Sense of coherence (SOC) is regarded as the individuals' capacity for managing the stressors over their lifespan. The aim of this systematic review and meta-analysis was to evaluate the association between SOC and dental caries. Electronic searchers were conducted in six databases: PubMed, Medline, Scopus, Web of Science, Lilacs and Proquest from their date of inception until November/2017. An update took place in August/2018. A hand search in the reference list of the included articles and gray literature search were also carried out. Retrieved titles/abstracts were screened by two review authors. Data of the included articles were extracted and quality assessment was also conducted. The first search retrieved 346 titles/abstracts. The update retrieved 33 records. Following the removal of 70 duplicates, 309 references were screened and 17 were included. The quality assessment ranged from low quality articles to high quality articles. High quality study showed that adult individuals with lower SOC were more likely to have dental caries. Meta-analysis showed that adolescents with low SOC were 5.41 times more likely to present dental caries than adolescents with high SOC (CI = 2.15–13.59). Mothers with low SOC were 5.55 times more likely to have children/adolescents with dental caries than mothers with high SOC (CI = 2.92–10.57). The subgroup analysis exploring continuous data showed that the SOC of mothers of children/adolescents without dental caries was significantly higher than the SOC of mothers of children/adolescents with dental caries (CI = 0.10–0.51). Higher levels of SOC seem to be associated with lower levels of dental caries.

Objective: To evaluate the impact of the first six months of orthodontic treatment with fixed appliances on the oral health-related quality of life (OHRQoL) of adolescents, comparing boys and girls, using a specific condition questionnaire. Design: Cross-sectional. Setting: School of Dentistry of the Federal University of Minas Gerais, Belo Horizonte, Brazil Participants: Adolescents aged 10–17 years. Methods: Forty-six adolescents participated in this study. Adolescents’ OHRQoL was evaluated using the Brazilian version of the questionnaire Impact of Fixed Appliances Measure. This questionnaire comprises 43 questions distributed across nine domains: aesthetics; functional limitation; dietary impact; oral hygiene impact; maintenance impact; physical impact; social impact; time constraints; and travel/cost/inconvenience implications. The answer options follow the Likert scale, in the range of 1–5. A higher score indicates a more negative impact on the OHRQoL. Adolescents’ malocclusion was assessed using the Dental Aesthetic Index. Information on family income, adolescents’ age and tooth extraction was also collected. A directed acyclic graph was used to identify potential confounders. Statistical analysis involved the chi-square test, the Student’s t test and the analysis of covariance. The minimal clinically important difference was also calculated. Results: Of the 46 participants, 25 were girls and 21 were boys. The female adolescents presented a more negative impact from the orthodontic treatment on the quality of life when compared to the male adolescents ( P < 0.001), regardless of the influence of the confounding variables. The most negative repercussions were identified in the domains of oral hygiene ( P = 0.002), physical impact ( P < 0.001) and social impact ( P < 0.001). Conclusion: The impact of the first six months of orthodontic treatment on OHRQoL is more negative in female individuals than in male individuals. The results of this study may be useful for the oral healthcare provider during the counselling of adolescents undergoing fixed appliance therapy.

Palavras-chaves: Má Oclusão. Adolescente. Qualidade de Vida. Epidemiologia. Saúde Pública. RESUMOObjetivo: Avaliar o impacto da má oclusão severa na qualidade de vida relacionada à saúde bucal de adolescentes (OHRQoL). Métodos: Este estudo consistiu em uma amostra de 117 adolescentes entre 11 e 12 anos, que responderam à versão brasileira da forma abreviada do Child Perception Questionnaire (CPQ11-14). Este questionário tem 16 itens distribuídos igualmente em quatro domínios: sintomas bucais (SO), limitações funcionais (LF), bem-estar emocional (BE) e bemestar social (BS). Escores mais altos indicam um impacto negativo maior na OHRQoL. A má oclusão foi avaliada por meio do Índice Estético Dental. Os adolescentes foram alocados nas seguintes categorias: sem má oclusão/má oclusão leve, má oclusão definitiva e má oclusão severa. Análise descritiva, teste de Kruskal Wallis, teste de Dunn, regressão logística univariada e multivariada foram conduzidas. Resultados: Indivíduos com má oclusão severa apresentaram escores significativamente mais elevados do que aqueles sem má oclusão/má oclusão leve para o BE (p=0,001), BS (p=0,027) e para o escore total do CPQ11-14 (p=0,015). Adolescentes com má oclusão severa apresentaram 2,63 vezes mais chance de apresentar um impacto negativo alto na OHRQoL do que aqueles sem má oclusão/má oclusão leve, independentemente das variáveis de confusão (IC=1,07-6,45, p=0,035). Conclusão: A má oclusão severa afeta negativamente a OHRQoL dos adolescentes. ABSTRACT Aim:To assess the impact of severe malocclusion on adolescents' oral healthrelated quality of life (OHRQoL). Methods: This study consisted of a sample of 117 adolescents between 11 and 12 years, who answered the Brazilian version of the short form of the Child Perception Questionnaire ). This questionnaire has 16 items distributed equally across four domains: oral symptoms (OS), functional limitations (FL), emotional well-being (EW) and social well-being (SW). Higher scores indicate a greater negative impact on OHRQoL. Malocclusion was evaluated using the Dental Aesthetic Index. Adolescents were assigned to the following categories: no or slight malocclusion, defined malocclusion and severe malocclusion. Descriptive analysis, the Kruskal Wallis test, post hoc test, univariate and multivariate logistic regression were conducted. Results: Individuals with severe malocclusion presented significantly higher scores than those with no or slight malocclusion for the EW (p=0.001), SW (p=0.027) and for the overall CPQ 11-14 score (p=0.015). Adolescents with severe malocclusion showed a 2.63 greater chance of presenting a high negative impact on OHRQoL than those with no or slight malocclusion regardless of the confounding variables (CI=1.07-6.45, p=0.035). Conclusion: Severe malocclusion negatively impacts adolescents' OHRQoL.

No abstract

The construct oral health-related quality of life (OHRQoL) is acknowledged as the effect of oral outcomes on the daily lives of individuals. 1 Therefore, quality of life (QoL) measures should be person-centred and applied to portray the perceptions and values of patients affected by diseases or those undergoing treatment. 2 The use of OHRQoL measures alongside conventional clinical approaches for assessment of health condition leads to a much more thorough assessment of the impact of outcomes related to oral health on the many aspects of subjective well-being. 3 Over the last two decades,