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Gonçalves IDC, Coelho VS, Ramos-Jorge J, Mourão PS, Soares KH, Ramos-Jorge ML, Fernandes IB. Utilization of dental services by preschool children: prevalence and associated factors. Braz Oral Res 2024; 38:e081. [PMID: 39258634 PMCID: PMC11376668 DOI: 10.1590/1807-3107bor-2024.vol38.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/21/2024] [Indexed: 09/12/2024] Open
Abstract
Dental associations worldwide recommend that the first dental visit should take place before 12 months of age; however, preschoolers' utilization of dental services remains low. The aim of this study was to assess the prevalence of, and factors associated with, dental services utilization among children aged 1 to 3 years. This was a cross-sectional study carried out in the city of Diamantina, MG, Brazil, and involved a sample of 308 child-mother pairs. Mothers completed a questionnaire addressing sociodemographic and economic aspects of the family and characteristics pertaining to their child's oral health. The clinical assessment of the children included dental caries, trauma, malocclusion, and mucosal changes. Analysis of the data comprised statistical description, application of the chi-square test, and Poisson's regression analysis. Among the children studied, 39.6% had attended at least one dental visit in their lifetime. Children whose families had a greater number of members relying on the family's income (PR = 1.40, 95%CI:1.04 -1.89, p = 0.028) and those with moderate/extensive dental caries (Codes 3-6 of the ICDAS; PR = 1.44, 95%CI: 1.08 -1.93, p = 0.014) exhibited a higher prevalence of dental services utilization. In conclusion, the prevalence of dental services utilization among children aged 1 to 3 years was low, and was associated with a greater number of family members relying on the family's income, and with the occurrence of moderate/extensive dental caries.
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Affiliation(s)
- Isabela da Costa Gonçalves
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte, MG, Brazil
| | - Valéria Silveira Coelho
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte, MG, Brazil
| | - Joana Ramos-Jorge
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte, MG, Brazil
| | - Priscila Seixas Mourão
- Universidade Federal dos Vasles do Jequitinhonha e Mucuri, School of Biological and Health Sciences, Department of Dentistry, Diamantina, MG, Brazil
| | - Kaio Henrique Soares
- Universidade Federal dos Vasles do Jequitinhonha e Mucuri, School of Biological and Health Sciences, Department of Dentistry, Diamantina, MG, Brazil
| | - Maria Letícia Ramos-Jorge
- Universidade Federal dos Vasles do Jequitinhonha e Mucuri, School of Biological and Health Sciences, Department of Dentistry, Diamantina, MG, Brazil
| | - Izabella Barbosa Fernandes
- Universidade Federal dos Vasles do Jequitinhonha e Mucuri, School of Biological and Health Sciences, Department of Dentistry, Diamantina, MG, Brazil
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Figueiredo Dos Santos RV, Bado FMR, da Cunha IP, de Castro Meneghim M. Impact of COVID-19 pandemic on pediatric dental procedures in primary healthcare settings in Piracicaba, Brazil: an ecological study. BMC PRIMARY CARE 2024; 25:71. [PMID: 38413864 PMCID: PMC10898019 DOI: 10.1186/s12875-024-02315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic brought significant changes to dental care, which may have affected pediatric dental care offered in primary healthcare settings. Therefore, the aim of this study was to analyze the quantity of dental procedures performed in primary healthcare for children aged 6 to 12 years, before and during the COVID-19 pandemic. METHODS This is an ecological study using data from the health information system of Piracicaba, São Paulo, Brazil. The variables considered were: coverage of first programmed dental consultation, restoration of permanent and deciduous teeth, topical fluoride application (individual per session), emergency care, and deciduous tooth extraction. Two periods were considered: period I (March 1, 2019 to February 29, 2020) and period II (April 1, 2020 to March 31, 2021), before and during the pandemic, respectively. Comparisons between periods were made using the paired nonparametric Wilcoxon test with a significance level of 5%. RESULTS There was an increase in emergency care from 15.4 to 32.4% (p = 0.0095) and a decrease in the number of restorations of deciduous teeth from 32.8 to 20.2% (p = 0.0217). The first programmed consultation showed a decrease of 9.60% (p = 0.0930) in period II. CONCLUSIONS The COVID-19 pandemic has hindered access to primary dental care for children, impacting the quantity of emergency care, reducing restorations of deciduous teeth, and first programmed dental consultations. These findings highlight the need for strategies to ensure that pediatric dental care is not neglected during pandemics.
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Lima RB, Vilela LD, Nelson-Filho P, Silva LABD, Silva RABD. Caries-related hospital morbidity in the Brazilian Unified Health System from 2008 to 2022. Braz Oral Res 2023; 37:e129. [PMID: 38126473 DOI: 10.1590/1807-3107bor-2023.vol37.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023] Open
Abstract
Dental caries is an important Public Health issue. However, the treatment of this disease in tertiary dental care requires further investigation. Therefore, the objective of this study was to evaluate caries-related hospital morbidity in the Brazilian Unified Health System (SUS) from 2008 to 2022. An ecological study was conducted with secondary data on caries-related Hospital Admission Authorizations (AIH) and in-hospital dental procedures (IDP). Data were collected nationwide and statistical analysis was performed with a significance level (p) of 5%. In the last 15 years, 3,474 caries-related AIH and 63,657 IDP were approved within SUS. There was a significant upward trend in the number of caries-related AIH (p = 0.018) and a stationary trend in the number of caries-related IDP (p = 0.841). Moreover, from 2008 to 2022, R$ 1,160,843.09 was allocated for caries-related AIH. Hospital mortality was 0.29% (10 deaths), and 75.1% were elective inpatient admissions. Among SUS users, adults constituted the majority (49%), with a higher frequency of males (59.8%) and whites (46.2%). The most frequent type of caries-related IDP was restoration of permanent teeth (55.3%). Nonetheless, during the COVID-19 pandemic years, significant reductions in caries-related AIH and IDP within the SUS were observed (all p <0.05). Thus, within the SUS, caries-related tertiary dental care has shown a specific pattern over the last 15 years, including an increase in hospitalizations and a high number of in-hospital dental procedures, especially before the COVID-19 pandemic onset.
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Affiliation(s)
- Ricardo Barbosa Lima
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Graduate Program in Pediatric Dentistry , Ribeirão Preto , SP , Brazil
| | - Larissa Dias Vilela
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Graduate Program in Pediatric Dentistry , Ribeirão Preto , SP , Brazil
| | - Paulo Nelson-Filho
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
| | - Léa Assed Bezerra da Silva
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto , Department of Pediatric Clinics , Ribeirão Preto , SP , Brazil
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Gomes AC, Vettore MV, Quadros LN, Rebelo MAB, Rebelo Vieira JM. Does using the sociodental approach in oral health care influence use of dental services and oral health of adolescents living in deprived communities? a one-year follow up study. BMC Health Serv Res 2023; 23:605. [PMID: 37296425 DOI: 10.1186/s12913-023-09596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Oral health needs assessment is important for oral health care planning. This study compared dental treatment needs between normative and sociodental needs. We also longitudinally examined the relationships of baseline sociodental needs measures and socioeconomic status with one-year follow up measures of use of dental services, dental caries, filled teeth, and oral health-related quality of life (OHRQoL). METHODS A prospective study was conducted with 12-year-old adolescents from public schools in deprived communities in the city of Manaus, Brazil. Validated questionnaires were used to collect adolescents' sex and socioeconomic status, OHRQoL (CPQ11 - 14) and behaviours (sugar intake, frequency of toothbrushing, regular use of fluoridated toothpaste and pattern of dental attendance). Normative need was assessed according to decayed teeth, clinical consequences of untreated dental caries, malocclusion, dental trauma, and dental calculus. The relationships between variables were tested thorough Structural equation modelling. RESULTS Overall 95.5% of adolescents had normative dental treatment needs. Of these, 9.4% were classified as high level of propensity. Higher normative/impact need and greater propensity-related need directly predicted use of dental services at one-year follow up. The latter mediated the association of normative/impact need and propensity-related need with incidence of dental caries and filled teeth. Normative/impact need and use of dental services were directly associated with filled teeth at one-year follow up. Poor OHRQoL at one-year follow-up was directly predicted by higher normative/impact need at baseline and less filled teeth at one-year follow up. Greater socioeconomic status was directly associated with better propensity-related need. Socioeconomic status indirectly predicted incidence of dental caries and filled teeth via propensity-related need and use of dental services. CONCLUSIONS Sociodental needs measures were related to use of dental services, dental caries, filled teeth and OHRQoL after one year among adolescents living in deprived communities. Adolescents with dental needs treatment priorities according to the sociodental approach had more filled teeth via use of dental services. Dental services utilisation did not attenuate the impact of normative and impact-related need on dental caries incidence and poor OHRQoL after one year. Our findings suggest the importance of developing oral health promotion and enhancing access to dental care to improve oral health of adolescents living in deprived communities.
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Affiliation(s)
- Andressa Coelho Gomes
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, Faculty of Health and Sports Sciences, University of Agder, Campus Kristiansand, Universitetsveien 25, Kristiansand, 4630, Norway.
| | - Larissa Neves Quadros
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Maria Augusta Bessa Rebelo
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
| | - Janete Maria Rebelo Vieira
- School of Dentistry, Federal University of Amazonas, Av. Ministro Waldemar Pedrosa, 1539, Praça 14 de Janeiro, Manaus, AM, CEP 69025-050, Brazil
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Tondolo Junior J, Ortiz FR, Ramadan YH, Maroneze MC, Agostini BA, Ardenghi TM. Direct relations between sense of coherence and oral health-related quality of life in adolescents. Oral Dis 2023; 29:1367-1375. [PMID: 34942045 DOI: 10.1111/odi.14111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/08/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To verify the relations between sense of coherence (SOC) and dental caries on oral health-related quality of life (OHRQoL) of adolescents. SUBJECT AND METHODS A cross-sectional sample of 768 adolescents nested in a cohort study was evaluated. SOC was measured using Antonovsky's scale. Dental caries was collected considering the decayed, missing, and filled teeth index (DMFT). OHRQoL was collected through the Child Perception Questionnaire. Demographic, socioeconomic, and use of service variables were also collected. The mediation effects between variables were tested by structural equation modeling. RESULTS The average age of the individuals was 17.5 years. Individuals with high SOC scores had a positive impact on OHRQoL (β-coefficient = -0.573, p < 0.00). Individuals with high DMFT (β-coefficient = 0.080, p = 0.034) and dental pain (β-coefficient = 0.079, p = 0.039) negatively impacted OHRQoL. Still, adolescents who had dental pain (β-coefficient = 0.112, p = 0.005), mothers with lower education levels (β-coefficient = -0.114, p = 0.004), lower household income (β-coefficient = -0.131, p = 0.003), and those who visited the dentist (β-coefficient = 0.109, p = 0.005) exhibited a higher DMFT index. CONCLUSIONS SOC and dental caries had a direct effect on OHRQoL, indicating that oral conditions and psychosocial characteristics are important contributors to OHRQoL.
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Affiliation(s)
- Jocelito Tondolo Junior
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fernanda Ruffo Ortiz
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Yassmín Hêllwaht Ramadan
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Marília Cunha Maroneze
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
- SOBRESP Faculty of Health Sciences, Santa Maria, Brazil
| | | | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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Rauber ED, Knorst JK, Noronha TG, Zemolin NAM, Ardenghi TM. Impact of the use of dental services on dental pain according to adolescents' skin colour: a 10-year cohort. Clin Oral Investig 2023:10.1007/s00784-023-04921-7. [PMID: 36829064 PMCID: PMC9957686 DOI: 10.1007/s00784-023-04921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/13/2023] [Indexed: 02/26/2023]
Abstract
OBJECTIVE Evaluate the association of the interaction between the use of dental services and the skin colour on the occurrence of dental pain over time. MATERIAL AND METHODS This study is a cohort with 10 years of follow-up, started in 2010 with a sample of 639 preschool children (1-5 years old). The use of dental services, race and the presence of dental pain were self-reported by the individuals according to predefined criteria. Multilevel logistic regression analysis was performed to assess the interaction between skin colour and use of dental services in the occurrence of dental pain over time. RESULTS About 449 and 429 were reassessed in 2017 and 2020, respectively. The occurrence of dental pain across the cohort was 60.7%. Caucasian individuals who used dental services throughout the cohort had a 51% lower chance of having a dental pain than those who used dental services but were non-white (OR 0.49; 95% IC 0.27-0.90). CONCLUSION There was a racial inequity in the occurrence of dental pain among individuals who managed to make use of dental services throughout the follow-ups. CLINICAL RELEVANCE The differences found should serve as a warning to the way how individuals with different characteristics are treated and must be used to combat this inequity. Individuals should receive resolute and personalized treatments according to their clinical condition and not according to their socioeconomic characteristics.
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Affiliation(s)
- Everton Daniel Rauber
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Rua Conde de Porto Alegre, Santa Maria, RS 961 Brazil
| | - Jessica Klöckner Knorst
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Rua Venâncio Aires, Santa Maria, RS 1434 Brazil
| | - Thaís Gioda Noronha
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Rua Conde de Porto Alegre, Santa Maria, RS 961 Brazil
| | - Nicole Adrielli Monteiro Zemolin
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Rua Conde de Porto Alegre, Santa Maria, RS 961 Brazil
| | - Thiago Machado Ardenghi
- Departament of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil. .,Universidade Federal de Santa Maria, Roraima nº 1000 Bairro Camobi, CEP: 97105900, Santa Maria, RS, Brazil.
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Nunes GP, Danelon M, Pessan JP, Capalbo LC, Junior NAN, Matos AA, Souza JAS, Buzalaf MAR, Delbem ACB. Fluoride and trimetaphosphate association as a novel approach for remineralization and antiproteolytic activity in dentin tissue. Arch Oral Biol 2022; 142:105508. [PMID: 35901595 DOI: 10.1016/j.archoralbio.2022.105508] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/28/2022] [Accepted: 07/10/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The study evaluated the effect of solutions containing fluoride (F) and/or sodium trimetaphosphate (TMP) and F/TMP on the inhibition of MMP-2 and MMP-9, and on dentin remineralization in vitro. DESIGN Bovine root dentin blocks were prepared, and caries-like lesions were induced in two thirds of the surface. Blocks were then randomly divided into 13 groups/solutions (n = 10): Placebo; 0.3 %, 1 % and 3 % NaOH-hydrolyzed TMP; 0.3 %, 1 % and 3 % TMP; 250, 500 and 1100 ppm F; 250 ppm F + 0.3 % TMP; 500 ppm F + 1 % TMP and 1100 ppm F + 3 % TMP. One third of each specimen was treated with the respective solutions in pH-cycling. The mineral concentration (gHAp × cm-3 × µm) was determined by computed X-ray microtomography, and data submitted to ANOVA and Student-Newman-Keuls' test (p < 0.05). The ability of the solutions to inhibit MMP-2 and MMP-9 activity was assessed by zymography. RESULTS F/TMP association led to less mineral loss in the deeper region of the lesion and reduced the depth of lesions when compared to its counterpart without TMP (p < 0.001). 3 % TMP (hydrolyzed or not), 500 ppm F and 1100 ppm F completely inhibited MMP-2 activity, while for MMP-9 such effects were only achieved by treatment with 1100 ppm F + 3 % TMP. CONCLUSION Treatment with 1100 ppm F + 3 % TMP fully inhibits the gelatinolytic activity of MMPs-2 and - 9 and shows greater remineralizing capacity in artificial caries lesions in dentin. However, hydrolyzing TMP does not improve its anti-proteolytic activity and its remineralizing capacity.
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Affiliation(s)
- Gabriel Pereira Nunes
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil
| | - Marcelle Danelon
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil; School of Dentistry, University of Ribeirão Preto - UNAERP, Ribeirão Preto, Brazil
| | - Juliano Pelim Pessan
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil
| | - Letícia Cabrera Capalbo
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil
| | - Nilson Antônio Nunes Junior
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil
| | - Adriana Arruda Matos
- São Paulo State University (USP), School of Dentistry, Bauru, Department of Biological Sciences, Brazil
| | - José Antonio Santos Souza
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil
| | | | - Alberto Carlos Botazzo Delbem
- São Paulo State University (UNESP), School of Dentistry, Araçatuba, Department of Preventive and Restorative Dentistry, Brazil.
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Emmanuelli B, Knorst JK, Menegazzo GR, Mendes FM, Ardenghi TM. The Impact of Early Childhood Factors on Dental Caries Incidence in First Permanent Molars: A 7-Year Follow-Up Study. Caries Res 2021; 55:167-173. [PMID: 33789289 DOI: 10.1159/000515083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
The development of dental caries in first permanent molars has been extensively investigated. However, studies are inconclusive in determining the influence of contextual and individual factors on dental caries incidence in this group of teeth. The aim of this study was to evaluate the influence of contextual and individual factors on dental caries incidence in first permanent molars. This 7-year cohort study was conducted with children (1-5 years of age) who had been assessed initially in a survey performed in 2010. Dental caries was assessed at the baseline through the International Caries Detection and Assessment System (ICDAS). Contextual and individual variables were collected at baseline and included the presence of cultural community centers in the neighborhood as well as demographic, socioeconomic, psychosocial, and biological characteristics. A multilevel Poisson regression model was used to investigate the influence of individual and contextual characteristics on dental caries incidence in first permanent molars (relative risk [RR] and 95% confidence interval [CI]). Of the 639 children examined at baseline, a total of 449 were reassessed after 7 years (70.3% retention rate). Children who lived in neighborhoods with cultural community centers had a lower risk of dental caries in first permanent molars at the follow-up (RR 0.78; 95% CI 0.62-0.99). Children from families with a low income (RR 1.34; 95% CI 1.03-1.76) and poor parental perception of children's oral health (RR 1.56; 95% CI 1.18-2.06) were associated with a higher risk of dental caries in first molars. In conclusion, individual and contextual determinants showed an important role in the incidence of caries in first permanent molars.
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Affiliation(s)
- Bruno Emmanuelli
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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