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This study aimed to investigate the association between bullying at school and tooth loss in southern Brazilian adolescents. This population-based cross-sectional study included a representative sample of 15-19-year-old students attending high schools in Santa Maria, southern Brazil. Data on sociodemographic and behavioral variables were collected through questionnaires. Contextual data on bullying at school was provided by educational institutions (bullying episodes in the previous year: 'no,' 'sometimes,' or 'often'). Tooth loss was clinically assessed by the M component of the DMFT index, modeled as a discrete variable. Multilevel Poisson regression was used, and rate ratios (RR) and 95% confidence intervals (CI) were estimated. The prevalence of tooth loss was 9.2% (95%CI = 7.5-10.8). Adolescents who attended the schools where bullying events often occurred had 0.39 (95%CI = 0.33-0.45) missing teeth, on average, in contrast to an average of 0.14 (95%CI = 0.08-0.19) among those whose schools did not experience bullying in the previous year. After adjusting for important cofactors, the contextual variable of bullying at school remained significantly associated with the study outcome. Adolescents who attended schools where bullying frequently occurred were 2.49-fold more likely to have an additional missing tooth than those whose school did not experience bullying in the previous year (RR = 2.49, 95%CI = 1.37-4.51, p = 0.003). In conclusion, the frequent bullying episodes at school were associated with more permanent teeth lost due to caries in this population. Hence, improving the school environment may improve the oral health of adolescents. [ABSTRACT FROM AUTHOR]

This study aimed to assess the association between underlying dentin shadows (UDS) and oral health-related quality of life (OHRQoL) among 15-19-year-old adolescents from southern Brazil. This population-based cross-sectional study included a representative sample of 1,197 15-19-year-old adolescents attending 31 public and private schools from Santa Maria, Brazil. The Oral Health Impact Profile-14 (OHIP-14) was used to evaluate the OHRQoL, and clinical examinations were performed by two calibrated examiners (intra/interexaminer kappa values for caries examination = 0.80) to diagnose UDS (ICDAS code 4 caries lesions). Sociodemographic information and clinical characteristics (overall caries experience, traumatic dental injury, malocclusion, and gingivitis) were also collected as adjusting variables. Multilevel Poisson regression models were used to assess the association between UDS and OHRQoL. Rate ratios (RR) and 95% confidence intervals (CI) were estimated. The UDS prevalence was 8.8% (n = 106 adolescents). In the adjusted models, adolescents with UDS had poorer OHRQoL than those without UDS, and the strength of the association was dependent on the number of lesions per individual. Individuals with 1-2 UDS had a mean OHIP-14 score 8% higher (RR = 1.08; 95%CI: 1.01-1.17) than adolescents without UDS, while those with 3-4 UDS had a mean score 35% higher (RR = 1.35; 95%CI: 1.12-1.63). This negative association was related to physical disability, psychological disability, social disability, and handicap domains. This study showed that UDS was associated negatively with OHRQoL among 15-19-year-old adolescents from southern Brazil. The negative effect of UDS on OHRQoL emphasizes the importance of addressing issues regarding OHRQoL even in the posterior teeth of adolescents. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the occurrence of erosive tooth wear (ETW) among 15-19-year-old South Brazilian adolescents, regarding prevalence, extent, severity, intraoral distribution, and sociodemographic risk indicators. A population-based cross-sectional survey was conducted in Santa Maria, southern Brazil, and included a representative sample of 15-19-year-old adolescents. Data collection included the application of a questionnaire and a clinical examination. A questionnaire was sent to the parents/legal guardians of the selected students, containing questions on demographic information, socioeconomic characteristics, and living conditions. After tooth cleaning and drying, all erupted permanent teeth were clinically assessed by two calibrated examiners, and classified according to the Basic Erosive Wear Examination (BEWE). The association between explanatory variables and the outcomes (ETW prevalence and extent) was assessed using Poisson regression models (both unadjusted and adjusted). A total of 1,197 adolescents were included in the study (participation rate of 72.3%). The overall prevalence of ETW was 57%. Severe ETW affected 16% of the sample. Overall, this adolescent population presented 13.3 affected surfaces, and 8.34 affected teeth. In the risk assessment analysis, gender, skin color, socioeconomic status, and family income were significantly associated with ETW. Boys, white adolescents, and those with higher socioeconomic status were more affected by ETW. This population-based cross-sectional study revealed that the prevalence of ETW was high, and that it was associated with sociodemographic variables in this South Brazilian population of adolescents. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65--1.07), 0.91 (95%CI = 0.59--1.23), and 0.42 (95%CI = 0.03--0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69--1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51--1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between dental caries treatment, intraoral distribution and oral health-related quality of life (OHRQoL) of 12-year-old South Brazilian schoolchildren., Methods: This crosssectional survey used a multistage probability sampling strategy to select a representative sample of schoolchildren from Porto Alegre, southern Brazil. Data were collected from September 2009 to December 2010, and 1528 of 1837 eligible schoolchildren attending public and private schools participated. Clinical examination was conducted to assess dental caries experience (DMFT). OHRQoL was assessed by a self-reported 16-item Child Perception Questionnaire (CPQ11–14). Parents/legal guardians answered questions on socio-economic status. Survey negative binomial regression models were used to assess the association between CPQ11–14 scores and caries treatment status (treated/untreated) and intraoral distribution (anterior/posterior). Estimates were controlled for gender and socioeconomic status., Results: Compared to schoolchildren without treatment needs, individuals with treated caries presented an improved OHRQoL (overall CPQ11 –14, adjusted RR = 0.90, 95%CI = 0.85–0.96; functional limitations, adjusted RR = 0.86, 95%CI = 0.75–0.99; emotional well-being, adjusted RR = 0.89, 95% CI = 0.80–0.99), whereas those with untreated caries presented a poorer OHRQoL (oral symptoms, adjusted RR = 1.06, 95%CI = 1.02–1.10; emotional well-being, adjusted RR = 1.09, 95%CI = 1.01–1.20). Individuals with caries in anterior teeth experienced greater negative impact on oral symptoms (adjusted RR = 1.11, 95%CI = 1.05–1.18) and social well-being (adjusted RR = 1.30; 95% CI = 1.14–1.47) domains than caries-free students., Conclusions: Treated caries was positively associated with OHRQoL; untreated caries and caries affecting anterior teeth were negatively associated with OHRQoL of 12-year-old Brazilian schoolchildren.