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Aim: Traumatic dental injuries (TDIs) among children and adolescents have been acknowledged as of public health concern worldwide. The aim of the study was to assess the relationship between contextual and individual characteristics and TDIs in 12‐year‐old schoolchildren. Materials and Methods: A cohort study was conducted with 355 schoolchildren living in deprived communities in the city of Manaus, Brazil. Contextual factors (place of residence and socio‐economic indicators) and individual characteristics, including sex, family income, parents/guardians years of schooling, overjet and open bite (Dental Aesthetic Index), self‐esteem (Rosenberg Self‐Esteem Scale), sense of coherence (Sense of Coherence Scale), oral health beliefs, social support (Social Support Appraisals) were assessed at baseline. TDIs were measured at baseline and at 2‐year follow‐up using the O'Brien Index. Data were analysed through confirmatory factor analysis and structural equation modeling. Results: The baseline prevalence of TDIs was 17.6% and the incidence of TDIs at 2‐year follow‐up was 26.8%. Better psychosocial status had a direct protective effect on the incidence of TDIs (β = −.184). Better contextual characteristics (β = −.135) and greater overjet (β = −.203) were directly associated with poor psychosocial status. Higher schooling of parents/guardians directly predicted better psychosocial status (β =.154). Psychosocial status mediated the relationship of greater overjet (β =.036), contextual factors (β =.024) and parental/guardian schooling (β = −.027) with TDIs. Conclusions: Contextual factors and individual characteristics predicted TDIs. Psychosocial status was a relevant individual attribute in the causal network of TDIs, due to the direct effect on the incidence of TDIs as well as a mediator on the influence of contextual factors, overjet and parents/guardians schooling on the incidence of TDIs. [ABSTRACT FROM AUTHOR]

Background: To examine the role of dental pain, sense of coherence (SOC) and social support on the relationship between dental caries and oral health-related quality of life (OHRQoL) in children aged 12 years. Methods: A cross-sectional study involving 400 schoolchildren selected from public schools in a socioeconomically disadvantaged region in the city of Manaus, Brazil was carried out. The predictors of OHRQoL were selected according to the Wilson and Cleary theoretical model, including number of decayed teeth and its clinical consequence (component D of the DMFT index and PUFA/pufa index), dental pain (symptom status), and SOC and social support (individual and environmental characteristics). Statistical analysis was conducted through structural equation modelling and multivariable negative binomial regression. The significance level established for all analyses was 5%. Results: Number of dental caries was indirectly linked with OHRQoL (β = 0.19, 95% CI 0.11/0.29) through dental pain, SOC and social support. Clinical consequences of untreated caries directly predicted poor OHRQoL (β = 0.12, 95% CI 0.01/0.23). Dental pain, SOC and social support did not moderate the effect of dental caries measures on OHRQoL. Conclusion: Our findings suggest the role of dental pain, SOC and social support as mediator factors on the link between dental caries and OHRQoL. Tackling dental caries along with psychosocial factors may attenuated the impact of oral health on OHRQoL in children. [ABSTRACT FROM AUTHOR]

Objective. Evaluate the spatial distribution of health services in primary care according to the characteristics of social vulnerability in the city of Manaus, Amazonas, Brazil. Methods. Selection of the census tracts that compose each human development unit was performed, creating a geographic database. Indicators were selected for each territorial unit and two constructs of social vulnerability were predicted using principal component analysis: one crude and other weighted by the population size. Four maps were created showing quintiles distribution of the constructs, with an overlap of spatial distribution of the coverage area of the family health and oral health teams. The descriptive analyzes of each map were performed. Results. 62.1% of the territories of the existing family health teams and 74.2% of the oral health teams were located in areas of greater social vulnerability, represented by the two worst construct quintiles. However, when considering the resident population, an increase of the teams coverage in areas of lower weighted vulnerability was observed. Conclusion. Despite low coverage the health teams were concentrated on areas of greater social vulnerability. Considering the population distribution of the municipality would allow an even more equitable distribution of health teams regarding organizational accessibility once it is expected that an equitable geographical distribution minimize barriers to access and improve the health conditions and quality of life of the population. The differences in levels of social vulnerability must be considered when making health policies, especially in places where the healthcare territorial coverage is low. [ABSTRACT FROM AUTHOR]