The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL). Methods: A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ(11-14)) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances. Results: Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life. Conclusions: It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.10Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2009/06081-7

The impact of socioenvironmental characteristics on domains of oral health-related quality of life in Brazilian schoolchildren

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: Recent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ(11-14)). Methods: A cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ(11-14), as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child's parents asking them about family socioeconomic status. The chi-square test and Poisson's regression analysis were performed. Results: After adjusting for potential confounders, variables sex, monthly family income, mothers' education showed a statistically significant association with all health domains of the CPQ(11-14). The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021). Conclusions: Clinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.13Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2009/06081-7

Oral clefts, consanguinity, parental tobacco and alcohol use: a case-control study in Rio de Janeiro, Brazil

This hospital-based, case-control study investigated the possible associations between family history of malformations, parental consanguinity, smoking and alcohol drinking and nonsyndromic orofacial cleft (OC, subdivided in 2 main groups: CL/P - cleft lip with or without cleft palate and CP - cleft palate alone). 274 cases were matched (age, sex and place of residence) to 548 controls. Odds ratios (OR) and 95% confidence intervals (95% CI) - adjusted for maternal age, schooling and smoking / alcohol use - were calculated by conditional logistic regression. The results demonstrated that the history of oral clefts either in the father's (CL/P: OR = 16.00, 5.64-69.23; CP: OR = 6.64, 1.48-33.75) or in the mother's family (CL/P: OR = 5.00, 2.31-10.99, CP: OR = 12.44, 1.33-294.87) was strongly associated with both types of clefts, but parental consanguinity was associated only with CL/P (OR = 3.8, 1.27-12.18). Prevalence of maternal smoking during the first trimester of pregnancy was higher among cases but the OR (1.13, 0.81-1.57) was not statistically significant. Maternal passive smoking (nonsmoking mothers) during pregnancy was associated with CL/P (1.39, 1.01-1.98) but not with CP. Maternal alcohol use during the 1st trimester increased odds for CL/P (OR = 2.08, 1.27-3.41) and CP (OR = 2.89, 1.25-8.30), and odds for OC tended to increase with dose. Neither smoking nor alcohol use by fathers increased risks for OC. This study provides further evidence of a possible role of maternal exposure to tobacco smoke and alcohol in the etiology of nonsyndromic oral clefts

Fendas orofaciais no recém-nascido e o uso de medicamentos e condições de saúde materna: estudo caso-controle na cidade do Rio de Janeiro, Brasil Oral clefts in the newborn and medical intakes and maternal health conditions: a case-control study in the city of Rio de Janeiro, Brazil

OBJETIVOS: avaliar a associação deste grupo de malformações e determinadas condições de saúde materna. MÉTODOS: estudo caso-controle reunindo 274 portadores de fendas lábio-palatinas e 548 controles hospitalares. As medidas de risco (odds ratio: OR), foram obtidos a partir da análise de regressão logística condicional. RESULTADOS: as principais associações foram o relato de malformações maternas (OR 8,01; IC95%: 2,23-28,81); infecções ginecológicas (OR 2,77; IC95%: 1,50-5,10); distúrbios neurológicos (OR 7,11; IC95%: 2,57-19,75); viroses (resfriados comuns, por exemplo) (OR 7,57; IC95%: 2,46-23,32). Na história reprodutiva, nenhuma condição foi estatisticamente significantes, no entanto, abortos espontâneos prévios (OR 1,42; IC95%: 0,95-2,13) e natimortos (OR 2,22; IC95%: 0,88-5,65) exibiram maior magnitude de risco. Além do uso de anticonvulsivantes (OR 20,00; IC95%: 3,36-437,97), outros grupos de medicamentos atuaram como fatores de risco, como analgésicos (OR 1,45; IC95%: 1,08-1,95); antibióticos (OR 2,43; IC95%: 1,33-4,57); antifúngicos (OR 9,00; IC95%: 2,14-61,12) e chás (OR 4,09; IC95%: 2,23-7,77). CONCLUSÕES: ao lado de exposições já descritas na literatura, como aquela relativa ao uso de anticonvulsivantes, outras tantas foram identificadas. Embora possam ter sofrido a influência de fatores de confundimento e viés de memória, que podem afetar os resultados deste estudo elas devem ser avaliadas servindo de subsídio para estudos mais específicos.<br>OBJECTIVES: to evaluate the association of this malformation group and specific conditions of maternal health. METHODS: case control study with 274 individuals with cleft lip and palate and 548 hospital controls. The odd ratio (OR) and confidence intervals were obtained based on conditional logistic interval analysis. RESULTS: the main associations were maternal malformation reports (OR 8,01; 95%IC%: 2,23-28,81); gynecological infections (OR 2,77; 95%IC: 1,50-5,10); neurological conditions (OR 7,11; IC95%: 2,57-19,75); viruses (common cold for example) (OR 7,57; 95%IC: 2,46-23,32). In reproductive history no condition was demonstrated as being statistically significant, nevertheless, previous spontaneous abortions (OR 1,42; 95%IC: 0,95-2,13) and stillborns (OR 2,22; 95%IC: 0,88-5,65) demonstrated more pronounced risks. In addition to the use of anticonvulsant drugs (OR 20,00; 95%IC: 3,36-437,97), other drug groups were indicated as risk factors such as analgesics (OR 1,45; 95%IC: 1,08-1,95); antibiotics (OR 2,43; 95%IC: 1,33-4,57); antifungical drugs (OR 9,00; 95%IC: 2,14-61,12) and teas (OR 4,09; 95%IC: 2,23-7,77). CONCLUSIONS: together with exposures already described in the literature, including the use of anticonvulsant drugs, many others were identified. Although they may have been affected by possible mental confusion and forgetfulness that could have affected the results of this study, they should be evaluated and used as subsidies to more specific studies

As faces simbólica e utilitária da chupeta na visão de mães The symbolic and utilitarian facets of pacifiers according to mothers

OBJETIVO: Mesmo com as iniciativas governamentais que controlam, desestimulam e até proíbem a divulgação e o uso de bicos e chupetas nas maternidades, é alta a freqüência do seu uso pelas crianças brasileiras. Diante desse cenário, o objetivo estudo foi conhecer as representações sociais sobre a chupeta, por parte das mães cujos filhos fizeram uso desse objeto. MÉTODOS: Estudo baseado nos pressupostos teóricos das representações sociais, propostos por Moscovici. Foram estudadas as mulheres que deram à luz num hospital de ensino, na cidade de São Paulo, que proíbe a oferta de chupeta durante a internação. Foram realizadas entrevistas não-estruturadas e individuais, transcritas na íntegra e organizadas para análise, segundo o método do discurso do sujeito coletivo. RESULTADOS: Os resultados evidenciaram representações maternas de que a chupeta: "Simboliza a criança"; "É um calmante para a criança e uma ajuda para a mãe"; e "O seu uso é passado pelas gerações". CONCLUSÕES: A chupeta oferece à mãe uma alternativa para confortar e apaziguar o filho em momentos de agitação ou quando ela não pode atendê-lo direta e continuamente.<br>OBJECTIVE: Despite governmental initiatives that control, discourage and even prohibit the divulgation of the usage of dummies and pacifiers in maternity wards, the frequency of pacifier use by Brazilian children is still high. In light of this phenomenon, the aim of the present study was to investigate the social representations of the pacifier constructed by mothers whose children used pacifiers. METHODS: The present study is based on the conceptual framework of social representations, proposed by Moscovici. We studied women who gave birth at a teaching hospital in the city of Sao Paulo that prohibits the use of pacifiers during hospital admission. We conducted non-structured individual interviews that were transcribed in full and organized for analysis according to the collective subject discourse method. RESULTS: Our results indicate maternal representations that the pacifier "symbolizes the child," that is "is a tranquilizer for the child and an aid for the mother," and that "its use is inherited from generation to generation". CONCLUSIONS: Pacifiers are an alternative for the mother for comforting and hushing her child in moments of agitation or for when the mother is not able to tend to the child in a direct and continuous manner