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Objectives To systematically review observational studies assessing the association between socioeconomic status (SES) and oral health‐related quality of life (OHRQoL) in children, adolescents and adults. Methods Electronic searches were performed in the PubMed, Embase, Web of Science, LILACS and Scopus databases for articles published up to September 2020. Two independent reviewers performed the search and critical appraisal of the studies. The inclusion criteria were observational studies that evaluated the effect of SES on the OHRQoL in all age groups using validated methods. Quality assessment was conducted using the Newcastle‐Ottawa Scale. Data were extracted for meta‐analysis followed by a meta‐regression analysis. A random‐effects model was used to estimate the pooled calculate prevalence ratio (PR) and respective 95% confidence intervals (CI) for each study. Results The search strategy retrieved 6114 publications. Some 139 articles met the eligibility criteria and were included in the systematic review. Of those, 75 were included in the general meta‐analysis they represented a total sample of 109 269 individuals. People of lower SES had worse OHRQoL (PR 1.30; 95% CI 1.26‐1.35). In the meta‐analyses of different subgroups, an association was found between low SES and worse OHRQoL in countries of all economic classifications, in all age groups and irrespective of the socioeconomic indicator used. A socioeconomic gradient in OHRQoL was also observed, in which the lower the individuals' socioeconomic position, the poorer their OHRQoL. Conclusions Individuals of low SES had poorer OHRQoL, regardless of the country's economic classification, SES indicator and age group. Public policies aiming to reduce social inequalities are necessary for better OHRQoL throughout life.

Background The impact of the COVID‐19 pandemic on behavioural and psychosocial aspects related to oral health is unknown. Aim This study evaluated the psychosocial and behavioural changes related to oral health in adolescents immediately before and during the pandemic period of COVID‐19, enabling a longitudinal assessment of the perceived changes. Design This cohort study evaluated 290 adolescents from November 2019 to February 2020 (T1—before the pandemic in Brazil) and from June to July 2020 (T2) in southern Brazil. Sociodemographic, behavioural, and psychosocial variables were measured before and during the pandemic. Issues related to social distancing and job loss were also collected. The differences between the variables in T1 and T2, as well as the effect of social distancing, were assessed using a multilevel‐adjusted logistic regression model for repeated measures. Results A total of 207 adolescents were re‐evaluated at T2 (a response rate of 71.3%). During the pandemic, the frequency of toothbrushing, the use of dental services, and the self‐perceived need for dental treatment significantly decreased. Sugar consumption, bruxism, and quality of sleep did not change significantly. Conclusion Behavioural and psychosocial factors showed significant changes due to the COVID‐19 pandemic in adolescents.

BackgroundSocioeconomic factors at both contextual and individual levels influence health.AimEvaluate the influence of socioeconomic inequalities on the incidence of dental caries in adolescents.DesignThis cohort study was conducted with a multistage random sample of 1134 12‐year‐old adolescents from Southern Brazil. The experience of dental caries was assessed according to the decayed, missed, or filled surfaces (DMF‐S) index. The Basic Education Development Index (IDEB) was collected during baseline as a school‐level variable. Individual variables included demographic, socioeconomic, behavior‐related, and oral health measures. Multilevel Poisson regression analysis through a hierarchical approach was used to explore the influence of exploratory variables on the mean of decayed surfaces.Results770 14‐year‐old adolescents were reevaluated (follow‐up rate of 68%) after 2 years. Examiner's Kappa values for the assessment of dental caries ranged from 0.81 to 0.90. Adolescents with low household income and lower school's IDEB had higher mean of decayed surfaces. Non‐white adolescents, lower frequency of dental attendance, parents' poor perception of child's oral health, and dental plaque were also associated with the incidence of dental caries.ConclusionAdolescents from a lower socioeconomic background and poor school context had higher levels of dental caries over time.

The aim of this study was to verify the influence of school environment and individual factors on oral health related quality of life (OHRQoL) in a representative sample of Brazilian schoolchildren. A cross-sectional study was conducted with 1,134 12-year-old schoolchildren from Santa Maria, Southern Brazil. Clinical variables were obtained from examinations carried out by calibrated individuals. In addition, parents/guardians answered a semi-structured questionnaire about sociodemographic characteristics. Contextual variables were obtained from the city's official database, including the mean income of the neighborhood in which the school was located and the Basic School's Development Index (IDEB) of the school. The Brazilian version of the Child Perception Questionnaire (CPQ11-14) was used to access OHRQoL. Data analysis was conducted using multilevel Poisson regression. Children studying in schools with a higher classification on the IDEB presented a lower CPQ11-14 mean score (rate ratio 0.80, 95%CI 0.74-0.88) than those studying in schools with a lower IDEB. Regarding individual variables, children with carious cavities, malocclusion, and gingival bleeding presented higher CPQ11-14 mean values than their counterparts. The same was observed in children from families with low socioeconomic status. School environment, and individual clinical and socioeconomic factors were associated with schoolchildren's OHRQoL.

Purpose As people around the world are facing the Covid-19 outbreak, their perception of oral health problems could be changed. This study aimed to evaluate the immediate effects of the Covid-19 pandemic on oral health-related quality of life (OHRQoL) of adolescents. Methods A cohort study with schoolchildren from southern Brazil was conducted. Data on adolescents' OHRQoL were collected from December 2019 to February 2020 (T1), before the Brazilian Covid-19 outbreak. Posteriorly, the data were collected again in June and July of 2020 (T2), under the Brazilian Covid-19 outbreak. The OHRQoL was assessed using the Brazilian short version of the CPQ11-14. Demographic and socioeconomic characteristics and the degree of social distancing were also assessed. Changes in OHRQoL between T1 and T2 were evaluated by adjusted Multilevel Poisson regression models for repeated measures. Results From 290 individuals evaluated at T1, 207 were reevaluated at T2 (response rate of 71.3%). The overall CPQ11-14 mean score was significantly lower during the pandemic, reducing from 10.8 at T1 to 7.7 at T2. This significant reduction was also observed for all CPQ domains, indicating a lower negative impact of oral conditions on adolescents' quality of life during the pandemic. Adolescents from families that had a middle or low degree of social distancing during the pandemic and whose parents were harmed in employment had higher CPQ11-14 scores. Conclusion Overall and specific-domains CPQ-14 scores were significantly lower during the Brazilian Covid-19 outbreak, indicating a decrease in the perception of oral health problems by adolescents over that period.

BackgroundThere is an improvement in oral health status among people who receive preventive dental care during their lifetime, highlighting the possible effect in resolving oral health problems and consequently oral health‐related quality of life (OHRQoL).AimAssessed the effect of routine dental attendance on child OHRQoL.DesignThis cohort study used baseline data from 639 preschoolers from 2010. After 7 years, 449 children were re‐examined (70.3%). Mothers of the children completed a questionnaire collecting data on the pattern of use of dental services. Children were classified as adhering to long‐term routine dental attendance according to their pattern of use (routine vs curative) in the baseline and in follow‐up. The child OHRQoL was assessed through the Child Perception Questionnaire (CPQ8‐10). The association between routine dental attendance and child OHRQoL was assessed using multilevel Poisson regression models.ResultsThe proportion of participants who reported the worst CPQ8‐10 scores were higher among those who, at some point in their life, experienced a curative dental attendance. Also, the mean CPQ8‐10 was two times higher for non‐routine dental attendance.ConclusionThe findings showed that there is an impact of long‐term routine attendance on child OHRQoL. This is important for tackling oral health iniquities.

Background Social capital incorporates contextual and individual levels of interactions, which influence human health. The aim of this study was to evaluate the influence of individual and contextual social capital in early childhood on gingival bleeding in children after 7 years. Methods This 7‐year cohort study was conducted with a randomized sample of 639 children (1 to 5 years old) evaluated in 2010 (T1) in Santa Maria, southern Brazil. Gingival bleeding was recorded during follow‐up (T2). Contextual (social class association and number of churches) and individual (religious practice, volunteer networks, and school involvement) social capital variables were collected at baseline, along with demographic, socioeconomic, and oral health variables. A multilevel Poisson regression model was used to investigate the influence of individual and contextual variables on mean gingival bleeding. The incidence rate ratio (IRR) and 95% confidence interval (95% CI) were calculated. Results A total of 449 children were reassessed after 7 years (70.3% cohort retention rate). Children living in areas with a larger number of churches at baseline had lower mean gingival bleeding at follow‐up. Regarding individual social capital, children whose parents did not attend school activities were more likely to have gingival bleeding. Additionally, low maternal education, poor parents’ perception of oral health, non‐use of dental services, and low frequency of tooth brushing were related to higher mean gingival bleeding at follow‐up. Conclusion The presence of more churches in neighborhoods and parents' involvement in a child's school activities positively influenced children's oral health, and these individuals had lower mean gingival bleeding.