Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion

The aim of this study was to evaluate whether there is an association between risk behavior for eating disorders (EDs) and dental erosion and caries. A controlled cross-sectional study was conducted in Brazil, involving 850 randomly selected female adolescents. After evaluating risk behavior for eating disorders through the Bulimic Investigatory Test of Edinburgh, 12 adolescents were identified with severe risk behavior for EDs and matched to 48 adolescents without such risk. Dental examinations, anthropometric measurements, and eating habits and oral hygiene were performed. Adolescents with high severity eating disorder condition were not more likely to show dental caries (p=0.329; OR = 2.2, 95% CI: 0.35–13.72) or dental erosion (p=0.590; OR = 2.33; 95% CI: 0.56–9.70). Adolescents with high body mass index (BMI) were five times more likely to have high severity eating disorder condition (p=0.031; OR = 5.1; 95% CI: 1.61–23.07). Therefore, high severity risk behavior for EDs was not significantly associated with dental caries and dental erosion. However, high BMI was a risk factor for developing eating disorders and should be an alert for individuals with this condition

RISK BEHAVIOR FOR BULIMIA AMONG ADOLESCENTS

ABSTRACT Objective: To analyze the risk behavior for bulimia among female adolescents from public and private high schools. Methods: A cross-sectional study with a random sample of 850 female students aged 15-18 years was carried out in a city in northeastern Brazil, using the Bulimic Investigatory Test of Edinburgh (BITE) to assess the risk behavior for bulimia. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software and the Pearson’s chi-square , Fisher’s exact and robust Poisson regression tests, adopting the significance level of 5%. Results: Less than half of the sample (42.0%) showed standards of dietary risk and weight control practices; in 1.4% of the sample, bulimia signs were already installed. Fear of gaining weight was reported by 62.8% of the subjects. Risk practices were lower among students from public schools; (Odds Ratio - OR - 0.82; confidence interval of 95% - 95%CI - 0.69-0.97). Among restrictive practices, fasting for a whole day was the most applied (29.9% of the students). Among individuals who were at risk situation, almost half believed to have normal eating habits (prevalence ratio - PR - 0.42; 95%CI 0.36-0.49). Individuals who consider their eating habits normal, who are afraid of gaining weight, those who seek emotional comfort in food and follow strict diets had higher risk for bulimia (p<0.05). Conclusions: The number of female adolescent students with risk behavior practices for bulimia is high, and the frequency of those unaware of this situation is also very high. Risk situations emerge as a collective health problem, and individuals from private schools were more likely to be in this situation

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8–10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers’ level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1–4.8), older children (OR = 1.8; 95%CI: 1.1–3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0–6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category

Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach

<div><p>Background</p><p>Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children.</p><p>Objective</p><p>To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables.</p><p>Methods</p><p>A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8–10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ_8–10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers’ level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05).</p><p>Results</p><p>The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001).</p><p>Conclusion</p><p>Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.</p></div

Bivariate multilevel models for individual and contextual variables associated with OHRQoL in children (n = 1,156): Belo Horizonte, 2010.

<p>Bivariate multilevel models for individual and contextual variables associated with OHRQoL in children (n = 1,156): Belo Horizonte, 2010.</p

Explanatory variables: individual and contextual variables.

<p>Explanatory variables: individual and contextual variables.</p

Frequency distribution of sample (n = 1,201) according to variables: Belo Horizonte, 2010.

<p>Some data is missing for a number of variables. Dental caries: n = 1,200; Residents in home: n = 1,184; Family income: n = 1,189; Parents/caregivers’ level of education: n = 1,197</p><p>Frequency distribution of sample (n = 1,201) according to variables: Belo Horizonte, 2010.</p

Bivariate analyses of individual and contextual variables associated with impact on OHRQoL in children (n = 1,201): Belo Horizonte, 2010.

<p>^a Chi-squared test</p><p>^b Mann-Whitney</p><p>OR, Odds Ratio; CI, Confidence Interval</p><p>Bivariate analyses of individual and contextual variables associated with impact on OHRQoL in children (n = 1,201): Belo Horizonte, 2010.</p

Final estimation of variance components in the multilevel analysis (“null-model”).

<p>^aIntraclass correlation coefficient (ICC): fraction of the total variance that is due to the contextual level</p><p>Final estimation of variance components in the multilevel analysis (“null-model”).</p