Fernanda Morais Ferreira

Impacto Relatado das Alterações Bucais na Qualidade de Vida de Adolescentes: Revisão Sistemática

Introducao: Alteracoes no estado de saude bucal tem o potencial de comprometer a funcao e o bem estar dos individuos. Objetivo: Buscar evidencia cientifica de que problemas bucais provocam repercussoes na qualidade de vida de adolescentes. Metodos: Foi realizada uma busca bibliografica eletronica em 4 bases de dados (MEDLINE, LILACS, BVS Adolec e Cochrane Library), abrangendo o periodo de janeiro de 2000 a outubro de 2011, sem restricao de lingua e com complementacao de busca realizada manualmente nas referencias dos artigos recuperados. Os descritores utilizados foram: “adolescen*”, “oral health” e “quality of life”. Resultados: A estrategia de busca adotada gerou 593 artigos. A partir da analise dos titulos e resumos, foram selecionados, com concordância de 100% entre dois examinadores, 29 artigos, os quais foram obtidos e avaliados na integra. Destes, 13 atenderam aos criterios de elegibilidade, tendo sido a decisao final tomada em consenso, sendo quatro estudos com desenho caso-controle e nove transversais. Nao foram identificados ensaios clinicos controlados sobre o tema. Os artigos incluidos foram avaliados quanto a sua qualidade metodologica. Dentre os artigos selecionados, a ma oclusao foi a condicao clinica que teve seu potencial de provocar repercussoes na qualidade de vida estudado com mais frequencia, seguida de traumatismo, carie e erosao dentaria. Conclusao: Com excecao da erosao dentaria, as alteracoes bucais estudadas apresentaram impacto relatado negativo na qualidade de vida associada a saude bucal de adolescentes. Contudo, estudos longitudinais, com especial atencao para aqueles com controle de fatores de confusao, sao necessarios para esclarecer o nivel de evidencia desta conclusao.

Association of parental attitudes at mealtime and snack limits with the prevalence of untreated dental caries among preschool children.

Eating behavior of parents exerts an influence on eating practices among their children, including the consumption of cariogenic products. The aim of this study was to determine the relationship between the snack limits established by parents/caregivers and the prevalence of untreated dental caries (UDC) among their children. A cross-sectional study was conducted with a representative sample of 686 children aged four and five years enrolled at public schools in the city of Curitiba, Brazil, and their parents/caregivers. The children were examined for dental caries and visible plaque. Parents/caregivers answered the Brazilian version of the Parent Mealtime Action Scale (PMAS). Data were analyzed using nonparametric tests and Poison regression analysis. The prevalence of UDC was 45.6%. The Snack Limits subscale of the PMAS was associated with a lower prevalence rate of UDC (PR: 0.83; 95%CI: 0.72-0.96), independently of the other variables. UDC was also associated with a greater prevalence of visible plaque (PR: 1.29; 95%CI: 1.08-1.54), a lower tooth brushing frequency (PR: 1.46; 95%CI: 1.22-1.77) and greater age of the child (PR: 1.31; 95%CI: 1.08-1.59). Snack limits established by parents/caregivers were associated to a lower prevalence rate of UDC among preschool children.

Profile of orofacial dysfunction in Brazilian children using the Nordic Orofacial Test-Screening

Abstract Objective: The parameters of orofacial dysfunction (OFD) in children can guide clinicians and researchers in the monitoring of deviations from normality. The aim for this study was to evaluate manifestation patterns and the prevalence of OFD in children. Materials and methods: A population-based cross-sectional study was conducted involving 531 schoolchildren (8–10 years old) in a small city in southern Brazil. OFD was evaluated using the Nordic Orofacial Test-Screening (NOT-S). Poisson multiple regression analysis with robust variance was used to estimate adjusted NOT-S rate ratios (ratio of arithmetic means) among the different categories of covariables and their respective 95% confidence interval (RR: 95%CI). Results: The mean NOT-S score was 2.1 (SD 1.4, median: 2.0; range: 0–8). The majority of children (87.6%) had at least one domain of the scale affected. The most affected were Chewing and Swallowing (50.5%), Habits (41.4%) and Breathing (26.4%). NOT-S scores were lower among children from higher income families (RR = 0.73; 95% CI: 0.61–0.87) and higher among those with difficulty regarding access to dental services (RR = 1.14; 95% CI: 1.01–1.28), those with sleep bruxism (RR = 1.18; 95% CI: 1.04–1.32) and those with open bite (RR = 1.65; 95% CI: 1.42–1.93). Conclusions: The prevalence of OFD was high and both socioeconomic and clinical factors exerted an influence on NOT-S scores.

A population-based study on the impact of orofacial dysfunction on oral health-related quality of life among Brazilian schoolchildren

Abstract Objective: The aim of the present study was to assess the impact of orofacial dysfunction on oral health-related quality of life (OHRQoL) among Brazilian schoolchildren. Material and methods: A population-based study was conducted with 531 children aged eight to 10 years at schools in the city of Campo Magro, Brazil. The Brazilian version of the Child Perceptions Questionnaire (CPQ8–10) was the outcome variable used to measure the impact on OHRQoL. The main independent variable was orofacial function, which was diagnosed using the Nordic Orofacial Test-Screening (NOT-S). Descriptive, bivariate and multiple Poisson regression analyses were performed using a multilevel approach, with the significance level set to 5%. Results: The mean (±SD) total CPQ8–10 score was 13.95 ± 0.5. The multilevel Poisson regression model revealed that the mean CPQ8-10 score was higher among girls (RR: 1.38, 95% CI: 1.17–1.63; p < 0.001) than boys and that children from families with a higher income had lower CPQ8–10 scores (RR: 0.67, 95% CI: 0.51–0.88; p = 0.004) than those from families with a lower income. Children who sought dental care due to pain or factors other than prevention (RR: 1.41; 95% CI: 1.18–1.68), those with orofacial dysfunction (RR: 1.62; 95% CI: 1.30–2.02) and those with a history of traumatic dental injury (RR: 1.39; 95% CI: 1.15–1.69) also experienced a greater impact on OHRQoL. Conclusions: Schoolchildren with orofacial dysfunction experience a greater negative impact on OHRQoL.

Cleidocranial Dysplasia: Diagnosis, Surgical and Orthodontic Planning and Interventions in a Pediatric Patient

La displasia cleidocraneal (CCD) es un trastorno oseo, autosomico dominante, causado por un defecto en el gen CBFA1 y se caracteriza por anomalias esqueleticas, craneofaciales y bucodentales. En este trabajo se describen los principales aspectos de un caso de CCD, desde el diagnostico y la planificacion para la primera etapa de las intervenciones. Un paciente varon de 11 anos de edad, concurrio a la Clinica de Odontologia Pediatrica de la Universidad Federal de Parana (Brasil) con un problema de retencion prolongada de casi todos sus dientes de leche. Se describen los examenes clinicos y de imagen dirigidos al diagnostico de la CCD y el plan de tratamiento. La primera etapa consistio en la extraccion de cuatro dientes primarios, dos dientes permanentes y dos dientes supernumerarios del maxilar, seguido de separacion del paladar, traccion de los dientes afectados y traccion inversa del maxilar. El paciente permanece en tratamiento. El seguimiento clinico, asi como la concientizacion y motivacion de la familia son factores importantes en este tipo de casos.

Dental care before cardiac valve surgery: Is it important to prevent infective endocarditis?

Background Infective endocarditis (IE) is a serious disease that affects the surface of the endocardium. The spread of microorganisms from the oral cavity has been associated with the occurrence of IE. Objective To analyze whether dental treatment before cardiac valve surgery (CVS) influenced the occurrence of IE. Methods We performed a retrospective analysis of the medical and dental histories of patients undergoing CVS from 2004 to 2014. The sample consisted of 481 patients who underwent CVS divided into two groups: patients submitted to dental treatment prior to CVS (n = 110) and patients undergoing CVS without dental treatment (n = 371). Results Of the total sample, 38 patients (8%) were diagnosed with IE. No significant difference was detected (p = 0.496) in comparing the occurrence of IE in the group with dental preparation (6.4%) and without dental preparation (8.4%). The logistic regression model confirmed that dental treatment did not change the IE risk (p = 0.504) and indicated that age (p < 0.003) and gender (p = 0.013) were significant risk factors for IE. There was a high demand for dental procedures in the group receiving dental preparation, with no significant differences between the patients with or without IE. Hemoculture indicated qualitative differences in comparing patients with and without dental treatment, especially in the frequency of Staphylococcus and Streptococcus. Conclusions The results did not allow for the determination of the impact of dental treatment before CVS on IE outcomes. However, it was not possible to exclude the potential beneficial effects of dental treatment in the prevention of IE.

Validade e Confiabilidade de Kits para Detecção dos Níveis de Estreptococos do Grupo Mutans e Lactobacilos na Saliva de Crianças e Adultos

Resumen pt: Objetivo: Avaliar a validade e a confiabilidade dos resultados obtidos por meio de kits pre-fabricados disponiveis no mercado brasileiro para a deteccao ...

Contextual and individual determinants of oral health-related quality of life among five-year-old children: a multilevel analysis

Background Contextual factors may influence oral health-related quality of life (OHRQoL) in children. The aim of the present study was to evaluate the influence of individual and contextual determinants of OHRQoL based on the perceptions of children. Methods A cross-sectional study was conducted with a representative sample of 769 five-year-old children from public and private preschools in a city in the countryside of northeast Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, sociodemographic data and aspects of the child’s oral health. The children answered the child version of the Scale of Oral Health Outcomes for five-year-old children and were submitted to oral examinations. Variables related to the context were obtained from the schools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models were used to investigate associations between variables. Results In the adjusted analysis, parent’s/caregiver’s schooling, household income, parent’s/caregiver’s age, a history of dental pain, dental caries and its consequences and traumatic dental injury were considered individual determinants of OHRQoL according to the children’s self-reports. After the incorporation of the contextual determinants, the association between parent’s/caregiver’s schooling and OHRQoL lost its significance. Type of school was the context variable that remained associated with OHRQoL. Discussion Besides the clinical and sociodemographic individual characteristics, characteristics of the school environment in which the child studies are associated with self-reported impacts on OHRQoL.

Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis

OBJECTIVES To conduct a systematic review and meta-analysis regarding the association of oral health literacy (OHL) with oral health behaviors, perception, knowledge, and dental treatment related outcomes. METHODS Eight electronic databases were searched up until June 2017. Studies regarding the aforementioned outcomes measuring OHL through a validated instrument and in which OHL was an explanatory variable were included. Two independent reviewers selected studies, extracted data, and analyzed the risk of bias of the studies. Meta-analysis using random effect modeling was undertaken. Pooled estimates were calculated with 95 percent confidence interval (CI) and odds ratios (OR). RESULTS Twenty-five studies were included in the systematic review and three in the meta-analysis. Most studies were cross-sectional (n = 21) and had a high risk of bias (n = 17). The meta-analysis showed no association between OHL and frequency of visit to the dentist for adults, either through bivariate analysis (OR = 1.25; 95 percent CI: 0.95-1.63) or multivariate analysis (OR = 1.90; 95 percent CI: 0.77-4.84). Dental anxiety and night bottle-feeding were associated with low OHL (P < 0.05). Most studies regarding tooth brushing frequency found no association with OHL. Most studies regarding oral health knowledge related outcomes reported an association with higher OHL. The literature was inconclusive regarding the association between OHL and dental treatment outcomes, oral health behaviors, and oral health perception. CONCLUSIONS The current scientific evidence suggests that no association exists between OHL and any of the outcomes investigated. Further prospective studies with a higher methodological quality are necessary to confirm the evidence.

Dental caries and dental fluorosis according to water fluoridation among 12-year-old Brazilian schoolchildren: a nation-wide study comparing different municipalities

AimTo test the correlation among dental caries, dental fluorosis, and the percentage of municipalities with optimal fluoridated water among Brazilian 12-year-old schoolchildren.Subjects and methodsAn ecological study was performed using primary data from the latest Brazilian Oral Health Survey. The units of analysis were the 26 states plus the Federal District of Brazil (n = 7328 schoolchildren). Dental caries was diagnosed according to the DMFT criteria and dental fluorosis according to Dean’s Index. Descriptive and analytical statistics (p < 0.05) were performed. Google My Maps® was used to display data by state.ResultsMean DMFT ranged from 1.06 to 4.81 between states, whereas the prevalence rates of dental caries and dental fluorosis ranged from 37.3 to 78.2% and from 0 to 45.8% between states, respectively. In Brazil, 60.25% of the municipalities have an optimal fluoridated water supply. The percentage of municipalities with an optimal fluoridated water supply in each state ranged from 0 to 97.4%. Dental fluorosis was negatively correlated with mean DMFT (r = − 0.645; p < 0.001) and with dental caries (r = − 0.678; p < 0.001). The percentage of municipalities with optimal fluoridated water was negatively correlated with dental caries (r = − 0.678; p < 0.001) and positively correlated with dental fluorosis (r = 0.668; p < 0.001).ConclusionLower prevalence of dental caries was found with the increasing percentage of municipalities with optimal fluoridated water and with the increasing prevalence of dental fluorosis.