Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite the importance of collecting individual data of socioeconomic status (SES) in epidemiological oral health surveys with children, this procedure relies on the parents as respondents. Therefore, type of school (public or private schools) could be used as an alternative indicator of SES, instead of collecting data individually. The aim of this study was to evaluate the use of the variable type of school as an indicator of socioeconomic status as a substitute of individual data in an epidemiological survey about dental caries in Brazilian preschool children.</p> <p>Methods</p> <p>This study followed a cross-sectional design, with a random sample of 411 preschool children aged 1 to 5 years, representative of Catalão, Brazil. A calibrated examiner evaluated the prevalence of dental caries and parents or guardians provided information about several individual socioeconomic indicators by means of a semi-structured questionnaire. A multilevel approach was used to investigate the association among individual socioeconomic variables, as well as the type of school, and the outcome.</p> <p>Results</p> <p>When all significant variables in the univariate analysis were used in the multiple model, only mother's schooling and household income (individual socioeconomic variables) presented significant associations with presence of dental caries, and the type of school was not significantly associated. However, when the type of school was used alone, children of public school presented significantly higher prevalence of dental caries than those enrolled in private schools.</p> <p>Conclusions</p> <p>The type of school used as an alternative indicator for socioeconomic status is a feasible predictor for caries experience in epidemiological dental caries studies involving preschool children in Brazilian context.</p

Trends in the prevalence of traumatic dental injuries in Brazilian preschool children

As Lesões Dentárias Traumáticas (LDTs) tem apresentado com uma expressiva prevalência em diversos países. Estudos epidemiológicos de traumatismo dentário são importantes para determinar a prevalência da doença e estabelecer estratégias de promoção de saúde. Na literatura não se encontra nenhum estudo na dentição decídua comparando a prevalência em diferentes momentos em uma determinada população. O objetivo desse estudo foi: 1) Determinar a prevalência e distribuição das LDTs em pré-escolares no município de Diadema no ano de 2006 e investigar a associação das LDTs com maloclusões e fatores sócioeconômicos; 2) estudar a tendência da prevalência de LDTs em crianças pré-escolares no Município de Diadema-SP baseado em três estudos transversais conduzidos em 2002, 2004 e 2006. Estes três estudos foram realizados por meio de três levantamentos epidemiológicos em crianças de 5 59 meses de idade utilizando à mesma metodologia. Cirurgiões dentistas treinados examinaram respectivamente 915, 1138 e 1265 crianças nos anos de 2002, 2004 e 2006. As amostras foram selecionadas durante as Campanhas Nacionais de Vacinação Infantil. As LDTs foram diagnosticadas de acordo com a Classificação de Ellis modificada (1952), adicionando-se a esse critério a alteração de cor na coroa do dente. No levantamento de 2006 as crianças foram avaliadas quanto às maloclusões (mordida aberta anterior, selamento labial inadequado e sobressaliência acentuada). Uma entrevista foi realizada com a mãe ou responsável pela criança para a coleta das informações sócio-econômicas utilizando-se o Índice de Jarman (1983). Utilizou-se na análise estatística o teste Qui-Quadrado, regressão logística univariada e multivariada e o teste Qui-quadrado para tendência. Os resultados do estudo de 2006 mostraram uma prevalência de 13,9%. O incisivo central superior foi o dente mais afetado sem diferença entre os lados direito e esquerdo. Não se encontrou diferença estatisticamente significante entre meninas e meninos. O trauma mais comum foi fraturas de esmalte (10,8%); seguida de alteração de cor (2,3%); fratura de esmalte e dentina (1,4%); ausência do dente (0,7%) e fístula (0,2%). Crianças com mordida aberta anterior, trespasse horizontal acentuado e selamento labial inadequado tiveram maior número de trauma quando comparadas com crianças com oclusão normal (p<0,05). Fatores sócioeconômicos não mostraram associação estatisticamente significante com a ocorrência de LDTs. Em relação ao estudo de tendência: as prevalências de LDTs obtidas foram 9,4% em 2002, 12,9% em 2004 e 13,9% em 2006. A análise da tendência mostrou um aumento na prevalência das LDTs estatisticamente significante entre os estudos de 2002 e 2006 (p=0,002). Pode-se observar que houve um aumento significativo da prevalência entre 2002 e 2004 (p = 0,012), porém entre 2004 e 2006 o aumento não foi estatisticamente significante (p = 0,500). Quando cada um dos estudos foi avaliado individualmente, confirmou-se o aumento estatisticamente significante na porcentagem de crianças com LDTs de acordo com o aumento da faixa etária (p<0,001).Traumatic dental injuries (TDI) present high prevalence in many countries. Epidemiological studies on TDI are important to determine the disease prevalence and to establish oral health promotion strategies. No study in the literature shows trend in TDI in primary dentition. The aim of this study was: 1) To determine the prevalence and distribution of TDI in the primary teeth of preschool children living in Diadema, Brazil, and to investigate its association with malocclusions and socio-economic factors; and 2) to assess trend in the prevalence of TDI in preschool children in Diadema, Brazil, during 2002 and 2006. Three cross-sectional surveys were conducted in 2002, 2004 and 2006, using the same protocol. All surveys were on children aged 5-59 months. Participants were selected from all children attending during The National Day of Children Vaccination. TDI were classified according to the modified classification proposed by Ellis (1970). In addition to these criteria the presence of tooth discoloration was also recorded. The presence of malocclusions (anterior open bite, overjet and short upper lip seemed) was assessed based on the criterion of lack of vertical overlap of the incisors in the occlusal position. An interview was carried out with mothers or guardians. The data collected included the Jarman Index (1983). Statistical analysis included Chi-square, Logistic Regression and Chi-square for trend. The prevalence of TDI in 2006 was 13.9%. The maxillary central incisor was the most affected teeth, without differences between the right and the left side. No significant difference between boys and girls. The most common crown fracture was in enamel only (10.8%), followed by tooth discoloration (2.3%), crown fracture of enamel and dentin(1.4%), missing teeth (0.7%) and fistulous tract without signs of caries (0.2%). Children with anterior open bite, overjet and short upper lip seemed to have more TDI compared to those with normal occlusions (p<0.05). Socio-economic factors were not statistically significantly associated with the occurrence of TDI. Concerning the trend analysis, prevalence were: 9.4% in 2002, 12.9% in 2004, and 13.9% in 2006; there was an increase in the prevalence of TDI between 2002 and 2006; and 2002 and 2004 (p = 0.012), however between 2004 and 2006 the increase was not significant (p=0.5). When each study was evaluated separetly, the increase in TDI with the increase of age of the children was confirmed to be significant (p<0.001)

Influence of ultrasound or halogen light on microleakage and hardness of enamel adjacent to glass ionomer cement

Background. The use of external sources of energy may accelerate the setting rate of glass ionomer cements (GICs) allowing better initial mechanical properties. Aim. To investigate the influence of ultrasound and halogen light on the microleakage and hardness of enamel adjacent to GIC restorations, after artificial caries challenge. Design. Cavities were prepared in 60 primary canines, restored with GIC, and randomly distributed into three groups: control group (CG), light group (LG) - irradiation with a halogen lightcuring unit for 60 s, and ultrasonic group (UG) application of ultrasonic scaler device for 15 s. All specimens were then submitted to a cariogenic challenge in a pH cycling model. Half of sample in each group were immersed in methylene blue for 4 h and sectioned for dye penetration analysis. The remaining specimens were submitted to Knoop cross-sectional microhardness assessments, and mineral changes were calculated for adjacent enamel. Results. Data were compared using Kruskal-Wallis test and two- way ANOVA with 5% significance. Higher dye penetration was observed for the UG (P &lt; 0.01). No significant mineral changes were observed between groups (P = 0.844). Conclusion. The use of halogen light- curing unit does not seem to interfere with the properties of GICs, whereas the use of ultrasound can affect its marginal sealing

Bleaching in vital deciduous teeth – a clinical case

There has been growing concern and search for esthetic beauty and harmony over the last few years. This concern does not form part ofadults’ lives only, but also of children’s. Among the substances used for bleaching dental structures, the most outstanding are those whoseactive principle is hydrogen peroxide-based . The present study reports a clinical case of a 4-year-old girl that suffered trauma of tooth 61 with consequent color alteration, but with no alteration in pulp vitality. The main complaint by the patient and her guardians concerned esthetics, therefore external dental bleaching was performed, using Opalescence Xtra® (Ultradent), in two sessions with an interval of one month between them. External in office bleaching was the treatment of choice, due to the tooth vitality, patient’s age and presence of only one darkened tooth. After the bleaching treatments an improvement in the darkening was observed, and both the child and her guardians were satisfied with the esthetic result

Does erosive tooth wear affect the oral health-related quality of life of preschool children?

<div><p>ABSTRACT Objective: The aim of this study was to investigate the impact of erosive tooth wear on the Oral Health-Related Quality of life (OHRQoL) of preschool children. Methods: Dental examinations were conducted on 815 children aged 3-4 years during the Children’s Vaccination National Day when their parents were also invited to answer the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). ETW prevalence and severity were measured using a modified version of the O’Brien index (1994). Data collected included socioeconomic factors and child's variables. OHRQoL was measured through B-ECOHIS domains and total score. Poisson regression was used to associate ETW to the outcome and this association was adjusted for dental caries and dental trauma. Results: The proportion of children who had at least 1 ETW tooth was 51.2%. Most erosive lesions were confined to enamel (42.7%). The multivariate adjusted model showed that child's age (children aged 4year-old) was associated to a negative impact on the symptom domain (RR=1.70; p=0.010), functional limitation domain (RR=1.85; p=0.005) and total B-ECOHIS score (RR= 1.63; p=0.006). Families with 2 or more children in the house have a negative impact on the self-image/social interaction domain (RR=5.41; p=0.043). ETW was not associated to total B-ECOHIS scores (RR= 0.79; p=0.163) and individual domains. Conclusion: Erosive tooth wear does not affect the OHRQoL in this sample of preschool children.</p></div

Giant Cell Fibroma in a Two-Year-Old Child

The giant cell fibroma is a benign nonneoplastic fibrous tumor of the oral mucosa. It occurs in the first three decades of life in the mandibular gingiva, predominantly, showing predilection for females. This article reports a case of giant cell fibroma in a 2-year-old girl, which is an uncommon age for this lesion. The patient was brought for treatment at the Research and Clinical Center of Dental Trauma in Primary Teeth, where practice for the Discipline of Pediatric Dentistry (Faculty of Dentistry, University of São Paulo, Brazil) takes place. During clinical examination, a tissue growth was detected on the lingual gingival mucosa of the lower right primary incisors teeth. The lesion was excised under local anesthesia and submitted to histological examination at the Oral Pathology Department of the Faculty of Dentistry, University of São Paulo, which confirmed the diagnosis of giant cell fibroma. There was no recurrence after 20 months of monitoring. This instance reinforces the importance of oral care from the very first months of life in order to enable doctors to make precocious diagnosis and offer more appropriate treatments for oral diseases, as well as to promote more efficient oral health in the community