Fernanda de Morais Ferreira

Influence of traumatic dental injury on quality of life of Brazilian preschool children and their families

AIM The aim of this study was to evaluate the impact of traumatic dental injury (TDI) on the oral health-related quality of life (OHRQoL) of Brazilian preschool children and their families. MATERIAL AND METHODS A cross-sectional study was carried out with 1632 children of both sexes aged 60-71 months in the city of Belo Horizonte, Brazil. Data on OHRQoL were collected using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), which was self-administered by parents/caregivers to record their perceptions regarding the oral health of their children. A questionnaire addressing demographic and socio-economic data was also sent to parents/caregivers. Oral examinations of the children were performed by a single, previously calibrated dentist (intraexaminer and interexaminer agreement: kappa ≥ 0.83) for the assessment of the prevalence and type of TDI using the diagnostic criteria proposed by Andreasen et al. [2007]. Bivariate and multiple Poisson regression analyses were performed, with the level of significance set at 5%. RESULTS The prevalence of negative impact from oral conditions on quality of life was 36.8% and 31.4% for children and families, respectively. TDI was not significantly associated with OHRQoL. Tooth avulsion remained in final multiple models of child OHRQoL [PR = 1.37, 95%CI = 1.02-1.85] and family OHRQoL [PR = 1.55, 95%CI = 1.12-2.14]. Tooth discolouration remained in the final multiple models of family OHRQoL [PR = 1.23, 95%CI = 1.05-1.44]. CONCLUSIONS The presence of TDI in Brazilian preschool children has no impact on quality of life of the children or their families. However, tooth avulsion is associated with a negative impact on OHRQoL in both groups, and tooth discolouration is associated with a negative impact on family OHRQoL.

Impact of Malocclusion on Oral Health-Related Quality of Life among Brazilian Preschool Children: a Population-Based Study

The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.

The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1.

OBJECTIVE To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). SUBJECTS AND METHODS A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). RESULTS The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. CONCLUSION Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow.

Validity and Reliability of the Brazilian Version of the Rapid Estimate of Adult Literacy in Dentistry – BREALD-30

Objective The aim of the present study was to translate, perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry to Brazilian-Portuguese language and test the reliability and validity of this version. Methods After translation and cross-cultural adaptation, interviews were conducted with 258 parents/caregivers of children in treatment at the pediatric dentistry clinics and health units in Curitiba, Brazil. To test the instruments validity, the scores of Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services and three dental outcomes. Results The BREALD-30 demonstrated good internal reliability. Cronbach’s alpha ranged from 0.88 to 0.89 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility (intraclass correlation coefficient = 0.983 and Kappa coefficient ranging from moderate to nearly perfect). In the bivariate analysis, BREALD-30 scores were significantly correlated with the level of general literacy (rs = 0.593) and income (rs = 0.327) and significantly associated with occupation, educational attainment, use of dental services, self-rated oral health and the respondent’s perception regarding his/her childs oral health. However, only the association between the BREALD-30 score and the respondent’s perception regarding his/her childs oral health remained significant in the multivariate analysis. Conclusion The BREALD-30 demonstrated satisfactory psychometric properties and is therefore applicable to adults in Brazil.

Impact of Oral Health Status on the Oral Health-Related Quality of Life of Brazilian Male Incarcerated Adolescents.

PURPOSE To assess the impact of oral health status on the oral health-related quality of life (OHRQoL) of incarcerated Brazilian male adolescents. MATERIALS AND METHODS A cross-sectional survey with 102 male adolescents incarcerated at the São Francisco Juvenile Detention Facility, Piraquara, Brazil in 2010 was carried out. Dental caries, oral hygiene, periodontal status, malocclusion, dental fluorosis and dental trauma were analysed. The Oral Health Impact Profile (OHIP-14) was administered to measure OHRQoL, along with a questionnaire addressing sociodemographic variables, health-related aspects and dental experience. Descriptive statistical analysis and univariate and multiple Poisson regression with robust variance were performed. RESULTS The prevalence of adolescents who reported an impact on OHRQoL was 64% (95% CI: 54-73) and the mean OHIP-14 score was 6.69 (SD = 8.79; median = 3.00). In the multiple regression model, the prevalence of a negative impact on OHRQoL was significantly higher among individuals with untreated caries (PR = 1.74; 95% CI: 1.10-2.77), those who reported having discomfort in the teeth or mouth (PR = 1.33; 95% CI: 1.03-1.73), using tobacco prior to internment (PR = 1.53; 95% CI: 1.04-2.24) and maintaining a stable relationship (PR = 1.31; 95% CI: 1.01-1.70) in comparison to individuals who did not exhibit these conditions. Moreover, each month of internment represented an increase in the prevalence of an impact on OHRQoL (PR = 1.03; 95% CI: 1.01-1.06). CONCLUSION Incarcerated male adolescents reported that oral health problems exerted an influence on quality of life, with untreated caries exhibiting the greatest impact.

Reliability of self-reported toothbrushing frequency as an indicator for the assessment of oral hygiene in epidemiological research on caries in adolescents: a cross-sectional study

BackgroundIn the present state of knowledge regarding the etiology of dental caries, it is unacceptable for studies addressing factors associated with this outcome to disregard oral hygiene. Simple, valid methods are needed for the assessment of oral hygiene in adolescents to allow this condition to be properly investigated in epidemiological studies on caries and assist in the establishment of health promotion measures. The aim of the present study was to test the hypothesis that the self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices in epidemiological studies on dental caries in adolescents.MethodsA cross-sectional study was conducted with a representative sample (n = 589) of 12-year-old school children in a medium-sized city in southern Brazil. A detailed questionnaire addressing socio-demographic and economic characteristics was sent to primary caregivers. Adolescents answered a brief self-administered questionnaire on behavioral characteristics, including toothbrushing frequency and sugar intake. Samples of stimulated saliva were collected from the adolescents and evaluated for levels of mutans streptococci and lactobacilli using Dentacult kits I and II, respectively. Examiners who had undergone a training and calibration exercise (kappa > 0.81) performed the clinical examination of the adolescents. Caries experience was assessed using the decayed, missing and filled teeth index. Oral hygiene was determined using the Simplified Oral Hygiene Index and the Visible Plaque Index.ResultsWhen the oral hygiene variables were used alone in the multiple models, significant associations with dental caries were found. When Simplified Oral Hygiene Index and/or Plaque Index were used together with toothbrushing frequency in the same model, only the latter was significantly associated with dental caries. A significant association was also found between self-reported toothbrushing frequency and the clinical indices.ConclusionBased on the present findings, self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices, which facilitates data collection in epidemiological studies addressing dental caries in adolescents.

Performance of Brazilian and imported glass ionomer cements used in Atraumatic Restorative Treatment (ART) regarding microleakage in primary molars

With the aim of assessing the performance of Brazilian and imported glass ionomer cements (GIC) with regard to microleakage, 40 primary molars received two standard class II cavity preparations with margins in enamel. Twenty cavities were filled with Brazilian materials (Vidrion® R and Vidrion® RCaps) and the other 20 cavities were filled with imported materials (Fuji® IX and Fuji® IXGPFast capsule). All fillings were performed by a single operator according to the manufacturers instructions. Teeth were immersed in 0.5% methylene blue and half-sectioned. Three independent calibrated examiners assessed microleakage using scores (0-3). Data were submitted to the Kruskal-Wallis statistical test and Wilcoxon analysis. High microleakage indexes were verified for all ionomer cements: 59.5% of the samples restored with Vidrion® R or Vidrion® RCaps and 83.4% of the samples restored with Fuji® IX or Fuji® IXGpFast capsule obtained the maximum score (3). The Brazilian ionomer cements presented less microleakage than imported cements, although this difference was only significant (p=0.003) among the encapsulated materials.

Association between untreated dental caries and household food insecurity in schoolchildren

The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US

Child abuse: validation of a questionnaire translated into Brazilian Portuguese

70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

The Waterbirth Project: São Bernardo Hospital experience

This study sought to validate the Portuguese translation of a questionnaire on maltreatment of children and adolescents, developed by Russell et al. and to test its psychometric properties for use in Brazil. The original questionnaire was translated into Portuguese using a standardized forward-backward linguistic translation method. Both face and content validity were tested in a small pilot study (n = 8). In the main study, a convenience sample of 80 graduate dentistry students with different specialties, from Curitiba, PR, Brazil, were invited to complete the final Brazilian version of the questionnaire. Discriminant validity was assessed by comparing the results obtained from the questionnaire for different specialties (pediatric dentistry, for example). The respondents completed the questionnaire again after 4 weeks to evaluate test-retest reliability. The comparison of test versus retest questionnaire answers showed good agreement (kappa > 0.53, intraclass correlation > 0.84) for most questions. In regard to discriminant validity, a statistically significant difference was observed only in the experience and interest domains, in which pediatric dentists showed more experience with and interest in child abuse compared with dentists of other specialties (Mann-Whitney test, p < 0.05). The Brazilian version of the questionnaire was valid and reliable for assessing knowledge regarding child abuse by Portuguese-speaking dentists.