70: CI95% 1.19 to 2.43). Inequalities in the distribution of dental caries continue affecting children from poorer socioeconomic profiles. There is need for planning public interventions for oral health promotion that take into account individual and contextual socioeconomic characteristics.


Assuntos
Cárie Dentária , Fatores Socioeconômicos , Criança , Feminino , Humanos , Masculino
8.
Community Dent Oral Epidemiol ; 44(3): 292-300, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26892250

RESUMO

OBJECTIVES: We aimed to assess the impact of the presence of initial and other stages of dental caries on the impairment of oral health-related quality of life in preschool children (COHRQoL) through a cohort study. METHODS: During an epidemiological survey, 478 children (12-59 months old) were examined for dental caries using the International Caries and Detection Assessment System (ICDAS), and their parents answered the Early Childhood Oral Health Impact Scale (ECOHIS). Children were categorized based on the presence of dental caries as follows: children with no caries lesions, children with only initial lesions (ICDAS scores 1 and 2), children with at least one moderate lesion (ICDAS scores 3 and 4) and children with extensive lesions (ICDAS scores 5 and 6). After 2 years, 352 children were re-examined for the presence of dentine cavitations, and their parents completed a new ECOHIS questionnaire. Multilevel Poisson regression analysis was performed to evaluate the impact of the presence of different stages of caries lesions at the baseline on COHRQoL impairment at the follow-up, considering two outcome variables: worsening and severe worsening of COHRQoL. Relative risk values (RR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS: Worsening or severe worsening of the COHRQoL at the follow-up were observed only in children with moderate lesions (RR = 2.00; 95% CI = 1.30-3.08 and RR = 2.38; 95% CI = 1.31-4.34, respectively) or children with extensive lesions (RR = 1.59; 95% CI = 1.10-2.30 for worsening and RR = 1.88; 95% CI = 1.13-3.12 for severe worsening). On the other hand, the presence of only initial caries lesions was not a significant predictor of COHRQoL impairment. CONCLUSIONS: The presence of only initial caries lesions does not impair COHRQoL of preschool children; however, moderate and extensive lesions are risk factors for worsening of the COHRQoL.


Assuntos
Cárie Dentária/epidemiologia , Qualidade de Vida , Pré-Escolar , Estudos de Coortes , Cárie Dentária/diagnóstico , Feminino , Humanos , Lactente , Masculino , Fatores de Risco , Inquéritos e Questionários
9.
Braz. dent. j ; 27(1): 72-78, Jan.-Feb. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-777142

RESUMO

Abstract This study aimed to assess the association between dental caries, socioeconomic individual and contextual factors in 12-years-old children. A representative sample of 1,134 children enrolled in public schools from Santa Maria, RS, Brazil, was obtained from a multistage random sampling. Four calibrated dentists examined participants at schools. Data about dental caries (DMF-T index) and dental plaque (present or absent) were assessed. Children's parents or guardians answered questions regarding their demographics and socioeconomic status. Context variables were also collected from official publications of the city. Data analyses were performed using multilevel logistic regression models. Caries prevalence in this sample (DMF-T≥1) was 49.9% (95%CI: 45.05% - 54.77%), and mean DMF-T was 1.15 (95%CI: 1.01-1.29) with 0.068 standard error. Children of the 3rd and 2nd tertile of income represented by the rich and intermediate categories, showed, respectively, a 50% (OR 0.50: CI95 % 0.35-0.71) and 39% (OR 0.61: CI95% 0.45-0.82) lower chance to present untreated caries compared with the poorest portion of the sample represented by the 1st tertile of income. Regarding the context covariates, children from lower income neighborhood presented a higher chance for having untreated dental caries compared with their counterpart (OR 1.70: CI95% 1.19 to 2.43). Inequalities in the distribution of dental caries continue affecting children from poorer socioeconomic profiles. There is need for planning public interventions for oral health promotion that take into account individual and contextual socioeconomic characteristics.


Resumo Esta pesquisa teve como objetivo avaliar a associação entre cárie dental e fatores socioeconômicos individuais e contextuais em crianças de 12 anos de idade. Uma amostra representativa de 1.134 crianças matriculadas em escolas públicas de Santa Maria, RS, foi obtida a partir de uma amostragem aleatória em duplo estágio. Quatro dentistas calibrados examinaram os participantes nas escolas. Foram avaliados dados sobre cárie dentária (índice CPO-D) e placa dentária (presente ou ausente). Os pais ou responsáveis pelos adolescentes responderam questionários sobre status socioeconômico e sociodemográficos. Variáveis contextuais também foram coletadas através de publicações oficiais do município. Os dados foram analisados utilizando-se modelos multiníveis de regressão logística. A prevalência de cárie da amostra (CPO-D≥1) foi 49.9% (95%IC: 45.05% - 54.77), e a média de CPO-D foi de 1.15 (95%IC: 1.01-1.29) com 0.068 de erro padrão. As crianças do 3º e 2º tercil de renda representado pelas categorias ricas e intermediárias apresentaram respectivamente 50% (OR 0,50: IC95% 0,35-0,71) e 39% (OR 0,61: IC95% 0,45-0,82) menor chance de apresentarem cárie não tratada em comparação com a porção mais pobre da amostra representada pelo 1º tercil de renda. Em relação à variável contextual "renda média do bairro", crianças que viviam em bairros com menor renda apresentaram uma chance 70% (OR 1,70: IC95% 1,19-2,43) maior de ter cárie dentária não tratada, quando comparadas com aquelas que viviam em bairros de maior renda. Desigualdades na distribuição da cárie dentária continuam afetando as crianças dos perfis socioeconômicos mais pobres. Os resultados mostram a necessidade de planejamento de intervenções públicas que visem a promoção da saúde bucal que levem em conta as características socioeconômicas individuais e contextuais.


Assuntos
Humanos , Masculino , Feminino , Criança , Cárie Dentária , Fatores Socioeconômicos
10.
Int J Paediatr Dent ; 26(2): 116-24, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25923059

RESUMO

AIM: To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children. DESIGN: A cohort study was designed with 639 children (12-59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years, 469 children were re-examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were calculated using multilevel Poisson regression analysis. Association with explanatory variables, including caries experience of the children, was also investigated. RESULTS: The higher the initial score attributed to the dental surface, the more likely was the progression. Moreover, children with severe lesions at baseline had higher risk of having a sound surface or a non-cavitated caries lesion progressing to cavitation when compared with caries-free children; however, this increased risk was not observed in children with only initial caries lesions. CONCLUSIONS: Initial caries lesions present a low frequency of progression. Moreover, sound surfaces and initial caries lesions in children already presenting cavitations are more likely to progress to more severe conditions.


Assuntos
Cárie Dentária/patologia , Brasil , Pré-Escolar , Esmalte Dentário/patologia , Dentina/patologia , Progressão da Doença , Feminino , Humanos , Masculino , Fatores de Risco , Dente Decíduo
11.
Caries Res ; 49(5): 548-56, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26381388

RESUMO

AIM: Although children spend most of their time involved in activities related to school, few studies have focused on the association between school social environment and oral health. This cross-sectional study assessed individual and school-related social environment correlates of dental caries in Brazilian schoolchildren aged 8-12 years. METHODS: A sample of children from 20 private and public schools (n=1,211) was selected. Socio-economic data were collected from parents, and data regarding children characteristics were collected from children using a questionnaire. Dental examinations were performed to assess the presence of dental plaque: dental caries experience (DMFT≥1) and dental caries severity (mean dmf-t/DMF-T). The social school environment was assessed by a questionnaire administered to school coordinators. Multilevel Poisson regression was used to investigate the association between school social environment and dental caries prevalence and experience. RESULTS: The dental caries prevalence was 32.4% (95% confidence interval: 29.7-35.2) and the mean dmf-t/DMF-T was 1.84 (standard deviation: 2.2). Multilevel models showed that the mean dmf-t/DMF-T and DMFT≥1 were associated with lower maternal schooling and higher levels of dental plaque. For contextual variables, schools offering after-hours sports activities were associated with a lower prevalence of dental caries and a lower mean of dmf-t/DMF-T, while the occurrence of violence and theft episodes was positively associated with dental caries. CONCLUSIONS: The school social environment has an influence on dental caries in children. The results suggest that strategies focused on the promotion of healthier environments should be stimulated to reduce inequalities in dental caries.


Assuntos
Índice CPO , Cárie Dentária/epidemiologia , Saúde Bucal , Instituições Acadêmicas , Meio Social , Brasil/epidemiologia , Criança , Estudos Transversais , Placa Dentária/epidemiologia , Feminino , Humanos , Masculino , Análise Multinível , Prevalência , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e Questionários
12.
Braz. dent. j ; 25(6): 546-553, Nov-Dec/2014. tab
Artigo em Inglês | LILACS | ID: lil-732247

RESUMO

The aim of this study was to assess the prevalence of toothache, associated factors and impact of this condition on the Child Oral Health Related Quality of Life (COHRQoL) in preschoolers. The study was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 534 children aged 0 to 5 years were included. Clinical variables included dental caries and dental trauma. A questionnaire was responded by the parents and provided information about several socioeconomic indicators, dental service use and toothache. Toothache was collected by the question: "Has your child ever had a toothache - Yes or no?". Data on COHRQoL were assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). Multivariable Logistic regression models were performed to assess the association between the predictor variables and outcomes. The prevalence of toothache was 10.11% (95% CI: 7.55% - 12.68%). Older children had a higher chance of presenting dental pain (OR 2.72; 95% CI: 1.01 - 7.56), as well as children with caries experience (OR 3.43; 95% CI: 1.81 - 6.52). Moreover, children who had not visited the dental service in the last 6 months were less likely to present toothache (OR 0.51; 95% CI: 0.28 - 0.95). The presence of dental pain negatively affects the COHRQoL; those with toothache presented a higher chance of having higher impact on the total scores of ECOHIS (OR 4.18; 95% CI: 1.76 - 9.95) than those without toothache. Similar observation was found for the child section of the questionnaire (OR 5.54; 95% CI: 2.15 - 14.24). Toothache negatively affects COHRQoL and is associated with caries experience, age and use of dental service.


O objetivo deste estudo foi avaliar a prevalência de dor dentaria, os fatores associados e seu impacto na qualidade de vida relacionada a saúde bucal de crianças pré-escolares. Esse estudo foi realizado em Santa Maria, Brasil, durante o dia nacional de vacinação infantil, e 534 crianças de 0 a 5 anos foram incluídas. As variáveis clinicas incluídas foram carie dental e traumatismo dentário. Um questionário foi respondido pelos pais, fornecendo informações sobre as condições socioeconômicas, uso de serviços odontológicos e dor dentaria. Dor de dente foi coletada através da pergunta: "Seu filho já teve dor de dente - Sim ou Não?". Os dados sobre qualidade de vida relacionada a saúde bucal foram obtidos através da versão brasileira do questionário "Early Childhood Oral Health Impact Scale" (ECOHIS). Modelos multivariáveis de regressão logística foram utilizados para avaliar a associação entre as variáveis preditoras e os desfechos. A prevalência de dor dentaria foi 10,11% (95% IC: 7,55% - 12,68%). Crianças mais velhas apresentaram uma maior chance de ter tido dor dentaria (OR 2,72; 95% IC: 1,01 - 7,56), assim como crianças com experiência de carie (OR 3,43; 95% IC: 1,81 - 6,52). Além disso, as crianças que não tinham visitado o dentista nos últimos 6 meses foram menos propensas a apresentar dor dentária (OR 0,51; 95% IC: 0,28 - 0,95). A presença de dor dentária afeta negativamente a qualidade de vida relacionada a saúde bucal das crianças; aquelas que tiveram dor de dente apresentaram uma maior chance de ter piores impactos nos escores totais do ECOHIS (OR 4,18; 95% IC: 1,76 - 9,95) quando comparadas àquelas que não tiveram dor dentária. O mesmo se pode observar para a seção do questionário correspondente aos impactos na criança (OR 5,54; 95% IC: 2,15 - 14,24. Dor dentaria afeta negativamente a qualidade de vida relacionada a saúde bucal e esta associada com experiência de carie, idade e uso de serviços odontológicos.


Assuntos
Anti-Inflamatórios não Esteroides/análise , Benzenoacetamidas , Ácidos Hidroxâmicos/análise , Anti-Inflamatórios não Esteroides/síntese química , Fenômenos Químicos , Química , Cromatografia Líquida de Alta Pressão , Ácidos Hidroxâmicos/síntese química , Espectroscopia de Ressonância Magnética
13.
J Periodontol ; 85(11): 1557-65, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24942231

RESUMO

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.


Assuntos
Gengivite/psicologia , Saúde Bucal , Qualidade de Vida , Criança , Saúde da Criança , Estudos Transversais , Índice CPO , Cárie Dentária/psicologia , Escolaridade , Feminino , Hemorragia Gengival/psicologia , Humanos , Renda , Masculino , Má Oclusão/psicologia , Mães/educação , Índice Periodontal , Fatores Sexuais , Classe Social , Traumatismos Dentários/psicologia
14.
Braz Dent J ; 25(6): 546-53, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25590204

RESUMO

The aim of this study was to assess the prevalence of toothache, associated factors and impact of this condition on the Child Oral Health Related Quality of Life (COHRQoL) in preschoolers. The study was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 534 children aged 0 to 5 years were included. Clinical variables included dental caries and dental trauma. A questionnaire was responded by the parents and provided information about several socioeconomic indicators, dental service use and toothache. Toothache was collected by the question: "Has your child ever had a toothache - Yes or no?". Data on COHRQoL were assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). Multivariable Logistic regression models were performed to assess the association between the predictor variables and outcomes. The prevalence of toothache was 10.11% (95% CI: 7.55% - 12.68%). Older children had a higher chance of presenting dental pain (OR 2.72; 95% CI: 1.01 - 7.56), as well as children with caries experience (OR 3.43; 95% CI: 1.81 - 6.52). Moreover, children who had not visited the dental service in the last 6 months were less likely to present toothache (OR 0.51; 95% CI: 0.28 - 0.95). The presence of dental pain negatively affects the COHRQoL; those with toothache presented a higher chance of having higher impact on the total scores of ECOHIS (OR 4.18; 95% CI: 1.76 - 9.95) than those without toothache. Similar observation was found for the child section of the questionnaire (OR 5.54; 95% CI: 2.15 - 14.24). Toothache negatively affects COHRQoL and is associated with caries experience, age and use of dental service.


Assuntos
Saúde Bucal , Qualidade de Vida , Odontalgia/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Assistência Odontológica para Crianças/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
15.
BMC Oral Health ; 13: 49, 2013 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-24090355

RESUMO

BACKGROUND: In epidemiological surveys, a good reliability among the examiners regarding the caries detection method is essential. However, training and calibrating those examiners is an arduous task because it involves several patients who are examined many times. To facilitate this step, we aimed to propose a laboratory methodology to simulate the examinations performed to detect caries lesions using the International Caries Detection and Assessment System (ICDAS) in epidemiological surveys. METHODS: A benchmark examiner conducted all training sessions. A total of 67 exfoliated primary teeth, varying from sound to extensive cavitated, were set in seven arch models to simulate complete mouths in primary dentition. Sixteen examiners (graduate students) evaluated all surfaces of the teeth under illumination using buccal mirrors and ball-ended probe in two occasions, using only coronal primary caries scores of the ICDAS. As reference standard, two different examiners assessed the proximal surfaces by direct visual inspection, classifying them in sound, with non-cavitated or with cavitated lesions. After, teeth were sectioned in the bucco-lingual direction, and the examiners assessed the sections in stereomicroscope, classifying the occlusal and smooth surfaces according to lesion depth. Inter-examiner reproducibility was evaluated using weighted kappa. Sensitivities and specificities were calculated at two thresholds: all lesions and advanced lesions (cavitated lesions in proximal surfaces and lesions reaching the dentine in occlusal and smooth surfaces). RESULTS: Regarding the reproducibility, the mean (range) of kappa values was 0.781 (0.529-0.927) for occlusal surfaces, 0.568 (0.191-0.881) for smooth surfaces, and 0.844 (0.698-0.971) for proximal surfaces. Considering all lesions, sensitivity and specificity mean values were respectively 0.724 and 0.844 for occlusal, 0.635 and 0.943 for smooth and 0.658 and 0.927 for proximal surfaces. For detecting advanced lesions, sensitivities and specificities were 0.563 and 0.920 for occlusal, 0.670 and 0.985 for smooth, and 0.838 and 0.985 for proximal surfaces. CONCLUSION: The methodology purposed for training and calibration of several examiners designated for epidemiological surveys of dental caries in preschool children using the ICDAS is feasible, permitting the assessment of reliability and accuracy of the examiners previously to the survey's development.


Assuntos
Cárie Dentária/diagnóstico , Inquéritos de Saúde Bucal , Modelos Dentários , Educação em Odontologia/métodos , Pessoal de Laboratório/educação , Pré-Escolar , Testes de Atividade de Cárie Dentária , Estudos de Viabilidade , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Dente Decíduo
16.
Community Dent Oral Epidemiol ; 41(3): 204-11, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23004568

RESUMO

OBJECTIVES: This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment, in an epidemiological survey of preschool children, involving cavitated and noncavitated caries lesions. METHODS: The survey was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 639 children aged between 12 months and 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and additional lesion activity assessment criteria. The mean of decayed surfaces (d-s), the mean of decayed teeth (d-t), caries prevalence, and 95% confidence intervals were calculated, initially by classifying all lesions using the various thresholds defined by the ICDAS. Caries activity status was then evaluated, and inactive lesions were classified as sound in a secondary analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children requiring assessment to change their classification from decayed to sound (number needed to be assessed) were also calculated. RESULTS: The majority of lesions were classified as active, mainly at cavitated thresholds. When activity was considered, values of all caries parameters decreased. This decrease was more evident at noncavitated thresholds. The number of children requiring assessment to change their classification from decayed to sound was <20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions. CONCLUSIONS: The inclusion of activity assessment in caries epidemiological surveys has little impact on the d-s, d-t and prevalence of dental caries considering both noncavitated and cavitated lesions.


Assuntos
Testes de Atividade de Cárie Dentária/estatística & dados numéricos , Cárie Dentária/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Índice CPO , Testes de Atividade de Cárie Dentária/classificação , Esmalte Dentário/patologia , Fissuras Dentárias/epidemiologia , Dentina/patologia , Progressão da Doença , Estudos Epidemiológicos , Feminino , Humanos , Lactente , Masculino , Prevalência , Descoloração de Dente/epidemiologia , Remineralização Dentária
17.
Int J Paediatr Dent ; 23(4): 266-73, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23016995

RESUMO

BACKGROUND: Traumatic dental injury (TDI) has been considered a significant problem in youth, not only because of its consequences to the craniofacial structures but also for its potential impact on the quality of life of affected individuals. AIM: The aim of this study was to investigate the impact of TDI with treatment needs on the oral health-related quality of life (OHRQoL) of South Brazilian schoolchildren. DESIGN: A cross-sectional study was performed in Porto Alegre, Brazil, using a multistage probability sampling strategy. Of 1837 eligible 12-year-old schoolchildren attending public and private schools, 1528 were examined. OHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11-to 14-year-old children (CPQ11-14) - 16-item short form. Clinical examination was conducted to assess the presence of TDI in permanent incisors (Children's Dental Health Survey criteria), malocclusion, and dental caries. Parents/legal guardians answered questions on socioeconomic status. Statistical analyses were performed using Poisson regression models. RESULTS: The overall CPQ11-14 score was not associated with TDI. In the functional limitations domain, individuals presenting TDIs with treatment needs experienced significantly higher mean CPQ11-14 than individuals with no TDI or without treatment needs (RR = 1.21; 95% CI = 1.05-1.39), after adjusting for malocclusion, dental caries, gender, and socioeconomic status. No other domains were associated with TDI. CONCLUSIONS: This study revealed that TDI with treatment needs negatively affects the OHRQoL in this population of 12-year-old schoolchildren and that this impact is related to oral functions.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Incisivo/lesões , Saúde Bucal , Qualidade de Vida , Atitude Frente a Saúde , Brasil , Criança , Estudos Transversais , Coroas/psicologia , Índice CPO , Cárie Dentária/psicologia , Esmalte Dentário/lesões , Exposição da Polpa Dentária/psicologia , Restauração Dentária Permanente/psicologia , Dentina/lesões , Prótese Parcial Removível/psicologia , Estética Dentária , Humanos , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão/psicologia , Tratamento do Canal Radicular/psicologia , Classe Social , Fraturas dos Dentes/psicologia , Perda de Dente/psicologia , Saúde da População Urbana
18.
Community Dent Oral Epidemiol ; 40(5): 451-8, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22537392

RESUMO

OBJECTIVES: The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. METHODS: A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05). RESULTS: The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. CONCLUSIONS: Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist.


Assuntos
Ansiedade ao Tratamento Odontológico , Assistência Odontológica para Crianças/estatística & dados numéricos , Mães/psicologia , Qualidade de Vida , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Disparidades em Assistência à Saúde , Humanos , Lactente , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Relações Mãe-Filho , Distribuição de Poisson , Inquéritos e Questionários
19.
Community Dent Oral Epidemiol ; 39(3): 260-7, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21198760

RESUMO

OBJECTIVES: We assessed how socioeconomic and clinical conditions could affect parents' perceptions of their child's oral health. METHODS: A cross-sectional study was conducted in a sample of 455 children, aged 1-5 years, representative of Santa Maria, a southern city in Brazil. Participants were randomly selected among children attending a National Day of Children's Vaccination. Clinical examinations provided information on the prevalence of caries, dental trauma, and occlusion. The caregivers' perception of children's oral health and socioeconomic status were assessed by means of a questionnaire. A Poisson regression model using robust variance (Prevalence ratio: PR; 95% CI, P ≤ 0.05) was performed to assess the association between the predictor variables and outcomes. RESULTS: Parents were more likely to rate their child's oral health as 'poor' if the former earned a lower income and the latter had anterior open bite and dental caries. Parents of black children with anterior open bite and dental caries were more likely to rate their child's oral health as 'worse than that of other children'. CONCLUSIONS: Clinical and socioeconomic characteristics are significantly associated with parents' perceptions of their child's oral health. Understanding the caregivers' perceptions of children's oral health and the factors affecting this could be useful in the planning of public health polices, in view of the inequity in the oral health pattern.


Assuntos
Saúde Bucal , Pais/psicologia , Atitude Frente a Saúde , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactente , Masculino , Mordida Aberta/psicologia , Distribuição de Poisson , Fatores Socioeconômicos , Inquéritos e Questionários
20.
J Public Health Dent ; 70(4): 319-26, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20735719

RESUMO

OBJECTIVES: This study assessed the inequality in caries distribution and the association between socioeconomic indicators and caries experience of preschool children in a city in Brazil. METHODS: A cross-sectional study in a multistage random sample of 455, 1-5-year-old children was conducted on National Children's Vaccination Day in Santa Maria, Brazil. Calibrated examiners evaluated the prevalence of dental caries and parents provided information about several socioeconomic indicators by means of a semistructured questionnaire. Data were analyzed using Poisson regression model. RESULTS: The caries prevalence was 23.5 percent and the means for the decayed, missing and filled primary teeth was 0.8. A high inequality in the caries distribution with Gini coefficient of 0.8 and Significant Caries Index of 2.8 was observed. The oldest children, non-white, with mothers having low level of education and from low household income had the highest prevalence of dental caries. CONCLUSION: Socioeconomic factors are strong predictors for the inequality in caries distribution in Brazilian preschool children.


Assuntos
Cárie Dentária/epidemiologia , Disparidades nos Níveis de Saúde , Fatores Socioeconômicos , Fatores Etários , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Índice CPO , Grupos Étnicos , Feminino , Humanos , Lactente , Masculino , Variações Dependentes do Observador , Prevalência , Análise de Regressão , Tamanho da Amostra , Inquéritos e Questionários , População Urbana
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