Objectives
To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents.
...Methods
A school‐based cross‐sectional study was conducted with a representative sample of 448 12‐year‐old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry BREALD‐30) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP‐IV) questionnaire for the detection of signs of ADHD. Multiple Poisson regression with robust variance was used for data analysis (α = 5%).
Results
The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01‐1.15) and connected (PR = 1.06; 95% CI: 1.01‐1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04‐1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01‐1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01‐1.11) were also associated with the outcome.
Conclusion
Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.
The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A ...population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18-2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01-1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39-2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist.
The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted ...in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio RR = 2.65; 95% confidence interval CI = 1.51-4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62-3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04-2.52) were associated with OHRQoL. Based on the children's perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21-3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents' perception, whereas only the preschool type was associated with OHRQoL based on the children's perception.
The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A ...cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.
Relationships amongst attention-deficit/hyperactivity disorder (ADHD), family factors, and oral health literacy (OHL) in adolescents are unclear. The objective of this research was to investigate ...whether family environment and signs of ADHD are associated with OHL at the onset of adolescence.
A cross-sectional study was performed with 448 twelve-year-old adolescents enrolled in schools in Cajazeiras, Brazil. Adolescents responded to an instrument measuring OHL (Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry BREALD-30) and a validated questionnaire addressing family cohesion and adaptability (Family Adaptability and Cohesion Scales FACES III). Parents and teachers answered subscales of the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) and a socioeconomic questionnaire. Adjusted Poisson regression analysis was employed for the data analysis (P < .05).
Greater OHL was found in adolescents with higher family cohesion scores (rate ratio RR, 1.02; 95% confidence interval CI, 1.01–1.03), those whose mothers had more than 8 years of schooling (RR, 1.07; 95% CI, 1.03–1.12), and those whose families earned more than the Brazilian minimum salary (RR, 1.08; 95% CI, 1.03–1.12). Higher family adaptability scores (RR, 0.99; 95% CI, 0.98–0.99) and more signs of ADHD (teachers’ reports) (RR, 0.95; 95% CI, 0.91–0.99) were associated with lower OHL.
OHL in adolescents was influenced by family adaptability and cohesion, signs of ADHD, maternal schooling, and family income.
Abstract The aim of this study was to evaluate associations between oral health literacy and family, sociodemographic and dental service characteristics in early adolescents. A cross-sectional study ...was conducted with 740 schoolchildren. The following variables were investigated using validated questionnaires: oral health literary (BREALD-30), sociodemographic characteristics, type of dental service and family functioning (FACES III). Associations were tested using robust Poisson regression analysis (α=5%). Higher oral health literacy was associated with the female sex (RR=1.09; 95%CI: 1.03-1.14), connected type of family cohesion (RR=1.12; 95%CI: 1.05-1.20), rigid (RR=1.14; 95%CI: 1.04-1.25) and structured (RR=1.11; 95%CI: 1.04-1.20) types of family adaptability, more than eight years of mother’s schooling (RR=1.16; 95%CI: 1.10-1.22), age of caregiver more than 38 years (RR=1.07; 95%CI: 1.02-1.13) and the use of private dental services (RR=1.06; 95%CI: 1.01-1.12). The level of oral health literacy in early adolescents was associated with sex, family structure, mother’s schooling, caregiver’s age and type of dental service used.
Resumo Este estudo avaliou a associação de fatores sociodemográficos, familiares e do tipo de serviço odontológico utilizado ao alfabetismo em saúde bucal em pré-adolescentes. Trata-se de um estudo transversal com 740 escolares. Foram avaliados o alfabetismo em saúde bucal (BREALD-30), fatores sociodemográficos, tipo de serviço odontológico e funcionalidade familiar (FACES III) por meio de questionários validados. A associação entre as variáveis foi avaliada por meio de regressão de Poisson robusta (α=5%). Um maior alfabetismo em saúde bucal foi associado ao sexo feminino (RR=1.09; IC95%: 1.03-1.14), coesão familiar do tipo conectada (RR=1.12; IC95%: 1.05-1.20), adaptabilidade familiar dos tipos rígida (RR=1.14; IC95%: 1.04-1.25) e estruturada (RR=1.11; IC95%: 1.04-1.20), escolaridade materna superior a oito anos de estudo (RR=1.16; IC95%: 1.10-1.22), idade do responsável superior a 38 anos (RR=1.07; IC95%: 1.02-1.13) e uso de serviços odontológicos privados (RR=1.06; IC95%: 1.01-1.12). O nível de alfabetismo em pré-adolescentes foi associado ao sexo, estrutura familiar, idade e escolaridade do responsável e tipo de serviço odontológico utilizado.
Background
The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments.
Aim
To evaluate the ...influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents.
Design
A cross‐sectional study was conducted with 740 12‐year‐old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD‐30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed.
Results
A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01‐1.03), high social class (PR = 1.28; 95% CI: 1.09‐1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37‐1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19‐2.02) and connected (PR = 1.22; 95% CI: 1.02‐1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01‐1.38) remained associated with having visited a dentist.
Conclusions
Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents.
To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents.
The study included 750 ...adolescents: 375 aged 12 years and 375 aged 15-19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%.
BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach's alpha = 0.871 and 0.834, respectively) and good test-retest reliability intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions 12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48-3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24-3.11.
BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.
Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents.
Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina ...Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87-0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study.
The following variables remained associated with better OHL: high mother's schooling level (RR = 1.07; 95%CI: 1.03-1.12), high income (RR = 1.04; 95%CI: 1.01-1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01-1.10), married parents (RR = 1.04; 95%CI: 1.01-1.09), "enmeshed" family cohesion (RR = 1.21; 95%CI: 1.12-1.30), "structured" (RR = 1.06; 95%CI: 1.01-1.12) or "rigid" (RR = 1.11; 95%CI: 1.04-1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01-1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03-1.13).
Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.
Background
Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors
Aim
The aim of this study was to investigate ...associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8‐10 years of age.
Design
A school‐based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples.
Results
Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self‐reported PAB.
Conclusions
Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self‐reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB.
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