The prevalence of malocclusion is higher in schoolchildren with signs of hyperactivity.

INTRODUCTION: Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to evaluate the association between signs of attention deficit-hyperactivity disorder and malocclusion in schoolchildren. METHODS: A cross-sectional study was conducted with a representative sample of 633 children aged 7-12 years. The children were clinically examined for malocclusion using the Dental Aesthetic Index. The predominant breathing pattern was also determined. Parents answered a questionnaire addressing socioeconomic characteristics and the presence of nonnutritive sucking habits. The Swanson, Nolan, and Pelham Scale-IV was filled out by both parents and teachers to compare behavioral patterns. The children were submitted to a neuropsychological evaluation using the Raven's Colored Progressive Matrix Test. Data analysis involved the chi-square test and Poisson regression analysis. RESULTS: The prevalence of malocclusion was 42% higher among children with signs of hyperactivity reported by both parents and teachers (prevalence ratio [PR], 1.42; 95% confidence interval [CI], 1.11-1.81; P = 0.004). In the final Poisson regression model, the prevalence of malocclusion was lower among schoolchildren aged 11 and 12 years (PR, 0.62; 95% CI. 0.52-0.73; P <0.001) and higher among those who used a pacifier for at least 4 years (PR, 1.25; 95% CI, 1.02-1.54; P = 0.029) as well as those classified as mouth breathers (PR, 1.28; 95% CI, 1.09-1.51; P = 0.003). CONCLUSIONS: The prevalence of malocclusion was higher among children with signs of hyperactivity independently of age, pacifier use, and mouth breathing.

Do Signs of Attention-Deficit/Hyperactivity Disorder Increase the Odds of Dental Caries? A Case-Control Study.

Attention-deficit/hyperactivity disorder (ADHD) is a behavioural disorder that can affect one's performance in activities of daily living and can exert a negative impact on the oral health of children. OBJECTIVE: The aim of this work was to determine the association between ADHD (signs and executive functions) and dental caries in children aged 7-12 years. METHODS: A case-control study was conducted with 532 children in the city of Diamantina, Brazil. The case group was composed of children with caries and the control group was composed of children without caries. The children were submitted to a clinical oral examination for the determination of caries and neuropsychological evaluations of intellectual function and executive function. Other signs of attention deficit and hyperactivity were investigated using the Swanson, Nolan, and Pelham scale administered to parents/guardians and teachers. Socioeconomic and demographic characteristics were also evaluated. Statistical analysis involved the McNemar χ2 test and conditional logistic regression. RESULTS: The multivariate logistic regression model demonstrated that monthly household income and parental reports of signs of attention deficit were significantly associated with the occurrence of dental caries. CONCLUSION: Children considered by their parents/guardians to have attention deficit have a greater chance of exhibiting dental caries, independently of household income.

Effects of attention deficit hyperactivity disorder signs and socio-economic status on sleep bruxism and tooth wear among schoolchildren: structural equation modelling approach.

BACKGROUND: The prevalence of both bruxism and attention deficit hyperactivity (ADHD) has increased in recent years. AIM: This study evaluated the direct and indirect effects of signs of ADHD, reported by parents/caregivers and teachers, with sleep bruxism. In addition, this study explores the effects of socio-economic status (SES) on sleep bruxism. DESIGN: This cross-sectional study was performed in Diamantina, Brazil, with 851 randomly selected schoolchildren aged 6-12 years. The schoolchildren were underwent an oral examination for the evaluation of bruxism. Moreover, parents/caregivers fill out a form for the assessment of sleep bruxism and sociodemographic factors. Parents/caregivers and teachers responded to the Swanson, Nolan and Pelham scale - version IV (SNAP-IV) for the assessment of ADHD signs. The structural equation modelling approach was used, and standardized coefficients to direct, indirect and total effects were calculated. RESULTS: ADHD signs had a significant moderate (SC = -0.19, P < 0.01) effect on sleep bruxism. SES had a significant indirect effect on bruxism via sucking habits. Moreover, SES had a significant direct (SC = -0.16, P = 0.01) and total effect on tooth wear (SC = -0.17, P < 0.01). CONCLUSION: This study concluded that signs of ADHD and SES have a complex direct and indirect effects on sleep bruxism among schoolchildren.

Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years.

OBJECTIVE: This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years. METHODS: A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL. RESULTS: The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales. CONCLUSION: Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

Signs of attention deficit/hyperactivity disorder as a risk factor for traumatic dental injury among schoolchildren: a case-control study.

BACKGROUND: The determination of risk factors for traumatic dental injury (TDI) is important to the implementation of preventive measures. AIM: The aim of this study was to evaluate the association between signs of attention deficit/hyperactivity disorder (ADHD) and TDI. MATERIAL AND METHODS: A case-control (1 : 1) study involved a population-based sample of 230 schoolchildren aged seven to 12 years. The case and control groups were composed of children with (n = 115) and without (n = 115) TDI, respectively. The groups were matched for age and sex. The outcome variable (TDI) was detected using the O'Brien criteria. The main independent variable (signs of ADHD) was evaluated using the Swanson, Nolan and Pelham scale (version IV) administered to parents and teachers. Socio-demographic characteristics and accentuated overjet were analyzed as confounding factors. Statistical analysis involved the McNemar's test as well as the bivariate and multivariate conditional logistic regression. RESULTS: The multivariate regression demonstrated that schoolchildren with the signs of hyperactivity (parental reports) had a 2.33-fold greater chance of exhibiting TDI (95% CI: 1.10-4.94) than those without this condition, as well as those with accentuated overjet (OR = 3.13, 95% CI: 1.70-5.77). CONCLUSION: Schoolchildren whose parents reported signs suggestive of hyperactivity had a greater chance of exhibiting TDI than those without such signs.

Parents' recognition of dental trauma in their children.

OBJECTIVES: The aim of the present study was to assess parents' recognition of dental trauma in their children. METHODS: A cross-sectional study was conducted in Belo Horizonte, Brazil, with 519 randomly selected children between 1 and 3 years of age. The parents answered questions on the occurrence of previous dental trauma, caregiver's schooling and the impact of dental trauma on activities and quality of life of the children. The children were also clinically examined for presence of dental trauma. Descriptive analysis, the chi-squared test, Mann-Whitney test and Poisson regression analysis were performed. The calculation of effect size was used to test the clinical significance of the findings. RESULTS: A total of 41.2% (n = 214) of the children had at least one tooth with dental trauma. Among the parents of the children with dental trauma, 42.5% (n = 91) had not recognized the trauma. Mean caregiver's schooling was 8.9 ± 3.3 years of study. The schooling of caregivers who were unaware of the dental trauma was lower (mean: 5.3 ± 2.5 years of study) than that of those who were aware of the trauma (10.4 ± 2.1 years of study; P < 0.001). The recognition of dental trauma was more prevalent among parents of children over 24 months of age (PR: 3.5; 95% CI: 2.2-5.6), those whose children experienced an impact of oral health status on quality of life (PR: 1.2; 95% CI: 1.1-1.4) and those with a higher level of schooling (PR: 1.2; 95% CI: 1.1-1.2). CONCLUSION: A large portion of parents do not recognize the occurrence of dental trauma in their toddlers. The age of the child, impact of oral health status on quality of life and caregiver's schooling were directly associated with parents' recognition of dental trauma in children aged 12 to 36 months.

Malocclusion Impact Scale for Early Childhood (MIS-EC): development and validation.

This study aimed to develop and validate the Malocclusion Impact Scale for Early Childhood (MIS-EC), a malocclusion-specific measure of oral health-related quality of life (OHRQoL) of children aged 3-5 years and their parents/caregivers. A pool of items was analysed to identify those relevant to the assessment of the impact of malocclusion on OHRQoL. Dental professionals and mothers of children with and without malocclusion rated the importance of these items. The final version of the MIS-EC was evaluated in a cross-sectional study comprising 381 parents of children aged 3-5 years to assess construct validity, internal consistency and test-retest reliability. Twenty-two items were identified from item pooling. After item reduction, eight items were chosen to constitute the MIS-EC, in addition to two general questions. The MIS-EC demonstrated good internal consistency (Cronbach's alpha = 0.79 for the Child Impact section and 0.53 for the Family Impact section), and excellent test-retest reliability (ICC = 0.94), floor effect was 55.7% and ceiling effect 0%. MIS-EC scores indicating worse OHRQoL were significantly associated with the presence of malocclusion (p < 0.05). The MIS-EC is reliable and valid for assessing the impact of malocclusion on the OHRQoL of preschool children and their parents/caregivers.

Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.

Fatores associados à prevalência de cárie dentária em crianças em Montes Claros - MG / Prevalence of dental caries in children and adolescents and associated factors in Montes Claros - MG

Objetivo: determinar os fatores associados à prevalência de cárie dentária em crianças atendidas em uma clínica de odontopediatria no norte de Minas Gerais. Métodos: estudo transversal retrospectivo, documental de abordagem quantitativa, por meio da avaliação de prontuários na clínica de odontopediatria e tabulação dos dados no programa Statistical Package For Social Science (SPSS) software version 23.0 for MacBook. Foram incluídos crianças e adolescentes de 2 a 12 anos que realizaram pelo menos uma sessão com procedimento clínico. Foram excluídos os prontuários que não apresentavam dados relacionados ao exame clínico ou que não constavam a assinatura do responsável legal.Resultados: Foram avaliados 459 prontuários, sendo 45 excluídos devido à ausência do exame clínico intrabucal. A amostra final foi composta por 414 prontuários de crianças e adolescentes. Dos avaliados 55,56% (n = 230) eram do gênero masculino e a média de idade sendo de 7,6 anos. Foi observado a presença de lesão cariosa cavitada em dentes decíduos e ou permanentes em 72,95% dos indivíduos, e estes apresentavam higiene bucal insatisfatória em 91,87% dos casos. Além disso, crianças e adolescentes sem presença de cárie foram ao dentista para um retorno periódico em 43,27% dos avaliados. Conclusão: Foi verificado uma alta prevalência da lesão cariosa, relacionado aos hábitos dos avaliados, portanto, deve-se adquirir medidas preventivas e tratamento em saúde bucal precoce, buscando minimizar os acometimentos e prejuízos em saúde bucal.

Aim:Determine the factors associated with the prevalence of dental caries in children treated at a pediatric dentistry clinic in the north of Minas Gerais. Methods: Retrospective cross-sectional, documentary study with a quantitative approach, through the evaluation of medical records at the pediatric dentistry clinic and data tabulation in the Statistical Package For Social Science (SPSS) software version 23.0 for MacBook. Children and adolescents aged 2 to 12 years who underwent at least one clinical procedure session were included. Records that did not present data related to the clinical examination or that did not contain the signature of the legal guardian were excluded. Results: 459 medical records were evaluated, 45 of which were excluded due to the absence of intraoral clinical examination. The final sample consisted of 414 medical records of children and adolescents. Of those evaluated, 55.56% (n = 230) were male, and the average age was 7.6 years. The presence of cavitated carious lesions in primary and/or permanent teeth was observed in 72.95% of individuals, and they had unsatisfactory oral hygiene in 91.87% of cases. Furthermore, children and adolescents without the presence of cavities went to the dentist for periodic check-ups in 43.27% of those evaluated. Conclusion: A high prevalence of carious lesions was found, related to the habits of those evaluated; therefore, preventive measures and early oral health treatment must be acquired, seeking to minimize problems and losses in oral health

Malocclusion Impact Scale for Early Childhood (MIS-EC): development and validation

Abstract: This study aimed to develop and validate the Malocclusion Impact Scale for Early Childhood (MIS-EC), a malocclusion-specific measure of oral health-related quality of life (OHRQoL) of children aged 3-5 years and their parents/caregivers. A pool of items was analysed to identify those relevant to the assessment of the impact of malocclusion on OHRQoL. Dental professionals and mothers of children with and without malocclusion rated the importance of these items. The final version of the MIS-EC was evaluated in a cross-sectional study comprising 381 parents of children aged 3-5 years to assess construct validity, internal consistency and test-retest reliability. Twenty-two items were identified from item pooling. After item reduction, eight items were chosen to constitute the MIS-EC, in addition to two general questions. The MIS-EC demonstrated good internal consistency (Cronbach's alpha = 0.79 for the Child Impact section and 0.53 for the Family Impact section), and excellent test-retest reliability (ICC = 0.94), floor effect was 55.7% and ceiling effect 0%. MIS-EC scores indicating worse OHRQoL were significantly associated with the presence of malocclusion (p < 0.05). The MIS-EC is reliable and valid for assessing the impact of malocclusion on the OHRQoL of preschool children and their parents/caregivers.

Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions

Abstract Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.

Does intellectual disability affect the development of dental caries in patients with cerebral palsy?

The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of these, 76 individuals had been diagnosed with spastic cerebral palsy and 89 had no neurological impairment. The subjects were matched based on age and gender and selected randomly by lottery. All patients were examined to determine the number of dental cavities, and tested for their intellectual functioning (Raven Test) and motor abilities. The study showed that children with CP who presented with intellectual disabilities had a larger number of dental cavities than children with CP without intellectual disabilities. Considering intellectual functioning and motor impairment in the multivariate logistic regression, only intellectual functioning was found to have a significant effect on the development of dental cavities. These results suggest that intellectual disability can be considered a contributing factor for the development of dental caries in patients with cerebral palsy.