Abstract This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent’s perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Aim This study aimed to assess the prevalence of temporomandibular disorders (TMD) and psychosocial comorbidities in undergraduate dental students in a southern Brazilian university, during the COVID-19 pandemic. Also, it aimed to verify the association between psychosocial factors and TMD. Methods Fonseca Anamnestic Index, Depression Anxiety Stress Scale (DASS-21), a socioeconomic questionnaire, and questions about academic performance and social distancing were applied. Poisson regression analysis was used to assess the association of predictive variables with TMD. Results The prevalence of TMD was found to be 82.4%, and more than half of the students had some degree of stress, anxiety, and depression. Students who had symptoms of stress (RR 1.11; 95% CI 1.04-1.19), anxiety (RR 1.19; 95% CI 1.12-1.27) and reported academic performance worsening (RR 1.12; 95% CI 1.07-1.19) had higher TMD scores. Conclusion The findings suggest that TMD was highly prevalent among dental students at a federal university in southern Brazil during the pandemic, being associated with high levels of stress, anxiety, poor academic performance, and greater social distancing.

Abstract This study aimed to investigate the impact of school bullying and oral health-related verbal bullying on the occurrence of bruxism associated with poor sleep quality among adolescents. This cross-sectional study was nested in a cohort study performed with a sample of children from southern Brazil. Possible sleep bruxism was determined by the question: “Has anyone told you that you grind your teeth in your sleep?” Sleep quality was determined by answering the following question: “How would you classify the quality of your sleep?”. The outcome was created by combining occurrence of sleep bruxism and poor sleep quality. The Sense of Coherence (SOC) was assessed using the SOC-13 scale. Bullying was investigated using the victim scale of the Olweus Bullying Questionnaire and oral health-related verbal bullying using an item from the Child Perceptions Questionnaire-11-14. Demographic, socioeconomic, psychosocial, and clinical data were also collected. Poisson regression models with robust variance were used. Results were expressed as prevalence ratio (PR) and 95% confidence intervals (95% CI). A total of 429 adolescents with a mean age of 12.6 (standard deviation 1.3) years were evaluated. The prevalence of bruxism associated with poor sleep quality was 23.7%. Victims of school bullying (PR 2.06; 95%CI: 1.01-4.22) and oral health-related verbal bullying (PR 1.87; 95%CI: 1.18-2.95) presented higher prevalence of bruxism associated with poor sleep quality. Factors such as skin color and SOC were also associated with the outcome. These findings suggest an association between episodes of bullying and bruxism related to poor sleep quality.

Abstract This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.

Resumo Este estudo teve como objetivo avaliar a influência do número de cirurgiões-dentistas do bairro na incidência de cárie dentária na dentição permanente. Esta coorte teve início em 2010 (T1) com uma amostra aleatória de 639 crianças (1 a 5 anos) acompanhadas por 7 anos, no sul do Brasil. A reavaliação (T2) ocorreu em 2017. A cárie dentária não tratada foi avaliada no T2 por meio do índice de superfícies cariadas, perdidas e obturadas (CPO-S). O número de dentistas do bairro foi obtido no banco de dados oficial da cidade e usada como uma variável contextual. Variáveis socioeconômicas, demográficas e de saúde bucal no nível individual foram avaliadas no T1. Foi realizada uma análise de regressão de Poisson multinível para avaliar a influência das variáveis preditoras na incidência de cárie dentária não tratada. Das 639 crianças no T1, 449 foram reavaliadas no T2 (taxa de retenção de 70,3%). A média das superfícies cariadas no T2 foi de 0,92 (EP 0,01). Quanto maior o número de dentistas nos bairros em que as crianças residiam, menor era a incidência de cárie dentária. Crianças com baixo nível socioeconômico, que não consultaram rotineiramente o dentista nos últimos 6 meses, que apresentaram experiência de cárie dentária e cujos pais perceberam sua saúde bucal como regular/ruim apresentaram maior incidência de superfícies com cárie dentária não tratada. Como conclusão, crianças que moram em bairros com menos dentistas têm maior incidência de cárie não tratada na dentição permanente.

Abstract This study aimed to evaluate the influence of the number of dentists in the neighborhood on the incidence of dental caries in the children permanent dentition. This cohort began in 2010 (T1) with a random sample of 639 children (1 to 5 years-old) followed for 7 years, in southern Brazil. The follow-up reassessment (T2) took place in 2017. Untreated dental caries was evaluated at T2 through the Decayed, Missing, and Filled surfaces index (DMF-S). The number of dentists in the neighborhood was obtained from the city’s official database and used as a contextual variable. Socioeconomic, demographic, and oral health variables at the individual level were evaluated at T1. A multilevel Poisson regression was performed to evaluate the influence of the predictor variables in the incidence of untreated dental caries. From 639 children at T1, 449 were reassessed at T2 (a 70.3% retention rate). The mean of decayed surfaces at T2 was 0.92 (SE 0.01). The greater the number of dentists in the neighborhoods where the children lived, the lower the incidence of dental caries. Children with low socioeconomic status, who have not routinely visited the dentist in the last 6 months, who presented a experience of dental caries, and whose parents perceived their oral health as fair/poor showed a higher incidence of surfaces with untreated dental caries. As conclusion, children who live in neighborhoods with fewer dentists have a higher incidence of untreated dental caries in permanent dentition.

RESUMO Objetivo Avaliar a concordância entre instrumentos de avaliação quantitativa do palato duro. Método Este estudo transversal foi realizado com uma amostra de 30 crianças de 6 a 11 anos de Santa Maria, sul do Brasil. Os instrumentos de medidas do palato avaliados foram: paquímetro digital, utilizado diretamente na cavidade oral e em modelos de gesso, arco tridimensional Korkhaus, usado diretamente na cavidade oral e em modelos de gesso, e Dolphin Imaging Software utilizado para medições em tomografia computadorizada de feixe cônico (CBCT). A concordância entre os diferentes instrumentos foi avaliada por meio do Coeficiente de Correlação Intraclasse (ICC). Resultados As médias de todas as dimensões transversais obtidas pela tomografia computadorizada de feixe cônico foram menores do que as dos outros instrumentos - os valores de concordância na largura entre os caninos e na largura entre os primeiros molares foram baixos na comparação entre a tomografia computadorizada de feixe cônico e os demais instrumentos. Na largura entre o primeiro e o segundo pré-molar, todas as comparações apresentaram valores de concordância aceitáveis. Valores de concordância aceitáveis também foram obtidos ao comparar a profundidade do palato na região do segundo pré-molar com o uso de um divisor de arco dentro da cavidade oral e no gesso. Conclusão A maioria dos instrumentos apresentou concordância satisfatória nas medidas relacionadas ao plano transverso do palato duro. Porém, quando avaliado o plano vertical, apenas o divisor de arco aplicado tanto no gesso quanto na cavidade oral apresentou concordância ideal.

ABSTRACT Purpose To evaluate the agreement among instruments of the quantitative evaluation of hard palate. Methods This cross-sectional study was performed with a sample of 30 children aged 6 to 11 from Santa Maria, Southern Brazil. The instruments for palate measurements evaluated were: digital caliper, used directly in the oral cavity and in plaster casts, Korkhaus tridimensional bow, used directly in the oral cavity and in plaster casts, and Dolphin Imaging Software used for measurements in cone-beam computed tomography (CBCT). The agreement among different instruments was evaluated using the Intraclass Correlation Coefficient (ICC). Results The means of all transversal dimensions obtained by cone-beam computed tomography were lower than those of the other instruments - the agreement values in the width between the canines and in the width between the first molars were lower when comparing the cone-beam computed tomography and the other instruments. In the width between the first and second premolars, all comparisons showed acceptable agreement values. Good concordance values were obtained when comparing the palate depth at the second premolar region when using a bow divider inside the oral cavity and in the cast. Conclusion Most instruments presented satisfactory agreement in the measurements related to the transverse plane of the hard palate. However, when the vertical plane was evaluated, only the bow divider applied to both cast and oral cavity presented ideal agreement.

RESUMO Objetivo Avaliar a associação entre as dimensões do palato duro de acordo com os sexos, cor da pele e períodos da dentição mista e apresentar parâmetros de normalidade de referência para esta fase de desenvolvimento. Método Este estudo transversal avaliou uma amostra representativa de crianças com idade entre 7 e 13 anos em Santa Maria, sul do Brasil. Os desfechos do estudo foram as dimensões do palato: medidas de largura e profundidade. Características sociodemográficas e medidas orais relacionadas também foram avaliadas. Modelos de regressão linear ajustados foram utilizados para avaliar o efeito das variáveis preditoras sobre as dimensões do palato duro em milímetros. Os padrões de referência para a normalidade do palato duro foram apresentados em média, desvio padrão e intervalo de confiança de 95%. Resultados Foram avaliadas 569 crianças. As dimensões do palato duro foram maiores no sexo masculino e menores no primeiro período de transição da dentição mista. A cor da pele influenciou a largura do palato duro ao nível dos pré-molares, sendo as medidas de largura menores nos brancos. Mordida cruzada posterior, más oclusões de Classe II e III de Angle e hábitos de sucção não nutricionais causaram redução nas medidas da largura do palato duro. Conclusão As diferentes dimensões do palato duro são influenciadas por variáveis demográficas como o sexo, cor da pele e período de dentição mista. Crianças do sexo feminino, de cor de pele branca e no primeiro período de transição de dentição mista apresentaram menores dimensões do palato duro. O estabelecimento de padrões de referência de normalidade nas medidas do palato orienta a prática clínica.

ABSTRACT Purpose To evaluate the association among dimensions of the hard palate according to the sexes, skin color, and periods of the mixed dentition and present reference parameters of normality for this stage of development. Methods This cross-sectional study evaluated a representative sample of children between the ages of 7 and 13 years in Santa Maria, southern Brazil. The outcomes of the study were the dimensions of the palate: width measurements and depth. Sociodemographic characteristics and related oral measures were also assessed. Adjusted linear regression model were used to evaluate the effect of the predictor’s variables on the dimensions of the hard palate in millimeters. The reference standards for the hard palate normality were presented in mean, standard deviation, and 95% confidence interval. Results A total of 569 children were evaluated. The hard palate dimensions were larger in the male sex and smaller in the first transitional period of mixed dentition. Skin color had an influence on the hard palate width at the level of the premolars, and the width measurements were smaller in white individuals. Posterior cross bite, Angle Class II and III malocclusions and non-nutritional sucking habits caused reduction in the hard palate width measurements. Conclusion Different dimensions of the hard palate are influenced by demographic variables such as sex, skin color, and mixed dentition period. Children of the female sex, white-skinned and in the first transition period of mixed dentition had smaller dimensions of the hard palate. Establishing normality reference standards in measurements of the palates guides the clinical practice.

Abstract: This study evaluated the influence of Oral Health-Related Quality of Life (OHRQoL) on the consumption of alcohol and cigarette use in adolescents. This prospective cohort began in 2012 (T1) with an initial random sample of 1134 12-year-old adolescents followed for 6 years in Santa Maria, southern Brazil. The present study comprised data from the two cohort reassessments that took place in 2014 (T2) and 2018 (T3). OHRQoL was measured with the Brazilian short version of the Child Perceptions Questionnaire (CPQ11-14) at T2. Socioeconomic, demographic, and oral health measures were also collected during this period. Alcohol and cigarette consumption (regular use) in the past 30 days was evaluated at T3 through questions in the of the National School Health Survey (PeNSE) questionnaire. A multilevel Poisson regression model was used to evaluate the influence of predictor variables on substance use. Of the 770 adolescents at T2, 575 and 576 adolescents were reassessed at T3 for alcohol and cigarette consumption, respectively. Adolescents with higher overall CPQ11-14 scores were at higher risk for regular consumption of alcohol (IRR 1.01; 95% CI 1.01-1.02) and cigarette (IRR 1.04; 95% CI 1.03-1.05). Non-white adolescents with low socioeconomic status, untreated dental caries, and who had not been to the dentist (last 6 months) were also associated with increased regular consumption of licit substances. Adolescents with worse OHRQoL presented a higher consumption of alcohol and cigarette. These findings are useful for planning public health strategies to improve adolescent OHRQoL and reduce the harmful substance use.

Abstract This study investigated the association between the city region and traumatic dental injury (TDI) among adolescents from Santa Maria, Rio Grande do Sul, Brazil. A population-based cross-sectional survey was conducted from March to November 2018, which included a representative sample of adolescents (15-19-year-old) attending public and private high schools. A questionnaire on sociodemographic information was sent to the parents/legal guardians of the selected adolescents. TDI in the upper and lower permanent incisors and canines was recorded based on the O’Brien classification. Environmental variables (sociodemographic and structural characteristics of the neighborhoods) were obtained from official publications. Multilevel Poisson regression models were used, and prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. A total of 1,146 adolescents participated in this study. The overall prevalence of TDI was 17.3%, mild trauma was 12.7%, and severe trauma was 5.8%. Adolescents living in the southern region had a prevalence of TDI of 25.3%, compared with 13.6% in the northern region. After adjusting for important cofactors, adolescents living in the southern region were more likely to have TDI than their counterparts in the northern region (PR, 1.91; 95%CI: 1.18-3.11; p = 0.009). Analyzing the number of environmental risk indicators in different regions, the southern region presented a higher mean and median than all other regions. In conclusion, living in the southern region was associated with a higher prevalence and severity of TDI among adolescents from Santa Maria, southern Brazil. Our findings suggest the role of the environment in the epidemiology of TDI.

RESUMO Objetivo: Avaliar a influência da má oclusão na primeira infância na qualidade de vida relacionada à saúde bucal (QVRSB). Métodos: Este estudo de coorte de 7 anos envolveu 639 pré-escolares (1 a 5 anos) que foram avaliados inicialmente em um levantamento transversal conduzido em 2010. As crianças completaram a versão brasileira do Child Perception Questionnaire (CPQ8-10) para avaliar sua QVRSB no período do acompanhamento. Variáveis exploratórias foram coletadas na linha de base, incluindo a presença e severidade de má oclusão (sobressaliência e cobertura labial). Características socioeconômicas, hábitos de saúde bucal e padrões de assistência odontológica também foram investigados. Um modelo de regressão de Poisson multinível foi utilizado para medir a associação entre má oclusão e QVRSB. Com essa abordagem, calculou-se a razão de taxa de incidência (IRR, incidence rate ratio) e o intervalo de confiança de 95% (IC 95%). Resultados: No total, 449 crianças foram reavaliadas (taxa de acompanhamento de 70,3%). A prevalência de sobressaliência acentuada e cobertura labial inadequada foi de 13,5% e 11,9%, respectivamente. A média±DP de pontuação do CPQ8-10 foi 10,57±10,32. A presença de selamento labial inadequado foi associada com maiores médias na pontuação total do CPQ8-10 (IRR 1,51; IC 95% 1,29-1,77) e nos domínios de bem-estar social, bem-estar emocional e limitação funcional. Crianças com sobressaliência acentuada (>3 mm) também demonstraram médias nas pontuações do CPQ8-10 total maiores do que suas contrapartes normais. A presença dessa condição também influenciou os domínios de sintomas bucais (IRR 1,29; IC 95% 1,08-1,53) e bem-estar emocional (IRR 1,30; IC 95% 1,02-1,66). Conclusão: Os resultados do presente estudo sugerem que a má oclusão na primeira infância é um fator de risco para baixa QVRSB no futuro.

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

Abstract Background Malocclusions are highly prevalent in childhood and adolescence, being considered a public health problem worldwide, in addition to be considered an important predictor in the tongue position and speech disorders. Objective Evaluate the association of malocclusions with tongue position and speech distortion in mixed-dentition schoolchildren from the south of Brazil. Methodology This cross-sectional study was performed using a database of an epidemiological survey realized in the southern of Brazil, in 2015, for evaluating the dental and myofunctional condition of the mixed-dentition from 7-13 years’ schoolchildren. The outcome variables were tongue position and speech distortion, evaluated by a trained and calibrated examiner. Characteristics regarding sociodemographic and oral health measures (Angle’s classification of the malocclusion, overjet, overbite, posterior crossbite and respiratory mode) were also assessed. Poisson regression models with adjusted robust variance were used to evaluate the association among predictors variables in the outcomes. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI). Results A total of 547 children were evaluated. Schoolchildren who presented anterior open bite (PR 2.36 95%CI 1.59-3.49) and having oral/oral-nasal breathing (RP 2.51 95%CI 1.70-3.71) are more likely to have altered position of the tongue. Both deep bite and being male represent protection factors for the abnormal tongue position. Regarding speech distortion, deep overbite presents a protective relationship to speech distortion (PR 0.41; 95%CI 0.24-0.71), whereas schoolchildren with posterior crossbite were more likely to present this problem (PR 1.77; 95%CI 1.09-2.88). Conclusion Anterior open bite and posterior crossbite were the malocclusions related to speech distortion and/or altered tongue position. Oral/oral-nasal breathing was also related to myofunctional changes. Deep bite malocclusion was a protective factor for both speech problems and altered tongue position when compared to a normal overbite.

Abstract The aim of the study was to investigate the influence of clinical and socioeconomic factors on social capital throughout adolescence. A cohort study was performed in 2012 (T1) with a random sample of 1,134 12-year-old adolescents from Santa Maria, Brazil. Questions on socioeconomic factors (maternal education, household income, household crowding) were answered by the parents. Clinicians evaluated their dental caries (decayed, missing, and filled status of permanent teeth) and gingival bleeding (using the Community Periodontal Index). Contextual variables including the mean income of the neighborhood in which the school was located were used (T1). The adolescents were revaluated in 2018 (T2) and answered questions regarding social capital (social trust, social control, empowerment, neighborhood security, and political effectiveness). A path analysis was used to test the relationship between the predictor variables (T1) and social capital (T2). A total of 768 adolescents were reevaluated at a 6-year follow-up (cohort retention rate of 67.7%). Most of the adolescents were girls, with a low household income, about 40% had caries experience (T1), and about 64% had high social capital (T2). The highest neighborhood’s mean income was related to a lower household income in T1 (p < 0.01), and this was directly related to a low social capital in T2 (p = 0.04). Furthermore, caries experience at T1 was directly associated with low social capital at T2 (p = 0.03). Socioeconomic factors were also related to caries experience. Individuals who lived in neighborhoods with greater inequality such as families with a low household income and those with untreated dental caries in early adolescence, had a low social capital after follow-up.

Abstract Objective: To evaluate the impact of early childhood caries, maternal behaviors and associated factors on the oral health-related quality of life (OHRQoL) of preschool children. Material and Methods: This cross-sectional study was conducted with 163 preschool children aged 3-4 old from Porto Alegre, Southern Brazil. Mothers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions about sociodemographic and maternal behaviors characteristics. The severity of dental caries was assessed by ICDAS criteria for evaluated early childhood caries (ECC). A Poisson regression model was used to investigate the association of ECC and associated factors on OHRQoL. Results: A total of 91.4% of preschooler children was ECC (ICDAS ≥ 1). Mean ECOHIS function domain and parental anxiety domain scores were significantly higher in children with dental caries (p<0.05). The adjusted Poisson regression model showed that household income, maternal education, mother’s job status and breastfeeding time was significantly associated with ECOHIS scores. Regarding oral conditions, child caries experience was associated with worsening child and family quality of life (RR 2.21; 95% IC: 1.43-3.41). Conclusion: Our findings suggest that ECC, socioeconomic and maternal behaviors characteristics influence children’s OHRQoL.

Abstract The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients’ charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.

Abstract Objective: To analyze the association between Early Childhood Caries (ECC) and mother´s knowledge, attitudes, and practices (KAP). Material and Methods: This cross-sectional study included a random sample of 163 preschool children aged 3-4 old in southern Brazil. The severity of dental caries and ECC was assessed by ICDAS criteria, while mothers completed the semi-structured questionnaire (KAP-ECC). Maternal behavior characteristics and answered questions about socioeconomic and demographic variables. Logistic regression was performed to evaluate the association of exploratory variables with ECC. For this approach, we calculated the odds ratio (OR) and 95% confidence intervals (95% IC). Results: Dental examinations revealed that 91.4% of children presented ECC (ICDAS = 3, 4, 5 or 6). Among those children, 31.9% presented cavities (ICDAS ≥ 3). Family income was significantly associated with the presence of ECC (OR 2.17; 95% CI: 1.41-3.36). Regarding KAP-ECC, mothers have knowledge related to ECC etiology, reported dental hygiene attitudes and practices that can prevent ECC but reported less healthy attitudes and practices regarding child’s diet, specifically with respect to bottle and breastfeeding habits (OR 0.52; 95% CI: 0.33-0.81). Conclusion: ECC was more frequent in children from low-income families and whose mothers reported the belief that milk with chocolate does not contribute to caries and that disagreed that it is normal that a 2-year-old baby wakes up during the night to suckle. That is, good knowledge toward health habits may impact on lower occurrence of ECC; however, this condition also depends on the socioeconomic level.