Avaliação das abordagens psicométricas nos instrumentos Geriatric Oral Health Assessment Index, Oral Health Impact Profile-14 e Oral Impacts On Daily Performances : uma revisão sistemática

A presente revisão sistemática objetivou avaliar as abordagens psicométricas dos instrumentos Geriatric Oral Health Assessment Index, Oral Health Impact Profile-14 e Oral Impacts On Daily Performances. As buscas foram realizadas nas bases de dados PubMed, Scopus e Google Scholar. Uma seleção manual dos artigos foi feita por dois pesquisadores, primeiro a partir de títulos e resumos, depois a partir da análise do texto completo. Os artigos incluídos foram submetidos à extração dos seguintes dados: nome dos autores; ano de publicação do artigo; país onde o estudo foi conduzido; número de participantes; idade dos participantes; método de análise fatorial; estimador; rotação; software; formato de resposta; e número de fatores. Os artigos selecionados na revisão sistemática do Geriatric Oral Health Assessment Index (19 artigos), do Oral Health Impact Profile (10 artigos) e do Oral Impact on Daily Performances (8 artigos) foram, em sua maioria, publicados após os anos 2000, com grande número de estudos desenvolvidos no Brasil e na Turquia. As divergências nas condutas foram encontradas para os métodos de extração dos fatores, a seleção dos estimadores, a rotação, o uso do software estatístico e o número de fatores dos modelos testados. Portanto, as abordagens psicométricas são heterogêneas entre os estudos de QVRSB para os instrumentos Geriatric Oral Health Assessment Index (GOHAI), Oral Health Impact Profile (OHIP-14) e Oral Impact on Daily Performances (OIDP)

Approaches adopted by dentists for management of occlusal caries in primary teeth

ABSTRACT Objective To evaluate the approaches used by Family Health Strategy dentists in the city of Campina Grande, Paraíba, Brazil, for management of occlusal caries in primary teeth. Methods In this observational, cross-sectional, census-based, descriptive study, 33 professionals completed a questionnaire designed to evaluate their approach to management of occlusal caries in enamel and dentin of deciduous teeth in different risk situations. Data were analyzed through descriptive and inferential statistics (Fisher's exact test with the level of significance set to 5%). Inter-examiner agreement was evaluated by Cohen's kappa statistic. Results For chronic enamel caries in primary teeth with low risk/activity, the approach of choice was preventive, with fluoride application being the most cited intervention (39.3%). For active carious dentin in primary teeth with high risk/activity and with low risk/activity, invasive approaches were most prevalent (93.9% and 78.8%, respectively), with complete caries removal (74.2%) and glass-ionomer restoration (69.2%) being the most frequent responses. Inter-examiner agreement was moderate (k = 0.44). Conclusion Although a wide range of approaches were adopted by dental practitioners, most preferred invasive interventions, even in situations where preservation of tooth structure was recommended

How to Select a Questionnaire with a Good Methodological Quality?

<div><p>Abstract In the last decades, several instruments have been used to evaluate the impact of oral health problems on the oral health-related quality of life (OHRQoL) of individuals. However, some instruments lack thorough methodological validation or present conceptual differences that hinder comparisons with instruments. Thus, it can be difficult to clinicians and researchers to select a questionnaire that accurately reflect what are really meaningful to individuals. This short communication aimed to discuss the importance of use an appropriate checklist to select an instrument with a good methodological quality. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was developed to provide tools for evidence-based instrument selection. The COSMIN checklist comprises ten boxes that evaluate whether a study meets the standard for good methodological quality and two additional boxes to meet studies that use the Item Response Theory method and general requirements for results generalization, resulting in four steps to be followed. In this way, it is required at least some expertise in psychometrics or clinimetrics to a wide-ranging use of this checklist. The COSMIN applications include its use to ensure the standardization of cross-cultural adaptations and safer comparisons between measurement studies and evaluation of methodological quality of systematic reviews of measurement properties. Also, it can be used by students when training about measurement properties and by editors and reviewers when revising manuscripts on this topic. The popularization of COSMIN checklist is therefore necessary to improve the selection and evaluation of health measurement instruments.</p></div

Cirurgião-dentista na Equipe de Saúde da Família: perfil profissional e diagnóstico de cárie

Objetivo: verificar o perfil profissional dos cirurgiões-dentistas das Equipes de Saúde da Família (ESF's) e avaliar a adequação dos diagnósticos das lesões cariosas. Metodologia: foi realizado um estudo transversal, com 97 cirurgiões-dentistas das Unidades da Saúde da Família (USF's) da cidade de João Pessoa, Paraíba. Foi utilizado um questionário dividido em duas partes. A primeira parte, abordava o perfil profissional dos participantes, e a segunda, o registro do diagnóstico da cárie dentária para dois casos clínicos. O caso clínico I correspondeu a uma lesão cariosa inativa limitada ao esmalte, e o caso clínico II, foi referente a uma cárie dentária ativa com envolvimento pulpar. Os diagnósticos foram categorizados em adequados e inadequados de acordo com critérios pré-determinados. Os dados foram analisados por meio de estatística descritiva e inferencial uni e bivariada, pelo teste Qui-Quadrado, Exato de Fischer e coeficiente de correlação de Cramer, adotando-se p < 0,05. Resultados: Os resultados mostraram a ocorrência de formados em universidades federais (89,7%), graduados há mais de 20 anos (63,9%), com pós-graduação (74,7%) e possuindo como principal local de trabalho o setor público (84,5%). O diagnóstico foi adequado em apenas 35,0% e 40,5% para os casos clínicos I e II, respectivamente. O diagnóstico de cárie dentária apenas apresentou associação com o distrito sanitário no caso clínico I. Conclusão: Poucos cirurgiões-dentistas diagnosticaram adequadamente os casos clínicos, não havendo associação com o perfil profissional.       PALAVRAS-CHAVES Cárie dentária; diagnóstico; odontólogos; saúde pública; odontopediatria.

Parental influence on children’s answers to an oral-health-related quality of life questionnaire

Abstract The aim of the study was to evaluate parental influence on children’s answers to an oral health-related quality of life (OHRQoL) questionnaire. A cross-sectional study was conducted with a non-probabilistic sample of 84 pairs of 5-year-olds and parents/guardians. The participants were selected from a primary family healthcare center in Campina Grande, Brazil. First, the children and parents answered respective versions of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Seven days later, the children answered their version of the SOHO-5, without the presence of their parents/guardians, and underwent a clinical exam of dental caries, traumatic dental injury and malocclusion, by a previously calibrated researcher. Statistical analysis involved a comparison of mean scores and the calculation of the intraclass correlation coefficient (ICC). Poisson regression models were used to associate the variables (α = 5%). No significant differences were found between the mean SOHO-5 scores of the children when alone or accompanied by parents/guardians (p > 0.05). The ICC between the answers of the children alone or accompanied was 0.84. White spot (PR = 6.32; 95%CI: 1.36 - 29.40) and cavitated lesions (PR = 9.81; 95%CI: 3.22 - 29.85) had an impact on OHRQoL, according to the children’s self-report, whereas cavitated lesions (PR = 90.52; 95%CI: 13.26 - 617.74) and anterior open bite (PR = 1.95; 95%IC: 1.07 - 3.53) remained on the final model, according to the parents’ version of the SOHO-5. In conclusion, parents did not influence the children’s responses, and dental caries are the oral health problem exerting the greatest impact on the children’s OHRQoL

Evaluation of the association of bruxism, psychosocial and sociodemographic factors in preschoolers

<div><p>Abstract The aim of the present study was to evaluate factors associated with sleep bruxism in five-year-old preschool children. A preschool-based cross-sectional study was conducted with 761 pairs of children and their parents/caregivers. Sleep bruxism was diagnosed using a questionnaire administered to the parents/caregivers, who also answered questionnaires addressing sociodemographic data and parent’s/caregiver’s sense of coherence. Clinical oral evaluations of the children to determine dental caries, traumatic dental injuries, malocclusion and tooth wear were performed by two researchers who had undergone a training exercise (interexaminer Kappa: 0.70 to 0.91; intraexaminer Kappa: 0.81 to 1.00). Descriptive analysis and logistic regression for complex samples were carried out (α = 5%). The prevalence of sleep bruxism among the preschool children was 26.9%. The multivariate analysis revealed that bruxism was associated with poor sleep quality (OR = 2.93; 95 CI: 1.52–5.65) and tooth wear (OR = 2.34; 95%CI: 1.39–3.96). In the present study, sleep bruxism among preschool children was associated with tooth wear and poor sleep quality of the child. In contrast, psychosocial aspects (sense of coherence) were not associated with sleep bruxism.</p></div