Background
Molar incisor hypomineralization (MIH) is associated with unfavourable dental conditions such as dental caries and may consequently impact oral health‐related quality of life (OHRQoL).
...Objective
To assess the impact of MIH on OHRQoL in children with early mixed dentition.
Method
A population‐based cross‐sectional study of 728 8‐year‐old children from the public school system in Curitiba, Brazil, was conducted. The Child Perception Questionnaire for 8‐ to 10‐year‐olds (CPQ8‐10) was used to evaluate OHRQoL. MIH was diagnosed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The assessments of MIH, dental caries, and malocclusion were performed by four calibrated examiners (κ ≥ 0.80). Demographic and socioeconomic data (DSE) were obtained from the children's parents/caregivers using a structured questionnaire. The analysis of OHRQoL determinants was performed through a three‐level hierarchical approach: mesial (DSE), intermediate (clinical conditions), and distal (child's oral self‐perception), using Poisson regression with robust variance (α = 0.05).
Results
The prevalence of MIH was 12.1% (95% CI: 10‐15). An association was found between MIH and OHRQoL in the “oral symptoms” domain of the CPQ8‐10 (PR: 1.07, 95% CI: 1.03‐1.11, P < 0.001) after adjusting for other clinical variables and DSE.
Conclusion
Molar incisor hypomineralization was associated with a greater impact on OHRQoL in children's oral symptoms.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Objective
This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported ...dental pain and dental anxiety.
Material and method
FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE—37% phosphoric acid etching) and self-etch (SE—no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale—revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods.
Results
A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (
p
> 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (
p
< 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE.
Conclusion
Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels.
Clinical relevance
A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.
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CMK, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Parental behavior towards their children's oral health is strongly influenced by parent's Oral Health Literacy (OHL) level. This study evaluated the impact of parental OHL on preschool children's ...utilization of dental services. A cross-sectional study was conducted with parents of 419 children aged 3 to 5 years who answered a self-administered questionnaire about their perception of their children's oral health and whether their children had already been to a dental visit. Parental OHL level was assessed by the validated version of the Oral Health Literacy Adult Questionnaire (OHL-AQ) translated into Brazilian Portuguese. Univariate and multivariate Poisson regression analyses with robust variance were used for the data analysis (α = 0.05). Most children had already been to a dental visit (73%). Overall, 31.7% of the parents or guardians reported that their children had experienced dental pain or dental caries. Parental OHL level was classified by tercile as low, medium, and high. The final model showed independent associations between children who had already been to a dental visit and higher parental OHL level (PR = 1.16; 95%CI = 1.00-1.35) when compared to the lowest OHL level, higher parental educational level (PR = 1.39; 95%CI = 1.03–1.87) when compared to lower educational level, the report of children's pain and dental caries (PR = 1.22; 95%CI = 1.09–1.36) and married parents or parents in a common-law marriage (PR = 1.17; 95%CI = 1.03–1.93). The prevalence of children who had already been to a dental visit was higher among those parents with a higher OHL level when compared to those with a lower OHL level.
The aim of this study was to evaluate the relationship between oral health literacy (OHL) among caregivers and untreated dental caries among preschoolers. A cross-sectional study was conducted ...involving 415 preschool children and their caregivers from Curitiba, Brazil. The children were examined for dental caries and dental plaque. The caregivers' OHL was evaluated using an instrument translated and validated for Brazilian Portuguese: the Brazilian Rapid Estimate of Adult Literacy in Dentistry-30. The prevalence of children with untreated caries was 42.9% (95%CI: 38.1-47.7%). A low degree of OHL was found among 15.7% (95%CI: 12.2-19.2) of caregivers. The multivariable Poisson regression analysis indicated a higher prevalence of untreated caries among children whose caregivers had a low OHL (PR = 1.35; 95% CI: 1.01-1.79), those with visible plaque (PR = 1.28; 95% CI: 1.01-1.62) and those who never or only occasionally had their teeth brushed by their caregivers (PR = 1.48; 95% CI: 1.16-1.91) in comparison to those without these conditions. In conclusion, a higher prevalence of untreated dental caries was found among preschool children whose caregivers had a low degree of OHL.
Polymorphisms in the COMT gene can alter enzymatic functions, raising levels of endogenous catecholamines, which stimulates beta-adrenergic receptors related to pain. This study aimed to evaluate ...whether a polymorphism in the COMT gene (rs4818) is associated with dental pain in children.
A cross-sectional study was conducted with a representative sample of 731 pairs of children and parents randomly selected from a population-based sample of eight-year-old children. Reports of dental pain was evaluated using a question directed at the parents and self-reported pain using the Faces Pain Scale - Revised. Dental caries experience was determined using the Decayed, Missing, and Filled Teeth (DMFT) index. For genetic analysis, DNA was obtained from oral mucosa epithelial cells of 352 children randomly selected from the initial sample.
Children with the CC genotype had higher odds of reporting moderate to intense pain than those with the GG genotype (OR=3.60; 95% CI=0.80-16.20; p=0.03). These same children had greater odds of parental reports of pain (OR=1.93; 95% CI=0.91-4.08; p=0.02). Moreover, lower schooling of parents/guardians and caries experience in the primary dentition were significantly associated with greater odds of a parental report of dental pain (OR=2.06; 95% CI=1.47-2.91; p<0.001; OR=6.26; 95% CI=4.46-8.78; p<0.001).
The rs4818 polymorphism of the COMT gene is associated with dental pain. Children with the C allele are more likely to report higher levels of pain. Clinical Relevance: Even though the experience of pain is subjective and multifactorial, this study raises the hypothesis that there is a genetic predisposition to dental pain that should be considered in clinical practice.
ABSTRACT Objective: To investigate whether children with premature birth (PB) and/or with low birth weight (LBW) have different tooth eruption patterns than those born at term or with normal weight. ...Material and Methods: Searches were performed in the PubMed, Cochrane Library, Sc1opus, Web of Science, LILACS, and BBO databases as well as the grey literature. Three independent reviewers were involved in study selection, data extraction, and bias assessment. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. Meta-analysis was conducted to compute the mean difference (MD) in mean chronological or adjusted age at the eruption of the first deciduous tooth between preterm children and those born at full term. The GRADE approach was used. Results: Among a total of 316 articles identified, 21 were eligible for inclusion and three were included in the meta-analysis. PB was associated with the delay in the first tooth deciduous eruption when chronological age was considered (MD: 1.36; 95%CI: 1.02–1.69) but not when considering adjusted age (MD: -0.30; 95%CI: -0.67–0.07). The evidence was graded as having very low quality. Conclusion: Based on a low certainty of evidence the PB is associated with the delayed eruption of the first deciduous tooth when considering chronological age but not when adjusted age is considered.
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 (PRa 1.33; 95% CI: 1.01‐1.76) and whose parents presented a lower level of education (PRa 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) (PRa 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.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Aim
To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD).
Methods
Patients with IBD and HbD were invited to participate in ...this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co‐variables (p < .05).
Results
The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio PR = 1.021; 95% confidence interval CI = 1.010–1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291–0.990).
Conclusion
Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Background
Identifying patients with high levels of DA helps to define the most adequate oral healthcare strategy, especially for pediatric patients.
Aim
To investigate the association between ...parental reports of dental anxiety (DA) and molar incisor hypomineralization (MIH) in schoolchildren.
Design
A cross‐sectional study was conducted in a representative sample of 731 8‐year‐old schoolchildren from the city of Curitiba, Brazil, who were clinically examined (k ≥ 0.75) for the diagnosis of MIH and dental caries using the EAPD criteria and dmft/DMFT index, respectively. Parents/guardians reported children's DA using the Dental Anxiety Question (DAQ) and answered a self‐administered structured questionnaire addressing socioeconomic and demographic characteristics. Associations were evaluated using Poisson regression analysis with robust variance (P < 0.05).
Results
A significant association was found between DA and MIH (PR = 1.20; 95%CI: 1.01‐1.42; P = 0.038), but this association lost its significance when adjusted for the other characteristics (PR = 1.13; 95%CI: 0.93‐1.38; P = 0.215). Caries experience in primary teeth was associated with lower levels of DA (PR = 0.83; 95%CI: 0.71‐0.96; P = 0.0013). The most recent visit to the dentist due to pain increased the levels of DA (PR = 1.18; 95%CI: 1.07‐1.30; P = 0.001).
Conclusions
The presence of MIH in schoolchildren was not associated with parental reports of DA.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The objective of this study was to describe an interviewer training and calibration method to evaluate oral health literacy using the Brazilian Rapid Estimate of Adult Literacy in Dentistry ...(BREALD-30) in epidemiological studies. An experienced researcher (gold standard) conducted all training sessions. The interviewer training and calibration sessions included three different phases: theoretical training, practical training, and calibration. In the calibration phase, six interviewers (dentists) independently assessed 15 videos of individuals who had different levels of oral health literacy. Accuracy and reproducibility were evaluated using the kappa coefficient and the intraclass correlation coefficient (ICC). The percentage of agreement for each word in the instrument was also calculated. After training, the kappa values were higher than 0.911 and 0.893 for intra- and inter-rater agreement, respectively. When the results were analyzed separately for the different levels of literacy, the lowest agreement rate was found when evaluating the videos of individuals with low literacy (K = 0.871), but still within the range considered to be near-perfect agreement. The ICC values were higher than 0.990 and 0.975 for intra- and inter-rater agreement, respectively. The lowest percentage of agreement was 86.6% for the word "hipoplasia" (hypoplasia). This interviewer training and calibration method proved to be feasible and effective. Therefore, it can be used as a methodological tool in studies assessing oral health literacy using the BREALD-30.
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