RESUMO
INTRODUCTION: Relationships amongst attention-deficit/hyperactivity disorder (ADHD), family factors, and oral health literacy (OHL) in adolescents are unclear. The objective of this research was to investigate whether family environment and signs of ADHD are associated with OHL at the onset of adolescence. METHODS: A cross-sectional study was performed with 448 twelve-year-old adolescents enrolled in schools in Cajazeiras, Brazil. Adolescents responded to an instrument measuring OHL (Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a validated questionnaire addressing family cohesion and adaptability (Family Adaptability and Cohesion Scales [FACES III]). Parents and teachers answered subscales of the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) and a socioeconomic questionnaire. Adjusted Poisson regression analysis was employed for the data analysis (P < .05). RESULTS: Greater OHL was found in adolescents with higher family cohesion scores (rate ratio [RR], 1.02; 95% confidence interval [CI], 1.01-1.03), those whose mothers had more than 8 years of schooling (RR, 1.07; 95% CI, 1.03-1.12), and those whose families earned more than the Brazilian minimum salary (RR, 1.08; 95% CI, 1.03-1.12). Higher family adaptability scores (RR, 0.99; 95% CI, 0.98-0.99) and more signs of ADHD (teachers' reports) (RR, 0.95; 95% CI, 0.91-0.99) were associated with lower OHL. CONCLUSIONS: OHL in adolescents was influenced by family adaptability and cohesion, signs of ADHD, maternal schooling, and family income.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Letramento em Saúde , Adolescente , Adulto , Brasil , Estudos Transversais , Humanos , Saúde Bucal/educaçãoRESUMO
Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Cárie Dentária , Letramento em Saúde , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos Transversais , Cárie Dentária/epidemiologia , Humanos , Saúde BucalRESUMO
AIM: To test the hypothesis that changes in enamel component volumes (mineral, organic, and water volumes, and permeability) are graded from outer to inner enamel after a short bleaching procedure. MATERIALS AND METHODS: Extracted unerupted human third molars had half of their crowns bleached (single bleaching session, 3 × 15 min), and tooth shade changes in bleached parts were analyzed with a spectrophotometer. Ground sections were prepared, component volumes and permeability were quantified at histological points located at varying distances from the enamel surface (n=10 points/location), representing conditions before and after bleaching. RESULTS: Tooth shade changes were significant (p<0.001; 95% CI=-1/-8; power=99%), and most of the enamel layer was unaffected after bleaching, except at the outer layers. Multiple analysis of covariances revealed that most of the variance of the change in enamel composition after bleaching was explained by the combination of the set of types of component volume (in decreasing order of relevance: mineral loss, organic gain, water gain, and decrease in permeability) with the set of distances from the enamel surface (graded from the enamel surface inward) (canonical R(2)=0.97; p<0.0001; power>99%). CONCLUSIONS: Changes in enamel composition after a short bleaching procedure followed a gradient within component volumes (mineral loss>organic gain>water gain>decrease in permeability) and decreased from the enamel surface inward.