An observational study of dental abnormalities in the primary teeth

Introduction: Pregnancy and early childhood are the most critical phases with regard to biological, cognitive, emotional, and social development. Adverse events in these periods of life may be related to alterations in dental development, including alterations in size, shape and mineralization. Objective: To evaluate the frequency of dental abnormalities and the factors associated with the developmental defects of the enamel in primary teeth. Material and methods: Information about family income, maternal education level, pretermbirth, and hospitalization history up to 11 months of age were collected from the dental records of 544 children. Clinical examination of the children was performed to investigate abnormalities of tooth number, form, size, and developmental defects of the enamel (DDE). Data were analyzed using χ2 test and Poisson regression. Results: In all, 544 children were evaluated. Sixty children (11.0%) presented some alterations in the primary teeth; and 7.5% showed DDE. Children born preterm were 3.17 times more likely to develop DDE in primary teeth (prevalence ratio – PR = 3.17, 95% confidence interval– 95%CI 1.26–7.98, p = 0.014). Among the alterations of number, 1.7% was hypodontia, and among the abnormalities of shape, 1.7% was fused teeth. Conclusion: The prevalence of dental anomalies in this sample was, in general, expressive. Children born preterm were more vulnerable to present developmental defects of the enamel.Introduction: Pregnancy and early childhood are the most critical phases with regard to biological, cognitive, emotional, and social development. Adverse events in these periods of life may be related to alterations in dental development, including alterations in size, shape and mineralization. Objective: To evaluate the frequency of dental abnormalities and the factors associated with the developmental defects of the enamel in primary teeth. Material and methods: Information about family income, maternal education level, pretermbirth, and hospitalization history up to 11 months of age were collected from the dental records of 544 children. Clinical examination of the children was performed to investigate abnormalities of tooth number, form, size, and developmental defects of the enamel (DDE). Data were analyzed using χ2 test and Poisson regression. Results: In all, 544 children were evaluated. Sixty children (11.0%) presented some alterations in the primary teeth; and 7.5% showed DDE. Children born preterm were 3.17 times more likely to develop DDE in primary teeth (prevalence ratio – PR = 3.17, 95% confidence interval– 95%CI 1.26–7.98, p = 0.014). Among the alterations of number, 1.7% was hypodontia, and among the abnormalities of shape, 1.7% was fused teeth. Conclusion: The prevalence of dental anomalies in this sample was, in general, expressive. Children born preterm were more vulnerable to present developmental defects of the enamel

Correlation and discriminant validity of the CAST and ceo instruments in the deciduous dentition.

Epidemiological surveys of dental caries require diagnostic tools that are valid, easy to apply and provide useful and easy to interpret results. The World Health Organization (WHO) criterion is widely accepted all over the world, being the most used index. Among the most recent instruments, Caries Assessment Spectrum and Treatment (CAST) seems to be useful for dental caries diagnosis in epidemiological research. The objective of Article 1 of this dissertation was to evaluate how the CAST instrument correlates with the WHO index and to determine the reproducibility of CAST in the deciduous dentition. A cross - sectional, school - based study was conducted with children aged 2 to 5 years, from Capão do Leão / southern Brazil. Demographic and socioeconomic data were collected in a questionnaire. Dental caries examinations were performed by two calibrated examiners in two stages: the first using the CAST instrument and the second, in the following weeks, using the WHO criteria. The time to use each instrument was recorded during all examinations. The analyzes were performed using descriptive statistics, paired t-tests, Pearson correlation coefficient (r), coefficient of variation (CV) and kappa coefficient (κ), together with the standard error (SE) and the percentage of concordance between examiners (Po). The values recorded with CAST were converted to the WHO criteria using the CAST codes 2,5-8 (CAST2,5-8). 200 children were included and the prevalence of dental caries in the sample was 40,5% with CAST2,5-8 and 47.0% when the WHO criteria was used. The instruments showed similar results of dental caries prevalence and experience and the CAST index allowed a more detailed report of the results, but it took more time to be applied. The intraexaminer reproducibility of CAST in the deciduous dentition examination was substantial. Article 2 aimed to know the discriminant validity of the CAST instrument and to compare it with the discriminatory power of the criterion recommended by the WHO. In the same sample of Article 1, during the dental caries examination, the visible plaque and dental pain were also evaluated. Two cut-off points were used for CAST – CAST4-7 (dentin caries threshold) and CAST3-7 (caries threshold on enamel) – which were compared to the WHO criteria. A descriptive analysis was carried out and, to evaluate the association of caries prevalence and dmfs values with the independent variables, a Poisson regression analysis with robust variance was used. The prevalence of caries was 47.0% when the WHO criteria was used, 42.5% when CAST4-7 was the threshold and 77.5% when CAST3-7 was used. All instruments and thresholds discriminated socioeconomic and clinical indicators of dental caries. The CAST instrument was able to discriminate risk indicators similar to the WHO criteria when the caries experience was the outcome. In conclusion, the findings of these studies suggest that the CAST instrument can be used for the diagnosis of dental caries in epidemiological surveys in the deciduous dentition.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESOs levantamentos epidemiológicos de cárie dentária requerem instrumentos para diagnóstico que sejam válidos, fáceis de aplicar e forneçam resultados úteis e fáceis de interpretar. O critério da Organização Mundial da Saúde (OMS) é amplamente aceito em todo o mundo, sendo o índice mais usado. Dentre os instrumentos mais recentes, o Caries Assessment Spectrum and Treatment (CAST) parece ser útil para diagnóstico de cárie dentária em pesquisas epidemiológicas. O objetivo do Artigo 1 dessa dissertação foi avaliar como o instrumento CAST se correlaciona com o índice da OMS e determinar a reprodutibilidade do CAST na dentição decídua. Foi realizado um estudo transversal, de base escolar, com crianças de 2 a 5 anos, de Capão do Leão / sul do Brasil. Dados demográficos e socioeconômicos foram coletados em um questionário. Os exames de cárie dentária foram realizados por dois examinadores calibrados, em duas etapas: a primeira utilizando o instrumento CAST e a segunda, nas semanas seguintes, utilizando o critério da OMS. O tempo para utilizar cada instrumento foi registrado durante todos exames. As análises foram realizadas utilizando estatística descritiva, testes t pareados, coeficiente de correlação de Pearson (r), coeficiente de variação (CV) e coeficiente kappa (κ), juntamente com o erro padrão (EP) e o percentual de concordância (Po). Os valores registrados com CAST foram convertidos para o critério da OMS usando os códigos CAST 2, 5-8 (CAST2, 5- 8). Foram incluídas 200 crianças e a prevalência de cárie dentária na amostra foi de 40,5% com o CAST2, 5-8 e de 47,0% quando foi utilizado o critério da OMS. Os instrumentos mostraram resultados semelhantes de prevalência e experiência de cárie dentária e o índice CAST possibilitou um relatório mais detalhado dos resultados, mas levou mais tempo para ser aplicado. A reprodutibilidade intra-examinador do CAST no exame da dentição decídua foi substancial. O Artigo 2 objetivou conhecer a validade discriminante do instrumento CAST e compará-la com o poder discriminatório do critério recomendado pela OMS. Na mesma amostra do Artigo 1, durante o exame de cárie dentária, também foi avaliada a placa visível e a dor dentária. Foram adotados dois pontos de corte para o CAST – CAST4-7 (limiar de cárie em dentina) e CAST3-7 (limiar de cárie em esmalte) – que foram comparados ao critério da OMS. Foi realizada análise descritiva e, para avaliar associação da prevalência de cárie e dos valores de ceos às variáveis independentes, foi utilizada análise de regressão de Poisson com variância robusta. A prevalência de cárie foi de 47,0% quando o critério da OMS foi utilizado, de 42,5% quando CAST4-7 foi o limiar e 77,5% quando CAST3-7 foi utilizado. Todos os instrumentos e limiares discriminaram indicadores socioeconômicos e clínicos de cárie dentária. O instrumento CAST apresentou capacidade de discriminar indicadores de risco semelhante ao critério da OMS quando a experiência de cárie foi o desfecho. Em conclusão, os achados desses estudos sugerem que o instrumento CAST pode ser usado para o diagnóstico de cárie dentária em levantamentos epidemiológicos na dentição decídua

Severe traumatic dental injuries and oral health related quality of life of preschool children

ABSTRACT Objective: The aim of this study was to investigate the impact of severe traumatic dental injuries on the Oral Health related Quality of Life (OHRQoL) of preschool children. Methods: This cross-sectional study was conducted with children aged 2 to 5 years and their mothers, in Pelotas/ Brazil Southern. The Early Childhood Oral Health Impact Scale (ECOHIS) was applied to assess the perception of mothers about children’s OHRQoL. Oral examination included dental trauma, categorized as absent/mild (enamel fracture only) or severe, the number of decayed, missing or restored primary teeth (dmft), and presence of anterior open bite. The impact of severe dental trauma on OHRQoL was evaluated using logistic regression analysis (P<0.05). Results: A total of 599 preschool children were included and 7.4% had severe dental trauma. Of these 73.3% showed negative impact on OHRQoL (p= 0.044). After adjustments, children with severe dental trauma had an impact in OHRQoL 110% higher than those without/with mild trauma (OR: 2.10, 95% CI 1.01-4.35). Severe dental injuries caused negative impact on the oral symptoms (OR: 2.13, 95% CI 1.10-4.14), psychological (OR: 2.13, 95% CI 1.10-4.13) and family function (OR: 2.79, 95% CI 1.17-6.61) domains. Conclusion: The presence of severe dental trauma impacts the OHRQoL of preschool children and their families