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      Factors Associated with No Dental Treatment in Preschoolers with Toothache: A Cross-Sectional Study in Outpatient Public Emergency Services

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          Abstract

          Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children’s age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children’s mean age was 4.1 (SD 1.0) years (range 1–5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of “sex”, the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5–0.8), radiography request (OR 3.8; 95% CI 1.7–8.2), medication prescribed (OR 7.5; 95% CI 4.9–11.5) and patient referred to another service (OR 5.7; 3.0–10.9). Many children with toothache received no oral procedure for pain relief.

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          Most cited references47

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          Oral health surveys, basics methods

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            The prevalence and impact of dental pain in 8-year-old school children in Harrow, England.

            To assess the prevalence, severity and impact of dental pain. Cross-sectional survey. Schools in the London Borough of Harrow, England, in the summer term of 1995. The base population were all 2,300 8-year-old school children in Harrow. A cluster sampling of schools based on quotas from all postcode areas in Harrow was used. Data were collected through interviews with the children. Prevalence of previous toothache; prevalence of toothache in the previous 4 weeks; prevalence of toothache in the previous 4 weeks which resulted in a visit to the dentist, in stopping playing, eating, sleeping, going to school and taking painkillers. Of the 664 sample of children in the participating schools, 589 were interviewed (88.7%). The frequency of previous toothache was 47.5% (95% CI, 44-52) and dental pain caused crying in 17.7% (95% CI, 15-21) of children. 7.6% (95% CI, 5-11) of children had pain in the previous 4 weeks (45 children). Among these 45 children, this recent pain resulted in a visit to the dentist in 41.9% (19 children, i.e. 3.2% of all children), in stopping playing in 26.7% (12 children, i.e. 2.0% of all children), eating in 73.3% (33 children, i.e. 5.6% of all children), sleeping in 31.1% (14 children, i.e. 2.4% of all children) and in going to school in 11.1% (5 children, i.e. 0.8% of all children). Toothache in children is a sizeable problem in Harrow and had substantial consequences for children and their guardians. Freedom from disabling dental pain/discomfort is an outcome indicator of oral health and could be used as an explicit goal by dental systems. It is important to note however, that the present study did not assess the extent to which the dental pain was associated with avoidable dental problems as opposed to normal physiological processes. It is important that future work try and separate the prevalence of dental pain caused by physiological from avoidable pathological factors. In addition, future work is needed to assess how effectively and efficiently dental services are responding to people suffering with dental pain.
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              Dental caries in 0- to 5-year-old Brazilian children: prevalence, severity, and associated factors.

              This cross-sectional study investigated the prevalence and severity of dental caries and their association with demographic and socio-economic variables in Brazilian preschoolers. The study population comprised 1487 0- to 5-year-old children attending government nurseries in Canoas, southern Brazil. Questionnaires regarding information related to the independent variables (age, gender, maternal level of education, and family income) were completed by the parents. Clinical examinations were carried out by five trained examiners and results were expressed using the deft index (World Health Organization criteria), including white spots. The outcomes considered in this study were caries occurrence (deft > 0) and caries severity (deft). Forty per cent of the children (589/1487) presented dental caries [mean deft (SD): 1.53 (2.75)]. Deft increased with age (P < 0.001) and was significantly higher in children from mothers with low educational level (P = 0.001) and low family income (P = 0.001). The greatest increase in caries prevalence and severity occurred between age groups of 1 and 2 years. Logistic regression demonstrated higher odds of dental caries with mother's completing < 4 years education, after adjusting for confounding. These findings indicate the need for preventive programmes, which should begin in the first year of life, with special attention given to families with mothers presenting low education levels.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                08 August 2014
                August 2014
                : 11
                : 8
                : 8058-8068
                Affiliations
                [1 ]Division of Pediatric Dentistry, Faculdade de Odontologia, Federal University of Goias, 1 av., Setor Universitario, 74605-220 Goiania-Goias, Brazil; E-Mail: geovannacm@ 123456yahoo.com.br
                [2 ]Health Sciences Graduate Program, Federal University of Goias, 74605-020 Goiania-Goias, Brazil; E-Mail: anelisedaher@ 123456terra.com.br
                Author notes
                [* ]Author to whom correspondence should be addressed: E-Mail: lsucasas@ 123456ufg.br ; Tel.: +55-62-3209-6047; Fax: +55-62-3209-6325.
                Article
                ijerph-11-08058
                10.3390/ijerph110808058
                4143849
                25111875
                61fbdcf3-9ad7-472d-89c2-a891a7c04964
                © 2014 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 03 June 2014
                : 28 July 2014
                : 29 July 2014
                Categories
                Article

                Public health
                dental pain,children,dental health services
                Public health
                dental pain, children, dental health services

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