Relation between anxiety disorders in adolescent mothers and dental fear in children.

BACKGROUND: Maternal anxiety disorders can cause adverse consequences in child's health, cognitive development, and behavior. AIM: To investigate the association of maternal anxiety disorders with the occurrence of dental fear in children aged 24-36 months. DESIGN: This cross-sectional study is part of a cohort of adolescent mothers and their children (n = 527) in the city of Pelotas, RS, Brazil. Anxiety disorders in mothers were assessed using Mini International Neuropsychiatric Interview (DSM-IV), whereas the Dental Anxiety Question was used to assess children's dental fear. Clinical oral examinations were performed on the cohort. Poisson regression analysis was used to determine the association of maternal anxiety disorders with maternal perception of dental fear in children (p < .05). RESULTS: The prevalence of dental fear in children was 21.7% (n = 114), and maternal age, agoraphobia, social phobia, and maternal caries experience (p < .05) were associated with the presence of dental fear. After adjusted analysis, children of mothers presenting with agoraphobia (Prevalence ratios [PR] = 1.52; 95% confidence interval [CI] = 1.00-2.32) and social phobia (PR = 1.69; 95% CI = 1.06-2.71) had higher prevalence of dental fear than children whose mothers did not have any of these conditions. CONCLUSIONS: In this population of young mothers, agoraphobia and social phobia were associated with children's dental fear. Detection of and treatment for maternal mental disorders may aid in the prevention of dental fear and its oral health-related consequences.

Dental caries severity and oral health-related quality-of-life in Brazilian preschool children.

The impact of dental caries on oral health-related quality-of-life (OHRQoL) may be influenced by disease severity. This study evaluated the impact of caries severity on OHRQoL in preschool children. A school-based, cross-sectional study was conducted with 205 children (aged 2-5 years) in Southern Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and provided sociodemographic information. The Caries Assessment Spectrum and Treatment criteria were used to evaluate caries severity, and Poisson regression with robust variance estimation conducted to determine the rate ratio (RR) and 95% confidence intervals (CIs) of the mean OHRQoL scores according to severity level. Most children had at least one tooth in the morbidity (37%) or pre-morbidity (35%) stages, and the prevalence of impacts on OHRQoL was 40%. Caries severity was associated with the impact scores: after adjustments, the mean B-ECOHIS scores were 6.31 (95% CI: 4.24-9.38) higher for children in the morbidity stage, and 10.84 (95% CI: 6.51-18.05) higher in the severe morbidity stage, than for healthy children [RR = 10.84 (95% CI: 6.51-18.05)]. Children with carious lesions into dentine or with pulpally-involved or abscessed teeth had poorer OHRQoL than children without such lesions.

Prognosis of primary teeth following intrusive luxation according to the degree of intrusion: A retrospective cohort study.

BACKGROUND/AIM: The degree of intrusion is an important aspect to be evaluated when treating children following intrusive luxation. The aim of this retrospective cohort study was to evaluate re-eruption rates and the occurrence of sequelae in intruded primary teeth according to the degree of intrusion. MATERIAL AND METHODS: A total of 238 teeth from 168 patients diagnosed with and treated for intrusion over a 16-year period at a specialized trauma center in South Brazil were included in this study. Patient details, including demographic characteristics, tooth affected, presence of sequelae of trauma during the follow up (pulp necrosis and infection, crown discoloration and abnormal mobility), and any effects on the permanent successors, were collected from their records. Photographs were analyzed to determine the degree of intrusion (Grade I, II, or III) and spontaneous re-eruption during follow up. Re-eruption and occurrence of sequelae according to the degree of intrusion were evaluated using the chi-squared test. The level of significance was set at 5%. RESULTS: Most teeth were maxillary central incisors (87.8%) with Grade I intrusion (32.8%). In the first 30 days, 13.1% had signs of re-eruption. After 3-6 months, the frequency of re-eruption increased to 58.7%. Of the teeth evaluated 6 months or more after intrusion, 68% had re-erupted. Total intrusion (Grade III) was associated with pulp necrosis and infection (p = .002), but the degree of intrusion was not associated with the presence of crown discoloration or abnormal mobility. Of the 78 permanent successors evaluated, 52.6% had developmental disturbances. CONCLUSION: Most intruded primary teeth re-erupted spontaneously, and the degree of intrusion was associated with a worse prognosis.

Association between malocclusion and the severity of dental trauma in primary teeth.

BACKGROUND/AIMS: The literature does not clearly state whether the type of malocclusion is associated with a specific type of trauma and the severity of the injury. Hence, the aim of this retrospective study was to assess the occlusal condition in children with traumatic dental injuries of the primary teeth, and the association between the occlusal characteristics and the type and severity of these injuries. MATERIAL AND METHODS: Data were collected from records of children treated at a dental trauma center in Brazil over a period of 16 years. The data included age, gender, etiology of the trauma, place of occurrence, number of affected teeth, type of trauma, and injury severity. The occlusal condition was assessed by a trained dentist using photographs of the patients from their first visit. Chi-square tests and Poisson regression were used for data analyses. RESULTS: This study included 209 patients, and most were aged between 2-4 years (50.55%). Multivariate regression analysis showed that children with an anterior open bite had a 47% higher prevalence of severe trauma than those who did not have an anterior open bite, and those with class II canines had a 56% higher prevalence of severe trauma than those with class I and III canines. Children with an anterior open bite had a 46% higher prevalence of injuries affecting multiple teeth than those without an anterior open bite. CONCLUSIONS: Anterior open bite and class II canine relationship were associated with a higher prevalence of severe traumatic dental injury in primary teeth, and anterior open bite was associated with trauma affecting multiple teeth.

Incidence and prognosis of crown discoloration in traumatized primary teeth: A retrospective cohort study.

BACKGROUND/AIM: Knowledge of factors influencing the occurrence of crown discoloration following traumatic dental injuries in primary teeth and understanding its possible consequences can help dentists to provide appropriate care. The aim of this retrospective cohort study was to investigate the incidence of crown discoloration following trauma in primary teeth. This study also estimated the risk of pulp necrosis with subsequent infection of the root canal system and pulp canal obliteration in discolored teeth. MATERIAL AND METHODS: Records of children treated at the specialized trauma center of the Federal University of Pelotas during a period of 10 years were analyzed. Patient details including the type of injury, presence of crown discoloration, pulp necrosis, and pulp canal obliteration were collected. Photographs of teeth with crown discoloration were assessed to evaluate the color presented (yellow or dark). Chi-square tests and Poisson regression were used for data analyses (P < .05). RESULTS: A total of 355 children with 628 traumatized teeth were included in the study. The incidence of crown discoloration was 27.9%, and 20.5% of the teeth were affected. Discoloration was higher in children whose age at the time of trauma was 2-4 years (P = .020), and it was associated with the type of injury (P = .019). Discolored teeth had a twofold risk of pulp necrosis and subsequent infection of the root canal system (RR 1.98 95% CI 1.42-276; P < .001) and a higher risk of pulp canal obliteration (RR 8.47; 95% CI 4.95-14.51; P < .001) than did teeth without discoloration. Teeth with dark and yellow discoloration were significantly associated with pulp necrosis and pulp canal obliteration, respectively (P < .001). CONCLUSIONS: This study demonstrates the importance of monitoring traumatized primary teeth with crown discoloration, particularly those appearing darker, owing to their higher risk of pulp necrosis and subsequent infection of the root canal system.

Validity of the Brazilian version of the Dental Subscale of Children's Fear Survey Schedule.

BACKGROUND: Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) is a tool widely used to assess dental fear in children. AIM: To translate and to verify the psychometric properties, including factor analyses of the Brazilian version of the CFSS-DS (B-CFSS-DS) in two settings. DESIGN: The CFFS-DS was translated into the Portuguese language. In the first cross-sectional study (dental setting), 128 children (age: 4-12 years) participated. Mothers were interviewed; children's dental fear was assessed through the CFSS-DS and the Venham picture test; and child behaviour was assessed using the Frankl Scale. The second was a longitudinal study, with 103 schoolchildren (age: 4-12 years). Two receiver operating characteristic curves were drawn to establish the cut-off points. RESULTS: The B-CFSS-DS version showed good internal consistency in dental and school settings (Cronbach's α = 0.88 and 0.77 respectively) and a good test-retest reliability (Weighted Kappa = 0.767), as well as good criterion and discriminant validities. Factor analyses showed four factors. CONCLUSION: The Brazilian version of the CFSS-DS is a valid tool for dental fear assessment in children aged 4-12 years. Further studies with representative samples should be performed to strengthen the findings of this study, especially in the school setting.

Perinatal health and malocclusions in preschool children: Findings from a cohort of adolescent mothers in Southern Brazil.

INTRODUCTION: Pregnancy in adolescence has long-term consequences that can negatively influence oral conditions. In this study, we aimed to assess malocclusion in deciduous dentition and its association with prolonged breastfeeding, pacifier use, and perinatal health indicators pertaining to the periods immediately before and after birth. METHODS: This cross-sectional study was nested in a cohort of adolescent mothers who became pregnant from 13 to 19 years of age (mean age, 17.3 ± 1.6 years). A total of 509 mother-child dyads were included. Information on perinatal indicators, including Apgar score (0-10), which is a standardized assessment of the condition of the infant at birth (heart rate, breath rate, muscle tone, reflex irritability, and skin color), head circumference, birth weight, and need for intensive care unit admission were collected after delivery through interviews with the mothers. By the time the children were 24 to 36 months of age, malocclusion was assessed, and information on the use of pacifiers and breastfeeding was collected. Multivariate Poisson regression was used to assess the effect of independent variables on the outcome (malocclusion). RESULTS: The prevalence of malocclusion was 62.33%, and open bite was the most frequent one (47.45%). After adjustments, children with no need for intensive care unit admission had a lower risk of malocclusion (prevalence ratio [PR] = 0.75; 95% CI, 0.56-0.99), whereas those with an Apgar score less than 7 had a higher risk (PR = 1.32; 95% CI, 1.06-1.64). Children who had used a pacifier (PR = 1.82; 95% CI, 1.02-3.24) or were still using it (PR = 3.88; 95% CI, 2.65-5.68) had a higher chance of malocclusion compared with children who never used a pacifier. Children breastfeeding for 24 months or longer were less likely to have malocclusion (PR = 0.46; 95% CI, 0.34-0.73). CONCLUSIONS: Poor perinatal health and pacifier use may be risk factors for malocclusion development in deciduous teeth. Long duration of breastfeeding is associated with better occlusal conditions in children of adolescent mothers. Further studies are needed with other age groups.

Long-term clinical and radiographic follow up of subluxated and intruded maxillary primary anterior teeth.

AIMS: This study aimed to determine the kinds of sequelae resulting from intrusive luxation and subluxative injuries in primary anterior teeth as well as the timing of such sequelae. MATERIALS AND METHODS: In this longitudinal retrospective study, data were collected from dental records and radiographs of patients with traumatic dental injury (TDI) treated at the Centre for the Study and Treatment of Dental Trauma in Primary Dentition (Pelotas, RS, Brazil). Fifty-two children, with seventy intruded teeth, and 76 children, with 99 subluxated teeth, met the inclusion criteria. Sequelae, such as crown discoloration, fistula, pulp canal obliteration (PCO), inflammatory root resorption (IRR), and internal root resorption, were investigated. The data on the sequelae were distributed into eight follow-up periods: 0-30 days, 31-90 days, 91-180 days, 181-365 days, 1-2 years, 2-3 years, 3-4 years, and >4 years. RESULTS: The sample comprised 99 subluxation cases and 70 intruded teeth. Crown discoloration was the most prevalent sequelae. Among the subluxated teeth, <50% of IRR, fistula, crown discoloration, and PCO occurred within 180 days after TDI; however, the sequelae were also diagnosed after longer periods. Majority of sequelae of intrusion were diagnosed within the 181-365 days and 1-2 years periods but were also observed after more than 4 years of follow up. CONCLUSIONS: For both intrusion and subluxation, trauma sequelae were diagnosed even after the 3-4 years of follow-up.

Agreement between schoolchildren and their parents on rating the child's oral health-related quality of life.

The perceptions of parents/caregivers regarding their children's oral health can influence the standard of care and decision-making regarding oral health. The children's perspective on their own oral health-related quality of life (OHRQoL) may differ from the parents/caregivers' views. This cross-sectional study aimed to analyze the agreement between the perceptions of parents/caregivers and schoolchildren regarding OHRQoL. It was conducted with a sample of children between 8 and 11 years old and their parents/caregivers from Pelotas. Children answered the Child Perceptions Questionnaire 8-10 (CPQ), and parents/caregivers answered the short form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Socioeconomic data were also collected. Children's dental caries, traumatic dental injuries, and malocclusions were examined. The Spearman's correlation test was performed. A total of 119 parents/caregivers-children pairs were included. There was an agreement between the total scores of parents/caregivers and children (0.2770; p = 0.003), in the oral symptoms (0.1907; p = 0.038), and functional limitations (0.2233; p=0.015) domains. The Bland-Altman graph showed an agreement between children's and parents/caregivers' OHRQoL total score, but there was an underestimation of approximately two points in the parents/caregivers' perception compared to the children's score. There was an agreement between the reports of parents/caregivers and children regarding children's OHRQoL.

Translation and cultural adaptation of the Illness Perception Questionnaire-Revised for Dental to Brazil.

This study aimed to translate and to perform the cultural adaptation of the instrument Illness Perception Questionnaire-Revised for Dental (IPQ-RD) into Brazilian Portuguese. The IPQ-RD consists of 34 items that assess the cognitive and emotional representation/perception of parents/caregivers of children with dental caries, with response options on a 5-point Likert scale, ranging from "Strongly agree" (score 1) to "Strongly disagree" (score 5). The higher the score, the lower the perception of the disease. The protocol consists of translation into Brazilian Portuguese, back-translation into English, revision by an Expert Review Committee, and pre-test (application in parents/caregivers of children in dental care). For some questions, the translated versions were identical (T1 = T2); for others, one version was preferred (T1 or T2); for still others, it was decided to modify terms to obtain greater clarity on the item (T3). In the first pre-test, three questions were misunderstood by more than 15% of the sample, after which the items were reviewed by the Expert Review Committee. In the second pre-test, the adapted version was applied to a new sample of parents/caregivers (n = 15) and the questions were understood by more than 85% of the participants. The Brazilian Portuguese version of the IPQ-RD was well understood by the evaluated population.

Comparison Between Two Protocols for Ankyloglossia Diagnosis in Newborn Babies.

Purpose: Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for ankyloglossia diagnosis: (1) the Neonatal Tongue Screening Test (NTST); and (2) the Bristol Tongue Assessment Tool (BTAT). Methods: This was a cohort study involving live births at the University Hospital of Brasilia, Brasilia, Brazil, from August 2017 to July 2018. The gathered data were based on clinical examinations and interviews with mothers. The Stata software program was applied to conduct the analyses using the chi-square test, Spearman's correlation and the receiver operating characteristic (ROC) curve, and sensitivity, specificity, and positive and negative predictive values. Results: A total of 972 mother-baby dyads were evaluated. The protocols showed agreement (P ≤ 0.001) for an ankyloglossia diagnosis, according to Spearman's correlation. The prevalence of ankyloglossia was 5.5 percent (NTST) and 5.1 percent (BTAT) and was greater in the male gender in both protocols. According to the ROC curve, the four cutoff point showed better sensitivity and specificity (98.4 percent and 64.2 percent, respectively). The BTAT was highly accurate in comparison with the NTST. Conclusions: Both protocols showed similar low ankyloglossia prevalence. The Bristol Tongue Assessment Tool protocol is potentially more viable as a screening instrument than the Neonatal Tongue Screening Test protocol because it is simpler and more concise.

Discriminant validity of the CAST instrument compared to the dmf index in the deciduous dentition: a cross sectional study.

This study aimed to assess the discriminant validity of the Caries Assessment Spectrum and Treatment (CAST) at different thresholds, compared with the Decayed, Missing, and Filled Teeth Index (dmf) instrument, to discriminate caries risk factors. A cross-sectional study was conducted including children aged 2-5 years from preschools in Southern Brazil. Parents answered a questionnaire, and children were clinically examined using the CAST instrument and, in the following weeks, using the dmf index. Two caries thresholds were adopted for CAST: caries in dentin (CAST4-7/CAST2,4-8) and enamel caries (CAST3-7/CAST2-8). Poisson regression was used in the analysis (p < 0.05). A total of 200 children were included. The prevalence of caries was 47.0% with dmf, 42.5% with CAST4-7, and 77.5% with CAST3-7. When the outcome was caries prevalence, CAST4-7 discriminated between sexes, household crowding, and dental pain, and CAST3-7 discriminated age and family income, while the dmf was associated with dental pain. When experience of caries was the outcome, all the criteria discriminated between sexes, age, family income, household overcrowding, visible dental plaque, and dental pain, while dmf and CAST2-8 also discriminated maternal schooling. The CAST discriminated caries risk factors similar to the dmf index when caries experience was the outcome. When prevalence was considered, CAST was able to discriminate for more individual characteristics than dmf.

Effectiveness of Virtual Reality Glasses as a Distraction for Children During Dental Care.

Purpose: The purpose of this review was to investigate the effect of virtual reality (VR) glasses as an audiovisual distraction technique on dental anxiety, pain perception, and behavior triggered during dental treatment in children up to 12 years old. The research question asked was: Can improvement be seen in the child's behavior, pain perception or anxiety when VR eyeglasses are used during dental treatment? Methods: Five databases were searched for studies published until September 2018. Studies were selected by titles and abstracts, followed by full-texts reading. Results: Meta-analysis was performed and combined results were presented as a pooled mean difference for each procedure, using random-effect models. Nine randomized clinical trials assessed the effect of VR glasses on children's behavior during dental care. No differences were observed in anxiety levels during local anesthesia, use of rubber dam, removal of caries and restorative procedures. Similar results were observed in children's behavior when local anesthesia and rubber dam were used. Conclusions: The use of virtual reality glasses is an effective tool for improving behavior and reducing pain perception during the dental treatment of children. Children who used VR eye-glasses behaved better during removal of caries and showed lower pain perception during restoration.

Screen time, dietary patterns and intake of potentially cariogenic food in children: A systematic review.

OBJECTIVES: To investigate the association between screen-time behavior and diet, including a potentially cariogenic diet, in children younger than 12 years old. SOURCES: Four electronic databases were searched, from their earliest records up to April 2018. STUDY SELECTION: Observational studies were included, assessing time spent in sedentary behavior (viewing of TV, DVDs, computer and electronic games) and dietary intake in preschoolers and school-aged children. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The strength of the evidence was evaluated by the GRADE system. DATA: Nineteen articles were included, all providing cross-sectional analysis. Sedentary behavior was assessed by parent-reported or self-reported questionnaires. In 10 studies, food frequency questionnaires were the method of dietary assessment. Most studies only assessed television viewing time (13). A significant relationship was found in all the studies, between television and/or total screen-time viewing and adverse dietary outcomes, including fewer fruits and vegetables, and greater consumption of unhealthy foods. In 15 studies, higher TV viewing and/or screen-time rates were associated with higher intake of cariogenic foods, like energy-dense snacks and sugar-sweetened beverages. CONCLUSIONS: There may be an association between sedentary behavior, particularly television viewing, and an unhealthy diet in young people involving increased intake of cariogenic foods. However, the strength of the evidence studies was limited. CLINICAL SIGNIFICANCE: Further efforts are needed to limit television viewing in young children, aimed at promoting health and preventing lifestyle-associated diseases, such as dental caries.

Relação entre a condição bucal de gestantes internadas e desfechos adversos na gestação / Relationship between the oral condition of hospitalized pregnant women and adverse pregnancy outcomes

Objetivo: avaliar se a condição bucal favoreceu a presença de desfechos adversos da gestação (DAG) em mulheres internadas e acompanhadas em um hospital escola. Métodos: um estudo de coorte retrospectiva com mulheres grávidas que foram internadas entre setembro de 2019 e início de março de 2020 e que continuaram o acompanhamento obstétrico. Resultados: Das 65 gestantes que seguiram acompanhamento, 27 (41,5%) dos bebês nasceram pré-termo e 20 (30,8%) com baixo peso, sendo que as duas condições estavam presentes em 15 crianças (23,1%), sendo significantemente relacionadas com a menor semana gestacional na internação. Ao relacionar diferentes fatores com o desfecho pré-termo, houve diferença significante em gestantes com a ocupação "do lar" e com o tempo de internação igual ou maior que 10 dias e com a presença de baixo peso ao nascer. Não foi observada relação dos dados avaliados da condição bucal das gestantes na internação com o parto pré-termo. Conclusões: Gestantes que necessitam de internação hospitalar durante a gravidez, independente da condição bucal, aumentam a possibilidade de apresentarem DAG, sendo fundamental a realização do correto acompanhamento pré-natal.(AU)

Objective: to assess whether the oral condition favored the presence of adverse effects during pregnancy in pregnant women hospitalized and followed up at a teaching hospital. Methods: a retrospective cohort study with mothers who were hospitalized during pregnancy between September 2019 and early March 2020 and who continued obstetric follow-up. Results: 83 pregnant women were interviewed and 65 were followed up Of the 65 pregnant women who followed up, 27 (41.5%) of the babies were born preterm and 20 (30.8%) with low birth weight, and both conditions were present in 15 children (23.1%), being significantly related to the shortest gestational week at admission. When relating different factors with the preterm outcome, there was a significant difference in pregnant women with the occupation "housewife" and with the length of hospital stay equal to or greater than 10 days and with the presence of low birth weight. There was no relationship between the evaluated data on the oral condition of pregnant women during hospitalization and preterm delivery. Conclusions: Pregnant women who require hospitalization during pregnancy, regardless of oral condition, increase the possibility of having negative pregnancy outcomes, and correct prenatal care is essential. (AU)

A internação da gestante pode afetar a condição bucal do filho no terceiro ano de vida? / Can a pregnant woman's hospitalization affect the child's oral condition in the third year of life?

Objetivo: Avaliar se a hospitalização na gestação pode influenciar na condição bucal do filho no terceiro ano de vida. Métodos: Estudo longitudinal com bebês de gestantes internadas e acompanhadas no setor da Obstetrícia de um Hospital Escola em Pelotas, RS, Brasil. Os dados referentes a hospitalização e ao parto foram coletados do prontuário hospitalar e no terceiro de vida do filho (a) de um questionário aplicado a mãe e do exame bucal da criança. Cada agravo bucal foi avaliado com critérios específicos, por uma examinadora calibrada e analisado no programa IBM SPSS Statistics com 5% de nível de significância. Resultados: Participaram 20 díades mãe-filho (a). Alterações da oclusão acometeram 95% das crianças, sendo a mordida aberta anterior (MAA) a principal. Ainda, 25% das crianças apresentaram opacidades demarcas e/ou hipoplasia do esmalte, sendo significativamente maior em filhos de mães mais jovens e 20% tinham cárie da primeira infância (CPI), estando relacionada à ausência de creme dental fluoretado e à qualidade da higiene bucal. Conclusão: O reflexo mais evidente da hospitalização na gestação na saúde bucal no terceiro ano de vida do filho (a) foi a oclusão alterada, especialmente a MAA.(AU)

Objective: To assess whether hospitalization during pregnancy can influence the child's oral condition in the third year of life. Methods: Longitudinal study with babies of pregnant women hospitalized and followed up in the Obstetrics sector of a Teaching Hospital in Pelotas, RS, Brazil. Data referring to hospitalization and childbirth were collected from the hospital records and in the child's third of life through a questionnaire applied to the mother and the child's oral examination. Each oral condition was evaluated with specific criteria, by a calibrated examiner and analyzed in the IBM SPSS Statistics program with a 5% minimum significance level. Results: 20 mother-child participated. Occlusion alterations affected 95% of the children, with anterior open bite (AOB) being the main. Still, 25% of the children had opacities and/or enamel hypoplasia, which was significantly higher in children of younger mothers, and 20% had early childhood caries, which is related to the absence of fluoride toothpaste and the quality of oral hygiene. Conclusion: The clearest reflection of hospitalization during pregnancy on oral health in the third year of the child's life was altered occlusion, especially the AOB.(AU)

Agreement between schoolchildren and their parents on rating the child's oral health-related quality of life

Abstract The perceptions of parents/caregivers regarding their children's oral health can influence the standard of care and decision-making regarding oral health. The children's perspective on their own oral health-related quality of life (OHRQoL) may differ from the parents/caregivers' views. This cross-sectional study aimed to analyze the agreement between the perceptions of parents/caregivers and schoolchildren regarding OHRQoL. It was conducted with a sample of children between 8 and 11 years old and their parents/caregivers from Pelotas. Children answered the Child Perceptions Questionnaire 8-10 (CPQ), and parents/caregivers answered the short form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Socioeconomic data were also collected. Children's dental caries, traumatic dental injuries, and malocclusions were examined. The Spearman's correlation test was performed. A total of 119 parents/caregivers-children pairs were included. There was an agreement between the total scores of parents/caregivers and children (0.2770; p = 0.003), in the oral symptoms (0.1907; p = 0.038), and functional limitations (0.2233; p=0.015) domains. The Bland-Altman graph showed an agreement between children's and parents/caregivers' OHRQoL total score, but there was an underestimation of approximately two points in the parents/caregivers' perception compared to the children's score. There was an agreement between the reports of parents/caregivers and children regarding children's OHRQoL.

Translation and cultural adaptation of the Illness Perception Questionnaire-Revised for Dental to Brazil

Abstract This study aimed to translate and to perform the cultural adaptation of the instrument Illness Perception Questionnaire-Revised for Dental (IPQ-RD) into Brazilian Portuguese. The IPQ-RD consists of 34 items that assess the cognitive and emotional representation/perception of parents/caregivers of children with dental caries, with response options on a 5-point Likert scale, ranging from "Strongly agree" (score 1) to "Strongly disagree" (score 5). The higher the score, the lower the perception of the disease. The protocol consists of translation into Brazilian Portuguese, back-translation into English, revision by an Expert Review Committee, and pre-test (application in parents/caregivers of children in dental care). For some questions, the translated versions were identical (T1 = T2); for others, one version was preferred (T1 or T2); for still others, it was decided to modify terms to obtain greater clarity on the item (T3). In the first pre-test, three questions were misunderstood by more than 15% of the sample, after which the items were reviewed by the Expert Review Committee. In the second pre-test, the adapted version was applied to a new sample of parents/caregivers (n = 15) and the questions were understood by more than 85% of the participants. The Brazilian Portuguese version of the IPQ-RD was well understood by the evaluated population.

Nonpharmacologic Intervention on the Prevention of Pain and Anxiety During Pediatric Dental Care: A Systematic Review.

BACKGROUND: Nonpharmacologic interventions may be used to reduce fear and anxiety during dental treatment. OBJECTIVES: To systematically review trials on the effect of nonpharmacologic interventions in behavior, anxiety, and pain perception in children undergoing dental treatment. DATA SOURCES: Medline, Scopus, Web of Science and CINAHL, Google Scholar, and studies' reference lists. PARTICIPANTS AND INTERVENTIONS: Studies performed with children and adolescents that evaluated the effect of interventions on children's behavior, anxiety, and pain perception during dental treatment were included. STUDY APPRAISAL METHODS: Independent quality assessment of the studies was carried out following the classification categories present on the Cochrane Handbook for Development of Systematic Reviews of Intervention. RESULTS: Twenty-two articles, reporting 21 studies, were selected. Most studies tested distraction techniques. Eight studies presented bias and results were not considered. The remaining 13 studies had control groups with inactive controls, and 4 also included a variation of the intervention. Of the 4 studies assessing behavior, 3 found difference between intervention and control. Anxiety was evaluated by 10 studies: 4 found differences between intervention and control and 2 found differences between interventions. Five studies investigated pain perception: 3 found difference comparing active versus inactive interventions. In 1 of the 3, variations in the intervention decreased pain perception. CONCLUSIONS: More research is needed to know whether the techniques are effective for improving behavior and reducing children's pain and distress during dental treatment. However, the majority of the techniques improved child's behavior, anxiety, and pain perception.

Maternal depression and anxiety associated with dental fear in children: a cohort of adolescent mothers in Southern Brazil.

Exposure to maternal symptoms of depression/anxiety has long-term negative consequences for child development, regardless of the contextual risk. The objective of this study was to investigate the relationship of the symptomatology of persistent maternal depression and anxiety with child dental fear. This study was nested in a cohort of adolescent mothers in southern Brazil. Symptomatology of maternal depression and anxiety was assessed during pregnancy and postpartum, when the mothers' children were 24-36 months old, using Beck Depression Inventory and Beck Anxiety Inventory. The mothers answered a questionnaire to assess dental fear in their children, and to obtain socioeconomic and demographic data. Both mothers and their children were submitted to clinical oral examination (n= 540 dyads) to obtain oral health data. Multivariate hierarchical Poisson regression analysis was used to determine associations (p < 0.05). At data collection, the prevalence of maternal depressive symptoms was 39.1%, and anxiety was observed in 27.8% of the mothers, whereas 21.6% of the children presented dental fear. In the adjusted analysis, children's dental fear was positively associated with mothers' presenting depressive symptomatology and caries experience. The depression symptomatology trajectory was not associated with dental fear, whereas mothers with persistent symptoms of anxiety reported higher prevalence of dental fear toward their offspring. The findings of symptomatology of maternal depression observed at data collection and persistence of anxiety may negatively impact the child's perception of dental fear. Mothers are the main caregivers and primary models responsible for transmitting health-related behaviors; consequently, mental disorders affecting mothers may negatively impact their children.