Trends and age-period-cohort effect on dental caries prevalence from 2008 to 2019 among Brazilian preschoolers

This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent's perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Does bullying due to oral conditions influence cigarette smoking in adolescents? A structural equation modeling

This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.

Metaresearch study highlights the gender gap in randomized controlled trials in dentistry

BACKGROUND AND OBJECTIVES

This study aimed to assess the gender gap in randomized controlled trials (RCTs) in dentistry in terms of authorship, collaborations, metrics, funding and reporting of good research practice and transparecy.

METHODS

The search was performed in PubMed for RCTs restricted to English texts in the dental field, indexed from 12/31/2016 to 12/31/2021. Two reviewers screened the studies in line with the eligibility criteria. A total of 844 articles were included. The name and gender of authors, citation metrics, funding, reporting of characteristics of good research practice and transparency were extracted. We considered "collaboration between authors" when the corresponding author was different from the first author.

RESULTS

The proportion of women as first authors was 46.56% and 40.12% for corresponding authors. The analysis showed that when a woman is the corresponding author, the probability of the first author also being a woman is 57% higher compared to the first author being a man. For "protocol registration" and "data sharing," the prevalence of reporting was higher when women were first authors.

CONCLUSION

A gender gap in dentistry RCTs was identified and related to the participation of women as first and corresponding authors and the collaboration between authors.

Exploring the use of preprints in dentistry

OBJECTIVE

This study aims to assess the use, impact, and dissemination of preprints in dentistry.

METHODS

This is a meta-research study with a cross-sectional design. We included preprints published in dentistry, regardless of the year of publication. Searches were performed in the medRxiv.org and Preprints.org platforms and restricted to English. One researcher extracted the data, and another researcher verified data consistency. The following data were extracted: year of publication, country of the corresponding author, number of abstract and full-text views and downloads, Altmetric attention score, whether the preprint was mentioned in other servers such as Twitter and Publons, number of mentions in other servers, number of citations in the Dimensions database, and whether the preprint had already been published in a peer-reviewed journal. If already published, we extracted the journal's impact factor (JCR 2021) and the number of citations in the Dimensions database. We conducted a descriptive analysis of the extracted characteristics and explored relationships between metrics using the Spearman correlation.

RESULTS

We identified 276 preprints. Most of the studies were published between 2020 and 2022 (n = 229), especially those from ten countries. The most-cited preprint and published article are the same study. Only the correlation between the number of preprint citations and peer-reviewed article citations in the Dimensions database showed a large positive association (Spearman's rho = 0.5809).

CONCLUSION

Preprints gained popularity over the last several years due to the COVID-19 pandemic and reached a larger audience, especially on platforms such as Twitter.

CLINICAL SIGNIFICANCE

Preprint publishing allows faster dissemination of science for the benefit of society.

Direct relations between sense of coherence and oral health-related quality of life in adolescents

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.

Prevalence of psychological disorders in patients with temporomandibular disorders: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Temporomandibular disorders (TMDs) affect the muscles of mastication, the temporomandibular joint, and associated structures. They are generally classified as muscular or articular and are the main cause of pain in the orofacial region, eventually causing psychological problems. However, the real burden of psychological disorders is unknown.

PURPOSE

The purpose of this systematic review and meta-analysis was to assess the prevalence of psychological disorders in patients with TMDs.

MATERIAL AND METHODS

The study was conducted through a bibliographic search carried out without initial limit until July 2021 in the following electronic databases: MEDLINE/PubMed, Scopus, and PsycINFO. Clinical observational studies investigating depression and somatization in patients with TMD diagnosed by the Diagnostic Research for Temporomandibular Disorders (RDC/TMD) criteria in muscular, articular, and disc disorders were included. A descriptive analysis of the included studies and a meta-analysis for the prevalence data were performed for the synthesis of evidence.

RESULTS

A total of 2320 studies were found, of which 48 complete articles were assessed for eligibility and 22 were included in the analysis. The general prevalence of depression and moderate and severe somatization in patients diagnosed with TMD was estimated at 43.0% (95% confidence interval (CI), 36.0% to 50.0%) and 60.0% (95% CI 52.0 - 67, 0%). The average overall score for depression was estimated at 0.92 (95% CI, 0.69-1.15), being classified as moderate depression. The average overall score for somatization was estimated at 1.09 (95% CI, 0.81-1.36), being classified as severe somatization. All analyses showed high heterogeneity (I2>90%). Based on the quality assessment, 80.9% of studies included in the review had low to moderate risk of bias.

CONCLUSIONS

Patients with TMDs who seek clinical care show a high prevalence of depression and somatization.

Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study

BACKGROUND

Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance.

OBJECTIVE

To ascertain the prevalence of self-reported xerostomia and to identify associated factors.

DESIGN AND SETTING

Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality.

METHODS

Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models.

RESULTS

The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030).

CONCLUSIONS

Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Influence of low-level laser therapy on implant stability in implants placed in healed sites: a randomized controlled trial

Background

The present study aims to assess the influence of low-level laser therapy (LLLT) on stability in implants placed in healed sites.

Material and methods

The present study followed the SPIRIT statement and is reported according to CONSORT. Patients were randomly allocated to LLLT or control groups. LLLT consisted in the application of 808-nm GaAlA laser applied before the preparation of the implant bed and after suturing (80 seconds; 11J/cm²). Implant stability quotient (ISQ) and the distance between the implant platform to the alveolar bone crest (millimeters) were assessed at implant placement (T₀) and the abutment selection phase (4–6 months, T_a).

Results

A total of 64 implants were placed in 33 patients. The insertion torque ranged from 10 to 70 N.cm (mean 43.23; SD ±16.82). The T₀ ISQ ranged from 18 to 95.5 (mean 61.7; SD ±18.23) and the crestal bone radiographic distance was 2.03 mm (SD±1.27). At T_a, the ISQ ranged from 39 to 90 (mean 64.2; SD±9.84), and the mean crestal bone radiographic loss was 1.70mm (SD±1.65). However, no differences were observed when LLLT and control groups were compared with ISQ difference (T_a–T₀; p=0.598) or radiographical peri-implant alterations (p=0.531).

Conclusion

LLLT did not influence the implant stability in implants placed in healed sites compared to a control group.

Trial registration

ReBEC, RBR-35TNJ7. Registered May 23, 2018

How are meta-analyses being conducted and reported in dentistry?

Aim: This study aimed to evaluate how meta-analyses are conducted and reported in dentistry. Methods: We conducted a search to identify dentistry-related Systematic Reviews (SRs) indexed in PubMed in 2017 (from January 01 until December 31) and published in the English language. We included only SRs reporting at least one meta-analysis. The study selection followed the 4-phase flow set forth in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), and it was independently conducted by two researchers. Data extraction was performed by one of three reviewers, and data related to conducting and reporting of the meta-analysis were collected. Descriptive data analysis was performed summarizing frequencies for categorical items or median and interquartile range for continuous data. Results: We included 214 SRs with meta-analyses. Most of the studies reported in the title that a meta-analysis was conducted. We identified three critical flaws in the included studies: Ninety (90) meta-analyses (43.1%) did not specify the primary outcome; most of the meta-analyses reported that a measure of statistical heterogeneity was used to justify the use of a fixed-effect or random-effects meta-analysis model (n=114, 58.5%); and a great part did not assess publication bias (n=106, 49.5%). Conclusion: We identified deficiencies in the reporting and conduct of meta-analysis in dentistry, suggesting that there is room for improvement. Educational approaches are necessary to improve the quality of such analyses and to avoid biased and imprecise results.

Saliva as a tool for monitoring hemodialysis: a systematic review and meta-analysis

This study aimed to assess whether the reductions in serum urea and creatinine levels are different from the reductions in salivary urea and creatinine levels that occur after hemodialysis in chronic renal patients. The systematic review protocol was registered in the PROSPERO database. Eight databases were searched to identify pretest-posttest studies of chronic kidney disease patients undergoing hemodialysis, with no language or year restrictions. The JBI Critical Appraisal Tool was used to assess the risk of bias. Meta-analyses using random-effect models were conducted to compare salivary and serum correlations and to pooled mean and proportion differences from pre- to posthemodialysis urea and creatinine levels by subgroup analysis. The I2 test was used to assess heterogeneity, and a meta-regression was performed to statistically assess correlations and differences in the pooled effects pre- and postdialysis. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. The search resulted in 1404 records, and only six studies (n = 252 participants) fulfilled the eligibility criteria and were included. The studies were published between 2013 and 2018. All studies showed a significant reduction in both salivary and serum urea/creatinine levels. All eligible studies presented a low risk of bias. The meta-analysis shows a moderate to high correlation between salivary and blood levels of urea (r: 0.79; 95% CI: 0.56-1.00) and creatinine (r: 0.64; 95%CI: 0.16-1.00), with a very low level of certainty. The reductions in salivary urea and creatinine levels are similar to and correlated with the reductions in blood urea and creatine levels after hemodialysis among chronic kidney disease patients.

Knowledge synthesis: How to improve the use of evidence from clinical trials?

BACKGROUND

The value of systematic reviews (SRs) is determined by methodology and reporting quality of primary studies and how the SR is conducted and reported.

AIM

This study discusses key aspects of clinical trials (CTs) that might affect the value of SRs.

DESIGN

Narrative review.

RESULTS

We highlighted the following CT factors that could affect SR value: Defining the purpose of CTs is important because it could directly impact whether an SR question is appropriately answered and formulated; choose the most appropriate intervention to answer a proposed SR question is critical because we can exclude or include different studies, directly influencing selection bias; when conducting SRs, the study's search must be restricted to equal or highly similar comparison groups, allowing suitable comparisons of the outcomes' estimates; in SRs, it may be interesting to explore the effect of the most common definition of the disease used in clinical practice, being useful in evidence-based dentistry and easily translated to daily practitioners; and deficiencies in CT reporting can lead to unusable reports, biased results, and conclusions.

CONCLUSION

All aspects discussed were found to be important for improving the use of evidence from CTs.

Prevalence of mental disorders among elderly men: a systematic review and meta-analysis

BACKGROUND

Elderly men have been characterized as a group vulnerable to suicide, motivated by loneliness, loss of loved ones and feelings of uselessness to family members.

OBJECTIVES

To ascertain the prevalence of different mental disorders among elderly men who attempted suicide.

DESIGN AND SETTING

Systematic review of observational studies developed as a result of a partnership between two postgraduate schools (Lagarto and Uberlândia).

METHODS

An electronic search was performed in eight electronic databases, including "grey literature", in January 2019. Observational studies that assessed mental disorders among men older than 60 years who attempted suicide were eligible for inclusion.

RESULTS

Among the disorders evaluated, mood disorders had the highest prevalence (42.0%; 95% confidence interval, CI: 31.0-74.0%; I2: 0.0%; P = 0.763), followed by substance use-related disorders (41.0%; 95% CI: 8.0-74.0%; I2: 96.4; P < 0.001) and, lastly, schizophrenic disorders (5.0%; 95% CI: 0.0%-14.0%; I2: 80.3%; P = 0.024).

CONCLUSIONS

It seems that mood disorders and substance use-related disorders are quite prevalent among elderly men with mental disorders who attempted suicide. It is important to consider the role of healthcare services in making early diagnoses of mental disorders among elderly men, in order to diminish the chances of suicide attempts among them.

SYSTEMATIC REVIEW REGISTRATION

CRD42018105981.

Trends in use of dental services by Brazilian pre-school children considering Age-Period-Cohort Effect

BACKGROUND

Besides the growth in Brazilian public oral health investments, no pre-school children preventive policies were done, and surveys demonstrated lower prevalences of use of dental service.

AIM

To verify trends in the use, type, and reason for seeking dental services among pre-school children considering time variations.

METHODS

This study used data of clinical examinations and structured interviews of three cross-sectional surveys of southern pre-school children in Brazil, from 2008, 2010, and 2013. Chi-square test for trends and hierarchical age-period-cohort (HAPC) analysis using the multilevel Poisson regression model assessing the influence of social and clinical variables in the use, type, and reason for seeking dental services were performed.

RESULTS

A total of 1765 pre-school children participated in all surveys. At least, one time-related variation affected one of three assessed outcomes. There was no significant change in prevalence of the use of dental services (75.8%, 77.4%, and 74.9%, respectively, for each year; P = 0.750). In the HAPC analysis, younger children and from low socio-economic backgrounds were less likely to have visited the dentist.

CONCLUSION

The prevalence of use of oral health services did not change and socio-economic inequalities persisted through the years, indicating a need of reviewing the policies to promote public health.

How Common is Dry Mouth? Systematic Review and Meta-Regression Analysis of Prevalence Estimates

The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

The role of asthma in caries occurrence - meta-analysis and meta-regression

Objective: We aimed to conduct a systematic review of the literature regarding the association between asthma and caries, assess the effect of asthma on the occurrence of caries in primary and permanent dentitions, and determine factors that could affect the estimates of this association. Data source: We used the following databases: PubMed, Web of Science, SCOPUS, and LILACS/BVS, for the literature review. Study selection: We included observational studies that investigated the association between asthma and dental caries, excluding studies with syndromic patients, literature reviews, case reports, and in vitro and in situ studies. A meta-analysis was performed to estimate a pooled effect, and meta-regression was conducted to determine study factors that could affect the estimates. Results: From 674 studies initially identified, 40 fulfilled the inclusion criteria, and 36 of these were used in the meta-analysis. Odds ratio (OR) for the pooled effect was 1.45 (95% confidence interval (CI): 1.22-1.72; I², 71.8%; p < 0.001) and 1.52 (95% CI: 1.34-1.73; I², 83.1%; p < 0.001) for primary and permanent dentitions, respectively. In addition, a small proportion of the heterogeneity was attributed to included factors in the meta-regression (primary dentition, 10.7%; and permanent dentition, 3.1%). Conclusions: This study provides reliable and robust evidence that emphasizes the impact of asthma on the occurrence of dental caries in both, primary and permanent, dentitions. The findings provide useful data for recommending that dentists and physicians collaborate to establish the control for both diseases in a multidisciplinary manner.

Comparison of Face-To-Face Interview and Telephone Methods of Administration on the Ecohis Scores

The aim of this study was to compare the administration of the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire, applied by face-to-face and telephone format. A randomized sample of 76 parents/guardians of children up to 6 years old was selected in a Pediatric Dentistry Clinic of the Federal University of Santa Maria, Brazil. Patients were randomly selected for 2 different groups, according to administration sequence: F-T (Face-to-face-Telephone) and T-F (Telephone-Face-to-face). Two interviewers administered the ECOHIS questionnaire with 2 week interval between the methods. The reliability between sections of the different methods of administration was assessed by Cronbach's alpha and Intraclass Correlation Coefficient (ICC). There were differences in means of the ECOHIS between face-to-face and telephone methods. However, the value Cronbach's alpha were between 0.94-0.96, and value ICC ranged from 0.91-0.93, proving to be acceptable values. The Bland-Altman plots confirmed the results of reliability tests, supporting the accuracy of the methods. Although there is a slight difference in the scores, the use of both mode of administration of the ECOHIS yields reliable data when single method is used from the beginning to the end of the study. The results provided evidence to use either Face-to-face or Telephone method of administration of the ECOHIS.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Trend of traumatic crown injuries and associated factors in preschool children

The aim of this study was to assess trends in traumatic crown injuries (TCIs), their prevalence, and association with socioeconomic and clinical factors in preschool children over a 5-year period. A series of cross-sectional surveys was conducted in Santa Maria, Brazil, on children attending a National Day of Children's Vaccination. The same protocol was used in all surveys conducted in 2008, 2010, and 2013. Clinical examinations were performed to evaluate types of traumatic crown injuries using the O'brien index. A semi-structured questionnaire was answered by the parents. It provided information about several socioeconomic factors as well as the parents' perception of their child's oral health. The chi-square for trends test was used to verify changes in TCI prevalence throughout the years. The association between socioeconomic and clinical factors with TCI was assessed by the Poisson regression analysis. A total of 1,640 children were examined. The prevalence of TCIs decreased significantly from 2008 to 2013 (10.12%; p < 0.001). Central incisors were the most vulnerable to injury, independent of the year. Moreover, older children and those with inadequate lip coverage were more likely to present with some traumatic dental injury (p < 0.001). prevalence of traumatic crown injuries decreased following the years, however TCI remain an important subject to consider when planning oral health policies.

Self-perceived oral health influences tooth brushing in preschool children

This study assessed the influence of socioeconomic and clinical factors, as well as parent's perception of child's oral health on the toothbrushing frequency of 0-5-year-old children. The study was carried out in Santa Maria, RS, Brazil, during the National Children's Vaccination Day, and 478 children aged 0-5 years were included. Data were collected by clinical examinations and a structured questionnaire, conducted by 15 calibrated examiners and 30 supports. A questionnaire was filled out by the parents with information about several socioeconomic indicators, perception of child's oral health and frequency of tooth brushing. The main outcome was collected by the question: "How many times a day do you brush your child's teeth?". Multivariable Poisson regression model taking into account the cluster sample was performed to assess the association between the predictors and outcome. Children whose parents related worse perception of child's oral health showed less tooth brushing frequency (PR 1.23; 1.06 - 1.43). Young children brush their teeth less than the older ones (PR 0.90; 0.84 - 0.96); and lack of visit to a dentist was predictor for less tooth brushing frequency (PR 1.29; 1.05 - 1.59). Parent's perception of child oral health influence children's healthy behaviors, supporting the evidence that psychosocial factors are strong predictors of children's oral health.

Racial Differences in Oral Health-Related Quality of Life: A Multilevel Analysis in Brazilian Children

This cross-sectional study aimed to assess the influence of race/ethnicity on Brazilian children' oral health-related quality of life (OHRQoL). A multistage random sampling selected a representative sample of 1,134 twelve-years-old children from public schools of Santa Maria, a city in Southern Brazil. Participants were examined by 4 calibrated clinicians (minimum Kappa-value for inter-examiner agreement of 0.8) and the Brazilian short version of the Child Perceptions Questionnaire (CPQ11-14) was administered. The children's parents or guardians answered questions regarding their demographics and socioeconomic status. Associations were analyzed using multilevel Poisson regression models. Children from racial/ethnic minority groups had poorer OHRQoL. The mean CPQ11-14 score was 1.08 times higher for non-white children than their white counterparts' score. "Social" and "Emotional well-being" were the most affected domains for non-white children, with significantly higher mean scores as compared to white children (RR 1.19, 95% CI, 1.07-1.33; and RR 1.14; 95% CI 1.04-1.24). This association remained significant even after adjusting for individual and contextual covariates. OHRQoL disparities are prevalent among children from racial/ethnic minority groups. Non-white children have lower OHRQoL compared to white children.

Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children

BACKGROUND

Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents' socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children's use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1-5 years.

METHODS

Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children's Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals.

RESULTS

Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as "poor" used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child's oral health as "fair/poor" were less likely to have visited the dentist for preventive care.

CONCLUSION

This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.