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1.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501238

RESUMO

BACKGROUND AND OBJECTIVES: Fifteen percent of US children live in households with inadequate food. Children who are food insecure often experience worse physical, emotional, and developmental health outcomes. Authors of previous studies have not examined the quality and cost implications of food insecurity in children. METHODS: This is a retrospective study of 7959 nationally representative US children (aged 1-17 years) in the 2016 Medical Expenditure Panel Survey. Households with food insecurity were identified by ≥3 positive responses to the 30-day, 10-item US Food Security Survey. Main outcomes were annual health expenditures and quality of care indicators: emergency department (ED) and inpatient use, primary care and specialist visits, routine medical and dental care, patient experience measures, and school absenteeism. Logistic and 2-part regression models were constructed to estimate outcomes conditional on sociodemographic and medical covariates. RESULTS: Children in households with food insecurity were more often publicly insured and had special needs compared with all other children. In multivariable logistic regression, household food insecurity was associated with significantly higher adjusted odds of an ED (adjusted odds ratio [aOR] = 1.37) or primary care treatment visit (aOR = 1.24) during the year. Household food insecurity was associated with significantly higher school absenteeism (aOR = 1.74) and lower access to care for routine (aOR = 0.55) or illness (aOR = 0.57) care. There were no differences in annual health expenditures, hospitalizations, or receipt of routine medical or dental care. CONCLUSIONS: Household food insecurity is associated with higher ED use and school absenteeism and lower access to care; however, it was not associated with higher annual health expenditures in children.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Absenteísmo , Adolescente , Criança , Pré-Escolar , Assistência Odontológica para Crianças/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Abastecimento de Alimentos/economia , Gastos em Saúde , Necessidades e Demandas de Serviços de Saúde/economia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Modelos Logísticos , Masculino , Razão de Chances , Atenção Primária à Saúde/economia , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Instituições Acadêmicas/estatística & dados numéricos , Estados Unidos
2.
Niger Postgrad Med J ; 26(3): 158-163, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31441453

RESUMO

Background: An early first dental clinic appointment offers the prospect of prompt preventative care and parental education regarding the oral health of the child. The evidence-based recommendation by dental professionals all over the world is that a child should visit a dentist before or by 1 year of age. Aim: This study aimed to determine the chronological age at and the purpose for a first dental clinic visit amongst children aged 16 years and below attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital (LUTH). Materials and Methods: This was a retrospective study conducted amongst children who attended the Paediatric Dental Clinic at the LUTH between January 2017 and December 2018. Data on age at first dental visit, reasons for attending and other information relevant to the study were collected. Descriptive statistics and Chi-square analysis were conducted, and the level of significance was set at P < 0.05. Results: A total of 1157 children were studied, comprising 580 (50.5%) males and 577 (49.9%) females. Their mean age on their first dental visit was 7.9 ± 3.7 years. Most of the children (31.4%) had their first dental visits at 7 and 9 years, and 0.8% of the children had their first dental visit below the age of 1 year. The most common reason for visiting the dental clinic was dental pain (33.1%). A higher proportion of the children (911 [79.0%]) had their first dental visit for therapeutic purposes, whereas 246 (21.0%) children visited the dental clinic for preventive care. Sex and age at first dental visit were statistically significantly associated with the reason for attendance (P < 0.001). Conclusion: Most children had their first dental visit between the ages of 7 and 9 years, mainly because of pain. It is necessary to create more awareness among parents/caregivers and to establish the concept of dental home.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Clínicas Odontológicas/estatística & dados numéricos , Visita a Consultório Médico/estatística & dados numéricos , Saúde Bucal , Pediatria/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Hospitais de Ensino , Humanos , Masculino , Nigéria , Estudos Retrospectivos
3.
Artigo em Inglês | MEDLINE | ID: mdl-31311179

RESUMO

Dental care under general anaesthesia (GA) is an option when normal treatment cannot be accomplished due to un-cooperation and systemic or cognitive/intellectual disabilities. The purpose of this retrospective cohort study was to analyse the dental treatment under GA in medically compromised and healthy children. The data were collected from the medical records of children who received their dental treatment under GA. The data regarding patient age, sex, general health, and type of treatment were analysed. This clinical trial included 229 study subjects (138 males, 91 females) with an average age of 8.34 (SD 3.78). Counts and relative counts were used for description of qualitative data. The association between the variables was analysed using contingency tables. The significance of the findings was tested by the chi-square test. Most of the children were older pre-school 63 (27.51%) and young school children 102 (44.54%). Medical disability (systemic or intellectual) was diagnosed in 142 children (62.01%); the remaining 87 (37.99%) were healthy children. Dental treatment of primary teeth was more commonly performed in healthy children (65.52%) compared to medically compromised children (58.45%) (p = 0.287). The total number of medically compromised children and the total number of healthy children were both considered to be 100% for the purpose of the following calculations. In terms of permanent dentition, medically compromised children required more extractions and fillings (38.03%, 57.04%) compared to healthy children (14.94%, 17.24%, respectively). The results of this study revealed that dental treatment under GA was more commonly performed in medically compromised children in permanent teeth only in comparison to healthy children. Based on these findings, both health professionals and state authorities should focus more on preventive care in medically compromised children in order to improve their oral health.


Assuntos
Anestesia Dentária/estatística & dados numéricos , Anestesia Geral/estatística & dados numéricos , Assistência Odontológica para Crianças/métodos , Utilização de Instalações e Serviços/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Estudos de Casos e Controles , Criança , Saúde da Criança , Pré-Escolar , Doença Crônica , República Tcheca , Assistência Odontológica para Crianças/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Estudos Retrospectivos
4.
Acta Odontol Scand ; 77(6): 468-473, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30983483

RESUMO

Objective: The aim of this study was to follow attendance patterns longitudinally by exploring length of intervals between routine dental examinations in children at the ages of 5 and 12 years, and study associations between length of recall intervals and caries prevalence, controlled for gender, parent's background and parent's education. Materials and methods: The study included 2960 children in one Norwegian county monitored from 5 to 12 years of age. Data were collected at clinical examinations, from dental records and by parental questionnaires. Length of recall intervals was dichotomized into short (shorter than 18 months) and long (18 months and longer). Data were analysed and tested using Chi-square statistics, correlation coefficient and multivariate regression. The study was ethically approved. Results: Recall intervals were individualized and varied from 4 to 30 months. The most frequent used recall intervals were 12, 18, 20 and 24 months. A majority of children at both ages were given long recall intervals. Multivariate logistic regression showed that the probability of having short interval was higher in children having caries experience than in caries-free children at both 5 years (OR 12.6 CI 9.9-16.0) and 12 years (OR 2.7 CI 2.3-3.1). At 5 years of age, length of recall intervals was associated with parents' background (OR 1.8 CI 1.4-2.4) and parents' education (OR 1.3 CI 1.0-1.5). Conclusions: The results showed that routine intervals were individualized and extended, indicating that more resources were spent on children with the highest need of dental care, aiming at reducing health inequalities.


Assuntos
Agendamento de Consultas , Assistência Odontológica para Crianças/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/prevenção & controle , Serviços de Saúde Bucal/estatística & dados numéricos , Cuidado Periódico , Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Noruega/epidemiologia , Visita a Consultório Médico/estatística & dados numéricos , Fatores de Tempo
5.
Cien Saude Colet ; 24(3): 953-961, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892516

RESUMO

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Saúde Bucal/estatística & dados numéricos , Adulto , Fatores Etários , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Renda , Lactente , Masculino , Análise Multivariada , Distribuição de Poisson , Inquéritos e Questionários , Adulto Jovem
6.
Acta Odontol Scand ; 77(5): 359-363, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30789085

RESUMO

OBJECTIVE: To test the association between maternal perception about child's oral health and child dental caries experience and maternal self-perception about oral health. MATERIALS AND METHODS: A cross-sectional study was performed with mothers and their children aged six to 13 years. A questionnaire was applied to mothers. Children were dentally examined using the DMF-T/dmf-t Index. For analysis, Poisson regression models with robust variance were employed for each variable of interest (child dental caries experience and maternal self-report about oral health). Magnitudes of associations were estimated through Prevalence Ratio (PR) as effect measure with 95% confidence intervals (CI). A significant level of p ≤ .05 was adopted. RESULTS: Overall, 131 mothers-children dyads were included. Most of children were girls (52.7%) and aged between 10 to 13 years (60.3%). Negative maternal perception about child's oral health was associated to maternal negative self-perception about oral health (PR 2.54; 95%CI 1.54-4.30) and to higher child dental caries experience (PR 2.21; 95%CI 1.41-3.47). CONCLUSION: Maternal perception about child oral health was associated to child dental caries and to maternal self-report about oral health.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/psicologia , Relações Mãe-Filho , Mães/psicologia , Saúde Bucal/estatística & dados numéricos , Higiene Bucal/psicologia , Adolescente , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Higiene Bucal/estatística & dados numéricos , Autorrelato , Inquéritos e Questionários
7.
Eur J Oral Sci ; 127(2): 147-155, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30724404

RESUMO

The aim of this study was to investigate whether there is an association between temperament characteristics of preschool children, dental anxiety, and their dental behaviour. A total of 100 children, aged 3-5 yr, who were attending their initial dental visit accompanied by a parent, were included in this cross-sectional study. Dental anxiety of children was measured using the Facial Image Scale. The behaviour of children during the initial oral examination and oral prophylaxis was assessed using Frankl's behaviour rating scale. Temperament was assessed using Emotionality, Activity, Shyness Temperament Survey for Children (parental ratings). Statistically significant weak linear positive correlations were seen between the following: the percentage duration of definitely negative behaviour and shyness scores (rs  = 0.28); anxiety level and emotionality scores (rs  = 0.28); and anxiety level and shyness scores (rs  = 0.26). Multinomial logistic regression analysis revealed that children with higher anxiety had higher odds of showing definitely negative behaviour, which decreased with increasing age of the child. Emotionality and shyness temperaments may be weakly associated with dental anxiety, and shyness may be weakly associated with the dental behaviour of the preschool child. Definitely negative dental behaviour is associated with dental anxiety and age of the child.


Assuntos
Comportamento Infantil , Ansiedade ao Tratamento Odontológico/psicologia , Assistência Odontológica para Crianças/estatística & dados numéricos , Temperamento , Pré-Escolar , Estudos Transversais , Ansiedade ao Tratamento Odontológico/diagnóstico , Consultórios Odontológicos , Emoções , Humanos , Índia , Relações Interpessoais , Masculino , Pais , Timidez , Inquéritos e Questionários
8.
Rev Saude Publica ; 53: 15, 2019 Jan 31.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30726496

RESUMO

OBJECTIVE: To evaluate whether characteristics of health services, oral health team and dental surgeon are associated with provision of dental care for children up to five years old in Brazilian Primary Health Care. METHODS: A cross-sectional study was conducted with data from 18,114 oral health teams in Brazil, evaluated in 2014 by the National Program for Access and Quality Improvement in Primary Care. The study outcome was the proven performance of dental procedures on children up to five years old. Statistical analysis was performed by Poisson regression based on a hierarchical model, where the first level was composed of service organization variables, the intermediate level composed of unit planning characteristics, and the proximal level composed of variables related to dental surgeon characteristics. RESULTS: Prevalence of dental care performed by oral health teams was 80.9% (n = 14,239). Scheduled appointments and activities of education in health were positively associated with the outcome, as well as planning and programming activities for the population and monitoring and analysis of oral health indicators. Complementary training in public health, continuing education activities and career plan were variables related to dental surgeons associated with the service provision. CONCLUSIONS: One fifth of health units in Brazil do not provide dental care for children in early childhood. Health units' well-structured organization and planning protocols are associated with the provision of this service, as well as better employment relationship and graduate activities for dental surgeons.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Brasil , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Distribuição de Poisson
9.
Pediatr Dent ; 41(1): 40-46, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30803476

RESUMO

Purpose: The purpose of this study was to assess the prevalence of and factors that contribute to sibling-recurrent dental general anesthesia (DGA) at the Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Va., USA. Methods: Subjects were recruited from July 25, 2017 to March 15, 2018. The guardian of patients with siblings who attended a university pediatric dental clinic were provided a questionnaire to assess the prevalence and factors associated with recurrent DGA. A provider survey was completed to ensure inclusion/exclusion criteria were met. Results: A total of 40 families with a child presenting for general anesthesia (GA) and who had at least one sibling were included in the study. Of these, 45 percent had sibling-recurrent GA treatment; 20 percent of patients had one sibling; and 25 percent had two or more sibling-recurrent DGA (P<.05). Additionally, 13 percent of the children currently presenting for GA had already been treated under GA, and 15 percent of the siblings previously treated with GA had recurrent caries after GA. Conclusions: Sibling-recurrent general anesthesia is high at Virginia Commonwealth University's Pediatric Dentistry Clinic. This increased prevalence could be due to parental acceptance and positive experiences with DGA. Dental providers should be proactive with prevention of recurrent DGA.


Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Anestesia Dentária/estatística & dados numéricos , Anestesia Geral/estatística & dados numéricos , Assistência Odontológica para Crianças/estatística & dados numéricos , Irmãos , Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Feminino , Humanos , Lactente , Masculino , Pais , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Virginia/epidemiologia
10.
Eur J Paediatr Dent ; 19(4): 265-270, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30567441

RESUMO

AIM: The aim of this study was to determine the age at and the reasons for the child's first dental visit, and to assess the oral health status and treatment needs in the analysed group of paediatric patients. MATERIALS AND METHODS: The study involved 320 children (154 girls and 166 boys) aged between 0.7 months and 13.5 years, visiting the dentist for the first time. All parents/legal guardians of the study participants gave written informed consent for participation in the study. Data on the child's age and reason for the dental visit were collected from interviews with parents. The state of oral health and dental treatment needs were assessed based on clinical examination, according to recommendations of the World Health Organization. STATISTICAL ANALYSIS: collected data were entered into an Excel spreadsheet and analysed using IBM SPSS software (version 24). Research hypotheses were verified using the Chi-square independence test at the level of statistical significance p<0.05. RESULTS: The mean age of children at their first dental visit was 3.79 years (+/- 1.82 years). The most common reasons (60%) for the first dental visit were pain followed by dental caries (33.1%) and the presence of decayed teeth (26.9%). The frequency of caries in the population was 75.9%, which means that only one out of four examined children was free from dental caries. Only 23.1% of patients did not require dental treatment and as many as 76.9% of the studied population needed dental treatment. CONCLUSION: Polish children make their first dental visit too late (usually at the age of 4 years) in relation to medical recommendations (between 6 and 12 months of life). The predominant reason for the child's first dental visit is caries and its complications. The results of this study indicate the bad oral health of Polish children making their first dental visit and low health awareness of parents and guardians.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Entrevistas como Assunto , Saúde Bucal , Polônia , Fatores de Tempo
11.
Clinics (Sao Paulo) ; 73: e721, 2018 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-30517306

RESUMO

The aim of this study was to provide an updated review of dental procedures undertaken at the dental unit of the Onco-hematology service of the Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (ICr/HC-FMUSP). We retrospectively reviewed 565 of 1902 medical and dental records of patients diagnosed with onco-hematological diseases who were seen in a 3-year study (January 2015 to December 2017). We assessed data regarding population characteristics, onco-hematological diagnosis and dental procedures performed. Of the selected medical records, preventive dentistry was the most common procedure undertaken in this population, followed by oral maxillofacial surgeries, restorative dentistry and oral mucositis treatment. The most prevalent malignant diagnosis was acute lymphocytic leukemia, and the most prevalent nonmalignant diagnosis was sickle-cell anemia. Preventive dental procedures represent most of the dental procedures undertaken in hospitalized onco-hematological pediatric patients.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Neoplasias/terapia , Doenças Estomatognáticas/prevenção & controle , Adolescente , Criança , Pré-Escolar , Prestação Integrada de Cuidados de Saúde , Serviços de Saúde Bucal , Humanos , Lactente , Recém-Nascido , Registros Médicos , Estudos Retrospectivos , Doenças Estomatognáticas/terapia
12.
Pediatr Clin North Am ; 65(5): 965-979, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30213357

RESUMO

Despite being largely preventable, oral diseases are still a major public health problem in child populations in many parts of the world. Increasingly, however, oral diseases disproportionately affect socially disadvantaged groups in society. It is unjust and unfair that children and families from disadvantaged backgrounds experience high levels of oral diseases. This article analyzes oral diseases through a health disparities lens. Action to combat oral health disparities requires a radical multifaceted strategy that addresses the shared underlying root causes of oral diseases, the social determinants of health inequality.


Assuntos
Disparidades nos Níveis de Saúde , Doenças da Boca/epidemiologia , Doenças da Boca/prevenção & controle , Saúde Bucal , Criança , Assistência Odontológica para Crianças/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Prevalência , Qualidade de Vida , Fatores de Risco , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
13.
Int J Paediatr Dent ; 28(6): 624-632, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30175414

RESUMO

BACKGROUND: Early-life dental service utilization could improve child dental health. AIM: Identify contextual, socioeconomic, and child characteristics associated with dental visitation by age 3 years. DESIGN: Within a Brazilian birth cohort (N = 435), multivariable regression models were fitted to identify independent predictors of having made a dental visit at age 3 years. Contextual variables considered included health center type (Traditional vs. Family Health Strategy, which perform home visits) and composition of oral health teams at the heath center where mothers accessed prenatal care. RESULTS: Dental visitation was positively associated with Family Health Strategy health centers (36% vs. 23%) and with higher maternal education and family social class. Visitation was lowest among families served by a health center without a dentist, but number of dentists and oral health team composition were not associated with visitation among facilities with ≥1 dentists. Dental visitation was not statistically significantly associated with caries experience but was higher if parents reported worse oral health-related quality of life. The vast majority of dental decay remained untreated. CONCLUSIONS: Dental visits were underutilized, and socioeconomic inequalities were evident. Dental visitation was more common when mothers received prenatal care at Family Health Strategy health centers, suggesting a possible oral health benefit.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Saúde da Família , Visita a Consultório Médico , Saúde Bucal , Brasil , Pré-Escolar , Assistência Odontológica para Crianças/psicologia , Cárie Dentária/prevenção & controle , Consultórios Odontológicos , Odontólogos , Escolaridade , Feminino , Humanos , Masculino , Mães/educação , Mães/psicologia , Análise Multivariada , Saúde Bucal/estatística & dados numéricos , Pais , Cuidado Pré-Natal , Qualidade de Vida , Classe Social , Fatores Socioeconômicos , Inquéritos e Questionários
14.
Community Dent Oral Epidemiol ; 46(6): 624-630, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30144146

RESUMO

OBJECTIVES: To investigate whether oral health literacy (OHL) impacts missing data obtained through self-reporting in oral health epidemiological research. METHODS: A cross-sectional study was conducted with parents (n = 344) of 4- to 5-year-old children randomly selected from public schools within the city of Curitiba, Brazil. Parental OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Parents answered a set of questionnaires comprising 88 items concerning sociodemographic and economic data, children's access to dental services, oral hygiene behaviour, diet and mealtime behaviour. The total number of unanswered items (TUI) and the number of unanswered items in each type of question (open-ended, dichotomous, multiple choice with up to 4 options and with 5-9 options) for each participant was compared across different levels of OHL (chi-squared, Mann-Whitney, Kruskal-Wallis and Spearman's correlation test). Multiple Poisson regression was used to estimate rate ratios (RR) of TUI between OHL scores and their respective 95% confidence interval (95% CI). RESULTS: Approximately one-third of studied parents (37%) exhibited low OHL (BREALD-30 ≤ 21). The prevalence of missing data in at least one item was 85.5%. Low OHL was associated with failing to respond open-ended items (P = 0.003) and multiple-choice items with up to 4 (P = 0.003) and between 5 and 9 options (P = 0.030). There was a negative correlation between OHL scores and TUI (r = -0.195; P < 0.001), as well as with the number of unanswered items in all types of questions (P < 0.01), except dichotomous questions. Parents with lower OHL were more likely to show higher values of TUI (RR 0.95: 0.93-0.98), when adjusted by income and education. CONCLUSIONS: Participants with lower OHL were significantly more likely to fail to complete research questionnaires. The impact of OHL on missing data was greater with more complex types of items.


Assuntos
Letramento em Saúde , Saúde Bucal , Adolescente , Adulto , Brasil , Pré-Escolar , Estudos Transversais , Assistência Odontológica para Crianças/estatística & dados numéricos , Medidas em Epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Higiene Bucal/psicologia , Pais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
15.
Braz Oral Res ; 32: e79, 2018 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-30088552

RESUMO

This study assessed the difference in the number of visits made to a dental care clinic and the time spent providing specific dental treatment for children with and without molar incisor hypomineralization (MIH). Children aged 8 to 16 years who presented at the Pediatric Dental Unit of the Obafemi Awolowo University Teaching Hospital Complex, in Ile-Ife, Nigeria, were eligible for the study. A comprehensive medical and dental history was taken, and each child was clinically examined, diagnosed, and treated according to a drawn-up plan. The time taken to establish a diagnosis and to provide specific treatments (scaling and polishing, restoration, pulpectomy, extraction, and placement of stainless steel crowns) and the number of visits made to complete the treatment plan were recorded for each child. Differences in the number of visits, time expended to make a diagnosis and to treat children with and without MIH were analyzed. The average time for diagnosis (p = 0.001) and the average time for placing amalgam restorations (p = 0.008) were significantly longer in children with MIH than in those without it. Children with MIH made more visits to the clinic (p < 0.001).There was no significant difference in the average time for scaling and polishing (p = 0.08), glass ionomer cement restorations (p = 0.99), composite restorations (p = 0.26), pulpectomy (p = 0.42), tooth extraction (p = 0.06), and placement of a stainless steel crown (p = 0.83) in children with and without MIH. In conclusion, children with MIH required more time for oral health care. Placing amalgam restorations took significantly longer than placing tooth bonding restorative materials in children with MIH than in those without it.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Hipoplasia do Esmalte Dentário/terapia , Adolescente , Criança , Clínicas Odontológicas , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Humanos , Masculino , Nigéria , Índice de Gravidade de Doença , Fatores Socioeconômicos , Fatores de Tempo
16.
Am J Prev Med ; 55(3): e53-e60, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30017612

RESUMO

INTRODUCTION: Healthy People 2020 includes a goal of increasing use of preventive dental care among children from low-income families. The services used to define preventive care are evidence-based services (i.e., dental sealants and professionally applied topical fluoride) and professional dental cleaning, which lacks evidence of effectiveness in preventing caries. This study examined how increasing preventive dental care use and reducing disparities by race/ethnicity among children from low-income families varied by the services included in case definitions of preventive dental care use. METHODS: Three case definitions of past-year preventive dental care use were considered: (1) the Healthy People 2020 definition; (2) receipt of an evidence-based caries prevention service; and (3) dental cleaning only. Using pooled data from the 2001-2002 and 2013-2014 Medical Expenditure Panel Survey for each definition, this study conducted in 2017 used multivariate logistic regression to estimate changes in preventive dental care use among children from low-income families by race/ethnicity. RESULTS: Use increased for all racial/ethnic groups for all definitions. Use of preventive dental care (Healthy People 2020 definition), however, was at least two times higher than evidence-based preventive dental use for all racial/ethnic groups in both survey periods. After controlling for insurance status and parental education, the disparity between non-Hispanic black and non-Hispanic white children in use of preventive dental care that was present in 2001-2002 was not detected in 2013-2014 whereas the disparity for evidence-based preventive dental care use persisted. CONCLUSIONS: Case definitions of preventive dental care that include non-evidence-based services may overstate receipt of effective preventive dental care and reductions in certain racial/ethnic disparities.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Serviços Preventivos de Saúde , Adolescente , Afro-Americanos/estatística & dados numéricos , Americanos Asiáticos/estatística & dados numéricos , Criança , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Estados Unidos
17.
Community Dent Oral Epidemiol ; 46(5): 442-448, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29873406

RESUMO

OBJECTIVES: Routine preventive dental care is important to overall child health and well-being. However, the experience of adversity in childhood may prevent children from getting adequate preventive care. This study seeks to explore how the prevalence of adverse childhood experiences (ACEs) and the role of a protective adult may be associated with dental care utilization in childhood. METHODS: Data from the 2016 South Carolina Behavioral Risk Factor Surveillance System (SC BRFSS), which interviews adults eighteen year of age and older, were used in this study. Dental care utilization in childhood was measured as the adult retrospectively reported frequency of dental care in childhood: at least once every 2 years (adequate dental care) or less often than every 2 years (inadequate dental care). ACEs were determined by asking about each of respondent's childhood exposure to eleven childhood experiences, including divorce, parental incarceration, domestic violence, drug and alcohol abuse, mental illness and emotional, physical or sexual abuse. The presence of a protective adult in childhood included respondents who had an adult who made them feel safe and protected during childhood. Descriptive and bivariate statistics explored differences in the adequacy of child dental care by ACE exposure, the presence of a protective adult and selected demographic characteristics. Multivariate regression models were used to examine the impact of counts and types of ACEs and the presence of a protective adult with inadequate childhood dental care. RESULTS: The unweighted study sample included 7079 respondents ageing from 18 to 79 years of age Sampling weights were used for all analyses. Among all respondents, 71.7% reported receiving adequate dental care during childhood; 28.3% responded that they received inadequate dental care. Adjusting for sociodemographic characteristics, respondents who experienced four or more ACEs had a higher likelihood of inadequate dental care than respondents who reported no ACEs (aOR 2.79; 95% CI 2.77-2.82). The odds of reporting inadequate dental care were lower among those grew up with an adult who made them feel safe and protected (aOR 0.38; 95% CI 0.37-0.39). CONCLUSIONS: The presence of protective factors may mitigate the effects of ACEs on paediatric dental care. This research contributes to the literature through the further identification of the role of dentists in identifying signs of abuse and neglect.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Assistência Odontológica para Crianças/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , South Carolina/epidemiologia , Adulto Jovem
18.
J Clin Pediatr Dent ; 42(4): 303-306, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29750625

RESUMO

PURPOSE: The aims of this study were to describe the demographic characteristics of pediatric dentistry patients undergoing dental rehabilitation under general anesthesia (DRGA) at UNC-Chapel Hill during the last 13 years and identify factors associated with multiple (1 versus 2 or more) DRGA visits during that timeframe. STUDY DESIGN: Administrative claims data were used to identify children and adolescents (age <18 years) who underwent DRGA between 1/1/2002 and 12/31/2014 at the UNC Hospitals system. Information on children's age, sex and all treatment-associated CDT codes were collected. Descriptive statistics and bivariate tests of association were used for data analyses. RESULTS: There were 4,413 DRGAs among 3,973 children (median age=4 years 8 months, males=55%) during the study period. The annual rate of DRGAs increased over time, peaking (n=447) in 2013. Overall, 9% of children had ≥2 visits with repeat rates up to 18%. There was no association between children's sex and receipt of one versus multiple DRGAs; however, craniofacial cases were more likely (p<0.0005) to have multiple DRGAs compared to non-craniofacial ones. CONCLUSION: DRGAs are on the increase-with the exception of craniofacial and special health care needs patients, multiple DRGAs may be reflective of sub-optimal adherence to preventive and continuing care recommendations.


Assuntos
Anestesia Dentária/estatística & dados numéricos , Anestesia Dentária/tendências , Anestesia Geral/estatística & dados numéricos , Assistência Odontológica para Crianças/estatística & dados numéricos , Anestesia Dentária/métodos , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Tempo
20.
Community Dent Health ; 35(2): 89-94, 2018 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-29645407

RESUMO

OBJECTIVE: To identify associations between child, caregiver, and family-level factors and child dental utilization. RESEARCH DESIGN: Cross-sectional oral health survey. PARTICIPANTS: Caregivers and one study child (ages 0-17) from Mexican migrant families in northern San Diego county, CA (n=142). METHODS: Caregivers reported on child's dental care utilization history and related factors, including: child (age, gender, dental insurance, source of care, believed to have cavities), caregiver (marital status, income, education, acculturation level, depressive symptoms), and family cohesion. Descriptive and logistic regression models identified predisposing, enabling, and need factors associated with child dental utilization during the past year. RESULTS: Most (76%) children had visited the dentist in the past year, while 8.6% had never been. Child factors (gender, insurance), caregiver factors (education, depressive symptoms), and family cohesion were each associated with child dental utilization in the bivariate analyses. In the final adjusted model, uninsured children were less likely to have a past year dental visit compared to insured children (Odds Ratio (OR) = 0.23, 95% Confidence Interval (CI) = 0.06-0.96). Children whose caregivers visited the dentist were 4.29 times more likely to visit the dentist in the past year (CI=1.36-13.61). Higher caregiver education was positively associated with child dental utilization (OR=4.50, CI=1.50-13.55). CONCLUSION: Child age and dental insurance, and caregiver education and dental utilization history were associated with whether or not a child had a past year dental visit. Ensuring child dental coverage and caregiver access to dental care may promote regular dental utilization by children.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Hispano-Americanos , Migrantes , Adolescente , California , Cuidadores , Criança , Pré-Escolar , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Cobertura do Seguro/estatística & dados numéricos , Masculino , México , Fatores de Risco , Inquéritos e Questionários
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