Parafunctional habits, such as bruxism, are contributory factors for temporomandibular disorders (TMD). The aim of this study was to evaluate the maximal bite force (MBF) in the presence of TMD and bruxism (TMDB) in young adults. Twelve women (mean age 21.5 years) and 7 men (mean age 22.4 years), composed the TMDB group. Ten healthy women and 9 men (mean age 21.4 and 22.4 years, respectively) formed the control group. TMD symptoms were evaluated by a structured questionnaire and clinical signs/symptoms were evaluated during clinical examination. A visual analogical scale (VAS) was applied for stress assessment. MBF was measured with a gnatodynamometer. The subjects were asked to bite 2 times with maximal effort, during 5 seconds, with a rest interval of about one minute. The highest values were considered. The data were analyzed with Shapiro-Wilks W-test, descriptive statistics, paired or unpaired t tests or Mann-Whitney tests when indicated, and Fisher's exact test (p < 0.05). TMDB women presented lower values of MBF as compared to those presented by TMDB men and by the control group. MBF for TMDB men was similar to that of the control group. The proportion of TMDB women with muscle pain and facial/teeth/head pain upon waking up was significantly higher than that of men. Control women presented significantly lower stress scores than the others. It was concluded that MBF was reduced in TMDB women, as they presented more signs and symptoms. Men presented higher MBF values than women, but TMD and bruxism did not significantly decrease MBF. Stress was not an influencing factor for TMD and bruxism in men.

The purpose of this study was to evaluate factors associated with temporomandibular disorder (TMD) in children. TMD clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD; axis I), and subjective symptoms were evaluated using a structured questionnaire. Eighty-two children were selected, 40 with TMD (19 boys and 21 girls, mean age 9.84 ± 1.53 and 9.71 ± 1.30 years, respectively) and 42 without TMD (21 boys and 21 girls, mean age 10.27 ± 1.63 and 9.9 ± 1.37 years, respectively). Intra-and extra-oral examinations were carried out to determine the myofunctional characteristics of the masticatory system. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Data were analyzed using descriptive statistics and bivariate analysis followed by multiple logistic regression (α = 0.05). In bivariate analysis, the variables of open lips, anxiety, and depression had a p value < 0.15 and were entered into the multivariate logistic regression model. The most significant predictor factors were the presence of open lips (odds ratio = 5.42, p = 0.034) and anxiety (odds ratio = 18.59, p < 0.001). Thus, anxiety levels and open lips were associated with TMD in children. Owing to the cross-sectional design of the present study, the associations observed may have a bidirectional relationship.

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BackgroundVoice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects’ lives.AimTo investigate the impact of educational voice interventions for teachers on quality of life and voice.MethodsA longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α < 0.05. Results: Teachers showed significantly higher domain and overall V-RQOL scores after preventive intervention, in both control and experimental groups. Nevertheless, there was no statistical difference in scores between the groups.ConclusionEducational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested.

Purpose: conduct a prospective study to analyze risk factors for dysphonia in teachers, associated with presence of vocal alterations. Method: one-hundred-and-two teachers (81 women and 21 men) were randomly selected from 11 schools in Piracicaba/SP, with mean age 42.48 years. A questionnaire covering aspects of the work environment and organization, vocal behavior, lifestyle and signs and symptoms of vocal alterations was applied. Acoustic analysis was performed and the dependent variables assessed were Fundamental Frequency and mean Vocal Intensity. There were associations between questionnaire variables and Fundamental Frequency, and mean Intensity. The following statistical tests were used: Chi-square, Fisher´s Exact Test and Odds Ratio calculation. Results: individuals of the male gender had less chance of presenting altered fundamental frequency of the voice than the female gender (p<0.0001). Teachers who had been teaching elementary II and middle school had less chance of presenting alteration in fundamental frequency of the voice than those who taught in (first grade) primary schools I (p=0.04). The environmental noise was significantly associated with alteration in mean voice intensity (p=0.02). Conclusion: factors such as female gender, teaching in primary school and exposure to work environment noise are considered risk indicators for voice disorders. KEYWORDS:

ObjectivesThe aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. Material and methodsSpeech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 ± 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40), TMD signs and symptoms (Group S and S, n=68), TMD signs or symptoms (Group S or S, n=33), and without signs and symptoms (Group N, n=11). Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (α=0.05). ResultsA slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /l/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. ConclusionsThere was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /l/.

Purpose: to analyze the knowledge and practices of nurses, doctors and dentists working in Primary Care for the development of the child's language early in life Methods: it is a qualitative research with 30 professionals from a network of Primary Care, among them doctors, nurses and dentists. An individual consultation was carried out through a semi-structured questionnaire. The technique of thematic speech analysis was used using three methodological approaches:The Central Idea, Expressions-Keys and the Collective Subject Discourse. Results: the knowledge that professionals have about the development of children's language were anchored to the core ideas to meet some milestones of development, the child's language depends on the middle stimulus, the family and normal hearing to know little or know nothing about the subject. The professionals reported that they would like to get more information on the subject in relation to the milestones of the child's language development, normal deviations and guidelines for parents in order to improve the care of children's health. Conclusion: the knowledge of professionals on the subject has been limited, and there is a need to expand educational practices in health through speech therapy, in partnership with the institutions of education

Aim: To estimate tooth loss prevalence among adolescents in São Paulo, considering socioeconomic and demographic factors, dental service use and pain. Methods: Data were obtained from the São Paulo Oral Health Survey 2008. The sample comprised 2858 adolescents from 15 to 19 years old from public and private schools, who underwent through an oral examination. In addition, a questionnaire was applied regarding the characterization of factors related to socioeconomics, demographics, use of dental services and pain in the last six months. At least one tooth lost was the outcome. The independent variables included gender, ethnicity, parents' schooling, type of school, number of rooms, people and cars per home, family income, dental service use, decayed teeth, toothache. A multivariate logistic regression model was used. Results: The prevalence of tooth loss was 7%. The independent variables decayed tooth (RP=1.71), toothache (RP=2.04), father's schooling-elementary (RP=1.40) and per capita family income-less than 1/ 2 a minimum salary (RP=1.45) were associated with the outcome. Conclusions: The results suggest that socioeconomic factors may contribute to the increase of early tooth loss among adolescents.