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Objectives:This study aimed to investigate the differential preventive effect of motivational interviewing (MI) on early childhood caries (ECC) according to socioeconomic variables, using a community-based trial in a public healthcare setting. Methods:A cluster-randomized, double-blind study with two parallel groups in healthcare clinical settings (HCCs) comparing conventional oral health education (CE) and MI aimed at mothers of children born in 2013 and 2014. The oral health team of 6 of the 12 HCCs were trained in MI. This training was intensive for active learning of the basic MI principles, conducted by a psychologist who is a PhD in psychiatry and has extensive experience in conducting MI training workshops. It was held in an experiential format divided into two 4-hour shifts, with a 1-week interval. Children who attended at least one dental visit in the first year of life at their HCC were clinically evaluated by trained examiners and parents responded to a questionnaire. The effect of MI on the caries outcome compared with CE was evaluated in different subgroups: family income, mother's education and skin colour. Results:One hundred and eighty-six were included in the CE group and 228 in the MI group. The caries rate per 100 surface-year was 1.29 (95%CI: 0.92-1.80) in the CE group and 0.46 (95%CI: 0.29-0.73) in the MI group. The effect of MI was statistically significant in the lower-income category (P = .03); MI prevented 57% of carious lesions (IRR = 0.43, 95% CI 0.22-0.83) and reduced the occurrence of the disease on more than one surface per 100 followed surface-year in this same category in the equivalent income subgroup (IRD = −1.37, P = .04). Conclusions:Motivational interviewing had a greater preventive effect against caries in children whose families are of lower income.

Objectives: This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity. Methods: Interventions based on motivational interviewing were considered eligible. The main outcome was new caries lesions (some studies included white-spot lesions in total count), and secondary outcomes included caregivers' oral health knowledge, home-care behaviours, plaque index, gingival index and fluoride varnish applications. Controls were any type of oral health education or negative controls without any specific intervention. Results: From a total of 1498 studies identified in the databases search, 1078 were assessed for eligibility by reading titles and abstracts, after removal of duplicates. Full-text screening was performed in 61 articles, with 18 reporting on 14 different studies included in the qualitative synthesis and 8 in the quantitative synthesis (four studies included new white-spot lesions in total count). Subgroup analysis was performed by the control group dmft/dmfs and the test for subgroup differences suggests that there is a subgroup effect (P = .06), so population caries experience modifies the effect of MI-based intervention. In populations with high caries experience, the MI-based approach proved preventing an average of 3.15 (95% CI: −6.14, −0.17) dmfs in young children. In samples with low caries experience, differences were smaller, since the caries levels were already lower (−0.31; 95% CI: −0.63, 0.00). Conclusion: Motivational interviewing has the potential to modify knowledge and behaviours and reduce ECC with a more significant impact on children with high caries experience. K E Y W O R D S dental caries, early childhood caries, motivational interviewing, preschool child, review 1 | INTRODUC TI ON Dental caries in children has declined in the past few decades, although many children still carry significant disease levels. 1 In 2010, untreated caries in primary teeth was the 10th most prevalent condition, affecting 621 million people globally, 2 but the effectiveness of individual interventions for disease prevention is unclear. 3 While dental health education seems to improve knowledge, its effects on

A oferta de cursos a distância implica no acompanhamento e na avaliação de seu processo de ensino. A avaliação de processos educacionais visa capturar suas lacunas e permitir, através de um ciclo de reflexão e ação estratégica, avançar na qualidade de sua construção. O objetivo deste estudo foi descrever a percepção da qualidade do processo de aprendizagem realizada por meio de pesquisa de opinião. Participaram 332 alunos concluintes de seis cursos de educação permanente a distância em áreas obrigatórias aos Centros de Especialidades Odontológicas. O instrumento utilizado foi o Constructivist On-Line Learning Environment Survey (COLLES), que consiste em 24 questões agrupadas em seis dimensões: relevância, reflexão crítica, interação, apoio dos tutores, apoio dos colegas e compreensão. As respostas foram em escala do tipo Likert, de cinco pontos, variando de quase nunca a quase sempre. Os dados foram computados e apresentados como frequências absolutas e relativas. Os resultados revelaram que, para maioria (85,3%) dos participantes, os cursos foram relevantes para a prática da profissão. A reflexão crítica foi realizada frequentemente (43,2%) sobre o conteúdo do curso. De acordo com 39,1% dos estudantes, o tutor estimulou a reflexão sobre as atividades do curso. Resultados piores foram obtidos em interatividade, dimensão na qual apenas 13,5% se dispuseram a explicar suas ideias e 44,3% quase nunca pediram explicações sobre as ideias dos colegas. O estudo permitiu observar que os alunos percebem favoravelmente quatro das seis dimensões, entretanto há necessidade de reorientação das atividades para melhoria da interatividade e de movimento colaborativo.

Conceptual or theoretical models are crucial in developing causal hypotheses and interpreting study findings, but they have been underused and misused in aetiological research, particularly in dentistry and oral epidemiology. Good models should incorporate updated evidence and clarify knowledge gaps to derive logical hypotheses. Developing models and deriving testable hypotheses in operational models can be challenging, as seen in the four examples referred to in this commentary. One challenge concerns the theoretical validity of the model, while another relates to difficulties in operationalizing abstract concepts. A third challenge refers to the lack of sufficient information in the dataset to test partially or even the whole model. Finally, a common challenge is the application of a conceptual model to different contexts. Among the existing methodological approaches to operationalize conceptual models, causal graphs may be helpful, especially when combined with approaches from diverse disciplinary fields via triangulation.

Objetivo: avaliar a atividade antimicrobiana in vitro daplanta Stevia rebaudiana Bertoni e de adoçantes nãocalóricos sobre o crescimento de Streptococcus mutanse Lactobacillus casei, micro-organismos cariogênicospresentes na cavidade bucal. Materiais e método: oestudo foi realizado utilizando as cepas padrões de S.mutans (UA159) e L. casei (ATCC7469). Foram avaliadosdiferentes compostos não calóricos substitutos dasacarose nas concentrações de 1%, 5% e 10%: eritritol(ER), Fit Sucralose® (SU), Stevita® (ST), solução de Steviarebaudiana Bertoni (SSr) e, como controle positivo,digluconato de clorexidina (DC). A análise do efeito inibitóriodesses compostos no crescimento das bactériasfoi feita por meio da técnica de difusão em ágar. Resultado:observou-se que existe um efeito inibitório decrescimento de ambos os micro-organismos por parteda SSr e do ER, enquanto os demais adoçantes testadosnão tiveram efeito inibitório sobre esses micro-organismos.Conclusão: os resultados demonstram que SSR eER apresentam efeito inibidor no crescimento das cepastestadas de S. mutans e L. casei. Palavras-chave: Adoçante natural. Cárie dentária. Lactobacilluscasei. Stevia. Streptococcus mutans.

Purpose to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. Methods a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. Results out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). Conclusion the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.

Objectives: The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health; and to identify the theoretical frameworks applied to guide this literature. Methods: A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted. Results: Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association. Conclusion: Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health.