Factors associated with no dental treatment in preschoolers with toothache: a cross-sectional study in outpatient public emergency services

Cárie dentária e fatores associados aos 12 anos na Região Centro-Oeste do Brasil em 2010: um estudo transversal

Resumo O objetivo do estudo é analisar o índice de dentes cariados, perdidos e obturados (CPO-D) na idade de 12 anos da Região Centro-Oeste e identificar fatores associados, segundo a Pesquisa Nacional de Saúde Bucal, o SB Brasil 2010. É um estudo transversal de base populacional do banco de dados do SB Brasil 2010, realizado nas capitais de Mato Grosso, Mato Grosso do Sul, Goiás, Distrito Federal e uma amostra de municípios da região. Os dados foram analisados pelo teste de qui-quadrado e razões de prevalências com seus respectivos intervalos de confiança, a um nível de significância de 0,05. A regressão de Poisson foi empregada na análise múltipla para analisar a associação entre a variável desfecho e as variáveis explicativas. As variáveis independentes que se mostraram associadas ao CPO-D foram: o estado de moradia em Mato Grosso, Goiás e Mato Grosso do Sul; a renda per capita ≤ R$500,00; dificuldade para comer e dormir, e o motivo da consulta por Dor/Extração/Tratamento/Outros. A média do índice CPO-D foi de 2,14 e a prevalência da cárie dental foi de 41% dos adolescentes.

Knowledge, Attitude, and Practice amongst General Dentists Regarding Dental Pain Perception in Children

Aim

The objective of this study was to evaluate the knowledge, attitude, and practice among general dentists regarding perception of dental pain in children.

Materials and methods

A cross-sectional study was conducted among 208 general dentists in a dental hospital in Chennai. A self-constructed questionnaire was distributed to the dental practitioners, which comprised 23 closed-ended questions. The data were entered and analyzed for frequency and percentages by using Statistical Package for the Social Sciences (SPSS), version 21.

Results

Results showed that most of the dentists (46%) treated less than five children per week and were having less than 2 years of experience (47%). Seventy one percent of the dentists felt that they did not feel prepared to identify a child with dental pain, and 57% of the dentists had less than two years of experience

Conclusion

Most of the dentists did not feel prepared to identify the children with dental pain. Measures should be introduced to train the general dental practitioners in identifying pain perception in children so as to achieve effective behavior management of children.

How to cite this article

Subramanyam D, Gurunathan D. Knowledge, Attitude, and Practice amongst General Dentists Regarding Dental Pain Perception in Children. Int J Clin Pediatr Dent 2020;13(3):207–210.

Urgency and discontinuity of oral health care in children and adolescents

The aim of the present study was to investigate the discontinuity of oral health care among children and adolescents who accessed emergency services at primary care units and urgent care units. Records were reviewed of patients aged 0 to 17 years treated in the public healthcare system in city of Curitiba, Brazil. Discontinuity was considered when elective treatment was not registered at the primary care unit within six months after urgent care. The sample was stratified based on the Municipal Human Development Index (MHDI) (≤0.799 or ≥0.800). The association between discontinuity and covariables was assessed using univariate and multivariate Poisson regression models with robust variance (α=0.05). The incidence of discontinuity was 42.2%. In the MHDI≤0.799 stratum, the risk of discontinuity was greater among children younger than five years of age and individuals who had not had a dental appointment in the previous year. In both MHDI strata, the risk of discontinuity was higher in patients who received urgent care at an urgent care unit than those treated at a primary care unit. The incidence of the discontinuity of oral health care was high and was strongly influenced by the characteristics of dental service utilization among individuals living in regions with a lower MHDI.

Determinants of parental report of dental pain and discomfort in preschool children-The Dental Discomfort Questionnaire

BACKGROUND

Pain is a major consequence of caries, which negatively impacts the quality of life of children and their families.

AIM

To analyse the parental report of dental pain and discomfort in preschool children, and to identify clinical and sociodemographic factors associated.

DESIGN

This cross-sectional study involved 375 four- and five-year-old preschoolers enrolled in the city of Campo Magro public school system, along with their parents and caregivers. Parents/caregivers answered the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) and a sociodemographic questionnaire. Two examiners (kappa > 0.79) performed clinical examinations using dmf-t and pufa index. The associations were statistically analysed by univariate and multiple Poisson regression with robust variance (α = 0.05).

RESULTS

The prevalence of dental pain and discomfort was 70.3% (66%-75% 95% CI). Children from non-nuclear families (PR_a 1.33; 95% CI: 1.01-1.76) and whose parents presented a lower level of education (PR_a 2.43; 95% CI 1.66-3.55) presented a higher prevalence of dental pain or discomfort. Considering the clinical determinants, after adjusting, only the presence of clinical consequences of untreated dental caries (pufa ≥ 1) (PR_a 1.37; 95% CI 1.02-1.84) was significantly associated with higher dental pain or discomfort.

CONCLUSIONS

Dental pain and discomfort were associated with socioeconomic factors and with the presence of clinical consequences of untreated dental caries.

Effect of dental pain and caries on the quality of life of Brazilian preschool children

OBJECTIVE

To investigate the impact of dental pain on daily performances among five-year-old Brazilian children.

METHODS

The study used data of 7,280 five-year-old children participating in the 2010 Brazilian Oral Health Survey (SBBrasil 2010 Project). Children were clinically examined and their parents or carers were interviewed at their homes. The outcome was the prevalence of the oral impacts on daily performance, and the explanatory variable was dental pain in the last six months. Other independent variables were children’s gender and skin color/race, family income, household overcrowding, and caries experience (dmft). Rao-Scott test and Poisson regression for complex samples were carried out.

RESULTS

The prevalence of impacts on daily performances was 26.1% (95%CI 22.3–30.2). Significant associations were found between the outcome and pain, caries experience, and sociodemographic variables. After adjusting for the independent variables, only pain and caries remained significant. Impacts on daily performances were more frequent among children with pain (PR = 1.14, 95%CI 1.06–1.23) compared to those without pain. Children with low dmft (PR = 1.90, 95%CI 1.39–2.60) and those with high dmft (PR = 3.53, 95%CI 2.78–4.49) had a higher prevalence of impact than those with no caries experience.

CONCLUSIONS

Dental pain and caries had strong negative impacts on the five-year-old children’s daily performances regardless of their demographic and socioeconomic characteristics.

[The potential financial impact of oral health problems in the families of preschool children]

The aim of the study was to evaluate the perception of parents/caregivers regarding the financial impact of oral health problems on the families of preschool children. A preschool-based, cross-sectional study was conducted with 834 preschool children in Campina Grande, Brazil. Parents/caregivers answered the Early Childhood Oral Health Impact Scale. "Financial impact" was the dependent variable. Questionnaires addressing socio-demographic variables, history of toothache and health perceptions were administered. Clinical exams were performed by three dentists previously calibrated (Kappa: 0.85-0.90). Descriptive statistics were performed, followed by logistic regression for complex samples (α = 5%). The frequency of financial impact due to oral health problems in preschool children was 7.7%. The following variables were significantly associated with financial impact: parental perception of child's oral health as poor, the interaction between history of toothache and absence of dental caries and the interaction between history of toothache and presence of dental caries. It is concluded that often parents/caregivers reported experiencing a financial impact due to seeking treatment late, mainly by the presence of toothache and complications of the clinical condition.

Oral health and quality of life: an epidemiological survey of adolescents from settlement in Pontal do Paranapanema/SP, Brazil

This study aimed to verify oral health, treatment needs, dental service accessibility, and impact of oral health on quality of life (QL) of subjects from settlement in Pontal do Paranapanema/SP, Brazil. In this epidemiological survey, 180 10-to 19- years old adolescents enrolled in the school that attend this population in settlement underwent oral examination, to verify caries index (DMFT- decayed, missing and filled teeth) and periodontal condition (CPI), and were interviewed using the World Health Organization Quality of Life (WHOQOL-Bref) and Oral Impact Daily Performance (OIDP) instruments to evaluate QL, and the Global School-Based Health Survey (GSHS) about dental service accessibility. DMFT average was 5.49 (± 3.33). Overall, 37.2% of participants showed periodontal problems, mainly CPI = 1 (77.7%). Treatment needs were mainly restorations. GSHS showed that the last dental consultation occurred > 1 year previously for 58.3% of participants at a public health center (78.9%). The average WHOQOL-Bref was 87.59 (± 15.23). Social relationships were related to dental caries and health service type. The average OIDP was 6.49 (± 9.15). The prevalence of caries was high and observed periodontal problems were reversible. The social relationships of adolescents from settlement were influenced by caries and health services type.

Perfil do atendimento odontológico no Serviço de Urgência para crianças e adolescentes da Faculdade de Odontologia de Araraquara (FOAr) ‒ UNESP

Resumo Introdução: Atendimentos de urgência são uma prática comum em Odontopediatria, porém pouco se sabe sobre o perfil desses atendimentos. Objetivo: Avaliar o perfil dos atendimentos de urgência de crianças de 0 a 13 anos de idade realizados na Clínica Infantil da FOAr, no período de 1997 a 2012, a fim de se quantificarem os pacientes e os procedimentos realizados no Serviço, além de identificar os tratamentos mais realizados. Material e método: Neste estudo transversal observacional, os relatórios desse Serviço, fornecidos pelo Sistema Integrado de Clínicas, foram analisados quanto ao número de pacientes, aos atendimentos e ao tipo de procedimentos realizados. Os procedimentos foram classificados em sete categorias: Diagnóstico, Preventivos, Anestesia, Endodônticos, Restauradores, Cirúrgicos e Outros. Esses dados foram tabulados e submetidos a uma análise descritiva. Resultado: De 1997 a 2012, foi atendido um total de 13.849 pacientes e foram realizados 25.786 atendimentos e 86.279 procedimentos. Houve diminuição do número de pacientes atendidos a partir de 2001, mas o número de consultas e de procedimentos não diminuiu na mesma proporção. Observou-se que, durante o período de 2007 a 2012, os procedimentos de diagnóstico foram os mais realizados, seguidos pelos preventivos. Dentre os procedimentos operatórios, o mais realizado foi o restaurador, seguido dos endodônticos. Procedimentos cirúrgicos estão entre os menos realizados. Conclusão: Conclui-se que houve uma mudança no perfil dos atendimentos dentro desse Serviço. Apesar de haver uma redução no número de pacientes atendidos, o número de consultas e a quantidade de procedimentos realizados permaneceram estáveis. Os procedimentos realizados estão de acordo com o perfil do Serviço de Urgência.