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Background: Traumatic dental injuries (TDIs) in early childhood exert a negative impact on the quality of life of children and their families. However, there is no evidence from cohort studies on which to base prevention strategies at the beginning of life, when children are entirely dependent upon supervision. The aim of the present study was to estimate the incidence of TDI in the first year of life and explore risk factors in a birth cohort followed up in three major cities in different regions of Brazil. Methods: A birth cohort study was conducted with children in the cities of Porto Alegre, Salvador, and Manaus. Socioeconomic, demographic, and anthropometric characteristics were collected at baseline. Behavioral characteristics were collected when the children were six and 12 months of age. After the first year of life, clinical examinations were performed by trained, calibrated dentists for the assessment of TDI (Andreasen's criteria). Poisson regression models were used to estimate associations between the independent variables and TDI, with the calculation of crude and adjusted relative risk (RR) and respective 95% confidence intervals (CI). Results: The incidence of TDI in the first year of life (range: 12 to 16 months) was 18.1% (95% CI: 13.6–22.6%). The multivariable analysis revealed a significantly greater risk of TDI in children from non-nuclear families (RR = 1.83; 95% CI: 1.11-3.00) as well as those whose mothers had a higher level of schooling (RR = 2.42; 95% CI: 1.04–5.63) and when tooth eruption began up to six months of age (RR = 2.30; 95% CI: 1.34–3.95). Being the first-born child was a protective factor (RR = 0.48; 95% CI: 0.27–0.87) for the occurrence of the outcome. Conclusion: The high incidence of TDI in the first year of life indicates the need for primary prevention strategies with an emphasis on active supervision in the first months of life. Risk factors associated with TDI related to the family, mother and child suggest pathways for the planning of such strategies. [ABSTRACT FROM AUTHOR]

Background: The impact of ankyloglossia (tongue-tie) on breastfeeding outcomes may be overestimated and surgical treatment in newborns remains a controversial topic. The aim of the present study was to assess and quantify the impact of ankyloglossia in newborns on breastfeeding self-efficacy at 14 days of life. Methods: A birth cohort study was conducted involving mothers and newborns soon after childbirth at a public hospital in the city of Canoas, southern Brazil. At the hospital, the lingual frenum of newborns were clinically examined and classified using the Bristol Tongue Assessment Tool. For every newborn with defined or suspected ankyloglossia, two newborns without ankyloglossia were co-enrolled for the study. At 14 days of the children's lives, the mothers were interviewed at home to collect data on breastfeeding self-efficacy using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Poisson regression with robust variance was conducted to quantify differences in the Breastfeeding Self-Efficacy scores between exposed and nonexposed newborns after adjusting for maternal sociodemographic variables (mother's completed years of schooling, mother's age, family structure, progenitor status of child, mother's smoking status), the gestational variables (number of prenatal appointments, gestational age, comorbidities, type of childbirth), and child related variables (sex, birth weight, birth length) as confounders. Results: The final sample was composed of 31 children with ankyloglossia (exposed) and 57 without ankyloglossia (nonexposed). No significant differences were found in the BSEF-SF scores between the 31 children with ankyloglossia (mean BSEF-SF scores: 56.0; median BSEF-SF scores: 60; 95% CI: 51.9–60.1) and the 57 children without ankyloglossia (mean BSEF-SF scores: 59.6; median BSEF-SF scores: 60; 95% CI: 57.5–61.7). The Poisson regression analysis showed no significant difference in the BSEF-SF scores between newborns with ankyloglossia and those without ankyloglossia (Ratio = 0.95; 95% CI: 0.88–1.02; p = 0.139). Conclusion: Ankyloglossia at birth exerted no clinically relevant impact on breastfeeding self-efficacy in children at 14 days of life. [ABSTRACT FROM AUTHOR]

BackgroundEarly-life dental service utilization could improve child dental health.AimIdentify contextual, socioeconomic, and child characteristics associated with dental visitation by age 3 years.DesignWithin a Brazilian birth cohort (N = 435), multivariable regression models were fitted to identify independent predictors of having made a dental visit at age 3 years. Contextual variables considered included health center type (Traditional vs. Family Health Strategy, which perform home visits) and composition of oral health teams at the heath center where mothers accessed prenatal care.ResultsDental visitation was positively associated with Family Health Strategy health centers (36% vs. 23%) and with higher maternal education and family social class. Visitation was lowest among families served by a health center without a dentist, but number of dentists and oral health team composition were not associated with visitation among facilities with ≥1 dentists. Dental visitation was not statistically significantly associated with caries experience but was higher if parents reported worse oral health-related quality of life. The vast majority of dental decay remained untreated.ConclusionsDental visits were underutilized, and socioeconomic inequalities were evident. Dental visitation was more common when mothers received prenatal care at Family Health Strategy health centers, suggesting a possible oral health benefit.

Background/aimThe impact of traumatic dental injuries (TDI) in the primary dentition on oral health-related quality of life indicates the need for the planning of prevention strategies. The aim of this study was to assess whether anthropometric characteristics in early life are associated with TDI by preschool age.Materials and methodsA birth cohort was recruited from the public healthcare system in the city of Porto Alegre, Brazil. Socio-demographic variables, type of birth, head circumference, weight, and length were collected at birth (WHO standards). Head circumference, body mass index for age, and height for age were collected at 12 months. TDI (Andreasen criteria) at three years of age (n = 458) were recorded by two examiners who had undergone training and calibration exercises. Multivariable analysis was carried out with Poisson regression with robust variance.ResultsA total of 31.0% of the children (142/458) exhibited TDI at three years of age. In the final model, the risk of TDI was 47% higher among children with a smaller head circumference upon birth and nearly 60% higher among those who were overweight/obese at 12 months of age (RR: 1.58; 95% CI: 1.15-2.17). The risk of TDI was also significantly higher among boys (RR 1.50; 95% CI: 1.13-2.00), but the outcome was not significantly associated with socioeconomic variables or other anthropometric variables.ConclusionOverweight/obesity in early life is a risk factor for TDI in preschool children.

Objectives(i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.MethodsThis study was a cross-sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre-based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1-4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income.ResultsCaries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3).ConclusionDental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality-of-life impact at the same level of disease experience. Thus, subjective quality-of-life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low-SES groups.

UnlabelledOral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening.ObjectivesQuantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time.MethodsRepresentative surveys of dental caries in children (age 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality).ResultsComparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality.ConclusionsOverall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.

Objectives: This laboratory study evaluated the effect of three polishing systems on the surface roughness and gloss of resin composites. Materials and Methods: Thirty specimens (6 mm Ø × 8 mm) were fabricated from each of three resin composites: Z 350 XT (nanofill), Harmonize (nanohybrid), and Estelite Omega (supranonofill). All specimens were photopolymerized using a multi‐peak LED curing unit (VALO—Standard mode), having a exitance irradiance of approximately 1000 mW/cm2 against a polyester strip (PS). 2 mm was then removed from the irradiated end (finished) using #320 abrasive paper (F). Specimens were then randomly polished (P) using a one‐step (1S) (OneGloss), two‐step (2S) (EVE Diacomp Twist Basic CA), or 3‐step (3S) (Astropol P) system (n = 10). For PS, F, and P groups, surface roughness (Ra) was measured using a surface roughness tester, and surface gloss was measured with a glossmeter. For each specimen, the percent recovery to the PS value (%R) of surface roughness and surface gloss were calculated. Data were analyzed using two–way ANOVA, followed by Tukey's test. Surface roughness and gloss values were submitted to Pearson's correlation test (α = 0.05). All statistical testing was performed using a pre‐set alpha of 0.05. Results: The interaction term [resin composite × polishing system] was significant for both surface roughness (p = 0.001) and gloss (p = 0.0001). For all resin composites, the 2S and 3S systems provided a higher %R of surface roughness and gloss compared to those of the 1S system. There was a negative correlation between surface roughness and gloss, but only a few combinations showed strong correlations. Conclusions: The 2S and 3S polishing systems provided surfaces having greater smoothness and gloss compared to the 1S system. The ability to recover surface roughness and gloss was dependent on type of resin composite filler classification. Clinical Significance: The 3S and 2S polishing systems were more effective in achieving PS values than was the 1S system for all tested resin composites. However, individual polishing systems performed differently depending on type of resin composite. [ABSTRACT FROM AUTHOR]

Background: Sugar consumption in early childhood is the primary cause of negative health outcomes, including early childhood caries. Aim: To investigate risk factors associated with early‐life sugar consumption. Design: Explanatory variables were collected at baseline of a birth cohort in Porto Alegre, Southern Brazil. At six months of age, data were collected on child feeding practices, including the number of foods and beverages containing sugar. Multivariate Poisson regression analysis with robust variance was performed. Results: Virtually all children (98.3%) had consumed sugar by the age of 6 months. Multivariable analysis showed that the number of sweet items was significantly larger in children whose mothers were less than 20 years of age (MR = 1.19; 95% CI: 1.05‐1.36), those from non‐nuclear families (MR = 1.12; 95% CI: 1.04‐1.20), those whose mothers had less than eight years of schooling (MR = 1.34; 95% CI: 1.20‐1.50) and those whose mothers smoked (MR = 1.23; 95% CI: 1.13‐1.35). Moreover, the number of sweet items was significantly lower among children who breastfed in the first hour of life (MR = 0.85; 95% CI: 0.76‐0.95). Conclusion: Sugar consumption begins very early, especially in children with no access to breastfeeding in the first hours of life and those from younger, less educated, and smoking mothers. [ABSTRACT FROM AUTHOR]

Background/aim: Enamel fractures are the most common type of traumatic dental injury (TDI) in children and adolescents. Recognizing the impact of these fractures on oral health-related quality of life (OHRQoL) could contribute to the establishment of treatment protocols. The aim of this study was to assess and quantify the impact of enamel fractures on overall OHRQoL and domain scores in adolescents.Materials and Methods: A cross-sectional study was conducted with 775 adolescents aged 11 to 14 years in the city of Santo Ângelo in southern Brazil. Sociodemographic variables were collected from parents/caregivers using a structured questionnaire. The adolescents answered the Child Perceptions Questionnaire (CPQ11-14 ). Physical examinations were performed by an examiner who had undergone training and calibration exercises for the investigation of TDI (Andreasen criteria), dental caries (WHO criteria), and malocclusion (Dental Aesthetic Index). Data analysis involved Poisson regression with robust variance.Results: The prevalence of TDI was 11.9% and enamel fractures accounted for 79.3% of all injuries. In the multivariate analysis, adolescents with enamel fractures had 29% higher CPQ11-14 scores (worse OHRQoL) than those without TDI, even after adjustment for sociodemographic and clinical variables (mean ratio = 1.29; 95% CI: 1.09-1.53; P = .003). Enamel fractures exerted a negative impact on the functional limitation, emotional well-being, and social well-being domains.Conclusions: Enamel fractures exert a negative impact on the OHRQoL of adolescents, suggesting that subjective measures should be incorporated in the evaluation of patients with this traumatic injury. [ABSTRACT FROM AUTHOR]

Aim: To explore the profile of articles on traumatic dental injuries (TDI) in the primary dentition published in Dental Traumatology in the last 15 years using bibliometric analysis.Methods: Three researchers read all titles and abstracts of articles published in Dental Traumatology between 2000 and 2014 (excluding editorials and letters) and selected all articles on TDI in the primary dentition. The articles were categorized according to year of publication, country in which the study was conducted, study design, and topics addressed. Divergences were resolved by consensus between the researchers.Results: Among a total of 1257 articles published, 98 were initially excluded. Among the remaining 1159 articles, 152 (13.1%) focused on TDI in the primary dentition. The articles were conducted in 29 countries, with Brazil (38.8%) and Turkey (11.8%) accounting for the largest numbers. Cross-sectional studies (36.2%) and case report/case series (33.6%) were the most frequent study designs. Only two systematic reviews were published. The most commonly addressed topics were frequency/etiology/associated factors (36.8%), treatment (30.9%), and prognosis (19.7%). Among the articles addressing treatment, two-thirds were case reports or case series. The effects of TDI in primary teeth on their permanent successors were addressed in 20.4% of the articles (31/152).Conclusions: The number of articles on TDI in the primary dentition has increased, but remains low. The evaluation of study designs and topics addressed identified gaps that could contribute to the development of new studies on TDI in the primary dentition, especially cohort studies that evaluate risk factors, prognosis, and treatment. [ABSTRACT FROM AUTHOR]