The Impact of Socio-Environmental, Individual, and Biological Factors on Oral Health-Related Quality of Life among Preschool Children: A Cohort Study with 3-Year Follow-Up.

This study assessed impact of socio-environmental, individual, and biological factors on the worsening and severe worsening of oral health-related quality of life (OHRQoL) among preschoolers and their families. A cohort study was conducted in Diamantina, Brazil, with 151 children between 1 and 3 years of age and their mothers, who were evaluated at baseline (2014) and re-evaluated after 3 years (2017). The children were clinically examined to assess the presence of dental caries, malocclusion, dental trauma, and enamel defects. The mothers answered the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing individual characteristics of the child and socio-environmental factors. Extensive caries found in the follow-up (relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.26-2.91) and failure to undergo the dental treatment recommended at baseline (RR = 2.49; 95% CI = 1.62-3.81) were associated with worsening of OHRQoL over 3 years. An increase in the number of children in the household (RR = 2.95; 95% CI = 1.06-8.25), occurrence of extensive caries in the follow-up (RR = 2.06; 95% CI = 1.05-4.07), and failure to undergo the dental treatment recommended at baseline (RR = 3.68; 95% CI = 1.96-6.89) were associated with a severe worsening of OHRQoL. In conclusion, the risk of worsening and severe worsening of OHRQoL was higher in preschoolers with extensive caries at follow-up and among those who did not undergo dental treatment. Furthermore, severe worsening of OHRQoL was also impacted by an increase in the number of children in the household.

Association between asthma and oral conditions in children and adolescents: a systematic review with meta-analysis.

OBJECTIVE: To investigate the association between asthma and oral conditions in children and adolescents. MATERIAL AND METHODS: Observational studies that evaluated the association between asthma and oral conditions in children and/or adolescents were retrieved from five databases, grey literature and reference lists up to April 7th, 2022. Meta-analyses were performed, and I2 statistics were calculated. The mean difference was used as a measure of effect for continuous variables. Event frequencies were evaluated to determine odds ratios for dichotomous variables. Publication bias was investigated using Egger's test. The methodological quality (JBI) and certainty of the evidence (GRADE) were assessed. RESULTS: Forty-two studies were eligible, and sixteen were included in the meta-analysis. Mean dmft (MD: 1.11, 95%CI: 0.48-1.73), DMFT (MD: 1.01, 95% CI: 0.45-1.56), dmfs (MD: 3.62, 95%CI: 2.60-4.63) and DMFS (MD: 4.47, 95%CI: 0.98-7.96) indices were significantly higher in asthmatic children and adolescents compared to those without asthma. In the analysis of biofilm, asthmatic children and adolescents had a higher Plaque Index compared to those without asthma (MD: 0.18, 95%CI: 0.03-0.33). CONCLUSION: Asthmatic children and adolescents may be more likely to develop tooth decay and build up biofilm compared to those without asthma. It is suggested that there are no differences between asthmatic and non-asthmatic children and adolescents regarding gingivitis, developmental defects of enamel or erosive tooth wear. The certainty of the evidence was classified as 'very low'. CLINICAL RELEVANCE: Knowledge of the risks that asthma and asthma medications for oral health can assist in counselling families of children and adolescents with this condition in terms of control and prevention measures for oral problems.

Association between child's behaviour during first dental appointment and effectiveness of dental plaque removal by caregivers.

OBJECTIVE: To evaluate the association between the behaviour of children aged 1 to 4 years during their dental appointment and the effectiveness of dental plaque removal by caregivers. METHODS: This longitudinal study with intervention had the participation of 146 children (mean age = 34.89 months), 75 of whom (51.4%) showed positive behaviour (+ and ++) and 71 (48.6%), negative behaviour (- and - -). The children were evaluated at the first dental appointment, according to the Frankl scale. They were subjected to an assessment of oral conditions, and their plaque level was recorded (Quigley-Hein Index modified by Turesky) using the Evince® device. Caregivers received oral hygiene guidance. The dental plaque assessment was performed before giving the oral hygiene guidance and 14 days later. The statistical analysis included a descriptive assessment and the Wilcoxon test (p < 0.05). RESULTS: Mean dental plaque levels dropped significantly from the first to the second assessment (p < 0.001). The sample was divided according to the child's behaviour, observing that only the group of children with positive behaviour showed significantly less dental plaque in the second assessment (p < 0.001). CONCLUSION: The positive behaviour of children aged 1 to 4 years during the first dental appointments is associated with more effective dental plaque removal by caregivers.

The 100 most cited articles about orofacial trauma in children and adolescents: bibliometric analysis.

This bibliometric study aimed to identify and analyze the 100 most cited articles about orofacial trauma in children and adolescents. The search was conducted in the Web of Science Core Collection (WoS-CC) using a combined search strategy. Two researchers collected the following data from each article: year of publication, country, journal, number and density of citations, author, institutions, study design, type of trauma, and keywords. The VOSviewer and SPSS version 22.0 softwares were used for data analyses. The articles were published from 1968 to 2012 and the number of citations ranged from 49 to 176. Europe was the continent with most articles (40 articles; 3,408 citations). Brazil was the country that made the largest contribution (20 articles; 1,741 citations) and the Universidade do Sul de Santa Catarina (Brazil) was the institution with most articles (5 articles; 492 citations). Marcenes W was the most productive author (8 articles; 968 citations). The cross-sectional study design was the most common (50 articles; 3,978 citations). The most frequent field was epidemiology (73 articles; 5,971 citations). The most widely used criteria for trauma diagnosis were the Andreasen (18 articles; 1,505 citations) and Le Fort (3 articles; 260 citations). Strong positive correlations were found in the number of citations between WoS-CC and Google Scholar (r = 0.929; p < 0.001), WoS-CC and Scopus (r = 0.976; p < 0.001), and Google Scholar and Scopus (r = 0.903; p < 0.001). The 100 most cited articles about orofacial trauma in children and adolescents were mainly cross-sectional studies published by Brazilian authors in epidemiology using Andreasen criteria. Dental Traumatology was the journal with the largest contribution.

Utilization of dental services by preschool children: prevalence and associated factors.

Dental associations worldwide recommend that the first dental visit should take place before 12 months of age; however, preschoolers' utilization of dental services remains low. The aim of this study was to assess the prevalence of, and factors associated with, dental services utilization among children aged 1 to 3 years. This was a cross-sectional study carried out in the city of Diamantina, MG, Brazil, and involved a sample of 308 child-mother pairs. Mothers completed a questionnaire addressing sociodemographic and economic aspects of the family and characteristics pertaining to their child's oral health. The clinical assessment of the children included dental caries, trauma, malocclusion, and mucosal changes. Analysis of the data comprised statistical description, application of the chi-square test, and Poisson's regression analysis. Among the children studied, 39.6% had attended at least one dental visit in their lifetime. Children whose families had a greater number of members relying on the family's income (PR = 1.40, 95%CI:1.04 -1.89, p = 0.028) and those with moderate/extensive dental caries (Codes 3-6 of the ICDAS; PR = 1.44, 95%CI: 1.08 -1.93, p = 0.014) exhibited a higher prevalence of dental services utilization. In conclusion, the prevalence of dental services utilization among children aged 1 to 3 years was low, and was associated with a greater number of family members relying on the family's income, and with the occurrence of moderate/extensive dental caries.

Is gestational diabetes mellitus associated with developmental defects of enamel in children? A systematic review with meta-analysis.

OBJECTIVE: The present systematic review aimed to verify the association between Gestational Diabetes Mellitus (GDM) and Developmental Defects of Enamel (DDE) in children. Design A systematic search was conducted in four databases and the grey literature. The risk of bias of the studies was analyzed with the aid of the Newcastle-Ottawa scale. A quantitative synthesis was performed through meta-analysis. The quality of the evidence was assessed for each result using the Grading of Recommendations: Assessment, Development and Evaluation approach. RESULTS: Thirteen studies (seven cross-sectional, two cohort and four case-control studies) were included in the qualitative analysis and eleven were included in the meta-analyses. Meta-analyses were conducted considering general DDE (regardless of the type of defect), hypoplasia, molar incisor hypomineralization (MIH) and hypomineralized primary second molars (HPSM). Subgroups based on the type of dentition were also analyzed. Children of mothers who had GDM presented a greater likelihood of general DDE (OR = 2.72; 95% CI: 1.66-4.44), MIH (OR = 3.14; 95% CI: 1.20-8.25) and hypoplasia (OR = 2.17; 95% CI: 1.36-3.46). No association was found between HPSM and GDM (OR = 0.60; 95% CI: 0.17-2.20). An association was found between GDM and DDE in the permanent dentition. Therefore, children whose mothers had GDM were more likely to present DDE compared to those whose mothers did not have this metabolic disorder. CONCLUSIONS: The results should be interpreted with caution due to the low evidence of the primary studies.

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study / Influência da duração da amamentação na incidência de cárie dentária em pré-escolares: um estudo de coorte

Abstract Objectives: investigate the association between breastfeeding duration and the incidence of severe caries in preschoolers. Methods: a cohort study was conducted with 132 pairs of mothers and children in the city of Diamantina, Brazil. Data collection was performed in 2 moments: when the children were between two and three years of age (baseline- 2013/2014) and after three years (T1-2016/2017). In both moments, children were evaluated for dental caries (International Caries Detection and Assessment System - ICDAS) and a questionnaire was administered to the mothers addressing socioeconomic aspects and thee habits of children. The outcome evaluated was the incidence of severe caries (Dentin caries - ICDAS Codes 5 and 6). Data analysis involved descriptive statistics, chi-squared test and Poisson hierarchical regression with robust variance. Results: children who breastfed for more than 24 months (RR = 2.24 CI95%= 1.23-4.08), those whose parents were separated (RR = 1.73 CI95%= 1.11-2.69), and those with estab-lished/severe caries (RR = 2.74 CI95%= 1.37-5.49) at baseline were at greater risk of incidence of severe caries after three years. Conclusion: breastfeeding for more than 24 months is a risk factor for incidence of severe caries. In addition, family structure and established or severe baseline caries were associated.

Resumo Objetivos: investigar a associação entre a duração da amamentação e a incidência de cárie grave em pré-escolares. Métodos: foi realizado um estudo de coorte com 132 pares de mães e crianças de Diamantina, Minas Gerais, Brasil. As crianças foram avaliadas em dois momentos: dois e três anos de idade (baseline-2013/2014) e após três anos (T1- 2016/2017). Dados socioeconómicos e relativos aos hábitos das criançasforam obtidos por meio de entrevistas com as mães e a presença de cárie dentária foi diagnosticada segundo o protocolo "International Caries Detection and Assessment System - ICDAS". O desfecho foi a incidência de cárie grave (cárie em dentina - códigos ICDAS 5 e 6). Para análise dos dados empregou-se regressão hierárquica de Poisson com variância robusta. Resultados: crianças que amamentaram por mais de 24 meses (RR = 2,24 IC95%= 1,234,08), cujos pais viviam separados no baseline (RR = 1,73 IC95%= 1,11-2,69) e aquelas com cárie estabelecida ou grave no baseline (RR = 2, 74 IC950%= 1,37-5,49) estavam em maior risco de incidência de cárie grave após 3 anos. Conclusão: a amamentação por mais de 24 meses foi um fator de risco para a incidência de cárie dentária grave em pré-escolares. Além disso, estrutura familiar e cárie estabelecida ou grave no baseline estiveram associados.