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Background: Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors AIM: The aim of this study was to investigate associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8-10 years of age., Design: A school-based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples., Results: Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self-reported PAB., Conclusions: Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self-reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB., (© 2021 BSPD, IAPD and John Wiley & Sons Ltd.)

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors., (© 2020 BSPD, IAPD and John Wiley & Sons Ltd.)

Background: The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments., Aim: To evaluate the influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents., Design: A cross-sectional study was conducted with 740 12-year-old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD-30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed., Results: A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01-1.03), high social class (PR = 1.28; 95% CI: 1.09-1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37-1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19-2.02) and connected (PR = 1.22; 95% CI: 1.02-1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01-1.38) remained associated with having visited a dentist., Conclusions: Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents., (© 2020 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Oral health literacy (OHL) is associated with oral health outcomes., Aim: To validate the Brazilian Portuguese version of the Hong Kong OHL Assessment Task for Paediatric Dentistry (HKOHLAT-P)., Design: We performed cross-cultural adaptation of the HKOHLAT-P. A sample of 200 pre-schoolers and caregivers from Campina Grande, Brazil completed the Brazilian HKOHLAT-P (BOHLAT-P), sociodemographic questionnaire, the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS), and the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Child dental caries was assessed. Instrument reliability was measured by internal consistency (Cronbach's alpha) and test-retest (ICC). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) evaluated dimensionality. Regression models tested associations between BOHLAT-P and exploratory variables (P < .05)., Results: BOHLAT-P demonstrated excellent reliability (Cronbach's alpha = 0.92; ICC = 0.95). BOHLAT-P and BREALD-30 scores (r = .71), number of schooling years (r = .60), and reading hours (r = .34) were positively correlated. BOHLAT-P and B-ECOHIS scores (r = -.22), and BOHLAT-P scores and number of cavitated teeth (r = -.15) were negatively correlated. After controlling for confounding variables, BOHLAT-P scores were not associated with caries or number of teeth with cavitated caries., Conclusion: BOHLAT-P is a valid and reliable instrument to assess the OHL of Brazilian parents., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Sleep bruxism (SB) is a masticatory muscle activity that affects children. Parents' knowledge is important for its identification and report to dentists., Aim: To investigate parents' knowledge about SB among their children., Design: A cross-sectional study included 1325 parents of children from dental clinics of seven institutions from all regions of Brazil. Parents answered questions about child's sleep, knowledge about SB and its occurrence among children and parents. SB definition given by parents was dichotomized as "correct"/"incorrect", based on the American Academy of Sleep Medicine definition. Descriptive, bivariate and multivariate analyses were performed (P < 0.05)., Results: Most parents (57.3%) did not know what SB is and 88.9% would like to receive more information. SB prevalence among parents was 15.4% and 24.0% among children. Between parents who correctly defined SB, its prevalence increased to 27.5% among parents and 40.6% among children. Parents whose children had/have SB, who would like to receive more information about SB and were from the North, Central-West, Southeast, and South regions were more likely to define SB correctly (P > 0.05)., Conclusion: There is a lack of knowledge of parents about SB. SB among children, parents' interest in receiving more information and their location were factors associated to their knowledge., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear., Aim: To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI)., Design: A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PR c ) for dental caries and this measure adjusted by HFI (PR a )., Results: The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI., Conclusions: Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The scientific evidence regarding the association between parental oral health literacy (OHL) and children's oral health is unclear., Aim: To evaluate the scientific evidence concerning the association between parental OHL and children's oral health outcomes., Design: Eight databases were searched. Studies that evaluated oral health outcomes among children and measured parental OHL through a validated tool were included. Two independent reviewers selected studies, extracted data and analysed the risk of bias., Results: Eleven studies were included. Most (n = 6) had a high risk of bias. Most studies evaluating dental caries found association between lower parental OHL and higher prevalence/experience of dental caries. Poor oral health-related quality of life was associated with decreased parental OHL (P < 0.05). Studies diverged on the association between OHL and the number of filled, extracted teeth, and dental visits. There was no association between children's tooth brushing frequency, use of toothpaste, oral health claim, oral health expenditures and parental OHL. The literature was inconclusive regarding the association between night bottle feeding, negative parental perception of the child's oral health and OHL., Conclusion: Low parental OHL was associated with dental caries among their children. It is too soon to assume an association between OHL and the remaining outcomes., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Dental caries have a high prevalence in children and need to evaluate their individual and contextual determinants., Aim: To evaluate the importance of individual and contextual determinants on the occurrence of cavitated lesions in 5-year-old children., Design: A cross-sectional study was conducted with 769 preschoolers in a city in northeastern Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, socio-demographic characteristics and the child's oral health. The diagnosis of dental caries (cavitated lesion) was performed using the ICDAS-II. Variables related to the context were collected at the preschools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models with robust variance correction were used., Results: The prevalence of cavitated lesions was 58.8%. In the analysis adjusted by individual determinants, low household income (PR = 1.61; 95%CI:1.27-2.05), lower parent's/caregiver's schooling (PR = 1.57; 95%CI:1.20-2.05), not visited to the dentist (PR = 0.77; 95%CI:0.62-0.94), brushing frequency under 2 times per day (PR = 2.17; 95%CI:1.35-3.51) and weak parent's/caregiver's SOC (PR = 1.30; 95%CI:1.09-1.56) were associated with cavitated lesions. However, after the incorporation of the contextual determinants, parent's/caregiver's schooling and SOC lost their association. Considering contextual factors, children attending public preschools (PR = 1.66; 95%CI:1.34-2.05) and/or smaller preschools (PR = 1.001; 95%CI:1.001-1.002) had a greater probability of exhibiting cavitated lesions., Conclusion: Contextual variables were more important to the occurrence cavitated lesions than individual socioeconomic variables., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: There is a need for studies on the biopsychosocial factors that influence the use of dental services by preschoolers., Aim: To evaluate the influence of the perceptions of parents/caretakers and children regarding oral health-related quality of life (OHRQoL) as well as the sense of coherence (SOC) of parents/caretakers on the use of dental services among Brazilian preschoolers., Design: A school-based, cross-sectional study was conducted with 768 preschoolers. Parents/caretakers answered a questionnaire addressing socio-demographic characteristics. The OHRQoL of the children was measured using the Scale of Oral Health Outcomes for Five-Year-Old Children. SOC among the parents/caretakers was evaluated using the Sense of Coherence scale. Clinical examinations were performed by examiners who had previously undergone a training exercise. Descriptive analysis was conducted, followed by Poisson's regression analysis (α = 5%)., Results: A total of 56.5% of the preschoolers had never used dental services. The following variables exerted a significant influence on the use of services: higher monthly household income (PR = 1.27; 95% CI: 1.07-1.51), toothache (PR = 1.59; 95% CI: 1.34-1.89), the absence of traumatic dental injury (TDI; PR = 1.18; 95% CI: 1.01-1.40), and a strong SOC (PR = 1.19; 95% CI: 1.01-1.42)., Conclusions: A higher monthly household income, history of toothache, the absence of TDI, and strong SOC of the parents/caretakers influence the use of dental services by preschoolers., (© 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: There is a need for investigations into the impact of oral problems on OHRQoL with study designs that offer greater strength of evidence., Aim: To evaluate the impact of dental caries and traumatic dental injury (TDI) on the OHRQoL of Brazilian preschool children., Design: A population-based, matched, case-control study was conducted involving 415 children aged 3-5 years enrolled at public and private preschools. The case group (impact on OHRQoL) and control group (no impact on OHRQoL) were matched for age, sex, and monthly household income at a 1 : 4 ratio (83 cases and 332 controls). Impact on OHRQoL was assessed using the B-ECOHIS. Dental caries and TDI were determined through clinical oral examinations. Data analysis involved descriptive statistics and conditional logistic regression analysis (P ≤ 0.05; 95% CI)., Results: The most frequent responses on the B-ECOHIS were 'felt pain' (79.7%) and 'difficulty in eating' (35.0%). The following variables were significantly associated with impact on OHRQoL: caries severity (OR = 12.58; 95% CI: 5.31-29.79) and TDI (OR: 2.11; 95% CI: 1.23-3.62)., Conclusions: Caries severity and TDI impacted the OHRQoL of preschool children., (© 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)