Milene Torres Martins

Malocclusion and oral health-related quality of life in Brazilian school children.

OBJECTIVE To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. MATERIALS AND METHODS A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05). RESULTS Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. CONCLUSIONS Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Feeding and nonnutritive sucking habits and prevalence of open bite and crossbite in children/adolescents with Down syndrome

OBJECTIVE To analyze the influence of breastfeeding, bottle feeding, and nonnutritive sucking habits on the prevalence of open bite and anterior/posterior crossbite in children with Down syndrome (DS). MATERIALS AND METHODS A cross-sectional study was carried out in 112 pairs of mothers/children with DS between 3 and 18 years of age at a maternal/childrens hospital in Rio de Janeiro, Brazil. The children with DS were clinically examined for the presence of open bite as well as anterior and posterior crossbite. Information on breastfeeding, bottle feeding, and nonnutritive sucking habits was collected using a structured questionnaire. The control variables were age and mouth posture of children/adolescents and mothers schooling. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. RESULTS The prevalence of anterior open bite was 21%, anterior crossbite was 33%, and posterior crossbite was 31%. The use of bottle feeding for more than 24 months (prevalence ratio [PR] = 1.6) was associated with the occurrence of open bite. Having breastfed for less than 6 months (PR = 1.4) and pacifier sucking for more than 24 months (PR = 3.1) were associated with the prevalence of anterior crossbite. Finger sucking (PR = 2.9) and the use of bottle feeding for more than 24 months (PR = 2.6) were associated with posterior crossbite. CONCLUSION The prevalence of open bite and crossbite in children with DS was associated with the use of bottle feeding and pacifier sucking for more than 24 months, breastfeeding for less than 6 months, and finger sucking.

Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach.

Background Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children. Objective To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables. Methods A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8–10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8–10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers’ level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05). Results The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001). Conclusion Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.

Prevalence and determinant factors of malocclusion in children with special needs

Careful attention to malocclusion in children with special needs leads to a considerable improvement in the quality of life. The present study analysed the prevalence of malocclusion in children with Down syndrome (DS) and cerebral palsy (CP) as well as associations with individual, socio-economic, and behavioural factors. A cross-sectional study was carried out that included 181 mothers and their children with DS and CP (aged 3-12 years) at two institutions for individuals with special needs in Rio de Janeiro, Brazil. Data were collected using a questionnaire administered to the mothers and a dental examination of the children. Clinical examination recorded the following: anterior/posterior crossbite and anterior openbite (AOB). The control variables were the mothers level of education as well as the gender and age of the child. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression. An anterior crossbite was present in 20.4 percent, a posterior crossbite in 21.5 percent, and an AOB in 29.8 percent. The presence of DS, bottle feeding, and non-nutritive sucking habits for 24 months or more was determinant factors for an anterior crossbite and the presence of DS, bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months was determinant factors for a posterior crossbite. The presence of CP and non-nutritive sucking habits for 24 months or more was determinant factors for an AOB. Thus, the prevalence of malocclusion in children with special needs was associated with the type of disability, use of bottle feeding and non-nutritive sucking habits for 24 months or more, and respiratory infection in the previous 6 months.

Dental caries remains as the main oral condition with the greatest impact on children’s quality of life

Purpose The objective of this study was to assess the negative impact of dental caries on the OHRQoL of 8- to 10-year-old Brazilian children. Methods This population-based case-control study involved 546 children (8–10 years old), 182 cases with a high negative impact on OHRQoL and 364 controls with a low negative impact on OHRQoL. Children’s OHRQOL was measured using the Child Perceptions Questionnaire (CPQ8-10). Cases and controls (1x2 ratio) were individually matched by school and gender. Dental caries experience, malocclusion, and traumatic dental injuries were used as independent variables. Dental examinations were carried out at school during daytime hours by two calibrated examiners (Kappa = 0.93-interexaminer and 0.95- intraexaminer). The data were analyzed by descriptive statistics, conditional bivariate and multiple logistic regression, with the significance level set at 5%. Results There was no significant difference in traumatic dental injuries and malocclusion between the case and control groups (p>0.05). Children with DMFT/dmft ≥3 had a 2.06-fold (95%CI = 1.28–3.31, p = 0.003) greater chance of experiencing a high negative impact on OHRQoL than those with DMFT/dmft = 0 Conclusion Children with high dental caries experience are more likely to present a high negative impact on OHRQoL than those with no dental caries experience.

Base of the skull morphology and Class III malocclusion in patients with unilateral cleft lip and palate

OBJECTIVE: The aim of the present study was to determine the morphological differences in the base of the skull of individuals with cleft lip and palate and Class III malocclusion in comparison to control groups with Class I and Class III malocclusion. METHODS: A total of 89 individuals (males and females) aged between 5 and 27 years old (Class I, n = 32; Class III, n = 29; and Class III individuals with unilateral cleft lip and palate, n = 28) attending PUC-MG Dental Center and Cleft Lip/Palate Care Center of Baleia Hospital and PUC-MG (CENTRARE) were selected. Linear and angular measurements of the base of the skull, maxilla and mandible were performed and assessed by a single calibrated examiner by means of cephalometric radiographs. Statistical analysis involved ANCOVA and Bonferroni correction. RESULTS: No significant differences with regard to the base of the skull were found between the control group (Class I) and individuals with cleft lip and palate (P > 0.017). The cleft lip/palate group differed from the Class III group only with regard to CI.Sp.Ba (P = 0.015). Individuals with cleft lip and palate had a significantly shorter maxillary length (Co-A) in comparison to the control group (P < 0.001). No significant differences were found in the mandible (Co-Gn) of the control group and individuals with cleft lip and palate (P = 1.000). CONCLUSION: The present findings suggest that there are no significant differences in the base of the skull of individuals Class I or Class III and individuals with cleft lip and palate and Class III malocclusion.

Impact of malocclusion on the quality of life of children aged 8 to 10 years

ABSTRACT Objective: The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil. Methods: The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study. Results: Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038). Conclusions: Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.