Evaluating the agreement between children and their parents on dental pain in children using the self-reported method.

BACKGROUND: Having preschool children evaluate their dental pain can provide an additional insight into pain diagnoses and improve patient-centered care. This study aimed to evaluate the agreement between self-reported dental pain by preschoolers and their parents' report (proxy measure). DESIGN: This cross-sectional study was conducted with children aged 4 to 6 years, and with one of their parents. Dental pain was reported using the Simplified Faces Pain Scale (S-FPS) and administered before the dental consultation. Dental pain was assessed using closed-ended questions, and a three-face scale was used to determine pain severity. The kappa and weighted kappa tests were used to evaluate the agreement between the children's self-report and their parents' report. RESULTS: A total of 198 child-parent dyads participated. Current child dental pain was reported by 44.4% of the children and 36.9% of the parents. Severe pain was reported most frequently between children (17.1%) and parents (16.2%). The agreement on the severity of dental pain ranged from substantial (children aged 6 years and parents: weighted kappa = 0.372) to moderate (4-year-olds: 0.412; 5-year-olds: 0.453). CONCLUSION: Children and parents agreed on the child's dental pain. The use of the S-FPS among younger children appears valid and feasible for assessing dental pain.

Sedation versus protective stabilization for dental treatment of children with caries and challenging behavior at the dentist (CHOOSE): a study protocol for a non-randomized clinical trial.

BACKGROUND: There is a lack of evidence on the effectiveness of moderate sedation in pediatric dentistry, compared to protective stabilization, which remains routinely used in Brazil despite moral questions. This prospective non-randomized clinical trial's objective is to evaluate the effectiveness of moderate sedation, compared to the protective stabilization, in the dental care of children with dental behavior management problems. METHODS: Participants will be 152 children under seven years of age with early childhood caries (ECC) who need specialized dental treatment due to a history of challenging behavior during dental care. The interventions to be compared are moderate sedation with oral administration of ketamine and midazolam and protective stabilization. The primary endpoint will be the child's behavior during treatment assessed using the Ohio State University Behavioral Rating Scale (OSUBRS). The secondary outcomes are (A) child's - behavior according to the visual analogue scale, anxiety, pain, and physiological stress; (B) parent's - satisfaction and anxiety; (C) family and child - impact on oral health-related quality of life (OHRQoL); (D) dentist's - satisfaction and stress; (E) procedure - adverse events of the intervention and dental treatment longevity. A cost-effectiveness analysis will be performed from the perspective of the Brazilian Unified Health System (SUS). DISCUSSION: Considering the primary outcome, this study hypothesis is that sedated children have better behavior during dental treatment than children whose behavior was managed by protective stabilization without sedation. Additionally, at the end of 12 months, we expect to identify participants' reported outcomes and objective measures related to dental behavior in early childhood. Trial registration Clinicaltrials.gov registration NCT04119180 on October 8th, 2019. https://clinicaltrials.gov/ct2/show/NCT04119180.

Developmental enamel defects are associated with early childhood caries: Case-control study.

BACKGROUND: Knowledge on the association between developmental enamel defects (DED) and early childhood caries (ECC) has importance for the drafting of prevention measures and oral healthcare planning. AIM: To compare the frequency of ECC in children with and without DED and verify their association with sociodemographic factors. DESIGN: This case-control study was carried out with Brazilian children aged one to five years. The case group made up of 98 children with ECC and the control group was made up of 98 children without ECC. DED were classified in diffuse opacity, demarcated opacity and enamel hypoplasia (Developmental Defects of Enamel Index). Sociodemographic data were collected by a questionnaire answered by parents. Statistical analysis used McNemar's test and logistic regression analyses. RESULTS: In the bivariate analysis, ECC was more frequent among children from families with poorer socioeconomic conditions (lower monthly household income [P ≤ .001] and lower maternal schooling [P = .001]) and among those with DED (P ≤ .001). The final logistical model showed that children with DED (OR: 1.94) and a monthly household income less than two Brazilian minimum salaries (OR: 2.24) were more likely to have ECC. CONCLUSIONS: The occurrence of DED and lower household income were pre-disposing factors for the occurrence of ECC.

Recommended procedures for the management of early childhood caries lesions - a scoping review by the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE).

BACKGROUND: Early childhood caries (ECC) affects millions of children up to 6 years old. Its treatment positively impacts the quality of life of children and their families. However, there is no consensus on how to treat ECC. Thus, we performed a scoping review to identify the recommended procedures for the management of ECC lesions. METHODS: A search was performed in PubMed, Scopus, The Cochrane Library, The International Guideline Library and pediatric dentistry associations around the world were contacted by email for unpublished search documents. ECC guidelines/guidance/policies were considered eligible regardless of language and publication date. RESULTS: From a total of 828 references, 52 full-text articles were assessed for eligibility and 22 included in the scoping review. We found different procedures recommendations for the management of ECC lesions. For incipient lesions, minimally invasive methods such as professional fluoride and cariostatic (silver diamine) applications, as well as surveillance were recommended. If restoration was required, the recommended materials were glass ionomer cement, composite resin, amalgam and stainless-steel crown. Interim restorations and Atraumatic Restorative Treatment (ART) were also recommended. Extractions have been suggested for teeth with lesions with pulpal involvement, depending on the child's behaviour and other clinical conditions. CONCLUSIONS: Non-operative procedures, restorative and extraction were recommended for the management of ECC, depending on the extent of the lesions. There is no difference between different management guidelines/guidance/policies for ECC lesions.

Developmental defects of enamel in the deciduous incisors of infants born preterm: Prospective cohort.

OBJECTIVE: Developmental defects of enamel (DDE) in preterm infants still require clarification and may favour dental caries, lower food intake and greater difficulty with weight-height gain. We evaluated factors associated with DDE in preterm infants. SUBJECTS AND METHODS: In this prospective cohort study, we monitored 54 prematurely born infants from birth to 24 months of age. Trained and calibrated dentists examined the oral cavity of these children to identify and categorize DDE. Information on perinatal variables was collected from the infants' medical records and interviews with their mothers. The data were analysed using Student's t test, a chi-squared test and Pearson's product-moment correlation coefficient. RESULTS: A total of 46.3% of the 54 children presented DDE, which was observed more frequently in the left hemiarch in children born extremely (<28 weeks of gestation) or very preterm (28 to <32 weeks; RR = 2.2; 95% CI 1.3-3.6), with very low birthweight (<1,500 g; RR = 2.0; 95% CI 1.1-3.5), who were admitted to the neonatal intensive care unit (RR = 1.3; 95% CI 1.0-1.7), and who were intubated (RR = 1.6; 95% CI 1.1-2.2). CONCLUSIONS: The high incidence of incisor enamel defects, particularly on the left side, was related to higher risk prematurity and to local trauma from intubation.

Risk of Dental Caries in Primary Teeth with Developmental Defects of Enamel: A Longitudinal Study with a Multilevel Approach.

The risk of dental caries seems to be greater in the presence of developmental defects of enamel (DDE). The aim was to determine whether the presence of DDE in the primary teeth of preschool children increases the risk of dental caries in the primary dentition after a period of approximately 2 years. This study was conducted in two stages: baseline (T0) and follow-up (T1). At T0, examinations were conducted for the diagnosis of enamel defects using the DDE index (FDI, 1992), dental caries, and oral hygiene. The participants were allocated to two groups according to the presence (affected) or absence (unaffected) of DDE. At the second evaluation (T1), examinations were performed for the diagnosis of dental caries. Poisson regression analysis with a multilevel approach was used to determine the association between DDE and dental caries. The two levels of the analysis were tooth and child. Among the 339 children (113 affected and 226 unaffected) examined at baseline (T0), 325 were re-examined at follow-up (T1). According to the multilevel analysis, teeth with enamel hypoplasia had a greater risk of having dental caries (RR: 1.99; 95% CI: 1.19-3.33). The risk of caries was greater on posterior teeth (RR: 2.59; 95% CI: 2.18-3.07) and maxillary teeth (RR: 1.48; 95% CI: 1.26-1.75) that had DDE at T0. On the child level, dental caries at T1 was associated with having dental caries at T0 (RR: 1.38; 95% CI: 1.32-1.46). In conclusion, enamel hypoplasia and previous dental caries are risk factors for carious lesions in the primary dentition.

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.

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.

Association of breastfeeding and malocclusion in 5-year-old children: Multilevel approach.

BACKGROUND: Breastfeeding plays an important role in child health, including the development of normal dental occlusion, but large epidemiological findings on the association breastfeeding-malocclusion are lacking. AIM: To investigate the association between the proportion of breastfed children in the city level and the prevalence of malocclusion in the primary dentition at age 5. DESIGN: This cross-sectional analysis used data from national population surveys on oral health and on breastfeeding practices. Data refer to 5278 5-year-old children and 44 Brazilian towns. Information on malocclusion and individual sociodemographic characteristics were obtained from the 2010 Brazilian Oral Health Survey. Breastfeeding rates during the first year of life were extracted from the Breastfeeding Prevalence Survey in Brazilian Towns. Population sociodemographic data were analysed as confounder. Multilevel Poisson analyses were performed. RESULTS: Malocclusion prevalence was 63.3%. Towns exhibiting higher prevalence of breastfeeding among 9- to 12-month-olds presented lower prevalence of malocclusion among children at age 5 (PR 0.98; 95% CI 0.98-0.99). CONCLUSIONS: Lower prevalence of malocclusion among 5-year-old children was associated with a higher proportion of children breastfed at ages 9 to 12 months at a city level, regardless of sociodemographic factors. These findings highlight the importance of encouraging breastfeeding during a child's first year.

Diagnosis of sleep bruxism can assist in the detection of cases of verbal school bullying and measure the life satisfaction of adolescents.

BACKGROUND: Adolescence is a period with changes and conflicts. AIM: The aim of this study was to investigate the association between sleep bruxism, verbal bullying at school, and life satisfaction among Brazilian adolescents. DESIGN: A cross-sectional study of 1344 Brazilian adolescents was performed. Possible sleep bruxism was identified using the consensus criteria based on the reports of parents. The parents and the adolescents answered validated questionnaires. The data were statistically analyzed using the chi-squared test, Mann-Whitney U-test, and Poisson regression with robust variance. RESULTS: A total of 205 adolescents presented possible sleep bruxism (15.3%). This parafunction was more prevalent among adolescents who were victims of verbal bullying at school (PR: 6.31; 95% CI: 4.78-8.32), victim/perpetrators (PR: 5.27; 95% CI: 3.82-7.27), and who belonged to families from a higher socioeconomic status (RP: 1.51; 95% CI: 1.23-1.86). Possible sleep bruxism was also associated with higher scores in the domains of self (PR: 1.04; 95% CI: 1.00-1.08), school (PR: 1.05; 95% CI: 1.02-1.09) and self-efficacy (PR: 1.07; 95% CI: 1.03-1.12), and lower scores in the non-violence domain (PR: 0.96; 95% CI: 0.93-0.99). CONCLUSIONS: Possible sleep bruxism can assist in the detection of adolescents involved in school bullying at school in the roles of victim and victim/perpetrator.

Association between dental caries experience and sense of coherence among adolescents and mothers.

BACKGROUND: Sense of coherence (SOC) is associated with oral health. AIM: Investigate associations between dental caries experience and SOC among mothers and adolescents. DESIGN: A cross-sectional study was conducted with 1195 adolescents and their mothers. Data were collected through a questionnaire, the short version of the SOC and oral clinical examinations. The data were statistically analyzed using bivariate analysis, Poisson regression models with robust variance, and Spearman's correlation coefficient. RESULTS: The prevalence of dental caries experience was 41.8%. A moderate correlation was found between the SOC of mothers and adolescents (r = 0.563; P < 0.001). A higher mother's SOC (PR: 0.44; 95% CI: 0.36-0.53) and adolescent's SOC (PR: 0.46; 95% CI: 0.39-0.55) were protective factors against dental caries experience in the adolescents. The prevalence of dental caries experience was higher among adolescents with visible plaque (Model 1-PR: 1.77; 95% CI: 1.53-2.04; Model 2-PR: 1.59; 95% CI: 1.37-1.84) and those whose families were in a lower economic class (Model 1-PR: 1.56; 95% CI: 1.35-1.80; Model 2-PR: 1.57; 95% CI: 1.36-1.81). CONCLUSION: Dental caries in adolescents was associated with social determinants evaluated through the sense of coherence.

Mother-child interactions and young child behavior during procedural conscious sedation.

BACKGROUND: As many preschoolers are not able to cooperate with health-related invasive procedures, sedation can help with the child's comfort and allow the intervention to be done. It is scarcely known how parents affect children's behavior during dental treatment under conscious sedation. The aim of this exploratory study was to analyze the association between mother-child interactions in day-to-day family life and preschool children's behavior during dental treatment under conscious sedation. METHODS: This cross-sectional study included 27 children aged 2-6 years and their mothers. The children's behavior during dental treatment under conscious sedation was verified through the analysis of videos and using an observational scale. Social skills of mothers were verified through interviews using the Parental Educative Social Skills Interview Script (RE-HSE-P); the sum of the scores allowed the establishment of the categories "clinical" and "non-clinical". We presented descriptive analyses and bivariate associations. RESULTS: Children's overall behavior during dental sedation was: very poor (n = 2), poor (n = 1), regular (n = 2), good (n = 9), very good (n = 9) and excellent (n = 4). Social skills varied: parental educational social skills (n = 24 clinical vs. n = 3 non-clinical); child social skills (n = 20 vs. n = 7), context variables (n = 15 vs. n = 12), negative educational practices (n = 12 vs. n = 15), child behavior problems (n = 7 vs. n = 20). There was no association between child behavior under sedation and social skills categories (P > 0.05). CONCLUSIONS: The majority of interviewed mothers reported issues in parental educational social skills and child social skills, which did not affect the outcomes of the children's behavior during the procedural conscious sedation.

Incidence of crown fracture and risk factors in the primary dentition: a prospective longitudinal study.

BACKGROUND/AIM: Few studies have assessed the incidence and risk factors to crown fractures in preschool children. The aim of this study was to estimate the incidence of crown fracture in the primary dentition over a 1-year follow-up period, identify risk factors, and test the hypothesis that children with previous crown fracture are more prone to experience further cases of crown fracture independently of other risk factors. MATERIALS AND METHODS: This study was developed in two phases: cross-sectional and prospective longitudinal study. The cross-sectional study was carried out 261 preschool children. The prospective longitudinal study was carried out 194 children allocated to two groups: exposed group (children with prior exposure to crown fracture) and non-exposed group (children without prior exposure). On both occasions, children were examined for the diagnosis of crown fracture and evaluation of lip coverage and overjet. The parents were interviewed with regard to the socioeconomic indicators. New cases of crown fracture were identified based on the comparison of the two examinations. Data analysis involved Pearson's chi-square test, McNemar's test, and Poisson regression with robust variance. RESULTS: Among the 261 children who participated in the cross-sectional study, 194 were re-examined (65 in the exposed group and 129 in the non-exposed group). The overall incidence of crown fracture was 55.7% (n = 108). The difference in percentage of increased risk of crown fracture in exposed and non-exposed groups was 13.4%. A greater incidence of crown fracture was found in the exposed group (64.6%; P < 0,001). The children exposed (RR: 1.30; 95% CI: 1.01-1.67) had a greater risk of developing new cases of crown fracture in comparison with the non-exposed group. CONCLUSION: The incidence of crown fracture was high and children with previous crown fracture had a greater risk of suffering new cases of crown fracture during the 1-year follow-up period.

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.

Dental caries, but not malocclusion or developmental defects, negatively impacts preschoolers' quality of life.

BACKGROUND: Oral diseases can negatively influence the quality of life causing harm in the development of routine activities, child development and their well-being. AIM: To investigate the impact of dental caries, malocclusion and developmental defects of enamel (DDE) on the oral health-related quality of life of preschool children and their parents. DESIGN: A cross-sectional study was carried out with 646 children aged 2-6 years in Diamantina, Brazil. Calibrated dental examiners performed the oral examinations. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire on socio-economic indicators. Statistical analyses involved the chi-square test and Poisson regression. RESULTS: Malocclusion and DDE did not cause a negative impact on the children's quality of life. Children with dental caries (PR: 1.92; 95%CI: 1.56-2.35) and those aged 5 (PR: 1.51; 95%CI: 1.13-2.02) and 6 years (PR: 1.51; 95%CI: 1.02-2.23) were more likely to have a negative quality of life impact on the total B-ECOHIS. CONCLUSIONS: Dental caries was associated with a negative impact on the quality of life of children. Malocclusion and DDE did not cause a negative impact on the children's quality of life. Older children had higher frequency of negative impact on OHRQoL.

Verbal school bullying and life satisfaction among Brazilian adolescents: profiles of the aggressor and the victim.

BACKGROUND: Bullying is a common occurrence in adolescence that may damage the physical and emotional health. OBJECTIVE: The purpose of the present cross-sectional study was to analyze the profile of the adolescent aggressor only, aggressor/victim, victim only, and those not involved in verbal school bullying, and to associate their profiles with life satisfaction and familial characteristics evaluated through socioeconomic status. SUBJECTS AND METHODS: A cross-sectional study was carried out with 366 Brazilian adolescents between 13 and 15years. Verbal school bullying was identified using the Brazilian National School-Based Adolescent Health Survey (PeNSE) questionnaire. The life satisfaction of the adolescents was assessed using the Multidimensional Life Satisfaction Scale for Adolescents (MLSSA). Statistical analyses involved the chi-square test, Fisher's exact test and the Poisson regression with robust variance. RESULTS: Sixty-six adolescents (18%) were aggressors, 5.5% were victims, 2.7% were both aggressor and victim, and 73.8% were not involved in verbal school bullying. Most aggressors were male (PR=1.97, 95% CI: 1.23-3.14) and were satisfied with their family life (PR=2.13, 95% CI: 1.18-3.8). Victims of verbal school bullying exhibited a low prevalence of non-violence (PR=0.24, 95% CI: 0.09-0.64). Those who were both aggressors and victims were associated with factors of family support (PR=0.25, 95% CI: 0.07-0.89) and self-efficacy (PR=6.29, 95% CI: 1.54-25.6). Most of the adolescents who were not involved in verbal school bullying were female (PR=1.32, 95% CI: 1.16-1.51). CONCLUSIONS: Boys tend to be aggressors and girls tend not to get involved in verbal school bullying. Family satisfaction, self-esteem, self-efficacy, and levels of violence are important factors that can influence the profile of adolescents in relation to verbal school bullying.

Are overweight/obese children at risk of traumatic dental injuries? A meta-analysis of observational studies.

BACKGROUND/AIM: Observational studies which investigated the association between overweight/obesity and traumatic dental injuries (TDI) reported contrasting results. Thus, this meta-analysis was designed to investigate such an association with the highest possible levels of internal and external validities. MATERIAL AND METHODS: A comprehensive literature search was performed through PubMed, ISI Web of Science, Cochrane Library, Scopus, Google scholar to ensure generalizability. Eligible studies reported clear case and control definitions, exposure assessment. Where possible, odds ratio (OR) adjusted for covariates was extracted. Study quality was assessed through Newcastle-Ottawa Scale (NOS). Only fair-to-good quality studies with NOS scores ≥4 were selected. The method to assess the pooled OR was based on the level of between-study heterogeneity, estimated through the Cochran's Q. Reliability of the pooled OR was improved by controlling for publication bias, sensitivity analysis to study inclusion, and subgroup analyses according to tooth type (permanent vs primary teeth) and country where the study was performed (Brazilian studies vs studies from other countries). RESULTS: Seventeen studies were selected from America, Asia, and Europe, their NOS scores ranged between 4 and 8. Overall, there were almost 28,000 patients, 7400 of them with TDI. The level of publication bias was minimal, and no adjustment was necessary. Between-study heterogeneity was high, and the random-effects method was used to assess the pooled OR, which resulted 1.30 (95% confidence interval, 1.11-1.53; P < 0.05). Sensitivity and subgroup analyses corroborated this estimate. CONCLUSION: The choice to increase internal and external validity levels decreased the precision of the pooled OR (i.e., confidence intervals were relatively wide). The statistically significant overweight/obesity-TDI association, together with the so-called counterfactual condition (i.e., TDI prevalence was higher among overweight/obese children than among lean children), suggests that causal association between these two conditions is plausible.

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.

Impact of oral mucosal conditions on oral health-related quality of life in preschool children: a hierarchical approach.

OBJECTIVE: To determine the impact of oral mucosal conditions on OHRQoL in preschool children. METHODS: A cross-sectional study was carried out with a selected representative sample of 724 children aged 2-5 years and their parents/caregivers. Data were collected through interviews with parents/caregivers, who also answered the B-ECOHIS. A clinical oral examination was performed to determine oral mucosal conditions, dental caries, dental trauma, and malocclusion. Data analysis involved descriptive statistics, the Kolmogorov-Smirnov normality test, the Mann-Whitney U-test and hierarchically adjusted Poisson regression models (P < 0.05, 95% CI). RESULTS: The prevalence of oral mucosal conditions was 50.7%, the most prevalent of which were melanotic macules (17.8%), oral ulcers (11.0%), Fordyce's spots (9.4%), geographic tongue (5.2%), fissured tongue (1.9%), median rhomboid glossitis (1.8%), and fistula (1.4%). In the final multivariate model, child with 5 years of age (RR = 1.60; 95% CI: 1.08-2.38; P = 0.020), with presence of fistula (RR = 1.94; 95% CI: 1.27-2.95; P = 0.002), and with dental caries (RR = 2.58; 95% CI: 2.00-3.35; P < 0.001) had a negative impact on children's OHRQoL. CONCLUSION: Child with 5 years of age, presence of fistula, and dental caries were associated with a negative impact on the quality of life of preschool children.

Association between developmental defects of enamel and early childhood caries: a cross-sectional study.

BACKGROUND: The determination of risk factors for early childhood caries (ECC) is important to the implementation of preventive and restorative measures. However, few studies have addressed the association between ECC and developmental defects of enamel (DDE). AIMS: To investigate the association between DDE and ECC, controlling for socioeconomic factors and the presence of dental plaque. DESIGN: A cross-sectional study was carried out with 387 children aged two to 5 years during the National Immunisation Day held in 2010 in Diamantina, Brazil. Data were collected through clinical examinations and interviews with parents/guardians addressing socioeconomic indicators. Statistical analysis involved the chi-squared test and Poisson regression. RESULTS: The prevalence of DDE and ECC was 33.9% and 43.3%, respectively. Children with DDE had a greater prevalence rate of ECC (PR: 1.325; 95% CI: 1.093-1.607). Early childhood caries was more prevalent among children with unsatisfactory oral hygiene (PR: 2.933; 95% CI: 2.22-3.86), those who resided in rural areas (PR: 1.267; 95% CI: 1.03-1.55) and those from families with a lower monthly household income (PR: 1.501; 95% CI: 1.06-2.12). CONCLUSIONS: The presence of ECC was associated with the occurrence of DDE in the primary dentition. Place of residence and monthly household income (socioeconomic indicators) and oral hygiene (behavioural factor) exerted an influence on the occurrence of ECC.