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Background: Dental caries is a prevalent oral disease affecting young children, leading to significant negative impacts on oral health-related quality of life (OHRQoL). This study aims to evaluate the relationship between extension of dental caries lesions and OHRQoL in children aged 3-6 years using the Early Childhood Oral Health Impact Scale (ECOHIS)., Methods: This cross-sectional study involved 300 children aged 3-6 years and their parents or caregivers. Clinical examinations were conducted using the decayed, missing, and filled teeth (dmft) Index, the pufa Index, and the International Caries Detection and Assessment System (ICDAS) II. The ECOHIS was administered through interviews with parents or caregivers to assess the impact of dental caries on OHRQoL. Statistical analyses, including Kruskal-Wallis and binomial logistic regression, were performed to evaluate the relationship between pufa scores and ECOHIS results., Results: The findings revealed a significant negative impact of dental caries on OHRQoL (p < 0.05). The mean ECOHIS score was 0.62 ± 0.552, with higher scores observed in children with a pufa Index score > 0 compared to those with a pufa Index score of 0 (p < 0.05). Significant impacts were observed in specific ECOHIS items, such as oral/dental pain (mean score 1.61 ± 1.13), difficulty eating (mean score 1.26 ± 1.26), and trouble sleeping (mean score 0.528 ± 0.942). Parental distress was also notably high, with significant scores in feeling upset (mean score 1.07 ± 1.31) and feeling guilty (mean score 0.929 ± 1.26). Binomial logistic regression analysis showed that a higher pufa score was a significant predictor of increased ECOHIS scores (adjusted OR = 1.929, p = 0.039). The dmft score also significantly predicted higher ECOHIS scores (adjusted OR = 6.597, p = 0.048). Spearman correlation analysis revealed a significant positive correlation between pufa and ECOHIS scores (r = 0.33, p < 0.05)., Conclusions: The study demonstrates that extension of dental caries lesions, particularly when measured by the pufa Index, significantly impacts specific aspects of OHRQoL, including pain, eating difficulties, and sleep disturbances in children, as well as emotional distress in parents. Early detection and management of dental caries are crucial in improving the quality of life for affected individuals. Dental practitioners should prioritize preventive measures and parental education to mitigate the adverse effects of dental caries., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted with ethical approval from the Non-Interventional Clinical Research Ethics Committee Presidency of the Recep Tayyip Erdoğan University Faculty of Medicine, under decision number 2020/18, dated 06.02.2020. A Participation Consent Statement was obtained from all children and their parents who were accepted to the study with their own consent. In addition, informed consent was obtained from the parents of all children via an Informed Consent Form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: This cross-sectional study addresses scarcity of evidence on oral health issues among Saudi children and their impact on quality of life (OHRQL). We aimed to investigate parental reports of oral health problems in children and their effect on their OHQRL., Methods: Parents of children aged 2-11-years from Five-Saudi regions participated from February 2021 to July 2021 by completing an electronic, self-administered questionnaire structured according to World Health Organization-Oral Health Questionnaire for children. It comprises questions on children experiencing oral pain/discomfort, oral lesions/manifestations and reduction in their OHRQL., Results: Among 1,516 responders, 1,107 (73.0%) reported that their children experienced toothache/discomfort. The possibility of parents reporting toothache/discomfort or oral manifestations decreased with younger children. For children aged 2-5 years, the odds ratio (AOR) was 0.18 (95% CI [0.13-0.24], P < 0.001) for toothache and 0.58 (95% CI [0.45-0.74], P < 0.001) for oral manifestations. For children aged 6-8 years, the AOR was 0.57 (95% CI [0.4-0.81], P = 0.002) for toothache. Additionally, parents of younger children less frequently reported reduced OHRQL with AORs of 0.58 (95% CI [0.45-0.73], P < 0.001) for children aged 2-5 years and 0.64 (95% CI [0.49-0.83], P < 0.001) for those aged 6-8 years. Lower parental education increased AORs, with values of 1.575 (95% CI [1.196-2.074], P = 0.001) and 1.505 (95% CI [1.208-1.876], P < 0.001) for younger and 6-8-year-old children, respectively., Conclusion: Results revealed notable prevalence of toothache/discomfort and oral manifestations in children reported by parents, which was related to age and parental education; ultimately leading to reduction in their OHRQL., Competing Interests: The authors declare that they have no competing interests., (© 2024 Sabbagh and Abudawood.)

Objectives: This study characterized toothache-related Portuguese Facebook posts, identifying factors driving misinformation production and user engagement. Methods: Investigators qualitatively analyzed 500 posts published between August 2018 and August 2022, screening on language and theme. Posts were selected using CrowdTangle and assessed for motivation, author profile, content, sentiment, facticity, and format. The interaction metrics (total interactions/overperforming scores) were compared between groups of dichotomized characteristics, including time of publication. Data were evaluated by descriptive analysis, the Mann-Whitney U test, and the path analysis by generalized structural equation modeling. Results: 39.6% of posts ( n = 198) contained misinformation, significantly linked to noncommercial posts with positive sentiment, links, and videos from regular users motivated by financial motivation. Additionally, user engagement was only positively associated with business/health authors' profiles and the time of publication. Conclusion: Toothache-related posts often contain misinformation, shared by regular users in links and video formats, tied to positive sentiments, and generally with financial motivation., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: There is an underuse of pain management strategies in dental care for children, possibly owing to perceived stress and discomfort when treating children, which has also been reported by dental students. The aim of this study was to explore how undergraduate dental students experience and understand pain related to dental treatment in children., Materials and Methods: Interviews were held with 21 Swedish dental students, from 3 dental schools, all in their final 2 years of education. The interviews were transcribed verbatim and analysed according to Grounded Theory., Results: A core category, seeking guidance to avoid pain, was identified and related to 6 conceptual categories. The students used different strategies to manage pain prevention in child dentistry and to become skilled dentists. They described high levels of stress, as well as having high expectations on themselves when treating children. The stress led to a surface learning approach, something the students were not fully aware of., Conclusion: All children should have the right to be ensured optimal pain prevention in dental care. The basis for this is laid during undergraduate education. Thus, pain management in child dentistry is an area in need of special attention in this respect. The academic staff has an important role in supporting their students in their process to gain an identity as professional dentists. To ensure that students incorporate an understanding of the importance of pain prevention when treating children there is a need to create more integration between theory and clinical training in undergraduate education., (© 2024 The Authors. European Journal of Dental Education published by John Wiley & Sons Ltd.)

This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.

Objective: Social media is a platform for sharing views on aspects of life, including oral health. This study aimed to characterize Facebook posts related to toothache information., Methods: Two independent investigators retrieved 500 English-language posts with the highest level of interaction using CrowdTangleTM and analyzed their facticity, motivation, author's profile, content, sentiment, and type of post. Data were analysed descriptively and using Pearson's Chi-square and Mann-Whitney U tests and multiple logistic regression models., Results: Most posts were produced by regular users and were not financially motivated, although commercial posts had significantly higher total interaction among users. While link- or video-containing posts (OR = 1.66) and posts with positive sentiments (OR = 1.53) were associated with users' total interaction, older (OR = 1.81) and link- or video-containing posts (OR = 2.04) were associated with overperforming scores. Misinformation was positively associated with financial motivation (OR = 2.03) and positive sentiments (OR = 3.79)., Conclusion: This study highlights the importance of addressing the spread of misinformation related to oral health on social media and taking steps to ensure that accurate and reliable information is readily available. Toothache-related misinformation was associated with positive sentiments and financial motivation. Links, videos, and positive sentiments awakened greater user engagements with toothache-related posts., (Copyright© 2024 Dennis Barber Ltd.)

Background: Gas expansion in body cavities due to pressure changes at high altitudes can cause barodontalgia. This condition may compromise flight safety., Aim: To investigate relationships among barodontalgia awareness, dental visit frequency, and barodontalgia prevalence in civilian and military pilots operating at high altitudes., Materials and Methods: Civilian pilots from Turkish Airlines and military pilots from the Turkish Air Force, flying between November 2022 and January 2023, participated in this study. A 20-question survey was administered to 750 pilots, covering topics such as barodontalgia awareness, dental visit frequency, breaks after dental treatments, in-flight pain, and pain type and severity. The voluntary surveys were distributed by email., Results: Of the 750 pilots, 526 completed the survey; 61% were aware of barodontalgia, and 81% of pilots who had experienced it reported pain at altitudes <2000 feet. The study revealed higher barodontalgia awareness among pilots who had experienced it, with the highest prevalence among jet pilots. Pilots with barodontalgia also showed a higher frequency of dental visits ( p  < 0.001). Additionally, this group reported more frequent interruption of flight due to dental treatment (IFDT), more problems experienced in flights after treatment (PFAT), and higher instances of bruxism or teeth clenching during flight, suggesting stress and anxiety ( p  < 0.05)., Conclusions: Barodontalgia, a type of pain linked to stress, significantly impacts pilot performance, and can threaten flight safety, even at lower altitudes. Thus, there is a need to educate pilots about stress management, barodontalgia awareness, and the importance of regular dental check-ups., Competing Interests: The authors declare there are no competing interests., (©2024 Topbaş et al.)

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Objective: The aim of this study is to investigate the impact of Coronavirus disease 2019 (COVID-19) on toothache patients through posts on Sina Weibo., Methods: Using Gooseeker, we searched and screened 24,108 posts about toothache on Weibo during the dental clinical closure period of China (February 1, 2020-February 29, 2020), and then divided them into 4 categories (causes of toothache, treatments of toothache, impacts of COVID-19 on toothache treatment, popular science articles of toothache), including 10 subcategories, to analyze the proportion of posts in each category., Results: There were 12,603 postings closely related to toothache. Among them, 87.6% of posts did not indicate a specific cause of pain, and 92.8% of posts did not clearly indicate a specific method of treatment. There were 38.9% of the posts that clearly showed that their dental treatment of toothache was affected by COVID-19, including 10.5% of the posts in which patients were afraid to see the dentists because of COVID-19, and 28.4% of the posts in which patients were unable to see the dentists because the dental clinic was closed. Only 3.5% of all posts were about popular science of toothache., Conclusions: We have studied and analyzed social media data about toothache during the COVID-19 epidemic, so as to provide some insights for government organizations, the media and dentists to better guide the public to pay attention to oral health through social media. Research on social media data can help formulate public health policies., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: When a person feels dental pain, it brings great discomfort and damages the quality of life. Symptomatic apical periodontitis is identified as the most frequent cause that triggers dental pain. Symptomatic apical periodontitis arises from an infection or inflammation in the pulpless root canal structure. According to clinical guidelines, the primary form of therapy for such teeth entails removing the inflammation or infection source through local surgical procedures. Presently, systemic antibiotics are recommended only for cases where there is clear indication of an infectious spread or a systemic involvement. Therefore, this study aims to assess the efficacy and level of safety of using antibiotics to treat adult symptomatic apical periodontitis patients., Methods: The present protocol study will conduct a search on electronic databases to look for randomized controlled trials (RCTs) that have evaluated the effectiveness and safety of antibiotics when used to treat adult patients with symptomatic apical periodontitis. The databases will be search from their beginning to April 2021. The search is not bound by publication status or language restrictions. The following databases will be searched: Web of Science, PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure, and EMBASE. This study will employ ZETOC Conference Proceedings and OpenGrey to identify potential grey literature. Afterwards, 2 independent authors will select the studies, extract data from the studies, and conduct a risk assessment to check for bias. All discrepancies between the authors will be resolute via discussion involving a third independent author. The data synthesis and statistical analysis of this study will be done with the RevMan software (Version: 5.3)., Results: The present protocol report will provide high-quality evidence related to the efficacy and level of safety when using antibiotics to treat mature symptomatic apical periodontitis patients., Conclusion: The outcomes of the present study will update the evidence available for assessing the efficacy and safeness of using antibiotics to treat mature symptomatic apical periodontitis patients., Ethics and Dissemination: This study does not require an ethical approval since individual patient data is not included in any form., Registration Number: DOI 10.17605/OSF.IO/CVP8 M (https://osf.io/cvp8m/)., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study examined the effects of delivery mode on the response to inflammatory pulpal pain and pain-induced changes in cognitive performance in adult rats. Experiments were done on rats born by vaginal or caesarean section (C-section) delivery. Dental pulp was irritated by intradental capsaicin (100 μg) application and then nociceptive scores were recorded for 40 min. Spatial and passive avoidance learning and memory were assessed using the Morris water maze (MWM) and shuttle box tools, respectively. Additionally, in vivo recording of field excitatory postsynaptic potential (fEPSP) in the CA1 of the hippocampus was used to verify synaptic plasticity. Capsaicin produced more significant nociceptive behavior in vaginally delivered rats compared to C-section rats ( P < 0.01). C-section-delivered rats show better performance in both MWM and shuttle box tests. Likewise, C-section rats had greater fEPSP slopes compared to the vaginally delivered group ( P < 0.05). Capsaicin impairs cognitive performance in rats born by each delivery route. However, capsaicin effects were more significant in rats delivered vaginally than by C-section. Overall, C-section-delivered rats show lower sensitivity to capsaicin-evoked pulpal nociception and better cognitive performance than vaginally delivered rats. These effects are in part mediated by reduced neuroinflammation and enhanced neuronal synaptic plasticity following C-section delivery.

The Indonesian family life survey (IFLS) is used for formulating various government policies. Our preliminary study using data from the IFLS showed increase in the prevalence of toothache from 2007 to 2014. Hence, a need to analyse the factors associated with toothache using structural equation modelling (SEM) for identifying the direct and indirect association of factors with toothache was evident. The objective of this study is to analyse the complex relationships between toothache and its associated risk factors. This cross-sectional study was conducted on the data obtained from the IFLS in 2014. The IFLS data pertaining to toothache and its prevalence were analysed using the STATA software, and the multifaceted relationship was analysed using SEM. The prevalence of toothache among Indonesian children was 15.55% (1,959 of 12,595). SEM showed the direct association between toothache and age (p < 0.001) and parent awareness of children's health conditions (p < 0.005) and food consumption frequency (p < 0.001). Parents' education level and residential area showed an indirect association with toothache, mediated by socio-economic status and parent awareness of children's health conditions (p < 0.001). We identified the multifaceted relationship between toothache and the social covariates. Parents' awareness of their children's health conditions mediated several indirect associations, highlighting its importance.

Background: Persistent idiopathic facial pain (PIFP) is the unexplained pain along the territory of the trigeminal nerve, including nonorganic tooth pain called atypical odontalgia (AO). Though PIFP is debilitating to patients' livelihood and well-being, its pathophysiology remains poorly understood. Although neurovascular compression (NVC) of the trigeminal nerve is known to be associated with trigeminal neuralgia (TN), the relationship between NVC and other orofacial pains has not been fully elucidated., Methods: In this study, we investigated the differences in the characteristics of PIFP (primarily AO) patients in the presence or absence of NVC. A retrospective analysis was performed on data from 121 consecutive patients who had been diagnosed with unilateral PIFP according to the criteria of the International Classification of Headache Disorders (ICHD)-3 and underwent magnetic resonance imaging scans of the head., Results: In the group without NVC, characteristic findings were significant for psychiatric morbidity, somatization, and pain disability, when compared with the group with NVC. Furthermore, the group without NVC exhibited significant headache, noncardiac chest pain, shortness of breath, and pain catastrophizing., Conclusions: These results suggest that PIFP patients can be divided into two groups: one consistent with a neuropathic pain phenotype when NVC is present and a functional somatic symptom phenotype when presenting without NVC. Our findings may enable a more precise understanding of pathophysiology of PIFP and lead to better treatment strategies., (© 2020 American Academy of Pain Medicine.)

The aim of this study is to assess the prevalence of odontogenic infection in low-income Brazilian schoolchildren and evaluate its association with the subjective variables of oral health-related quality of life and dental pain. In this cross-sectional study, 230 schoolchildren aged eight to ten years old underwent a clinical oral survey in which the DMFT/dmft and PUFA/pufa indexes were measured. Afterward, children responded individually to the Child Perceptions Questionnaire (CPQ8-10) and self-reports of dental pain were collected. Data were statistically analyzed using MannWhitney or Kruskal-Wallis test with a post-test by Dunn's and Pearson correlation. Of the children evaluated, 42.6% had odontogenic infection and 80% reported experiencing dental pain. Children's age (p = 0.034) and past experience of dental pain (p < 0.002) were associated with odontogenic sepsis, in addition to impairment of their emotional well-being (p = 0.008), social welfare (p = 0.009) and overall impact on quality of life (p = 0.019). Toothache intensity (p < 0.001), frequency (p < 0.001) and duration (p < 0.001) were correlated to the overall impact on children's quality of life. The prevalence of odontogenic infection remains high among low-income Brazilian schoolchildren. Pediatric infection and its related pain induce not only various biological disorders but also impair children's self-perception of quality of life.

We report a case that illustrates how chronic migraine headaches and multiple dental pathologies caused severe and long-standing cranial pain that affected the quality of life of a man for more than 35 years. His case was investigated at several settings including the neurology outpatient clinic of the hospital without a definitive diagnosis or resolution. After investigations, multiple oral pathologies including two occult dental abscesses were diagnosed. Once both affected teeth and associated abscesses were surgically removed, with subsequent antibiotic therapy the headaches resolved., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The aim of this study was to evaluate patients' pain levels during four different debonding procedures. The null hypothesis was that the pain perception of the patients undergoing four different debonding applications was not statistically significant different., Material and Methods: One hundred and twenty orthodontic patients who underwent orthodontic debonding were included in this study. The patients were randomly divided into 4 groups according to technique used in the patients. Debonding groups were as follows: Group 1) Conventional debonding group, Group 2) Medication group (acetaminophen was given 1 hour before debonding), Group 3) Soft bite wax group, and Group 4) Soft acrylic bite wafer group. The patients' levels of anxiety and fear of pain were evaluated before debonding, and Numerical Rating Scale (NRS) was applied to evaluate their pain perception during debonding. Mann-Whitney U and Kruskal-Wallis tests were used to evaluate non-normally distributed data. Categorical data analysis were carried by chi-square and McNemar tests. The significance level was set at p<0.05., Results: Anxiety scores of the patients were not statistically significant between both genders and debonding groups. In the quadrants in which the patients were perceived, the highest pain level was in the left side of the mandible. The teeth in which the highest pain level was perceived were the lower left and upper right lateral incisors. Although there was no statistically significant difference among the pain scores of the patients in each group, quadrant scores of female patients showed significant differences, being the lowest scores in the soft bite wax group., Conclusions: Majority of the patients had no fear of pain before debonding. Pain levels of the patients in the conventional debonding group were not significantly different from those of the other groups, except quadrant scores of females in the soft bite wax group. The null hypothesis was accepted.

Objective: To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain., Methods: Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment., Results: The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly., Conclusion: There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.

Self-medication with analgesics in dental pain management is a common practice as most of these medicines are available over-the-counter (OTC). The study aims to examine the relationship between beliefs about medicines and self-medication with analgesics in dental pain management in Malaysia. This cross-sectional study was conducted among conveniently sampled patients attending dental clinics, located in Kuala Lumpur, Malaysia to assess association between self-medication with analgesics and patient's beliefs about medicines via Beliefs about Medicines Questionnaire. Participants were evaluated for their self-medication practices via 4 items. Further assessment was done via Quantitative Analgesic Questionnaire (QAQ) regarding the analgesics taken. Statistical analyses were performed using SPSS version 24, with 0.05 as level of significance. The prevalence of self-medication with analgesics was 29.4%, with 95.6% of the participants took analgesics when necessary. Participants practising self-medication for dental pain reported more positive beliefs in General-Necessity (13.04 vs. 9.98, p = 0.001) than those not practising self-medication. However, these participants had weaker beliefs in General-Harm (12.00 vs. 10.29, p = 0.006) and General-Overuse (11.38 vs. 10.31, p = 0.032) than those not practising self-medication. Participants beliefs in General-Harm (r = -0.243; p = 0.003) and General-Overuse (r = -0.203; p = 0.012) were negatively correlated with total QAQ point. The study found that individuals who practised self-medication had stronger beliefs about the benefits of medicines and weaker beliefs in viewing medicines as harmful and overused. Findings can guide public education to improve the safety aspects of self-medication with analgesics in dental practice., Competing Interests: The authors have declared that no competing interests exist.

Objective: This study aimed (1) to investigate the differences in clinical characteristics of patients between 2 groups, those who have atypical odontalgia (AO) only and those who have AO with burning mouth syndrome (BMS), and (2) to assess the influence of psychiatric comorbidity factors on patients' experiences., Method: Medical records and psychiatric referral forms of patients visiting the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University between 2013 and 2016 were reviewed. The final sample included 2 groups of 355 patients: those who have AO only (n = 272) and those who have AO with BMS (AO-BMS; n = 83). Clinicodemographic variables (gender, age, comorbid psychiatric disorders, and history of headache or sleep disturbances) and pain variables (duration of illness, pain intensity, and severity of accompanying depression) were collected. Initial pain assessment was done using the Short-Form McGill Pain Questionnaire, and depressive state was determined using the Zung Self-Rating Depression Scale., Results: The average age, female ratio, and sleep disturbance prevalence in the AO-only group were significantly lower than those in AO-BMS group. AO-BMS patients rated overall pain score and present pain intensity significantly higher than did the AO-only patients (P = 0.033 and P = 0.034, respectively), emphasizing sharp (P = 0.049), hot-burning (P = 0.000), and splitting (P = 0.003) characteristics of pain. Patients having comorbid psychiatric disorders had a higher proportion of sleep disturbance in both groups and a higher proportion of depressive state in the AO-only group., Conclusions: AO-BMS patients have different epidemiological characteristics, sleep quality, and pain experiences compared to AO-only patients. The presence of psychiatric comorbidities in both groups may exacerbate sleep quality. We suggest that BMS as a comorbid oral disorder in AO patients contributes to a more intensively painful experience., (© 2017 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.)

Background: Oral health perception has multidimensional nature and can be influenced not only by clinical conditions but also by psychosocial characteristics., Hypothesis: Dental fear could modify the association between dental caries and dental pain and the perception of negative impact., Design: A cross-sectional study was conducted with (n = 1,196) children aged 8-12 years attending public and private schools in Pelotas/Brazil. Children were interviewed and examined. Oral health perception was assessed using a global oral health impact item. Crude and adjusted multivariable regression models were built and effect modification of dental fear in the association between clinical indicators and perception of impact was tested., Results: Compared with children without fear and caries, children with fear and dental caries presented a 1.45 higher prevalence of negative impact (95% CI: 1.18-1.79) while those without fear and with dental caries had a 1.31 higher prevalence (95% CI: 1.11-1.54) after adjustments. Also, the prevalence of negative perception was higher for children with fear and dental pain (PR: 2.95; 95% CI: 1.59-2.39) and for children without fear and with pain (PR: 1.53; 95% CI: 1.29-1.80), compared to children without fear and pain., Conclusion: The presence of fear increased the effect of pain and caries on children's oral health perception., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To investigate the impact of dental pain on daily performances among five-year-old Brazilian children., Methods: The study used data of 7,280 five-year-old children participating in the 2010 Brazilian Oral Health Survey (SBBrasil 2010 Project). Children were clinically examined and their parents or carers were interviewed at their homes. The outcome was the prevalence of the oral impacts on daily performance, and the explanatory variable was dental pain in the last six months. Other independent variables were children's gender and skin color/race, family income, household overcrowding, and caries experience (dmft). Rao-Scott test and Poisson regression for complex samples were carried out., Results: The prevalence of impacts on daily performances was 26.1% (95%CI 22.3-30.2). Significant associations were found between the outcome and pain, caries experience, and sociodemographic variables. After adjusting for the independent variables, only pain and caries remained significant. Impacts on daily performances were more frequent among children with pain (PR = 1.14, 95%CI 1.06-1.23) compared to those without pain. Children with low dmft (PR = 1.90, 95%CI 1.39-2.60) and those with high dmft (PR = 3.53, 95%CI 2.78-4.49) had a higher prevalence of impact than those with no caries experience., Conclusions: Dental pain and caries had strong negative impacts on the five-year-old children's daily performances regardless of their demographic and socioeconomic characteristics.

Background: Dental treatment still remains as one of the most anxious visits despite awareness between dentists and patients in building trusting relationships. The fear of dental treatment determines the frequency of treatment availed with long-term implications in oral health maintenance., Aim: This study aims to estimate prevalence, extent, and factors influencing dental anxiety in a sample of the adult population visiting a private dental hospital in Chennai, India., Materials and Methods: The study sample included 300 consecutive outpatients visiting a private dental hospital in Chennai. Any patient aged 18 and above was considered for the study. A structured custom-made questionnaire composed of ten questions was designed to assess the anxiety levels of dental patients. The level of the patient's anxiety was assessed taking into account various factors that could influence their mental state. This included their age, gender, educational qualification, number/frequency of their dental visits, reason for their visit, past dental experiences, and nature of the dental procedure planned. Enquiries about the related time of anxiety manifestations as well as their preferred anxiety reducing protocols were done as part of the study., Statistics: The data analysis was performed using SPSS Version 11.5. Analysis initially was performed with Chi-square test for frequency and reason of visit, with the independent samples t-test used for assessing mean score differences along with Pearson's correlation coefficient., Results: The study revealed that dental anxiety has a wide prevalence rate encompassing both genders. Distinctive predominance among females (65.2%) and professionals (66.9%) exhibiting a greater degree of anxiety was identified. Pain and extraction have been cited as duress and anxiety inciting procedures (72.6%)., Conclusion: This survey has revealed that age, gender, level of education, and procedure along with visit frequency has a direct effect on the patient's state of mind and anxiety., Competing Interests: There are no conflicts of interest.

The aim of the present study was to evaluate the influence of the severity/activity of dental caries as well as sense of coherence (SOC) and locus of control (LOC) on oral health-related quality of life (OHRQoL) among 5-year-old children. A cross-sectional study was conducted involving 769 children at schools in a city in northeast Brazil. Parents/caregivers answered validated questionnaires addressing SOC and LOC. The children and parents/caregivers answered their respective modules of the Brazilian version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). Data were also collected on sociodemographic characteristics, visits to the dentist, and the occurrence of toothache. Clinical examinations were performed by 2 trained examiners. A directed acyclic graph was used to select covariates for statistical adjustment, and logistic regression for complex samples was used to test associations between the dependent and independent variables (α = 5%). For parents/caregivers, the variables associated with a negative impact on OHRQoL were the occurrence of toothache (odds ratio, OR: 10.53; 95% confidence interval, CI: 6.34-17.51; p < 0.001) and a low SOC (OR: 2.17; 95% CI: 1.37-3.43; p = 0.001). According to the children's perceptions, the following variables were associated with a negative impact on OHRQoL: toothache (OR: 3.58; 95% CI: 2.30-5.55; p < 0.001), caries activity (OR: 1.97; 95% CI: 1.07-3.62; p = 0.028), and traumatic dental injury (OR: 1.71; 95% CI: 1.15-2.53; p = 0.007). Among parents/caregivers, a low SOC led to poorer OHRQoL. For the children, however, neither psychological aspect affected OHRQoL. In the perception of both the parents/caregivers and children, toothache was the oral condition that exerted a negative impact on OHRQoL., (© 2018 S. Karger AG, Basel.)

Objectives: This study had two objectives: (i) to explore and model domains describing the real-time impact of third molars (TMs) on quality of life (QoL); and (ii) to assess the percentage coverage, in some generic health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) instruments, of the TM QoL domains identified in this study., Methodology: A global cross-sectional sample of tweets containing 'wisdom tooth' over a 1-week period retrieved 3,537 tweets. After random quota sampling, classification and filtering, only 843 tweets were included in the thematic analysis. A TM QoL model was constructed based on the associations of the identified domains. Domains for the selected generic HRQoL and OHRQoL instruments were plotted against the domains identified in the study to calculate the percentage coverage for each., Results: The QoL domains identified were pain (n = 348, 41%), mood (n = 173, 20%), anxiety and fear (n = 54, 7%), enjoying food (n = 41, 4%), coping (n = 37, 4%), daily activities (n = 34, 4%), sleep (n = 24, 2%), social life (n = 19, 2%), physical health (n = 17, 2%), ability to think (n = 9, 1%), self-care (n = 8, 1%) and sporting & recreation (n = 2, <1%). The Assessment Quality of Life instrument (AQoL-8D) covers 87% of the TM QoL domains, while the rest of the HRQoL and OHRQoL instruments cover 33-60%., Conclusion: This study shows how Twitter can be used to obtain real-time QoL data, which might be used to model how TMs impact on QoL. The TM QoL domains identified in the study were generally under-represented among the generic OHRQoL instruments assessed while, the HRQoL AQoL-8D covered most of the TM QoL domains. The QoL domains identified in the study might be used to develop a new OHRQoL measure for TMs., (© 2017 FDI World Dental Federation.)

Background: Oral disorders may negatively affect the quality of life (QoL) of adolescents. To investigate how social vulnerability and oral-health status factors affect QoL in 15-19 years olds who participated in the "SB São Paulo 2015" state survey., Methods: The relationship of several independent variables, namely Paulista Social Vulnerability Index (PSVI) score, gender, skin color, family income, age, untreated caries, tooth loss [determined by the Decayed, Missing, Filled-Teeth (DMF-T) index], toothache, periodontal condition [determined by the Community Periodontal Index (CPI)], and malocclusion (maxillary overjet, cross bite, or open bite) affect daily life, measured by the Oral Impacts on Daily Performance (OIDP) instrument. Logistic regression analyses were carried out based on a hierarchical model., Results: The final sample consisted of 5402 adolescents. The prevalence of at least one negative impact of oral health on QoL was 37.3%. After adjustment, demographic factors that were found to influence this impact significantly (p < 0.01) were female gender [odds ratio (OR) 1.78, 95% confidence interval (CI) = 1.59-2.0], non-white skin color (OR 1.66, 95% CI = 1.47-1.88), and a low family income (OR 1.28, 95% CI = 1.28-1.29). Additionally, oral conditions associated with oral health impact on QoL included the presence of at least one untreated tooth decay lesion (OR 1.42, 95% CI = 1.25-1.61), loss of at least one tooth (OR 1.49; 95% CI = 1.25-1.78), toothache (OR 4.87, 95% CI = 4.25-5.59), bleeding on probing (OR 1.45, 95% CI = 1.25-1.68), and severe maxillary overjet (OR 1.68, 95% CI = 1.15-2.45)., Conclusion: Social vulnerability (PSVI score) was not associated with the OIDP score, but oral health conditions and socio-demographic variables, including gender, skin color, and income, were found to affect adolescents' daily activities. Strategies that consider the perceptions of this segment of the population should be implemented to strengthen their autonomy and totality of care.

The aim of this study was to evaluate the factors associated with high dental fear among Brazilian university students, especially the effect of a negative dental experience in childhood. This paired case-control study was conducted at the Universidade Federal de Minas Gerais in Brazil. Dental, psychology and mathematics students were divided into cases (high fear) and controls (low fear), defined by cluster analysis, according to the items of the Dental Fear Survey (DFS). Cases (n = 65) and controls (n = 260) participants were paired (1:4) by gender, undergraduate course and social vulnerability. The students self-reported the DFS and a questionnaire about oral health. Descriptive analysis, bivariate and multivariate conditional logistic regression were used as statistical tests with a significance level of 5%. The multivariate model showed that students who reported negative dental experiences in childhood (OR = 2·97; 95% CI: 1·44-6·14), toothache in the last 12 months (OR = 11·31; 95% CI: 4·79-26·68), discomfort during dental treatment (OR = 5·36; 95% CI: 2·53-11·36) and poor self-evaluation of oral health (OR = 3·82; 95% CI: 1·61-8·11) were more likely to have high dental fear. Negative dental experiences in childhood influence dental fear in adulthood. Oral health education should be addressed among university students to reduce dental fear., (© 2017 John Wiley & Sons Ltd.)

Early childhood caries (ECC) represents a major health and economic problem worldwide. Its consequences such as early pain experience may affect the immediate and long-term quality of life of the child. In very young and uncooperative children the therapy of ECC is often viable only under general anesthesia. After treatment these affected children have a higher risk for future caries either soon thereafter, or later in life. The aim of the present study was to determine risk indicators and their correlation among children with high caries prevalence and high treatment needs, in order to facilitate the development of targeted prophylaxis programs that would reduce future occurrences of ECC or at least positively influence the outcome. For this purpose, between 2010 and 2014 the parents of these children (n=82) were interviewed in the University Children’s Hospital in Basel (UKBB) prior to the children's treatment under general anesthesia. The standardized questionnaire included questions regarding the age of the child, the mother's country of origin, the oral hygiene, and the drinking habits of the child. The analysis shows that the high mean dmft/ dmfs values (dmft: 9.49 and dmfs: 26.35) correlated significantly with the geographic origin of the mother (p<0.05), the beginning of tooth brushing (p<0.05), lack of supervised tooth brushing (p<0.01), and nighttime consumption of sugar-sweetened beverages (p<0.05). In contrast, the duration of breastfeeding and prolonged use of a baby bottle (about 2.5 years) did not have a clear impact on high caries prevalence.

Objectives: To explore the effects of menstrual cycle on orthodontic pain following initial archwire engagement., Methods: Female participants with regular menstrual cycles were recruited and assigned into follicular group or luteal group. Demographical and baseline variables were collected: age, education, menstrual duration, anxiety, oral health impact profile-14 (OHIP-14), and index of complexity outcome and need (ICON). Following initial archwire engagement, orthodontic pain was determined through visual analogue scale (VAS) on 1st day, 2nd day, and 3rd day. Demographical and baseline variables were compared between the two groups. Two-way repeated-measures anova was used to examine the effects of menstrual phase, time, and their interactions on orthodontic pain. Multivariate linear regression was employed to examine the independent effect of each variable on orthodontic pain., Results: Finally, 37 and 39 were assigned to the follicular and luteal groups, respectively, with balanced demographical and baseline data. Orthodontic pain was significantly affected by menstrual phase and time (both P < 0.001), but there was no interaction (P > 0.05). Moreover, orthodontic pain was independently predicted by menstrual phase, OHIP, education level, and anxiety (all P < 0.05)., Conclusion: We suggest that practitioners arrange female patients to receive initial archwire engagement during their follicular phases to relieve orthodontic pain., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The primary intention of this study was to determine whether salivary alpha-amylase (sAA) factors or the Dental Anxiety Scale (DAS) was a better predictor of dental extraction pain. This study followed a cross-sectional design and included a convenience sample (n = 23) recruited from an outpatient oral surgery clinic. While waiting for their scheduled appointments, consenting patients completed both basic demographic/medical history questionnaires and Corah's DAS as well as submitted sublingual saliva samples. After their extractions, patients marked visual analog scales (VAS) to indicate the intensity of their intraoperative discomfort. Results of this study confirm that there is a relationship between a patient's dental anxiety and intraoperative extraction pain (r[21] = .47, P = .02). This study did not find that preoperative sAA factors (concentration and output rate) were related to either VAS extraction pain or DAS score. A strong positive relationship was observed between the concentration of sAA and the rate of sAA output (r[21] = .81, P < .001). Based on the results of our study, we conclude that dental anxiety has a moderate but significant correlation with intraoperative dental pain. Factors of sAA do not appear to be predictive of this experience. Therefore, simply assessing an anxious patient may be the best indication of that patient's extraction pain.

Purpose: To evaluate sex-related differences in dental pain perception in children., Methods: Fifty-two children who received a dental procedure with local anesthesia were selected to participate. Pain perception levels were assessed with the Wong-Baker FACES Pain Rating Scale. Twenty-four and 48 hours following the procedure, the parents were contacted by phone for a verbal survey to assess their child's postoperative pain. Age, type of dental procedure, and behavior were also evaluated as covariables. The data were analyzed using Epi Info 7.0 software and GraphPad Prism 5.0 software. Chi-square or t test were performed with a significance level of five percent., Results: The mean age of the children was 6.7 (±2.4 [SD]) years. Twenty-seven (51.9 percent) were boys. None of the parents reported pain at 48 hours. None of the covariables were differentially distributed among the sexes (P>0.05). There was no statistical difference between sex and pain perception immediately after the procedure (P=0.64) and after 24 hours (P=0.41). However, when the analysis was performed according to age group, a borderline association was found. Female preschoolers reported more pain immediately after the procedure than male preschoolers (P=0.06)., Conclusion: There was no statistical difference in pain perception between sexes.

Objective The aim of the study was to investigate oral health-related knowledge, attitudes and habits and their relationship to perceived oral symptoms among 12-year-olds and differences between boys and girls. Material and methods The study population consisted of children (n = 588) in 15 randomly selected elementary schools in Turku, Finland. Associations between oral health-related habits, knowledge and attitudes with perceived oral symptoms and gender differences were evaluated with χ(2)-test, Mann-Whitney U-test and logistic regression analysis. Results Oral health promoting habits but not knowledge or attitudes associated significantly with absence of oral symptoms. Girls reported a higher percentage of several health promotional habits than boys. Girls reported more frequently gingival bleeding and less frequently dental calculus than boys did. The most common oral symptom was gingival bleeding. Conclusions The present findings suggest some gender-related differences in oral health habits, attitudes, as well as perceived oral symptoms in 12-year-olds. There seems, however, not to be gender differences in relation to knowledge or the association of health habits with perceived oral symptoms. It is important to maintain health promotion at schools and additional efforts should be aimed at translating knowledge into action.

Objectives In Finland, a dental subsidization reform, implemented in 2001-2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform. Materials and methods Three identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (n = 2157), in 2004 (n = 1814) and in 2007 (n = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities. Results The proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care. Conclusions It seems that the income-related inequalities in perceived oral health remained or even widened after the reform.

Objective: To observe the clinical efficacy of transcutanclus electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache and oral dysfunction., Methods: A total of 85 patients of malocclusions in the preliminary diagnosis were randomly divided into a control group (20 cases), a psychological intervention group (22 cases), a medication group (20 cases) and a TEAS group (23 cases). Orthodontics treatment was given in all the groups. Patients in the control group received no further treatment; patients in the psychological intervention group received comprehensive psychological intervention, including cognitive education and music therapy; patients in the medication group received oral administration of ibuprofen; patients in the TEAS group received TEAS at Juliao (ST 3), Jiachengjiang (Extra) and auricular point Ya (LO1). The treatment was given twice a day, one in morning and one at night, for 7 days. The pain scores of orthodontic toothache and changes of oral dysfunction were observed in all groups., Results: (1) At 5 time points from the 12th hour to the 4th day, the scores of spontaneous pain in TEAS group were lower than those in the control group (all P < 0.01); during the time points, the scores in TEAS group were lower than those in the psychological intervention group (P < 0.05, P < 0.01), which were similar to those in the medication group (all P > 0.05). (2) During the peak cycle of spontaneous toothache, the scores of irritation pain in TEAS group were significantly lower than those in the control group (all P < O.01), regardless of time-point statistics or general statistics; the scores of irritation pain in the TEAS group were also significantly lower than those in the psychological intervention group (all P < 0.01), which were similar to those in the medication group (all P > 0. 05). (3) Compared with control group, the grading of talking disorder in the remaining groups did not change significantly (P > 0.05). (4) Compared with control group, the grading of moderate-severe eating disorder in TEAS group was significantly reduced (P < O.05), which was not different from that in the medication group (P > 0.05). The differences of the grading of moderate-severe eating disorder were not significantly different between the psychological intervention group and control group (P > 0.05). (5) There were 3 cases of digestive system adverse reactions in the medication group., Conclusion: TEAS can efficiently prevent orthodontic toothache and oral dysfunction, which is superior to psychological intervention and similar to medication. In addition, it can avoid possible side-effect of medication.

Unlabelled: Evidence of the link between sense of coherence (SOC), dental caries and dental pain is scarce., Objective: To explore the relationship of SOC and dental caries with dental pain prevalence in low-social status women., Basic Research Design: A cross-sectional study., Participants: A convenience sample of 190 women whose children attended a selected school in São João de Meriti, Brazil., Method: Socioeconomic, demographic and oral health behaviour data were collected through interviews. SOC was assessed using the Antonovsky scale. Dental caries was evaluated through oral examinations. Multivariate logistic regression models were used to obtain Odds Ratio (OR) and 95% Confidence Intervals (CI)., Main Outcome Variable: Dental pain in the past 6 months., Results: Dental pain prevalence was 26% (95% CI 20, 33). DMFT and decayed teeth means were 14.3 (SD 7.2) and 2.4 (SD 2.6), respectively. The odds of having dental pain was higher for women with moderate dental caries and low SOC (OR 3.3, 95%CI 1.1, 9.3) and women with high caries and low SOC (OR 4.0, 95% CI 1.7, 9.5) compared with women with low caries and high SOC., Conclusions: Dental caries and lower SOC were factors associated with dental pain. SOC appeared to buffer the effect of dental caries on dental pain in women from low-socioeconomic status.

Objective: To assess the parents' perception of the oral health-related quality of life (OHRQOL) in children with Cerebral Palsy (CP) and compare it with normally developing children., Study Design: 63 children with CP were recruited from 8 disability centers, and 99 healthy controls were recruited from 5 elementary schools. The ages of the children in both groups were from 6-12 years. The Franciscan Hospital for Children Oral Health-Related Quality of Life (FHC-OHRQOL) was used to measure the OHRQOL and an oral examination was conducted in the schools/centers of the children to assess the teeth, gingival health, and oral hygiene., Results: The FHC-OHRQOL showed a significant difference in 3 out of 4 sections indicating lower OHRQOL in the CP group. The examination showed no significant difference in the dental and gingival health and in the level of oral hygiene., Conclusion: The OHRQOL of children with CP is significantly lower than that of normally developing children although the oral health status of children with CP is not significantly different from that of normally developing children.

The purpose of this study was to evaluate the relationships between the prevalence of depression and dental pain using a well characterised, nationally representative, population-based study. This study analysed data from the 2012 Korea National Health and Nutrition Examination Survey (n = 4886). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Depression was defined as the participant having been diagnosed as depression during the previous year. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI), controlling for a range of covariates. Results demonstrated that participants included in 'root canal treatment is necessary' showed higher prevalence of self-reported dental pain; in particular, participants with depression presented more dental pain than those without depression. After adjusting for sociodemographic factors, self-reported dental pain increased in participants with depression. The AOR (95% CI) for having self-reported dental pain was 1·58 (1·08-2·33) in dentists' diagnosis of no dental pain/depression group, 1·62 (1·32-1·98) in dentists' diagnosis of dental pain/no depression group and 2·84 (1·10-7·37) in dentists' diagnosis of dental pain/depression group. It was concluded that depression was associated with dental pain after adjustment for potential confounders in Korean adults. Thus, dentists should consider the possible presence of psychopathology when treating patients with dental pain., (© 2015 John Wiley & Sons Ltd.)

Introduction: The purpose of this study was to assess the agreement between Brazilian adolescents and their parents or caregivers regarding the adolescents' oral health-related quality of life during orthodontic treatment., Methods: The sample consisted of 102 adolescent-parent/caregiver pairs. Adolescents answered the short form of the child perceptions questionnaire, and the parents or caregivers answered the parental-caregiver perceptions questionnaire. These questionnaires have 14 items in common organized across 4 subscales: oral symptoms, functional limitations, emotional well-being, and social well-being. Agreement on the overall score and the subscales was determined using comparison and correlation analysis. The former was performed through comparison of the mean directional and absolute differences. The latter was analyzed using the intraclass correlation coefficient., Results: The mean directional difference was significant for the oral symptoms subscale, with parents' reports lower than adolescents' reports (P = 0.012). However, it was not significant for the other 3 subscales and the overall score (P >0.05). The mean absolute difference for the overall score was 5.15, representing 9.2% of the maximum possible score. The intraclass correlation coefficient was 0.66, indicating substantial agreement., Conclusions: There was agreement between adolescents and their parents or caregivers in rating adolescents' oral health-related quality of life during orthodontic treatment., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

There are no longitudinal studies that assess the impact of traumatic dental injury (TDI) on the oral health-related quality of life (OHRQoL) of preschool children. To investigate the impact of TDI on OHRQoL among preschool children, a population-based case-control study was carried out with a representative sample of 335 children, 3-5 years of age, enrolled at public and private preschools in the city of Campina Grande, Brazil. The case group and the control group were matched for age, gender, type of preschool and monthly household income at a ratio of 1:4 (67 cases and 286 controls). Impact on the OHRQoL of children was assessed through administration of the Early Childhood Oral Health Impact Scale (ECOHIS). The occurrence of TDI was determined through clinical examinations performed by three calibrated dentists. Data analysis involved descriptive statistics, McNemar's test, the chi-square test with linear trend and conditional logistic regression analysis [P≤0.05; 95% confidence interval (95% CI)]. The most frequent responses were 'felt pain' (19.4%) and 'difficulty eating' (16.4%). The prevalence of TDI was 37.3% in the case group and 33.9% in the control group. No statistically significant differences were found between case and control groups regarding the presence of TDI (odds ratio=1.16; 95% CI: 0.66-2.02). TDI had no impact on the quality of life of preschool children., (© 2015 FDI World Dental Federation.)

Background: Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents' quality of life., Objective: To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London., Method: Overall, 325 residents from nine nursing homes were clinically examined and 180 residents were interviewed to assess their oral symptoms and their OHRQoL using the OIDP measure. Managers and carers working in the homes were also interviewed., Results: Almost two thirds of the sample were dentate (64.5%). 61.3% of dentate and 50.9% of edentate residents reported problems such as dry mouth, sore cracked lips, broken teeth and toothache and ill-fitting dentures. Oral health impacted considerably upon resident's OHRQoL; 20.2% of dentate and 30.9% of edentate reported at least one oral impact in the past 6 months. Sensitive teeth, toothache, bleeding gums, dry mouth and loose natural teeth among the dentate and loose or ill-fitting dentures among the edentate were strongly associated with higher prevalence of oral impacts even after adjusting for demographic and socio-economic factors, and for the number of teeth (dentate only)., Conclusion: The burden of oral conditions was considerable. Oral symptoms were very common and were strongly associated with residents' worse OHRQoL. Health promotion programmes are important to help residents maintain an acceptable level of oral health and function.

Aims: To investigate the association in adolescents between toothache and sense of coherence (SOC), a psychosocial construct defined as a global orientation to life., Methods: A school-based cross-sectional study was carried out in 36 municipalities comprising up to 50,000 residents in southern Brazil. The target population was adolescents from 15 to 19 years of age. The sample consisted of 1,150 adolescents chosen by systematic sampling; the final adjusted analysis by Poisson regression included 1,065 individuals. Data were collected using a questionnaire, SOC scale, and the Decayed Missing Filled Teeth (DMFT) index., Results: Of the adolescents in the sample, 29.8% reported experiencing toothache in the previous 6 months. The prevalence of dental caries was 31.0%, and the DMFT index was 3.22. SOC was a significant protective factor for toothache; the prevalence ratio was 0.65 (95% confidence interval [CI] = 0.55-0.75). Girls presented 39% more toothaches than boys (95% CI = 1.15-1.68). Individuals who saw the dentist for reasons other than reviews or check-ups had a toothache prevalence that was 85% higher than their counterparts (95% CI = 1.47-2.34). Adolescents with tooth decay reported up to two times more toothache than those without tooth decay., Conclusion: The results of this study showed that a strong SOC protected against toothache. A health-promotion approach may lead to better patterns of oral health.

This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL., (© 2015 Eur J Oral Sci.)

Orexin 1 receptor signaling plays a significant role in pain as well as learning and memory processes. This study was conducted to assess the changes in orexin 1 receptor expression levels in hippocampus following learning and memory impairment induced by tooth inflammatory pulpal pain. Adult male Wistar rats received intradental injection of 100 µg capsaicin to induce pulpal pain. After recording the pain scores, spatial learning and memory were assessed using Morris Water Maze test. The hippocampal levels of orexin 1 receptor mRNA and protein were determined by semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) and immunoblotting respectively. The data showed that capsaicin-induced tooth inflammatory pulpal pain was correlated with learning and memory impairment. Intra-hippocampal injection of orexin A inhibited pain-induced learning and memory impairment. However, orexin 1 receptor antagonist, SB-334867, had no effect on learning and memory impairment. Moreover, capsaicin-induced pain significantly decreased hippocampal orexin 1 receptor mRNA and protein levels. Meanwhile, reversed changes took place in the ibuprofen-pretreated group (p < 0.05). It seems that decrease in orexin 1 receptor density and signaling could be involved in tooth pain-induced learning and memory impairment., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aims: To assess reports of dental pain in a school-based sample of children in South Brazil and test its association with socioeconomic, demographic, psychosocial, and clinical variables. Also, the consequences of dental pain on oral health perception and its impact on daily life were investigated., Methods: A two-stage cluster procedure was used to select 1,199 children in 20 public and private schools in Pelotas, Brazil. Children were interviewed to obtain selfreports of dental pain. They were also asked about perception of their oral health and dental fear. Mothers answered a questionnaire on socioeconomic characteristics. A clinical oral examination was conducted to assess dental caries, malocclusion, and dental trauma. Multivariate Poisson regression analysis was used to investigate factors associated with dental pain in the previous 6 months and its effect on oral health perception., Results: The prevalence of dental pain was 35.7% (95% confidence interval [CI] 33.0-38.5) in the previous 6 months. A higher prevalence of dental pain was observed for children from lower-income families (prevalence ratio [PR] 1.39; 95% CI 1.10-1.76), for girls (PR 1.24; 95% CI 1.06-1.46), for those living in overcrowded houses (PR 1.23; 95% CI 1.01-1.49), for those who reported dental fear (PR 1.19; 95% CI 1.00-1.42), and for those with caries experience (PR 1.57; 95% CI 1.34- 1.84), after adjustments. Dental pain presence influenced oral health perception (PR 2.56; 95% CI 1.55-3.29) and impacted the children's daily life (PR 1.89; 95% CI 1.64-2.17)., Conclusion: A high percentage of schoolchildren suffered from dental pain, which was influenced by demographic, socioeconomic, psychosocial, and clinical characteristics, causing a negative impact on oral health perception.

The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). Intra-class correlation coefficients and kappa values for interexaminer and test-retest reliability were computed. Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region., (© 2014 John Wiley & Sons Ltd.)

Objective: To evaluate the self-reported oral health attitudes and behaviour among the clinical dental students and to compare the influence of clinical experience on oral health attitudes and behaviour among dental students at the different clinical years in the University of Benin using the modified Hiroshima University Dental Behavior Inventory (HU-DBI)., Methods: The study involved 156 clinical dental students from the University of Benin, Benin City, Nigeria. Demographic data were obtained for age and gender from 4th, 5th and 6th year clinical students. A modified English version of HU-DBI survey consisted of 22 items with dichotomous responses (yes-no) was used in this study. Descriptive statistics was performed for age and clinical level of education. Chi-square text was applied to the percentages of responses. Tamhane's T2 post-hoc multiple comparison for pairwise comparison of the three clinical levels of students was done to determine the differences. Test significance was set at P < 0.05., Results: The response rate was 87.2%. The mean age of the respondents was 26.2 + 2.4 years. A total of 62 (39.7%) respondents were females and 94 (60.3%) males. Statistically significant differences were found among the various clinical levels of dental students for previous visit to the dentist office, visiting the dentist unless there is toothache, brushing the teeth twice daily and the prevention of gum disease with tooth brushing alone., Conclusion: There was improvement in the dental students' oral health behaviour and attitudes with increasing level of dental education.

Objectives: We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship., Methods: Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator., Results: Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (β coefficient=0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator., Conclusions: The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache., (© 2014 American Association of Public Health Dentistry.)

The aim of the present study was to assess the impact of malocclusion on oral health-related quality of life (OHRQoL) among preschool children and their families. This study involved 732 preschoolers. Parents/caregivers filled out the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing sociodemographic data. Overbite, overjet, and crossbite were recorded during the clinical examination. Bivariate and multiple Poisson regression analyses were performed and prevalence ratio (PR) were calculated (α = 5%). The prevalence of negative impact from malocclusion on OHRQoL was 27.6% among the children and 22.3% among the families. Mother's schooling (PR = 1.37; 95% CI: 1.10-1.70), parent's/caregiver's assessment of child's oral health (PR = 2.07; 95% CI: 1.60-2.58), history of toothache (PR = 3.84; 95% CI: 2.34-6.30), and visits to the dentist (PR = 0.59; 95% CI: 0.37-0.94) remained significantly associated with OHRQoL in the final model for the children, whereas parent's/caregiver's assessment of child's oral health (PR = 2.32; 95% CI: 1.71-3.14) and history of toothache (PR = 2.28; 95% CI: 1.69-3.09) remained significantly associated with OHRQoL for the families. Malocclusion was not associated with a negative impact on OHRQoL. In contrast, parents'/caregivers' perceptions regarding the oral health of their children and a history of toothache were predictors of a negative impact on the OHRQoL., (© 2014 Eur J Oral Sci.)