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OBJECTIVES: To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents. METHODS: A school-based cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP-IV) questionnaire for the detection of signs of ADHD. Multiple Poisson regression with robust variance was used for data analysis (α = 5%). RESULTS: The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01-1.15) and connected (PR = 1.06; 95% CI: 1.01-1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04-1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01-1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01-1.11) were also associated with the outcome. CONCLUSION: Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.

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ABSTRACT: Oral and dental health are vital parts of general baby health, and early dental visits provide significant prevention-focused intervention and parental counseling regarding oral health. Evaluating the age and main complaints of children is therefore important during their first dental visit (FDV). The purposes of this study were to determine the age, reason for the visit, behavioral response, and caries status at the FDV and to evaluate the factors affecting these parameters. Parents of 325 pediatric patients (159 males; 166 females; mean age 7.20±2.78 years) at their FDV were asked to fill out a questionnaire requesting sociodemographic information and their child's medical history, brushing habits, and reasons for attending dental consultation. The decayed-missing-filled-teeth (dmft/DMFT) scores were also recorded. The child's behavioral responses during the FDV were evaluated according to Frankl's Behavior Rating Scale (FBRS). Higher maternal education level and dmft/DMFT score were associated with earlier FDV age. The most common reason for the FDV was dental caries in 33.5% of patients, followed by toothache (29.5%). Most of the children showed positive behavior (46.7%), with positive behavior affected by age and negative behavior affected by the dmft/DMFT score and distance from home. The mean dmft/ DMFT score was 8.1±4.4 and was negatively affected by toothbrushing frequency and family income. These study results indicate that Turkish children living in Edirne present at a late age for the FDV. Raising awareness in terms of dental health care among parents is important to ensure that children attend their FDV at an early age.

RESUMEN: La salud oral y dental son partes vitales de la salud general del bebé, y las visitas dentales tempranas brindan una importante intervención centrada en la prevención y asesoramiento a los padres sobre la salud bucal. Por lo tanto, evaluar la edad y las principales quejas de los niños es importante durante su primera visita al dentista (FDV por sus siglas en inglés). El propósito de este estudio fue determinar la edad, motivo de visita, respuesta conductual y estado de caries en la FDV y evaluar los factores que afectan estos parámetros. A los padres de 325 pacientes pediátricos (159 hombres; 166 mujeres; edad media 7,20±2,78 años) en su FDV se les pidió que llenaran un cuestionario solicitando información sociodemográfica y el historial médico de su hijo, hábitos de cepillado y motivos de presentación a la consulta dental. También se registraron las puntuaciones de dientes cariados-faltantes-obturados (dmft/DMFT). Las respuestas conductuales del niño durante la FDV se evaluaron de acuerdo con la escala de calificación de conducta de Frankl (FBRS). Un mayor nivel de educación materna y una puntuación de dmft/DMFT se asociaron con una edad más temprana de la FDV. La causa más común de la FDV fue la caries dental en el 33,5% de los pacientes, seguida del dolor de muelas (29,5%). La mayoría de los niños mostró un comportamiento positivo (46,7%), con un comportamiento positivo afectado por la edad y un comportamiento negativo afectado por el puntaje dmft/DMFT y la distancia del hogar. La puntuación media de dmft/DMFT fue de 8,1±4,4 y se vio afectada negativamente por la frecuencia de cepillado de dientes y los ingresos familiares. Los resultados de este estudio indican que los niños turcos que viven en Edirne se presentan a una edad avanzada para la FDV. Es importante concienciar a los padres sobre el cuidado de la salud dental para garantizar que los niños asistan a su FDV a una edad temprana.

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OBJECTIVES: This longitudinal study assessed the prevalence of dental fear in adulthood and the association with socio-economic, behavioural and clinical variables. Also, the existence of a vicious cycle of dental fear was tested. METHODS: A random sample of adults (n = 535) from the 1982 Pelotas Birth Cohort, Brazil, was selected. Socio-economic data, behavioural characteristics and clinical variables were collected during different cohort waves. Oral health data were collected at ages 15, 24 and 31 years old, using questionnaires and oral examination. Dental fear (the outcome) was assessed by the question: 'Are you afraid of going to the dentist?', with possible responses: dichotomized into 'No' or 'A little/Yes/A lot'. Exposure variables were as follows: dental visit in the last years (at the ages 15 and 31); caries experience (DMFT ≥ mean) at the ages 15 and 31; the trajectory of caries prevalence from 15 to 31 years old; dental pain in the last six months in the two ages evaluated; and self-rated oral health at age 31. Several multivariable Poisson regression models were used to investigate the association between each of the exposure variables and dental fear. RESULTS: Dental fear prevalence was 22.1%, and it was more prevalent among non-white individuals and females. After controlling for potential confounders, dental fear was more likely to be reported by those individuals who had dental pain or a higher prevalence of dental caries at the age 15. Dental fear was also associated with a worse trajectory of dental caries, negative self-rated oral health at age 31 and with not having visited the dentist in the last year (at the age 31). Results supported the proposed vicious cycle of dental fear. CONCLUSIONS: Dental fear in adulthood was related to exposures occurring across the lifecourse. Also, it was possible to observe the occurrence of the vicious cycle of dental fear in the 1982 Pelotas Birth Cohort. Therefore, preventive measures during different periods of the life course are required to prevent dental fear and adulthood.

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The objective of this study was to describe the timing of the first dental visit and investigate the association of socioeconomic and behavioral factors with dental visit delay among 10/11-year-old children from two live-birth population cohorts with extremely contrasting socioeconomic profiles. Follow-up data (2004-2005) from cohorts of Ribeirão Preto (RP) (n=790) and São Luís (SL) (n=673) were evaluated. Delay in dental visit was defined as not visiting a dentist before the age of 7. Covariates included family socioeconomic characteristics, mother-related health behavior, and child-related characteristics. Prevalence ratios with robust standard errors were estimated. In both cohorts, less than 5% of children had visited a dentist before the age of two and about 35% of them had not visited a dentist before the age of seven. Lower mother's schooling and lack of private health insurance were associated with the delay in first dental visit for both cohorts. A small number of mother's prenatal care visits and being from a single-father family or a family without parents were only associated in the RP cohort, while having ≥4 siblings and lifetime dental pain were associated in the SL cohort. The association with dental pain probably reveals a preventive care-seeking behavior. Therefore, the percentage of delayed first dental visit of children was very high even among those with the most educated mothers. Further studies are necessary to analyze recent changes and underlying factors related to access to first dental visit after the implementation of the National Oral Health Policy in 2006.

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BACKGROUND: The aim was to analyze an infant preventive program determining at what age parents take their children for their first dental visit and the reasons why they do it. MATERIALS & METHODS: A total of 844 children aged from 0 to 36 months, enrolled in the program of oral health maintenance of the Baby Clinic, participated in this study. During the first dental visit, the parents were inquired about the reasons that led them to enroll their children in the program. One trained investigator identified this reasons on the records and classified them according to the following scores: orientation/prevention, caries treatment, malpositioned teeth, dental trauma, tooth color alterations and others. RESULTS: Orientation/prevention was the most prevalent reason from 0-6 months to 25-30 months of age, and at the age 30-36 months, the reason caries/treatment overcame orientation/prevention, becoming the most prevalent reason in that age group. The third place was occupied by dental trauma. The mean age parents seek for dental care to their children was 14, 92 months. CONCLUSION: This study showed a preferentially preventive/educational profile for the children. However, lots of parents still take children to the dentist preferentially for curative instead of preventive treatment. How to cite this article: Volpato LE, Palti DG, Lima JE, Machado MA, Aranha AM, Bandeca MC, Pedro FL, Borges AH. When and Why Parents Seek Dental Care for Children under 36 Months. J Int Oral Health 2013; 5(4):21-25.

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O objetivo deste estudo foi avaliar o perfil dos pacientes com deficiência atendidos no projeto de extensão "Conquistando Saúde: atendimento a pacientes com necessidades especiais" do Curso de Odontologia da Universidade Luterana do Brasil - Campus Canoas / RS, no período de 2001 a 2006. A coleta dos dados foi feita a partir dos prontuários dos pacientes atendidos no referido período. Observou-se um equilíbrio entre os pacientes do sexo masculino e feminino, uma maior procura ao serviço por pacientes jovens, procedentes de Canoas e com distúrbios neurológicos. Aproximadamente 80% dos pacientes apresentavam experiência de cárie. A partir dos resultados obtidos sugere-se o estabelecimento de políticas públicas de promoção de saúde e reorientação de serviços odontológicos que facilitem o acesso e a utilização por indivíduos com deficiências.

The objective of this study was to evaluate the profile of patients with disabilities served by the extension project "Conquering Health: serving patients with special needs" in the School of Dentistry Lutheran University of Brazil - Canoas Campus/RS, from 2001 to 2006. The data was collected from patients's charts. A similar number of male and female patients, a higher prevalence of young patients, coming from Canoas and with neurological disorders was observed. Approximately 80% of the patients with disabilities presented caries. The results obtained suggest the establishment of public policies on health promotion and reorientation of dental services that facilitate access and use by individuals with disabilities.

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