Matheus de França Perazzo

Oral health-related quality of life and sense of coherence regarding the use of dental services by preschool children.

BACKGROUND There is a need for studies on the biopsychosocial factors that influence the use of dental services by preschoolers. AIM To evaluate the influence of the perceptions of parents/caretakers and children regarding oral health-related quality of life (OHRQoL) as well as the sense of coherence (SOC) of parents/caretakers on the use of dental services among Brazilian preschoolers. DESIGN A school-based, cross-sectional study was conducted with 768 preschoolers. Parents/caretakers answered a questionnaire addressing socio-demographic characteristics. The OHRQoL of the children was measured using the Scale of Oral Health Outcomes for Five-Year-Old Children. SOC among the parents/caretakers was evaluated using the Sense of Coherence scale. Clinical examinations were performed by examiners who had previously undergone a training exercise. Descriptive analysis was conducted, followed by Poissons regression analysis (α = 5%). RESULTS A total of 56.5% of the preschoolers had never used dental services. The following variables exerted a significant influence on the use of services: higher monthly household income (PR = 1.27; 95% CI: 1.07-1.51), toothache (PR = 1.59; 95% CI: 1.34-1.89), the absence of traumatic dental injury (TDI; PR = 1.18; 95% CI: 1.01-1.40), and a strong SOC (PR = 1.19; 95% CI: 1.01-1.42). CONCLUSIONS A higher monthly household income, history of toothache, the absence of TDI, and strong SOC of the parents/caretakers influence the use of dental services by preschoolers.

Impact of Caries Severity/Activity and Psychological Aspects of Caregivers on Oral Health-Related Quality of Life among 5-Year-Old Children

The aim of the present study was to evaluate the influence of the severity/activity of dental caries as well as sense of coherence (SOC) and locus of control (LOC) on oral health-related quality of life (OHRQoL) among 5-year-old children. A cross-sectional study was conducted involving 769 children at schools in a city in northeast Brazil. Parents/caregivers answered validated questionnaires addressing SOC and LOC. The children and parents/caregivers answered their respective modules of the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Data were also collected on sociodemographic characteristics, visits to the dentist, and the occurrence of toothache. Clinical examinations were performed by 2 trained examiners. A directed acyclic graph was used to select covariates for statistical adjustment, and logistic regression for complex samples was used to test associations between the dependent and independent variables (α = 5%). For parents/caregivers, the variables associated with a negative impact on OHRQoL were the occurrence of toothache (odds ratio, OR: 10.53; 95% confidence interval, CI: 6.34–17.51; p < 0.001) and a low SOC (OR: 2.17; 95% CI: 1.37–3.43; p = 0.001). According to the children’s perceptions, the following variables were associated with a negative impact on OHRQoL: toothache (OR: 3.58; 95% CI: 2.30–5.55; p < 0.001), caries activity (OR: 1.97; 95% CI: 1.07–3.62; p = 0.028), and traumatic dental injury (OR: 1.71; 95% CI: 1.15–2.53; p = 0.007). Among parents/caregivers, a low SOC led to poorer OHRQoL. For the children, however, neither psychological aspect affected OHRQoL. In the perception of both the parents/caregivers and children, toothache was the oral condition that exerted a negative impact on OHRQoL.

Oral Problems and Self-Confidence in Preschool Children

The aim of the present study was to evaluate the impact of clinical oral factors, socioeconomic factors and parental sense of coherence on affected self-confidence in preschool children due to oral problems. A cross-sectional study with probabilistic sampling was conducted at public and private preschools with 769 five-year-old children and their parents/caretakers. A questionnaire addressing socio-demographic characteristics as well as the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Sense of Coherence Scale (SOC-13) were administered. The dependent variable was self-confidence and was determined using the SOHO-5 tool. Dental caries (ICDAS II), malocclusion and traumatic dental injury (TDI) were recorded during the clinical exam. Clinical examinations were performed by examiners who had undergone training and calibration exercises (intra-examiner agreement: 0.82-1.00 and inter-examiner agreement: 0.80-1.00). Descriptive statistics and Poisson regression analysis were performed (a=5%). Among the children, 91.3% had dental caries, 57.7% had malocclusion, 52.8% had signs of traumatic dental injury and 26.9% had bruxism. The following variables exerted a greater negative impact on the self-confidence of the preschool children due to oral problems: attending public school (PR=2.26; 95% CI: 1.09-4.68), a history of toothache (PR=4.45; 95% CI: 2.00-9.91) and weak parental sense of coherence (PR=2.27; 95% CI: 1.03-5.01). Based on the present findings, clinical variables (dental pain), socio-demographic characteristics and parental sense of coherence can exert a negative impact on self-confidence in preschool children due to oral problems.

Approaches adopted by dentists for management of occlusal caries in primary teeth

Objective To evaluate the approaches used by Family Health Strategy dentists in the city of Campina Grande, Paraiba, Brazil, for management of occlusal caries in primary teeth. Methods In this observational, cross-sectional, census-based, descriptive study, 33 professionals completed a questionnaire designed to evaluate their approach to management of occlusal caries in enamel and dentin of deciduous teeth in different risk situations. Data were analyzed through descriptive and inferential statistics (Fishers exact test with the level of significance set to 5%). Inter-examiner agreement was evaluated by Cohens kappa statistic. Results For chronic enamel caries in primary teeth with low risk/activity, the approach of choice was preventive, with fluoride application being the most cited intervention (39.3%). For active carious dentin in primary teeth with high risk/activity and with low risk/activity, invasive approaches were most prevalent (93.9% and 78.8%, respectively), with complete caries removal (74.2%) and glass-ionomer restoration (69.2%) being the most frequent responses. Inter-examiner agreement was moderate (k = 0.44). Conclusion Although a wide range of approaches were adopted by dental practitioners, most preferred invasive interventions, even in situations where preservation of tooth structure was recommended.