BackgroundOral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD.MethodsFive hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ)8-10 (n = 247) and CPQ11-14 (n = 300). A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD), examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (κ) and intraclass correlation coefficient (ICC). Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES). Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation.ResultsIntraexaminer reliability values ranged from regular (κ = 0.30) to excellent (κ = 0.96) for the categorical variables and from moderate (ICC = 0.49) to substantial (ICC = 0.74) for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ8-10 scores were slightly higher for TMD children than control children (ES = 0.43). Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p < 0.0001). Significant correlation between the CPQ scores and global oral health, as well as overall well-being ratings (p < 0.001) occurred, supporting the construct validity. The Cronbach's alphas were 0.93 for CPQ8-10 and 0.94 for CPQ11-14. For the overall CPQ8-10 and CPQ11-14 scales, the corrected item-total correlation coefficients ranged from 0.39-0.76 and from 0.28-0.73, respectively. The alpha coefficients did not increase when any of the items were deleted in either CPQ samples.ConclusionsThe questionnaires are valid and reliable for use in children and preadolescents with signs and symptoms of temporomandibular disorder.

Children and preadolescents with poor emotional well-being are more sensitive to the impacts of OH and its effects on OWB.

Objectives: This study aimed to evaluate the associations between psychological factors and the presence of deleterious oral habits in children and adolescents. Study Design: 147 students aged 8 to 14-years-old were divided in two groups concerning the presence and absence of DOH: Habit group (HG) and Habit free group (HFG). Participants were asked about the presence of DOH using the domain III (Oral Habits) of the Nordic Orofacial Test-Screening (NOT-S). Symptoms of anxiety and depression were evaluated using the Brazilian Portuguese versions of the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI), respectively. Saliva was collected 30min after waking and at night to determine the diurnal decline in salivary cortisol (DDSC). Data were analyzed using the Chi-squared, Mann-Whitney, Spearman's correlation and logistic regression. Results: The prevalence of DOH was higher in females than males (65.1 vs 34.9; p&lt;0.05). The most frequent DOH was nail biting (58.7%). HG presented more depressive symptoms than HFG (p&lt;0.05). There was positive correlation between salivary cortisol levels and age (p&lt;0.01). Logistic regression analysis found association between symptoms of anxiety and the presence of DOH (OR=2.35; p&lt;0.05). Conclusions: In conclusion, children and adolescents with DOH presented more symptoms of depression than their counterparts. Moreover, they were more likely to report symptoms of anxiety.

Abstract:The objective was to evaluate the relationship among oral habits, oral function and oral health-related quality of life (OHRQoL) in children. Three hundred and twenty-eight subjects (8-14 years old) were assessed for orofacial function using the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S). OHRQoL was assessed using the Child Perceptions Questionnaires (Brazilian versions) for the 8-10 (CPQ 8-10 ) and 11-14 (CPQ 11-14 ) year age groups. The subjects were distributed into a Habit group and a Habit-free group according to domain III (Habits) of the NOT-S. Oral habits were present in 71.3% of the sample (p = .0001), with a higher prevalence in females (62.8%, p = .001). The NOT-S, CPQ 8-10 and CPQ 11-14 scores were higher in the Habit group (P = .0001, P = .009 and p = .001, respectively). Domain I (Sensory Function) was significantly more affected in Habit group subjects (p = .001). The NOT-S scores were positively correlated with the CPQ 8-10 and CPQ 11-14 scores only in the Habit group (r = .32, p = .0003 and r = .30, p = .001, respectively). These results indicate that oral habits can impact OHRQoL. Moreover, orofacial dysfunctions were associated with worse OHRQoL in subjects with oral habits.

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Objetivo: Traduzir o instrumento The Nordic Orofacial Test -Screening (NOT-S), que avalia disfunções orofaciais, para a língua portuguesa e realizar a adaptação transcultural em crianças brasileiras. Método: O instrumento foi submetido às seguintes etapas: tradução para português (Brasil), tradução reversa, revisão por comitê (composto por três professores universitários de Odontologia e um paciente formalmente instruído) e pré-teste. Para a fase de equivalência cultural (pré-teste), a cada um dos itens do instrumento foi acrescentada a alternativa "não entendi" ou "não aplicável", se o índice dessas repostas fosse superior a 15%, a questão deveria ser reformulada pelo comitê e reaplicada em outro grupo de crianças. O NOT-S foi aplicado em uma amostra de 20 crianças de 8 a 14 anos, de escolas da rede pública de Piracicaba, selecionadas aleatoriamente. Resultados: A comparação entre o instrumento original e o resultado da tradução reversa mostrou forte concordância entre ambos. As mudanças realizadas pelo comitê revisor foram o acréscimo de palavras e frases e a substituição de advérbios e palavras por sinônimos para facilitar o entendimento. No pré-teste, duas questões tiveram um índice de respostas "não entendi" de 15%, foram reformuladas e, a partir disso, o índice de resposta "não entendi" foi nulo. Conclusão: A versão em português do NOT-S foi criteriosamente traduzida e adaptada à cultura brasileira e mostrou-se ser de fácil compreensão pela população de crianças brasileiras avaliada. Sistema Estomatognático; Tradução (Processo); Criança. Objective: To translate the instrument The Nordic Orofacial TestScreening (NOT-S), which evaluates orofacial dysfunctions, intoBrazilian Portuguese and to perform the cross-cultural adaptation for Brazilian children. Method: The instrument was subjected to the following stages: translation into Brazilian Portuguese, back-translation, revision by a committee (composed by three Professors of Dentistry and a formally instructed patient) and pretest. For the phase of cultural equivalency (pretest), a "did not understand" or "does not apply" item was added to each one of the items of the instrument; if the rate of these answers was 15% or above, the question should be reformulated by the committee and reapplied to another group of children. The NOT-S was applied to a sample of randomly selected 20 children aged 8 to 14 years from public schools of the city of Piracicaba, SP, Brazil. Results: There was a strong agreement between the original instrument and its back translated version. The changes made by the revising committee were the addition of words and sentences and the substitution of adverbials and words by synonyms to facilitate the understanding. In the pretest, two questions had 15% of "did not understand" answers and were reformulated; thereafter, the rate of "did not understand" answers was null. Conclusion:The final Portuguese version of NOT-S was rigorously translated and adapted to the Brazilian culture, and was easily understood by the sample of Brazilian childre...

Purpose: Orofacial function is the result of complex activities of the central nervous and neuromuscular systems. Orofacial dysfunction can compromise vital actions, such as breathing, chewing and swallowing, and facial expressions. The aim of this study was to apply the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S), which assesses orofacial dysfunction, to a sample of Brazilian children and adolescents. Methods: The Brazilian version of NOT-S was applied in 197 girls and 135 boys, aged from 8 to 14 years old. They were clinically examined for the phase of dentition and characteristics of occlusion. For assessing NOT-S reliability, a test-retest was performed in 50 subjects randomly selected from the total sample15 days after the first application. Descriptive statistics, Pearson's chi-squared, Mann-Whitney and Kappa tests were applied for data analysis at significant level of α=0.05. Results: The scores ranged from 0 to 7; score 0 had a rate of 5%; the mean score was 2.64. The most frequent domains were III (Habits) and IV (Chewing and Swallowing) with a rate of 70 and 50%, respectively. No difference between genders was seen in relation to orofacial dysfunction, but subjects in mixed dentition and those with frontal open bite presented more orofacial dysfunction. The rate of intra-examiner agreement was 97.8% comparing the first and retest applications. Conclusion: No differences between genders were detected, but subjects in mixed dentition and in those with anterior malocclusion the orofacial dysfunction was more present. The Brazilian version of NOT-S was considered proper for application in Brazilian subjects.

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