Maria Letícia Ramos-Jorge

Impact of dental pain on daily living of five-year-old Brazilian preschool children: prevalence and associated factors

AIM: To assess the impact of dental pain on the daily living of 5-year-old preschool children using reports from parents/guardians. DESIGN SND METHODS: A cross-sectional study was carried out involving 549 five-year-old children randomly selected from preschools in the city of Belo Horizonte, Brazil. Data were collected using a previously validated parent-reported questionnaire. The children received dental examinations from a single calibrated examiner. The following outcome variables were selected: age, gender, dental caries, filled teeth, missing teeth, caries involving pulp and social class. Simple and multiple logistic regression analyses were performed on the data. RESULTS: According to parents’ reports, 11.1% of children were affected by dental pain in the previous 4 months and of these 72.6% had their daily activities hampered by pain. The majority of these children had difficulty in eating, brushing teeth, sleeping, playing and going to school. The impact of dental pain had a statistically significant association with gender (p=0.001), social class (p=0.009), dental caries (p<0.001), missing teeth (p<0.001), filled teeth (p<0.001) and caries involving pulp (p<0.001). CONCLUSION: The prevalence of difficulties performing tasks of daily living due to dental pain was relatively high among the children studied.

Does intellectual disability affect the development of dental caries in patients with cerebral palsy

The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of these, 76 individuals had been diagnosed with spastic cerebral palsy and 89 had no neurological impairment. The subjects were matched based on age and gender and selected randomly by lottery. All patients were examined to determine the number of dental cavities, and tested for their intellectual functioning (Raven Test) and motor abilities. The study showed that children with CP who presented with intellectual disabilities had a larger number of dental cavities than children with CP without intellectual disabilities. Considering intellectual functioning and motor impairment in the multivariate logistic regression, only intellectual functioning was found to have a significant effect on the development of dental cavities. These results suggest that intellectual disability can be considered a contributing factor for the development of dental caries in patients with cerebral palsy.

Association between executive/attentional functions and caries in children with cerebral palsy

The aim of the present study was to evaluate the existence of an association between attention/executive functions and the development of dental caries in individuals with cerebral palsy (CP). Seventy-six children with CP were selected from a physical rehabilitation center and a school serving children with disabilities. The control group was made up of 89 children without neurological impairment. Socioeconomic status, presence of teeth with cavities due to caries, degree of motor impairment and intellectual, executive and attentional functions were assessed. Mean age of participants was 8.9 years (SD=3.56). The CP group had a significantly lower performance (p<0.05, Mann-Whitney test) on the intelligence, attentional function and executive function tests in comparison to the control group. Controlling for the clinical diagnosis (CP or control group), motor impairment and intellectual function, the significant explanatory variables for the presence of teeth with cavities were performance on the Complex Rey figure test (OR=0.941) and the Digit Span subtest of the Wechsler Intelligence Scale for Children in backward order (OR=0.581). After controlling for intellectual function, clinical diagnosis and motor impairment, deficits in executive and attentional functions increased the odds of developing dental caries in children with cerebral palsy.

Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study

The present study was designed to evaluate associations between developmental defects of enamel (DDE) in the primary dentition and aspects related to mothers and preschoolers in the city of Diamantina, Brazil. A case-control study was carried out involving children aged three to five years. The case group was composed of 104 children with at least one dental surface affected by DDE. The control group comprised 105 children without DDE, matched for gender and age. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel Index. Information was collected through interviews investigating socio-demographic aspects, gestation, birth weight, prematurity and breastfeeding. Simple and multiple regression analyses were performed, providing unadjusted and adjusted prevalence ratios (Poisson regression). DDE were more prevalent among children who had not been breastfed (PR=1.57; 95% CI: 1.1-2.2) and those whose mothers were under 24 years of age at the birth of the child (PR=1.41; 95% CI: 1.1-1.9). The prevalence of DDE in the primary dentition was higher among children who had not been breastfed and those whose mothers were under 24 years of age at the birth of the child.

Association between malocclusion and dental caries in adolescents: a systematic review and meta-analysis

AimTo evaluate the scientific evidence regarding the association between malocclusion and dental caries in adolescents.MethodsSearches were conducted of six electronic databases, complemented by manual searching of the reference lists of the selected articles and grey literature. Two independent reviewers performed the selection of the articles, data extraction and the evaluation of the risks of bias through an assessment of methodological quality. Meta-analysis was performed considering the mean decayed, missing and filled teeth (DMFT) index for caries and the Dental Aesthetic Index (DAI) for malocclusion. Heterogeneity was tested using the I2 statistic and a random effect model was employed. Summary effect measures were calculated as differences in means.ResultsThe initial search retrieved 2644 studies, only 15 of which were selected for full-text analysis. Four cross-sectional studies were included in the qualitative systematic review. Only one of these studies found no association between malocclusion and dental caries. The meta-analysis of three studies demonstrated that a lower DAI value was significantly associated with a lower mean DMFT index, except for the comparison of DAI 26–30 vs. 31–35.ConclusionsBased on the studies analysed, the scientific evidence indicates an association between malocclusion and dental caries.

Impact of malocclusion on oral health-related quality of life among schoolchildren

The aim of the present study was to evaluate the prevalence and impact of malocclusion on oral health-related quality of life (OHRQoL) among schoolchildren aged 8 to 10 years and their parents in Diamantina, a town in the southeast of Brazil. A cross-sectional study was conducted with a sample of 390 randomly selected children who were subjected to a clinical oral examination. The Dental Aesthetic Index was used to diagnose malocclusion and the need for orthodontic treatment. The Child Perceptions Questionnaire (CPQ (8-10)) was used to evaluate the impact of malocclusion on OHRQoL. The childrens parents answered the Brazilian Economic Criterion Questionnaire for the socioeconomic classification. Data analysis involved the nonparametric Kruskal-Wallis test and Spearmans correlation coefficients. The variables were grouped into a hierarchy of categories ranging from distal to proximal determinants. Poisson regression analysis with robust variance was performed at each level to correlate the total CPQ (8-10) score with the independent variables. The prevalence of malocclusion was 78.7%. Crossbite remained significantly associated with a negative impact on OHRQoL (PR = 1.28; 95%CI:1.17-1.39; p < 0.001). The prevalence of malocclusion was high in the sample investigated and exerted a negative impact on OHRQoL.

Mechanical control of biofilm in children with cerebral palsy: a randomized clinical trial

BACKGROUND Dental biofilm removal is difficult and can be ineffective in individuals with cerebral palsy. OBJECTIVE Determine the effectiveness of brushing with an electric toothbrush on and off in comparison with manual brushing for the removal of biofilm in children aged four to 16 years with cerebral palsy. METHODS A crossover, randomized, simple-blind, clinical trial was conducted. The examiner was blinded to the brushing method (G1: manual; G2: electric toothbrush on; and G3: electric toothbrush off). The order was determined randomly. The participants (n = 40) were examined before and after brushing performed by caregivers using the Turesky-Quigley-Hein biofilm index. Statistical analysis involved the paired t-test, Wilcoxon, Kruskal-Wallis, and anova tests. RESULTS Biofilm was significantly reduced with the three brushing methods (P < 0.001) (mean reductions: 47.6% in G1; 47.4% in G2; 44.5% in G3). Significant differences were found between G1 and G3 (P < 0.001) and between G2 and G3 (P = 0.007). No significant difference was found between G1 and G2 (P = 0.06). CONCLUSION All methods reduced biofilm. Effectiveness was similar between manual brushing and with the electric toothbrush on, whereas both these methods achieved better results in comparison with the electric toothbrush switched off.