Global overview on current paediatric dentistry teaching: A survey of National Member Societies of the IAPD.

BACKGROUND: Published information on the teaching and recognition of paediatric dentistry (PD) is limited worldwide. AIM: The aim of this study was to investigate the status of current teaching of undergraduate and postgraduate training in PD and identify differences by country-level economic development. DESIGN: Representatives from 80 national member societies of the International Association of Paediatric Dentistry (IAPD) were invited to complete a questionnaire on undergraduate and postgraduate PD curricula, types of postgraduate education offered, and recognition of the specialty. Country economic development level was classified according to the World Bank criteria. The chi-squared test and the Spearman correlation coefficient were used for data analysis (α = 0.005). RESULTS: Response rate was 63%. Teaching of PD at the undergraduate level was present in all countries, but PD specialization, master's, and Doctor of Philosophy (PhD) coursework were offered in 75%, 64%, and 53% of surveyed countries, respectively. Postgraduate specialization courses were offered in a significantly larger proportion of high-income countries than in upper-middle- or lower-middle-income countries (p < .01). In 20% of participating countries, PD was not an officially recognized specialty with no difference in recognition of the specialty by country's economic development level (p = .62). CONCLUSION: Paediatric dentistry is taught at the undergraduate level universally, but at the postgraduate level, significantly fewer courses are available, especially in lower-income countries.

Retrospective study of oral lesions biopsied in babies and toddlers.

Epidemiological data on the distribution of oral and maxillofacial diseases present in early childhood are scarce in the literature. This study analyzed the frequency of lesions biopsied in this region in children aged 0 to 3 years and sent for histopathological analysis in a reference oral pathology laboratory . Histopathological diagnostic data, lesion location, sex, and age were collected. Of the total of 93,950 records, 250 cases (0.27%) belonged to the age group from 0 to 3 years old. The most frequently diagnosed oral alterations were: mucocele (34/250; 13.6%); papilloma (11/250; 4.4%), giant cell fibroma (6/250; 2.4%), pyogenic granuloma (5/250; 2%) and hemangioma (3/250; 1.2%). The lip was the most affected site, followed by the gingiva and the tongue. These results generate information on the lesions most frequently diagnosed in early childhood, which facilitates the process of diagnosis and, consequently, treatment.

Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study.

BACKGROUND: Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children's oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL). METHODS: This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI). RESULTS: Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52-0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52-0.98). CONCLUSIONS: The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.

Atraumatic Restorative Treatment-Sealed versus Nonsealed First Permanent Molars: A 3-Year Split-Mouth Clinical Trial.

To investigate the efficacy of atraumatic restorative treatment (ART) sealants vs. no sealant in preventing the development of dentine caries lesions in first permanent molars over a period of 3 years. A total of 187 schoolchildren (aged 6-8 years) from a low-income population presenting the 4 first permanent molars without clinically detectable dentine caries lesions were selected to be part of a split-mouth clinical trial. All 4 first permanent molars were investigated in this trial and the children's mouth was split vertically into left and right sides; therefore, 2 molars were randomly allocated to receive ART sealants, while the other 2 molars remained nonsealed. All children received toothbrushing instructions and dietary advice every 6 months for a period of 3 years. Clinical evaluations were performed after 3, 6, 12, 18, 24, and 36 months and both sealant retention and dental caries were scored. Kaplan-Meier survival analysis, log-rank test, and Cox regression with shared frailty analysis were performed. A cavitated dentine caries lesion was considered a failure. The cumulative survival rates of dentine cavity-free first permanent molars were 90% for ART-sealed molars and 90.8% for nonsealed molars, with no statistically significantly difference between sealed and nonsealed molars (p = 0.70). The retention of sealants was not associated with the development of cavitated dentine caries and children presenting a higher baseline caries experience had greater chances of developing dentine lesions. In conclusion, the application of ART sealants was not more efficacious than nonsealing in reducing the development of dentine cavitated lesions in first permanent molars.

Impact of untreated dental caries severity on the quality of life of preschool children and their families: a cross-sectional study.

PURPOSE: Untreated dental caries is a persistent oral problem among preschool children. Although there is vast evidence regarding the impact of dental caries on oral health-related quality of life (OHRQoL) in this age group, evidence on the impact of untreated caries severity is scarce. The purpose of this study was to investigate the impact of untreated caries severity on the OHRQoL of preschool children and their families. METHODS: A cross-sectional study was conducted with 563 individuals in the city of Goiania, Brazil. Data were collected through interviews with parents/caregivers and clinical examinations of their children. The OHRQoL was measured by the Brazilian version of the Early Childhood Oral Health Impact Scale. Untreated dental caries severity was assessed using validated indices. Other independent variables were socioeconomic, toothache prevalence, and the questionnaire respondent. Statistical analysis involved bivariate comparisons and Poisson regression analyses. RESULTS: A higher prevalence of impact on OHRQoL was found among preschool children with untreated dental caries with clinical consequences (PR 1.31; 95% CI 1.01-1.70) compared to those without caries; those aged 5 years (PR 1.47; 95% CI 1.18-1.82), compared to those aged two; and those with a toothache (PR 1.54; 95% CI 1.34-1.76), compared to those without toothache. Moreover, fathers (PR 0.71; 95% CI 0.55-0.92) and other respondents (PR 0.70; 95% CI 0.52-0.96) perceived less impact on the OHRQoL in comparison to mothers. CONCLUSIONS: Severe untreated dental caries with clinical consequences had a negative impact on the children's OHRQoL, regardless of toothache and socioeconomic factors.

Impact of demographic and clinical variables on the oral health-related quality of life among five-year-old children: a population-based study using self-reports.

BACKGROUND: Although SOHO-5 has been validated, there is no study testing this instrument in population-based samples. AIMS: To evaluate the impact of demographic and oral clinical variables on the oral health-related quality of life (OHRQoL) in 5-year-old children from a socially deprived Brazilian area using selfreports. DESIGN: Data from 588 children were analyzed. Examinations included untreated dental caries and occlusal deviations. Children answered the Brazilian SOHO-5 version and interviewers collected demographic characteristics of the child (sex and skin color). Robust Poisson regression associated outcome and exposures. RESULTS: General, the oral impacts were reported by 71.1% of children. The mean and standard deviation total score of the Brazilian SOHO-5 were 3.51 and 3.82, respectively. Children with untreated dental caries (PR = 1.28; P = 0.004) and increased overjet (PR = 1.35; P = 0.002) experienced a worse OHRQoL. Dark and mixed skin color children did not have a good impact on their OHRQoL (PR = 1.53; P = 0.006 and PR = 1.44; P < 0.000, respectively) compared to light ones. CONCLUSIONS: Untreated dental caries and increased overjet were independently associated with worst OHRQoL in 5-year-old children. As an indication of social deprivation, dark and mixed skin color children compared to light ones presented higher probability for reporting worst OHRQoL independently of the oral clinical conditions.

Early childhood caries and psychological perceptions on child's oral health increase the feeling of guilt in parents: an epidemiological survey.

AIM: To assess whether parents feel guilty for their children's oral problems, associating this feeling with socio-economic, demographic, and psychological factors. DESIGN: We included 1313 parent-and-child pairs in this study. The children were 2-4 years old. Parents answered questionnaires on socio-economic and demographic data, and on psychological variables. Sixteen trained dentists (κ > 0.8) examined the children for oral hygiene (the presence and absence of plaque), early childhood caries (ECC; no caries, low and high severity), malocclusion (the presence and absence), and traumatic dental injuries (TDI; the presence and absence). We analysed the data with a hierarchical regression. RESULTS: Twenty-four percentage of parents reported feeling guilty for the oral problems in their children; 26.3% of the children presented with caries, 39.8% malocclusion, 22.9% TDI. Of the parents who felt guilty, 54% thought that their children had problems in their teeth, and most of them (82%) thought that the problem could have been avoided. The feeling of guilt in parents was significantly associated with ECC and the psychological variables: the thought that the child had problems in his/her teeth and the thought that the problem could have been avoided. CONCLUSION: Parents feel more guilty with increased caries severity in their children, and the likelihood of feeling guilty increases when parents believe that their child has an oral problem or that this problem could have been avoided.

Caries severity declined besides persistent untreated primary teeth over a 22-year period: Trends among children in Goiânia, Brazil.

BACKGROUND: Evidence of time trends in early childhood caries in low- and middle-income countries in the second decade of the year 2000 is scarce. AIM: To assess the trends in early childhood caries prevalence and severity in 2- to 5-year-old children over a 22-year period (1993-2015) in Goiânia, Midwest Brazil. Additionally, we aimed to investigate the changes regarding affected dental arches and teeth. DESIGN: A time-lag analysis of trends in caries was carried out using data from three cross-sectional studies based on the World Health Organization diagnostic criteria, in 1993 (N = 1362), 2001 (N = 1620), and 2015 (N = 548). RESULTS: Caries prevalence declined from 45.1% in 1993 to 29.0% in 2015. Prevalence of severe caries (dmft ≥ 6) in 2015 was nearly one-third of that found in 1993, and the SiC index (mean dmft of the highest tertile) decreased from 4.55 to 3.32. Decline was higher in the 1993-2001 than in the 2001-2015 time-lag. Posterior teeth and second molars had the greatest reductions. High proportions of untreated caries were found in all ages and survey years. CONCLUSION: There were significant changes in caries prevalence and severity, marked by a striking decline from 1993 to 2001, followed by a less prominent decrease up to 2015, and high levels of untreated caries.

Clinical factors and socio-demographic characteristics associated with dental trauma in children: a systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the factors associated with traumatic dental injury (TDI) in the primary dentition. METHODOLOGY: An electronic search addressing factors associated with TDI was conducted in the PubMed, ISI, LILACS, Cochrane Library, and Embase databases. Data were extracted and analyzed regarding risk factors, statistical test, effect measures, and study design. RESULTS: The online search strategy led to the initial retrieval of 2566 articles. After evaluating the titles and abstracts, 24 papers were selected for complete review and data collection. TDI was associated with males (OR: 1.24; 95%CI: 1.09-1.41), inadequate lip coverage (OR: 1.81; 95%CI: 1.50-2.17), overbite (OR: 1.438; 95%CI: 0.94-2.19), and age (1 vs 2 years - OR: 0.47; 95%CI: 0.38-0.58; 2 vs 3 years - OR: 0.78; 95%CI: 0.67-0.91; 3 vs 4 years - OR: 0.82; 95%CI: 0.71-0.95). Overjet and anterior open bite were associated with TDI in the majority of studies. CONCLUSIONS: Males, older children, and those with inadequate lip coverage, overbite, or overjet are more likely to have TDI in the primary dentition.

Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data.

OBJECTIVE: To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables. METHODS: Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Children's Vaccination day. Calibrated examiners performed the children's oral examination for TCI according to Andreasen's criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables. RESULTS: The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P < 0.05). Children's age was associated with TCI in all the surveys. Male gender, presence of anterior open bite and inadequate lip coverage were associated with TCI in some surveys along the years (P < 0.05). CONCLUSION: This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with children's age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy.

Exploring the association between oral health problems and oral health-related quality of life in Peruvian 11- to 14-year-old children.

BACKGROUND: This is the first study that tested a Spanish version of the Child Perceptions Questionnaire (CPQ11-14 ) in a population-based sample. AIM: To assess the impact of oral health problems on OHRQoL in 11- to 14-year-old children. DESIGN: Data from 473 11- to 14-year-old children were analysed. They were interviewed using the CPQ11-14. Examinations included dental caries, malocclusion, and traumatic dental injuries. Adjusted Poisson regression was used to associate different clinical conditions to the outcome. RESULTS: Overall, 100% of children reported oral impacts (total CPQ11-14 score ≥ 1). Children aged 12- to 14 years old experienced a negative impact on all domains and total CPQ11-14 scores (P < 0.05); the increase in DMFT index showed a negative impact on the oral symptoms domain (RR = 1.01; P = 0.05, whereas Class III malocclusion showed a positive impact on the emotional well-being domain (RR = 0.71; P < 0.01). TDI (RR = 1.11; P = 0.01) and crown discoloration (RR = 1.23; P < 0.01) showed a negative impact on the emotional social well-being domain. CONCLUSION: Children aged 12- to 14 years old had a negative impact on all domains and total CPQ11-14 scores compared with those who are 11 years old. The increase in dental caries experience, presences of TDI and crown discoloration have a negative impact on some aspects of the children's OHRQoL. Class III malocclusion showed a positive impact on the emotional well-being domain.

Trends in the prevalence of erosive tooth wear in Brazilian preschool children.

OBJECTIVES: To report trends in the prevalence of ETW in Brazilian preschool children. METHODS: Three cross-sectional surveys were carried out on boys and girls aged 3-4 years living in Diadema, in the years 2008, 2010 and 2012 following the same criteria and methodology. A total of 2801 children were systematically examined during a National Day of Children's vaccination. Examiners were trained and calibrated to diagnose ETW using a modified version of the O'Brien index. RESULTS: The prevalence of ETW was 51.6% (95% CI 48.4-55.0) in 2008, 53.9% (95% CI 50.7-57.0) in 2010 and 51.3% (95% CI 47.8-54.7) in 2012. There was no significant association between prevalence of ETW from 2008 to 2012 (χ(2) for trend: P = 0.92). There was no significant association in the severity of ETW during this study's period. Most lesions were confined to enamel in all three studies. CONCLUSIONS: A high prevalence of ETW was found in this sample of preschool children in 2008, 2010 and 2012. No trends of increase or decrease in the prevalence and severity of ETW during this study's period.

Changes in preschool children's OHRQoL after treatment of dental caries: responsiveness of the B-ECOHIS.

BACKGROUND: Oral health-related quality of life (OHRQoL) measures should be tested for responsiveness to change if they are to be used as outcomes in randomized clinical trials. AIM: To assess the responsiveness of the Brazilian ECOHIS (B-ECOHIS) to dental treatment of dental caries. METHODS: One hundred parents of 3- to 5-year-old children completed the B-ECOHIS prior to their children's treatment and 7-14 days after completion of treatment. The post-treatment questionnaire also included a global transition judgment that assessed parent's perceptions of change in their children's oral health following treatment. Change scores, longitudinal construct validity, standardized effect sizes (ES) and standardized response mean (SRM) were calculated. RESULTS: Improvements in children's oral health after treatment were reflected in mean pre- and post-treatment B-ECOHIS scores. They declined considerably significantly from 17.4 to 1.6 (P < 0.0001), as did the individual domain scores (P < 0.0001). There were significant differences in the pre- and post-treatment scores of children who reported little improvement (P < 0.0001) as well as in those who reported large improvements (P < 0.0001). The ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were large. CONCLUSIONS: Dental treatment resulted in significant improvement of the preschool children's OHRQoL. The B-ECOHIS is responsive.

Bilayer technique and nano-filled coating increase success of approximal ART restorations: a randomized clinical trial.

BACKGROUND: The high-viscosity consistency of glass ionomer cement (GIC) may lead to its incorrect adaptation into the cavity and therefore to restoration failure. AIM: To compare two different insertion techniques for GIC in approximal atraumatic restorative treatment (ART) restorations and two different surface protection materials. DESIGN: Approximal caries lesion in primary molars from 208 schoolchildren was randomly assigned into four groups: G1, conventional GIC insertion protected with petroleum jelly (PJ); G2, bilayer technique protected with PJ; G3 conventional GIC insertion protected with nano-filled particles coating for GIC (NPC); G4, bilayer technique protected with NPC. Restorations were evaluated after 1, 6, 12, 18, 24, and 36 months. Kaplan-Meier survival analysis and log-rank test were performed. Cox regression analysis (α = 5%) was used to verify the influence of clinical factors. RESULTS: Restoration survival was 52.8%. Log-rank test indicated a better survival of the bilayer technique restorations, compared to conventional restorations (P = 0.005), whereas the coated conventional restorations presented higher survival than the uncoated ones (P = 0.035). Cox regression analysis showed no influence of any clinical tested variables. CONCLUSION: The survival rate of the approximal ART restorations is positively influenced by the bilayer technique, and the application of nano-filled coating increases the longevity of the conventional approximal ART restorations.

Effectiveness of conventional treatment using bulk-fill composite resin versus Atraumatic Restorative Treatments in primary and permanent dentition: a pragmatic randomized clinical trial.

BACKGROUND: Clinical studies are being conducted in less strict conditions in order to establish an adequate scientific basis for decision making. The aim of this pragmatic randomized clinical trial is to evaluate the effectiveness of single and multiple-surfaces restorations performed following the Atraumatic Restorative Treatment (ART) premises compared with Conventional Treatment (CT) using bulk fill composite restorations in primary and permanent teeth. METHODS/DESIGN: A total of 1,214 5-to-13 year-old children with at least one single or multiple-surface dentin caries lesion in primary or permanent molars will be selected in public schools of Barueri-SP, Brazil. The participants will be randomly assigned into 2 groups: CT (caries removal with bur and restoration performed with Scotchbond™ Universal Adhesive system associated with Filtek Bulk Fill - 3 M/ESPE) and ART (Caries removal with hand instruments and restoration with high viscosity glass ionomer cement Ketac Molar Easy Mix - 3 M/ESPE). Ten untrained dentists will perform the treatment in in dental offices located at public schools. The restorations will be evaluated after 6, 12 and 24 months by an independent trained and calibrated examiner. The restoration and tooth survival, the cost-effectiveness analysis between the two groups and the operators' preferences regarding the techniques will be also evaluated. Kaplan-Meier survival analysis and log-rank test will be applied for the restoration and tooth survival. All the average event rates in the two groups will be modelled and compared with a Cox proportional hazard shared frailty model since there is an operator-cluster effect. The significance level for all analyses will be 5 %. DISCUSSION: Our hypothesis is that despite similar expected effectiveness between ART using high viscosity GIC and conventional treatment using bulk fill composite resin when treating single or multiple-surface in posterior primary and permanent teeth, ART will present superior cost-effectiveness. The results of this trial will support decision-making by clinicians and policy makers. TRIAL REGISTRATION: NCT02568917 . Registered on May 10th 2015.

Fluoride varnishes containing calcium glycerophosphate: fluoride uptake and the effect on in vitro enamel erosion.

OBJECTIVES: Calcium glycerophosphate (CaGP) was added to fluoride varnishes to analyze their preventive effect on initial enamel erosion and fluoride uptake: potassium hydroxide (KOH)-soluble and KOH-insoluble fluoride bound to enamel. MATERIALS AND METHODS: This study was carried out in two parts. Part 1: 108 enamel samples were randomly distributed into six varnish groups: base varnish (no active ingredients); Duraphat® (2.26%NaF); Duofluorid® (5.63%NaF/CaF2); experimental varnish 1 (1%CaGP/5.63 NaF/CaF2); experimental varnish 2 (5%CaGP/5.63%NaF/CaF2); and no varnish. Cyclic demineralization (90 s; citric acid, pH = 3.6) and remineralization (4 h) was made once a day, for 3 days. Change in surface microhardness (SMH) was measured. Part 2: 60 enamel samples were cut in half and received no varnish (control) or a layer of varnish: Duraphat®, Duofluorid®, experimental varnishes 1 and 2. Then, KOH-soluble and KOH-insoluble fluoride were analyzed using an electrode. RESULTS: After cyclic demineralization, SMH decreased in all samples, but Duraphat® caused less hardness loss. No difference was observed between varnishes containing CaGP and the other varnishes. Similar amounts of KOH-soluble and insoluble fluoride was found in experimental varnish 1 and Duofluorid®, while lower values were found for experimental varnish 2 and Duraphat®. CONCLUSION: The addition of CaGP to fluoride varnishes did not increase fluoride bound to enamel and did not enhance their protection against initial enamel erosion. CLINICAL RELEVANCE: We observe that the fluoride varnishes containing CaGP do not promote greater amounts of fluoride bound to enamel and that fluoride bound to enamel may not be closely related to erosion prevention.

Absence of an association between socioeconomic indicators and traumatic dental injury: a systematic review and meta-analysis.

OBJECTIVE: The aim of this study was to perform a systematic review and search for scientific evidence on the association between socioeconomic indicators and traumatic dental injury (TDI) in the primary dentition. METHODOLOGY: The PubMed, ISI, LILACS, Cochrane Library, and Embase databases were searched for articles addressing possible associations between socioeconomic indicators and TDI in the primary teeth in journals dating from the inception of the databases through to December 2013. Two independent reviewers performed data extraction and analyzed the quality of the studies. Meta-analysis was undertaken. Pooled estimates were calculated with a 95% confidence interval (CI) and odds ratios (OR). RESULTS: Sixteen articles were included in the systematic review. Children from families with household income less than two times average salary (U$ 592) (OR: 0.77; 95% CI: 0.66-0.90) or more than three times the average salary (U$ 888) (OR: 0.76; 95% CI: 0.65-0.89) had a significantly lower chance of having TDI in the primary dentition. TDI was not associated with socioeconomic status (high vs low - OR: 0.77; 95% CI: 0.43-1.36; high vs medium - OR: 1.03; 95% CI: 0.72-1.48; medium vs low - OR: 0.70; 95% CI: 0.42-1.19), house ownership (owned vs rented - OR: 1.28; 95% CI: 0.98-1.66), mother's schooling (OR: 0.89; 95% CI: 0.74-1.08), or father's schooling (OR: 1.01; 95% CI: 0.62-2.74). CONCLUSION: The scientific evidence demonstrates that socioeconomic indicators are not associated with TDI in the primary dentition. The evidence of an association between a low income and TDI is weak. In general, studies had low risk of bias. Further prospective cohort studies are needed to confirm this association.

Effectiveness of a preventive program based on caries risk assessment and recall intervals on the incidence and regression of initial caries lesions in children.

BACKGROUND: Evidence on caries risk assessment (CRA) and recall intervals are limited in terms of caries prevention. AIM: To assess the effectiveness of a program on the incidence and regression of initial caries lesions. DESIGN: A total of 296 children aged 1-12 years old were assessed by calibrated examiners for Gingival Bleeding Index, Dental Plaque Index, dmf-t/DMF-T Index, initial caries lesions, and caries lesion activity. Children were classified as low, moderate, and high caries risk with different recall interval visits. Statistical analysis included Cox regression and Kaplan-Meier curves. RESULTS: The mean (SD) time of total follow-up for the sample was 11.5(5.5). Higher dmft index at baseline showed a higher risk of new initial lesions (HR = 1.93; P < 0.0001). Higher number of active initial lesions, at baseline and during follow-up visits, is a higher risk predictor for new initial lesions (HR = 9.49; P < 0.0001), as well as for no arrestment of active lesions during follow-up (HR = 1.32; P < 0.0001). Each follow-up visit attended presented a 77% lower risk of initial lesions. The majority (94.8%) of patients did not show new initial lesions. CONCLUSIONS: The Program is effective on reducing the incidence and promoting regression of initial caries lesions in children.

Impact of traumatic dental injuries and malocclusions on quality of life of preschool children: a population-based study.

BACKGROUND: Few studies assessed the impact of traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) in preschool children. AIM: To assess the impact of the presence of TDI and malocclusions, as well as its severity and types, respectively, on the OHRQoL of preschool children. DESIGN: The study was conducted in 1215 children aged 1-4 years old who attended the National Day of Children Vaccination in Diadema, Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and socio-demographic conditions. Calibrated dental examiners performed the oral examinations for TDI and malocclusions. Poisson regression models adjusted by dental caries associated the clinical and socio-demographic conditions with the outcome. RESULTS: The multivariate adjusted models showed associations between some individual domains of the B-ECOHIS and clinical and socio-demographic conditions (P < 0.05). The severity of TDI showed a negative impact on the symptoms domain and self-image/social interaction domain (P < 0.05). Children with complicated TDI were more likely to experience a negative impact on total B-ECOHIS scores (PR = 2.10; P = 0.048). CONCLUSIONS: The presence of complicated TDI and dental caries were associated with worse OHRQoL of Brazilian preschool children, whereas malocclusions do not.

Correlation and comparative analysis of discriminative validity of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Early Childhood Oral Health Impact Scale (ECOHIS) for dental caries.

BACKGROUND: The perceptions of parents and children regarding oral health are useful to oral public health and clinical practice in pediatric dentistry. The primary aim of the present study was to evaluate the correlation between the total and item scores of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) (parental version and child's self-reports) and the Early Childhood Oral Health Impact Scale (ECOHIS). Subsequently, the discriminative validity of these assessment tools regarding dental caries was compared. METHODS: One hundred twenty-one children randomly selected in the city of Diamantina (Brazil) were submitted to oral examinations. Parents answered the ECOHIS and SOHO-5p (parental version) and children answered the SOHO-5c (child's self-reports). Statistical analysis involved the Mann-Whitney test as well as the calculation of Spearman's correlation coefficients. RESULTS: A significant correlation was found between the SOHO-5p and ECOHIS (r = 0.85), whereas no significant correlations were found between the SOHO-5c and SOHO-5p (r = 0.00) or between the SOHO-5c and ECOHIS (r = -0.41). Significant differences in the impact on quality of life were found between children with severe decay and no severe decay (caries free, with initial or established caries) both the ECOHIS and SOHO-5p (p ≤ 0.05), whereas no difference was found in SOHO-5c (p > 0.05). CONCLUSIONS: The ECOHIS and SOHO-5p were correlated with each other. The accounts of the children differed from their parents' reports and were not capable of discriminating dental caries in advanced stages of progression.