Cristiane Bendo | UFMG - The Federal University of Minas Gerais (original) (raw)

Papers by Cristiane Bendo

Research paper thumbnail of Oral health-related quality of life and traumatic dental injuries in Brazilian adolescents

Community Dentistry and Oral Epidemiology, 2013

To evaluate the impact of traumatic dental injuries (TDI) on oral health-related quality of life ... more To evaluate the impact of traumatic dental injuries (TDI) on oral health-related quality of life (OHRQoL) among Brazilian adolescents. A population-based case-control study was carried out, which was nested to a cross-sectional study with a sample of 1215 adolescents aged 11-14 years from Belo Horizonte, Brazil. OHRQoL was measured using the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14 )--Impact Short Form (ISF:16). Two-step cluster analysis was performed to define cases and controls based on CPQ11-14--ISF:16 scores. This method considers the pattern of responses for each item separately and how important each item is to the formation of clusters. The case group included those adolescents who presented higher negative impact on OHRQoL (n=405), while the control group included those with lower negative impact (n=810). Two controls for each case were individually matched from the same school and gender. The main independent variable was TDI, diagnosed by the Andreasen's classification. Untreated dental caries, malocclusion, and age were confounding variables. Conditional logistic regression analysis was performed with the significance level set at 5%. A multiple conditional logistic regression model demonstrates that adolescents diagnosed with fracture involving dentin and/or pulp had a 2.40-fold greater chance of presenting high negative impact on QHRQoL [95% CI=1.26-4.58; P=0.008] than those without evidence of fractures. Enamel fracture only [P=0.065] and restored fractures [P=0.072] were not statistically associated with OHRQoL. Adolescents with more severe untreated TDI, such as fractures involving dentin and/or pulp, were more likely to self-report a higher negative impact on their OHRQoL than those without TDI.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity

Journal of pediatric gastroenterology and nutrition, 2013

Objective: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a p... more Objective: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of information on health-related quality of life (HRQOL). The objective of the study was to report on the measurement properties of the PedsQL EoE Module. Methods: The PedsQL EoE Module was completed in a multisite study by 196 pediatric patients with EoE and 262 parents of patients with EoE. Results: The PedsQL EoE Module scales evidenced excellent feasibility (0.6%-3.1% missing), excellent group comparison reliability across total scale scores (patient a 0.93; parent proxy a 0.94), good reliability for the 7 individual scales (patient a 0.75-0.87; parent proxy a 0.81-0.92), excellent test-retest reliability (patient intraclass correlation coefficient 0.88; parent intraclass correlation coefficient 0.82), demonstrated no floor effects and low ceiling effects, and demonstrated a high percentage of scaling success for most scales. Intercorrelations with the PedsQL Generic Core Scales were in the medium (0.30) to large (0.50) range. PedsQL EoE Module scores were worse among patients with active histologic disease (!5 eos/hpf) compared with those in remission (patient self-report: 63.3 vs 69.9 [P < 0.05]; parent proxy report: 65.1 vs 72.3 [P < 0.01]), and those treated with dietary restrictions compared with those with no restrictions (patient self-report: 61.6 vs 74.3 [P < 0.01]; parent proxy report: 65.5 vs 74.7 [P < 0.01]). Conclusions: The results demonstrate excellent measurement properties of the PedsQL EoE Module. Patients with active histologic disease and those treated with dietary restrictions demonstrated worse PedsQL scores. The PedsQL EoE Module may be used in the evaluation of pediatric EoE diseasespecific HRQOL in clinical research and practice.

Research paper thumbnail of PedsQL™ sickle cell disease module: feasibility, reliability, and validity

Pediatric blood & cancer, 2013

BackgroundSickle cell disease (SCD) is an inherited chronic disease that is characterized by comp... more BackgroundSickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5–18 years and parent proxy-report for ages 2–18 years.Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5–18 years and parent proxy-report for ages 2–18 years.ProcedureThe 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.The 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.ResultsThe PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69–0.90; parent proxy-report α = 0.83–0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.The PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69–0.90; parent proxy-report α = 0.83–0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.ConclusionsThe PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD. Pediatr Blood Cancer 2013;60:1338–1344. © 2013 Wiley Periodicals, Inc.The PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD. Pediatr Blood Cancer 2013;60:1338–1344. © 2013 Wiley Periodicals, Inc.

Research paper thumbnail of Malocclusion and oral health-related quality of life in Brazilian school children

The Angle orthodontist, 2013

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to... more To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Research paper thumbnail of Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren

Journal of public health dentistry, 2010

Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associate... more Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associated factors in the permanent incisors of Brazilian schoolchildren.Methods: A cross-sectional survey was carried out with 1,612 male and female children aged 11 to 14 attending public and private elementary schools in Belo Horizonte, Brazil. A multistage sampling technique was adopted to select the children. Oral examinations were performed by calibrated examiners for the diagnosis of TDI (criteria proposed by Andreasen) and dental caries [Decayed, Missing and Filled Teeth Index (DMFT)]. The Social Vulnerability Index was used for socioeconomic classification. Data analysis involved descriptive statistics and the Poisson regression model.Results: The prevalence of TDI was 17.1%. Falls (43.6%) were the most common cause of TDI, mainly at home (41.8%). Boys were more affected than girls. There was no statistically significant association between TDI and socioeconomic status. The adjusted results revealed that TDI was significantly associated with DMFT [1.11, 95% confidence interval (CI): 1.06 to 1.16] and overjet (1.15, 95% CI: 1.00 to 1.31).Conclusions: TDI was associated with dental caries and overjet and was not influenced by socioeconomic status.

Research paper thumbnail of Association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in Brazil

International journal of environmental research and public health, 2012

The aim of the present study was to evaluate the association between childhood dental experiences... more The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of OPEN ACCESS Int. J. Environ. Res. Public Health 2012, 9 4677 specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.

Research paper thumbnail of Social vulnerability and traumatic dental injury among Brazilian schoolchildren: a population-based study

International journal of environmental research and public health, 2012

The aim of the present study was to test the association between social vulnerability and the pre... more The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen's criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11-1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11-4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI.

Research paper thumbnail of The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

Health and quality of life outcomes, 2012

Background: Oral and orofacial problems may cause a profound impact on children's oral health-rel... more Background: Oral and orofacial problems may cause a profound impact on children's oral health-related quality of life (OHRQoL) because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory TM (PedsQL TM ) Oral Health Scale in combination with the PedsQL TM 4.0 Generic Core Scales. Methods: The PedsQL TM Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL TM Oral Health Scale, PedsQL TM 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ 11-14 and CPQ 8-10 ) and Parental-Caregiver Perception Questionnaire (P-CPQ) were administered. Statistical analysis included feasibility (missing values), confirmatory factor analysis (CFA), internal consistency reliability, and test-retest intraclass correlation coefficients (ICC) of the PedsQL TM Oral Health Scale. Results: There were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL TM Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbach's alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test-retest reliability (ICC) for child self-report and parent proxy-report were 0.90 [95% confidence interval (CI) = 0.86-0.93] and 0.86 (95%CI = 0.81-0.90), respectively. The PedsQL TM Oral Health Scale demonstrated acceptable construct validity, convergent validity and discriminant validity. Conclusions: These results supported the feasibility, reliability and validity of the Brazilian version of the PedsQL TM Oral Health Scale for child self-report for ages 5-18 years-old and parent proxy-report for ages 2-18 years-old children.

Research paper thumbnail of Agreement between adolescents' and their mothers' reports of oral health-related quality of life

Brazilian oral research

The aim of this study was to determine the level of agreement between reports by adolescents and ... more The aim of this study was to determine the level of agreement between reports by adolescents and their mothers regarding the impact of oral health on the adolescents' quality of life. The sample consisted of 960 pairs of adolescents aged 11 to 14 years and their mothers. The Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) and the short form of the Child Perceptions Questionnaire ) were administered. Agreement on the total scale and the subscales was determined through a comparison of mean values. The means of the directional and absolute differences were also determined. Agreement on each item on the group level and in the individual pairs was analyzed using the Intraclass Correlation Coefficient (ICC). The difference between the means and the directional differences were significant for the total score as well as for the functional limitation and social well-being subscales (p < 0.001). The ICC for the total P-CPQ and CPQ 11-14 scores was 0.43. The ICC indicated weak agreement on the subscales, ranging from 0.36 to 0.40. Agreement between reports by adolescents and their mothers regarding oral health-related quality of life (OHRQoL) was moderate, indicating that both perspectives should be considered.

Research paper thumbnail of Post-discharge adverse events following pediatric sedation with high doses of oral medication

The Journal of pediatrics, 2012

Objective To compare the occurrence of post-discharge adverse events in children having received ... more Objective To compare the occurrence of post-discharge adverse events in children having received a high dose of either chloral hydrate (CH) or midazolam (MZ) during outpatient dental treatment.

Research paper thumbnail of Malocclusion and oral health-related quality of life in Brazilian school children.

Angle Orthod., 2012

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to... more To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument.
MATERIALS AND METHODS:
A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05).
RESULTS:
Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income.
CONCLUSIONS:
Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Research paper thumbnail of Association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in Brazil.

Int J Environ Res Public Health, 2012

The aim of the present study was to evaluate the association between childhood dental experiences... more The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.

Research paper thumbnail of Social vulnerability and traumatic dental injury among Brazilian schoolchildren: a population-based study.

Int J Environ Res Public Health, 2012

The aim of the present study was to test the association between social vulnerability and the pre... more The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen's criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11-1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11-4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI.

Research paper thumbnail of PedsQL™ sickle cell disease module: feasibility, reliability, and validity.

Pediatr Blood Cancer, 2013

Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications ... more Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5-18 years and parent proxy-report for ages 2-18 years.
PROCEDURE:
The 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.
RESULTS:
The PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69-0.90; parent proxy-report α = 0.83-0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.
CONCLUSIONS:
The PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity.

J Pediatr Gastroenterol Nutr, 2013

Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of i... more Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of information on health-related quality of life (HRQOL). The objective of the study was to report on the measurement properties of the PedsQL EoE Module.
METHODS:
The PedsQL EoE Module was completed in a multisite study by 196 pediatric patients with EoE and 262 parents of patients with EoE.
RESULTS:
The PedsQL EoE Module scales evidenced excellent feasibility (0.6%-3.1% missing), excellent group comparison reliability across total scale scores (patient α 0.93; parent proxy α 0.94), good reliability for the 7 individual scales (patient α 0.75-0.87; parent proxy α 0.81-0.92), excellent test-retest reliability (patient intraclass correlation coefficient 0.88; parent intraclass correlation coefficient 0.82), demonstrated no floor effects and low ceiling effects, and demonstrated a high percentage of scaling success for most scales. Intercorrelations with the PedsQL Generic Core Scales were in the medium (0.30) to large (0.50) range. PedsQL EoE Module scores were worse among patients with active histologic disease (≥ 5 eos/hpf) compared with those in remission (patient self-report: 63.3 vs 69.9 [P < 0.05]; parent proxy report: 65.1 vs 72.3 [P < 0.01]), and those treated with dietary restrictions compared with those with no restrictions (patient self-report: 61.6 vs 74.3 [P < 0.01]; parent proxy report: 65.5 vs 74.7 [P < 0.01]).
CONCLUSIONS:
The results demonstrate excellent measurement properties of the PedsQL EoE Module. Patients with active histologic disease and those treated with dietary restrictions demonstrated worse PedsQL scores. The PedsQL EoE Module may be used in the evaluation of pediatric EoE disease-specific HRQOL in clinical research and practice.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity.

Research paper thumbnail of Correlation between socioeconomic indicators and traumatic dental injuries: a qualitative critical literature review

Dental Traumatology, 2009

Abstract – Background/Aim: Traumatic dental injuries are widespread and have become a serious den... more Abstract – Background/Aim: Traumatic dental injuries are widespread and have become a serious dental public health problem in childhood. Despite its importance, very few studies have correlated the prevalence of permanent tooth injury and socioeconomic indicators. The aim of the present study was to evaluate just such a correlation. Materials and Methods: Electronic searches were performed in the following bibliographical databases: Brazilian Bibliography of Dentistry, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature and PubMed Central. Reference lists from articles that fulfilled the inclusion criteria in this review were searched for additional relevant articles. The Brazilian Coordination of Higher Education Personnel Improvement Theses Databank was also included. Selection and analysis of the articles were performed independently by two authors of the present literature review. Results: A total of 21 of 98 articles were eligible for inclusion in the review. However, only nine articles performed all the methodology criteria analyzed. Seven of the surveys were carried out in Brazil and two in Thailand. The age of children was 9–14 years. Statistically significant associations between permanent tooth injuries and high economic status were found in four studies. Conclusion: There were few studies correlating traumatic injuries in permanent teeth and socioeconomic indicators and the majority found no such association. It is suggested that the association between traumatic dental injuries and socioeconomic factors may be related to the indicators used, considering differences in their individual components. Furthermore, the heterogeneity of the methodologies hinders the comparison of the studies.

Research paper thumbnail of Association between treated/untreated traumatic dental injuries and impact on quality of life of Brazilian schoolchildren

Health and Quality of Life Outcomes, 2010

Background: Traumatic dental injury (TDI) could have physical and psychosocial consequences for c... more Background: Traumatic dental injury (TDI) could have physical and psychosocial consequences for children. Thus, it is important to measure the impact of TDI on the quality of life of children (QoL). The aim of the present study was to investigate the association between treated/untreated TDI and the impact on the quality of life of 11-to-14year-old Brazilian schoolchildren. Methods: A cross-sectional study was carried out involving 1612 male and female schoolchildren aged 11 to 14 years attending public and private elementary schools in the city of Belo Horizonte, Brazil. A multi-stage sampling technique was adopted to select the children. Three calibrated examiners used the Andreasen classification for the diagnosis of TDI. Oral health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ 11-14 ) -Impact Short Form (ISF:16), composed of 16 items and self-administered by all children. Other oral conditions (dental caries and malocclusion) and the Social Vulnerability Index were determined and used as controlling variables. Results: Two hundred nineteen children were diagnosed with untreated TDI and 64 were diagnosed with treated TDI. There were no statistically significant associations between untreated or treated TDI and overall CPQ 11-14 (Fisher = 0.368 and Fisher = 0.610, respectively). Children with an untreated TDI were 1.4-fold (95% CI = 1.1-2.1) more likely to report impact on the item "avoided smiling/laughing" than those without TDI, whereas children with a treated TDI were twofold (95% CI = 1.1-3.5) more likely to report impact on the item "other children asked questions" than those without TDI. Conclusions: Neither treated nor untreated TDI was associated with oral symptoms, functional limitations or emotional wellbeing. However, children with a TDI in the anterior teeth experienced a negative impact on social wellbeing, mainly with regard to avoiding smiling or laughing and being concerned about what other people may think or say.

Research paper thumbnail of Prevalence and determining factors of traumatic injuries to primary teeth in preschool children

Dental Traumatology, 2009

Abstract – The objective of the study was to assess the prevalence of dental injuries and the in... more Abstract – The objective of the study was to assess the prevalence of dental injuries and the influence of determining factors in preschool children from Belo Horizonte, Brazil. A cross-sectional survey was carried out through clinical examinations and the application of a questionnaire to the parents of 419 children aged 0 to 5 years attending preschool. The sample was stratified by region, type of institution and age. The eighteen preschools visited were chosen randomly. The prevalence of traumatic injury to primary teeth was 39.1%. Enamel fractures were the most common traumatic injury (49.7%). Boys were 1.62 times more likely to have dental injuries than girls. Children with inadequate lip coverage were 3.75 times more likely to have a traumatic dental injury than those with adequate lip coverage. Children attending state preschools had nearly two times greater chances of having dental trauma than children attending private preschools. It was concluded that the prevalence of dental injuries in preschool children is high in Belo Horizonte, Brazil and constitutes a public health problem.

Research paper thumbnail of Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren: Associated factors of traumatic dental injuries

Journal of Public Health Dentistry, 2010

Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associate... more Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associated factors in the permanent incisors of Brazilian schoolchildren.Methods: A cross-sectional survey was carried out with 1,612 male and female children aged 11 to 14 attending public and private elementary schools in Belo Horizonte, Brazil. A multistage sampling technique was adopted to select the children. Oral examinations were performed by calibrated examiners for the diagnosis of TDI (criteria proposed by Andreasen) and dental caries [Decayed, Missing and Filled Teeth Index (DMFT)]. The Social Vulnerability Index was used for socioeconomic classification. Data analysis involved descriptive statistics and the Poisson regression model.Results: The prevalence of TDI was 17.1%. Falls (43.6%) were the most common cause of TDI, mainly at home (41.8%). Boys were more affected than girls. There was no statistically significant association between TDI and socioeconomic status. The adjusted results revealed that TDI was significantly associated with DMFT [1.11, 95% confidence interval (CI): 1.06 to 1.16] and overjet (1.15, 95% CI: 1.00 to 1.31).Conclusions: TDI was associated with dental caries and overjet and was not influenced by socioeconomic status.

Research paper thumbnail of Oral health-related quality of life and traumatic dental injuries in Brazilian adolescents

Community Dentistry and Oral Epidemiology, 2013

To evaluate the impact of traumatic dental injuries (TDI) on oral health-related quality of life ... more To evaluate the impact of traumatic dental injuries (TDI) on oral health-related quality of life (OHRQoL) among Brazilian adolescents. A population-based case-control study was carried out, which was nested to a cross-sectional study with a sample of 1215 adolescents aged 11-14 years from Belo Horizonte, Brazil. OHRQoL was measured using the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14 )--Impact Short Form (ISF:16). Two-step cluster analysis was performed to define cases and controls based on CPQ11-14--ISF:16 scores. This method considers the pattern of responses for each item separately and how important each item is to the formation of clusters. The case group included those adolescents who presented higher negative impact on OHRQoL (n=405), while the control group included those with lower negative impact (n=810). Two controls for each case were individually matched from the same school and gender. The main independent variable was TDI, diagnosed by the Andreasen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s classification. Untreated dental caries, malocclusion, and age were confounding variables. Conditional logistic regression analysis was performed with the significance level set at 5%. A multiple conditional logistic regression model demonstrates that adolescents diagnosed with fracture involving dentin and/or pulp had a 2.40-fold greater chance of presenting high negative impact on QHRQoL [95% CI=1.26-4.58; P=0.008] than those without evidence of fractures. Enamel fracture only [P=0.065] and restored fractures [P=0.072] were not statistically associated with OHRQoL. Adolescents with more severe untreated TDI, such as fractures involving dentin and/or pulp, were more likely to self-report a higher negative impact on their OHRQoL than those without TDI.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity

Journal of pediatric gastroenterology and nutrition, 2013

Objective: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a p... more Objective: Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of information on health-related quality of life (HRQOL). The objective of the study was to report on the measurement properties of the PedsQL EoE Module. Methods: The PedsQL EoE Module was completed in a multisite study by 196 pediatric patients with EoE and 262 parents of patients with EoE. Results: The PedsQL EoE Module scales evidenced excellent feasibility (0.6%-3.1% missing), excellent group comparison reliability across total scale scores (patient a 0.93; parent proxy a 0.94), good reliability for the 7 individual scales (patient a 0.75-0.87; parent proxy a 0.81-0.92), excellent test-retest reliability (patient intraclass correlation coefficient 0.88; parent intraclass correlation coefficient 0.82), demonstrated no floor effects and low ceiling effects, and demonstrated a high percentage of scaling success for most scales. Intercorrelations with the PedsQL Generic Core Scales were in the medium (0.30) to large (0.50) range. PedsQL EoE Module scores were worse among patients with active histologic disease (!5 eos/hpf) compared with those in remission (patient self-report: 63.3 vs 69.9 [P < 0.05]; parent proxy report: 65.1 vs 72.3 [P < 0.01]), and those treated with dietary restrictions compared with those with no restrictions (patient self-report: 61.6 vs 74.3 [P < 0.01]; parent proxy report: 65.5 vs 74.7 [P < 0.01]). Conclusions: The results demonstrate excellent measurement properties of the PedsQL EoE Module. Patients with active histologic disease and those treated with dietary restrictions demonstrated worse PedsQL scores. The PedsQL EoE Module may be used in the evaluation of pediatric EoE diseasespecific HRQOL in clinical research and practice.

Research paper thumbnail of PedsQL™ sickle cell disease module: feasibility, reliability, and validity

Pediatric blood & cancer, 2013

BackgroundSickle cell disease (SCD) is an inherited chronic disease that is characterized by comp... more BackgroundSickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5–18 years and parent proxy-report for ages 2–18 years.Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5–18 years and parent proxy-report for ages 2–18 years.ProcedureThe 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.The 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.ResultsThe PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69–0.90; parent proxy-report α = 0.83–0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.The PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69–0.90; parent proxy-report α = 0.83–0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.ConclusionsThe PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD. Pediatr Blood Cancer 2013;60:1338–1344. © 2013 Wiley Periodicals, Inc.The PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD. Pediatr Blood Cancer 2013;60:1338–1344. © 2013 Wiley Periodicals, Inc.

Research paper thumbnail of Malocclusion and oral health-related quality of life in Brazilian school children

The Angle orthodontist, 2013

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to... more To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Research paper thumbnail of Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren

Journal of public health dentistry, 2010

Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associate... more Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associated factors in the permanent incisors of Brazilian schoolchildren.Methods: A cross-sectional survey was carried out with 1,612 male and female children aged 11 to 14 attending public and private elementary schools in Belo Horizonte, Brazil. A multistage sampling technique was adopted to select the children. Oral examinations were performed by calibrated examiners for the diagnosis of TDI (criteria proposed by Andreasen) and dental caries [Decayed, Missing and Filled Teeth Index (DMFT)]. The Social Vulnerability Index was used for socioeconomic classification. Data analysis involved descriptive statistics and the Poisson regression model.Results: The prevalence of TDI was 17.1%. Falls (43.6%) were the most common cause of TDI, mainly at home (41.8%). Boys were more affected than girls. There was no statistically significant association between TDI and socioeconomic status. The adjusted results revealed that TDI was significantly associated with DMFT [1.11, 95% confidence interval (CI): 1.06 to 1.16] and overjet (1.15, 95% CI: 1.00 to 1.31).Conclusions: TDI was associated with dental caries and overjet and was not influenced by socioeconomic status.

Research paper thumbnail of Association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in Brazil

International journal of environmental research and public health, 2012

The aim of the present study was to evaluate the association between childhood dental experiences... more The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of OPEN ACCESS Int. J. Environ. Res. Public Health 2012, 9 4677 specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.

Research paper thumbnail of Social vulnerability and traumatic dental injury among Brazilian schoolchildren: a population-based study

International journal of environmental research and public health, 2012

The aim of the present study was to test the association between social vulnerability and the pre... more The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen's criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11-1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11-4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI.

Research paper thumbnail of The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

Health and quality of life outcomes, 2012

Background: Oral and orofacial problems may cause a profound impact on children's oral health-rel... more Background: Oral and orofacial problems may cause a profound impact on children's oral health-related quality of life (OHRQoL) because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory TM (PedsQL TM ) Oral Health Scale in combination with the PedsQL TM 4.0 Generic Core Scales. Methods: The PedsQL TM Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL TM Oral Health Scale, PedsQL TM 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ 11-14 and CPQ 8-10 ) and Parental-Caregiver Perception Questionnaire (P-CPQ) were administered. Statistical analysis included feasibility (missing values), confirmatory factor analysis (CFA), internal consistency reliability, and test-retest intraclass correlation coefficients (ICC) of the PedsQL TM Oral Health Scale. Results: There were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL TM Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbach's alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test-retest reliability (ICC) for child self-report and parent proxy-report were 0.90 [95% confidence interval (CI) = 0.86-0.93] and 0.86 (95%CI = 0.81-0.90), respectively. The PedsQL TM Oral Health Scale demonstrated acceptable construct validity, convergent validity and discriminant validity. Conclusions: These results supported the feasibility, reliability and validity of the Brazilian version of the PedsQL TM Oral Health Scale for child self-report for ages 5-18 years-old and parent proxy-report for ages 2-18 years-old children.

Research paper thumbnail of Agreement between adolescents' and their mothers' reports of oral health-related quality of life

Brazilian oral research

The aim of this study was to determine the level of agreement between reports by adolescents and ... more The aim of this study was to determine the level of agreement between reports by adolescents and their mothers regarding the impact of oral health on the adolescents' quality of life. The sample consisted of 960 pairs of adolescents aged 11 to 14 years and their mothers. The Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) and the short form of the Child Perceptions Questionnaire ) were administered. Agreement on the total scale and the subscales was determined through a comparison of mean values. The means of the directional and absolute differences were also determined. Agreement on each item on the group level and in the individual pairs was analyzed using the Intraclass Correlation Coefficient (ICC). The difference between the means and the directional differences were significant for the total score as well as for the functional limitation and social well-being subscales (p < 0.001). The ICC for the total P-CPQ and CPQ 11-14 scores was 0.43. The ICC indicated weak agreement on the subscales, ranging from 0.36 to 0.40. Agreement between reports by adolescents and their mothers regarding oral health-related quality of life (OHRQoL) was moderate, indicating that both perspectives should be considered.

Research paper thumbnail of Post-discharge adverse events following pediatric sedation with high doses of oral medication

The Journal of pediatrics, 2012

Objective To compare the occurrence of post-discharge adverse events in children having received ... more Objective To compare the occurrence of post-discharge adverse events in children having received a high dose of either chloral hydrate (CH) or midazolam (MZ) during outpatient dental treatment.

Research paper thumbnail of Malocclusion and oral health-related quality of life in Brazilian school children.

Angle Orthod., 2012

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to... more To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument.
MATERIALS AND METHODS:
A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05).
RESULTS:
Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income.
CONCLUSIONS:
Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Research paper thumbnail of Association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in Brazil.

Int J Environ Res Public Health, 2012

The aim of the present study was to evaluate the association between childhood dental experiences... more The aim of the present study was to evaluate the association between childhood dental experiences and dental fear in adulthood among dentistry, psychology and mathematics undergraduate students. A cross-sectional study of 1,256 students from the city of Belo Horizonte, Brazil, was performed. Students responded to the Brazilian version of the Dental Fear Survey (DFS) and a questionnaire regarding previous dental experiences. Both the DFS and the questionnaire were self-administered. Association was tested using descriptive, bivariate and multivariate linear regression analysis, with a 5% significance level. Dentistry undergraduates reported lower scores than psychology (p < 0.001) and mathematics undergraduates (p < 0.05) for all three dimensions of the DFS. Negative dental experiences in childhood was associated with dimensions of Avoidance (B = 2.70, p < 0.001), Physiological arousal (B = 1.42, p < 0.001) and Fears of specific stimuli/situations (B = 3.44, p < 0.001). The reason for first visit to dentist was associated with dimensions of Physiological arousal (B = 0.76, p < 0.01) and Fears of specific stimuli/situations (B = 1.29, p < 0.01). Dentists should be encouraged to evaluate the dental fear of their patients before treatment. The DFS has been found to be an effective instrument for this purpose.

Research paper thumbnail of Social vulnerability and traumatic dental injury among Brazilian schoolchildren: a population-based study.

Int J Environ Res Public Health, 2012

The aim of the present study was to test the association between social vulnerability and the pre... more The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen's criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11-1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11-4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI.

Research paper thumbnail of PedsQL™ sickle cell disease module: feasibility, reliability, and validity.

Pediatr Blood Cancer, 2013

Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications ... more Sickle cell disease (SCD) is an inherited chronic disease that is characterized by complications such as recurrent painful vaso-occlusive events that require frequent hospitalizations and contribute to early mortality. The objective of the study was to report on the initial measurement properties of the new PedsQL™ SCD Module for pediatric patient self-report ages 5-18 years and parent proxy-report for ages 2-18 years.
PROCEDURE:
The 43-item PedsQL™ SCD Module was completed in a multisite study by 243 pediatric patients with SCD and 313 parents. Participants also completed the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Multidimensional Fatigue Scale.
RESULTS:
The PedsQL™ SCD Module Scales evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.95; parent proxy-report α = 0.97), and good reliability for the nine individual scales (patient self-report α = 0.69-0.90; parent proxy-report α = 0.83-0.97). Intercorrelations with the PedsQL™ Generic Core Scales and PedsQL™ Multidimensional Fatigue Scales were medium (0.30) to large (0.50) range, supporting construct validity. PedsQL™ SCD Module Scale Scores were generally worse for patients with severe versus mild disease. Confirmatory factor analysis demonstrated an acceptable to excellent model fit.
CONCLUSIONS:
The PedsQL™ SCD Module demonstrated acceptable measurement properties. The PedsQL™ SCD Module may be utilized in the evaluation of SCD-specific health-related quality of life in clinical research and practice. In conjunction with the PedsQL™ Generic Core Scales and the PedsQL™ Multidimensional Fatigue Scale, the PedsQL™ SCD Module will facilitate the understanding of the health and well-being of children with SCD.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity.

J Pediatr Gastroenterol Nutr, 2013

Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of i... more Eosinophilic esophagitis (EoE) is a chronic esophageal inflammatory condition with a paucity of information on health-related quality of life (HRQOL). The objective of the study was to report on the measurement properties of the PedsQL EoE Module.
METHODS:
The PedsQL EoE Module was completed in a multisite study by 196 pediatric patients with EoE and 262 parents of patients with EoE.
RESULTS:
The PedsQL EoE Module scales evidenced excellent feasibility (0.6%-3.1% missing), excellent group comparison reliability across total scale scores (patient α 0.93; parent proxy α 0.94), good reliability for the 7 individual scales (patient α 0.75-0.87; parent proxy α 0.81-0.92), excellent test-retest reliability (patient intraclass correlation coefficient 0.88; parent intraclass correlation coefficient 0.82), demonstrated no floor effects and low ceiling effects, and demonstrated a high percentage of scaling success for most scales. Intercorrelations with the PedsQL Generic Core Scales were in the medium (0.30) to large (0.50) range. PedsQL EoE Module scores were worse among patients with active histologic disease (≥ 5 eos/hpf) compared with those in remission (patient self-report: 63.3 vs 69.9 [P < 0.05]; parent proxy report: 65.1 vs 72.3 [P < 0.01]), and those treated with dietary restrictions compared with those with no restrictions (patient self-report: 61.6 vs 74.3 [P < 0.01]; parent proxy report: 65.5 vs 74.7 [P < 0.01]).
CONCLUSIONS:
The results demonstrate excellent measurement properties of the PedsQL EoE Module. Patients with active histologic disease and those treated with dietary restrictions demonstrated worse PedsQL scores. The PedsQL EoE Module may be used in the evaluation of pediatric EoE disease-specific HRQOL in clinical research and practice.

Research paper thumbnail of PedsQL eosinophilic esophagitis module: feasibility, reliability, and validity.

Research paper thumbnail of Correlation between socioeconomic indicators and traumatic dental injuries: a qualitative critical literature review

Dental Traumatology, 2009

Abstract – Background/Aim: Traumatic dental injuries are widespread and have become a serious den... more Abstract – Background/Aim: Traumatic dental injuries are widespread and have become a serious dental public health problem in childhood. Despite its importance, very few studies have correlated the prevalence of permanent tooth injury and socioeconomic indicators. The aim of the present study was to evaluate just such a correlation. Materials and Methods: Electronic searches were performed in the following bibliographical databases: Brazilian Bibliography of Dentistry, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature and PubMed Central. Reference lists from articles that fulfilled the inclusion criteria in this review were searched for additional relevant articles. The Brazilian Coordination of Higher Education Personnel Improvement Theses Databank was also included. Selection and analysis of the articles were performed independently by two authors of the present literature review. Results: A total of 21 of 98 articles were eligible for inclusion in the review. However, only nine articles performed all the methodology criteria analyzed. Seven of the surveys were carried out in Brazil and two in Thailand. The age of children was 9–14 years. Statistically significant associations between permanent tooth injuries and high economic status were found in four studies. Conclusion: There were few studies correlating traumatic injuries in permanent teeth and socioeconomic indicators and the majority found no such association. It is suggested that the association between traumatic dental injuries and socioeconomic factors may be related to the indicators used, considering differences in their individual components. Furthermore, the heterogeneity of the methodologies hinders the comparison of the studies.

Research paper thumbnail of Association between treated/untreated traumatic dental injuries and impact on quality of life of Brazilian schoolchildren

Health and Quality of Life Outcomes, 2010

Background: Traumatic dental injury (TDI) could have physical and psychosocial consequences for c... more Background: Traumatic dental injury (TDI) could have physical and psychosocial consequences for children. Thus, it is important to measure the impact of TDI on the quality of life of children (QoL). The aim of the present study was to investigate the association between treated/untreated TDI and the impact on the quality of life of 11-to-14year-old Brazilian schoolchildren. Methods: A cross-sectional study was carried out involving 1612 male and female schoolchildren aged 11 to 14 years attending public and private elementary schools in the city of Belo Horizonte, Brazil. A multi-stage sampling technique was adopted to select the children. Three calibrated examiners used the Andreasen classification for the diagnosis of TDI. Oral health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ 11-14 ) -Impact Short Form (ISF:16), composed of 16 items and self-administered by all children. Other oral conditions (dental caries and malocclusion) and the Social Vulnerability Index were determined and used as controlling variables. Results: Two hundred nineteen children were diagnosed with untreated TDI and 64 were diagnosed with treated TDI. There were no statistically significant associations between untreated or treated TDI and overall CPQ 11-14 (Fisher = 0.368 and Fisher = 0.610, respectively). Children with an untreated TDI were 1.4-fold (95% CI = 1.1-2.1) more likely to report impact on the item "avoided smiling/laughing" than those without TDI, whereas children with a treated TDI were twofold (95% CI = 1.1-3.5) more likely to report impact on the item "other children asked questions" than those without TDI. Conclusions: Neither treated nor untreated TDI was associated with oral symptoms, functional limitations or emotional wellbeing. However, children with a TDI in the anterior teeth experienced a negative impact on social wellbeing, mainly with regard to avoiding smiling or laughing and being concerned about what other people may think or say.

Research paper thumbnail of Prevalence and determining factors of traumatic injuries to primary teeth in preschool children

Dental Traumatology, 2009

Abstract – The objective of the study was to assess the prevalence of dental injuries and the in... more Abstract – The objective of the study was to assess the prevalence of dental injuries and the influence of determining factors in preschool children from Belo Horizonte, Brazil. A cross-sectional survey was carried out through clinical examinations and the application of a questionnaire to the parents of 419 children aged 0 to 5 years attending preschool. The sample was stratified by region, type of institution and age. The eighteen preschools visited were chosen randomly. The prevalence of traumatic injury to primary teeth was 39.1%. Enamel fractures were the most common traumatic injury (49.7%). Boys were 1.62 times more likely to have dental injuries than girls. Children with inadequate lip coverage were 3.75 times more likely to have a traumatic dental injury than those with adequate lip coverage. Children attending state preschools had nearly two times greater chances of having dental trauma than children attending private preschools. It was concluded that the prevalence of dental injuries in preschool children is high in Belo Horizonte, Brazil and constitutes a public health problem.

Research paper thumbnail of Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren: Associated factors of traumatic dental injuries

Journal of Public Health Dentistry, 2010

Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associate... more Objectives: This study investigated the prevalence of traumatic dental injury (TDI) and associated factors in the permanent incisors of Brazilian schoolchildren.Methods: A cross-sectional survey was carried out with 1,612 male and female children aged 11 to 14 attending public and private elementary schools in Belo Horizonte, Brazil. A multistage sampling technique was adopted to select the children. Oral examinations were performed by calibrated examiners for the diagnosis of TDI (criteria proposed by Andreasen) and dental caries [Decayed, Missing and Filled Teeth Index (DMFT)]. The Social Vulnerability Index was used for socioeconomic classification. Data analysis involved descriptive statistics and the Poisson regression model.Results: The prevalence of TDI was 17.1%. Falls (43.6%) were the most common cause of TDI, mainly at home (41.8%). Boys were more affected than girls. There was no statistically significant association between TDI and socioeconomic status. The adjusted results revealed that TDI was significantly associated with DMFT [1.11, 95% confidence interval (CI): 1.06 to 1.16] and overjet (1.15, 95% CI: 1.00 to 1.31).Conclusions: TDI was associated with dental caries and overjet and was not influenced by socioeconomic status.