Introduction : Certaines études ont démontré que les patients présentant un trouble du déficit de l’attention et de l’hyperactivité (TDAH) ont plus de problèmes respiratoires du sommeil et d’habitudes orales parafonctionnelles. Bien que ces facteurs puissent être liés aux malocclusions dentaires, aucune donnée n’a encore permis de déterminer si la prévalence de malocclusions dentaires et la nécessité d'un traitement orthodontique sont plus élevés chez les enfants atteints d’un TDAH. Ainsi, une étude plus approfondie de la prévalence et de la sévérité des malocclusions dentaires chez ces patients est importante pour favoriser un diagnostic précoce et une planification optimale de leur traitement orthodontique. Objectifs : Les objectifs primaires de la présente étude sont de : (i) comparer la sévérité des malocclusions des patients avec TDAH et des patients sans TDAH et de (ii) déterminer le type de malocclusion le plus fréquent chez les patients avec TDAH. Les objectifs secondaires de l’étude sont d’évaluer le lien entre : (i) les habitudes orales parafonctionnelles et les malocclusions des patients avec TDAH et (ii) la prise de médicaments utilisés dans le traitement du TDAH et les malocclusions dentaires. Matériels et méthodes : Les patients ont été divisés en deux groupes : un groupe de patients avec TDAH (n = 44) et un groupe contrôle (n = 44). Un questionnaire médical et un examen orthodontique ont été complétés pour chaque patient. Résultats : Les patients atteints de TDAH présentaient une plus grande sévérité de malocclusion (p=0,042), un plus grand nombre de rotation dentaire (p=0,021) et plus d’habitudes orales parafonctionnelles (p=0,001) que le groupe contrôle. Les habitudes orales présentent de façon plus significative chez les patients atteints d’un TDAH comparativement au groupe contrôle étaient le bruxisme (p=0,005) et l’utilisation de la suce pendant l’enfance (p=0,009). Conclusion : Il est important de prendre conscience du risque accru d’habitudes orales parafonctionnelles et de malocclusion dentaire chez les patients atteints de TDAH et de développer des programmes de prévention ainsi que des stratégies thérapeutiques à leur égard. / Introduction: Evidence has shown that patients with attention deficit and hyperactivity disorder (ADHD) have more sleep-breathing problems and parafunctional oral habits. Although these factors can be related to dental malocclusion, it is still unclear if the prevalence of malocclusion and need for orthodontic treatment are higher in children with ADHD. Thus, the knowledge about its prevalence and severity in children with ADHD is valuable in their early diagnosis and treatment planning. Objectives: The primary objectives of this study are: (i) to compare the type of malocclusions of patients with ADHD and patients without ADHD and (ii) to determine the most common type of malocclusion in patients with ADHD. The secondary objectives of the study are to assess the link between: (i) parafunctional oral habits and malocclusions of patients with ADHD and (ii) the drugs used in the treatment of ADHD and malocclusions. Materials and Methods: Patients were divided in two groups: ADHD (n=44) and control (n=44). A medical questionnaire and an orthodontic examination were completed for each patient. Results: Compared to the control group, patients with ADHD had a significantly higher severity of malocclusion (p=0.042), more dental rotation (p=0.021) and more parafunctional oral habits (p=0.001), especially bruxism (p=0.005) and history of pacifier use (p=0.009). Conclusion: It is important to be aware of the increased risk of oral habits and dental malocclusion among ADHD patients and to develop preventive programs as well as therapeutic strategies for them.

Made available in DSpace on 2014-12-17T15:30:55Z (GMT). No. of bitstreams: 1 bdtd64931.pdf: 725709 bytes, checksum: e506cf320238d8d1a757e736677a5cda (MD5) Previous issue date: 2006-05-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / O estudo da preval?ncia e fatores de risco dos h?bitos bucais de suc??o n?o nutritiva ? de grande relev?ncia para a Odontologia Preventiva e Interceptativa porque abrange conhecimentos do crescimento e desenvolvimento dentofacial e os aspectos psicol?gicos relacionados aos mecanismos de instala??o e persist?ncia destes h?bitos ap?s a idade de 5 anos, onde come?am a produzir altera??es oclusais e faciais permanentes. Objetivo: Esse estudo objetiva verificar a preval?ncia de h?bitos bucais e os prov?veis fatores de risco ? persist?ncia dos mesmos. Metodologia: O presente trabalho pesquisou 1.190 crian?as na faixa et?ria de 3 a 5 anos matriculadas em creches e pr?-escolas das redes de ensino p?blica e privada da cidade do Natal. O instrumento utilizado para coleta de dados foi um question?rio estruturado respondido pelos pais ou respons?vel. Resultados: Os resultados indicaram uma preval?ncia de 41% de h?bitos de suc??o n?o nutritiva, distribu?dos em 28,5% suc??o de chupeta e 12,5% suc??o de dedo. Foi encontrada rela??o entre a presen?a de h?bitos de suc??o de chupeta e a idade, renda, tempo de amamenta??o e escolaridade dos pais (p<0,05). A preval?ncia do h?bito de suc??o do dedo esteve relacionada ao sexo, renda, escolaridade dos pais e posi??o da crian?a na fam?lia (p<0,05). A freq??ncia de h?bitos de suc??o apresentou associa??o com o sexo, idade e escolaridade da m?e (p<0,05). Amamenta??o inferior a 6 meses (ORaj=2,931), renda familiar maior que 5 sal?rios (ORaj= 2,183) e idade de 3 anos (ORaj= 1,566) se apresentaram como fatores de risco independentes para o desenvolvimento do h?bito de chupeta. Para o desenvolvimento do h?bito de suc??o do dedo, apenas ? posi??o de filho ca?ula (ORaj= 1,452) foi considerado fator de risco independente das demais vari?veis. O sexo feminino (ORaj= 1,383) foi fator de risco independente quando se avaliou a freq??ncia do h?bito. Obtivemos uma alta preval?ncia de h?bitos de suc??o n?o nutritiva na popula??o estudada, onde as vari?veis que demonstram influ?ncia estatisticamente significativa na persist?ncia dos h?bitos de suc??o de chupeta foram a idade, o tempo de amamenta??o natural, renda familiar e a escolaridade dos pais, sendo que apenas as tr?s primeiras mantiveram-se como fator de risco independentes das demais. J? a suc??o de dedo, mostrou rela??o estat?stica com o sexo, escolaridade dos pais, renda familiar, posi??o da crian?a na fam?lia. Houve uma diminui??o na incid?ncia de h?bitos de suc??o de chupeta com o avan?ar da idade. Verificamos uma freq??ncia bastante elevada de suc??o de chupeta em crian?as amamentadas num per?odo inferior a 6 meses, enquanto para o h?bito de suc??o de dedo, n?o observamos rela??o com o tempo de amamenta??o natural

Introduction : Les dysfonctions et désordres temporo-mandibulaires (DTM) sont un groupe de conditions pathologiques et dysfonctionnelles affectant les articulations temporo-mandibulaires, les muscles masticateurs et les tissus contigus. Les DTM ont une origine multifactorielle, impliquant des facteurs de risque comportementaux, psychosociaux, génétiques et orthodontiques. Objectifs : Le but de cette recherche est de déterminer la prévalence des DTM et de leurs possibles associations aux parafonctions orales dans une population orthodontique, et d’autre part, par une éducation thérapeutique simple (exposé oral avec illustrations et courtes vidéos), de faire prendre conscience de ces mauvaises habitudes aux patients. Matériels et méthodes: Dans un échantillon de candidats au traitement orthodontique (n=101, âge moyen 15,4±5,6 ans), nous avons dépisté les habitudes orales, les DTM et l'anxiété à l'aide de la liste des habitudes orales (OBC), des critères de diagnostic pour les DTM (RDC/DTM) et du questionnaire GAD-7. Une conférence de prévention de 10 minutes a suivi, en petits groupes. Après 2 mois, les patients ont reçu de nouveaux questionnaires OBC et RDC/ DTM via une enquête par e-mail. Résultats: Les symptômes de DTM ont affecté 21% des sujets, tandis que 10% ont montré une anxiété modérée à sévère (GAD7≥ 10), avec des scores plus élevés chez les femmes (p<0,05). Les symptômes n'étaient pas liés à des malocclusions mais étaient positivement corrélés avec l'anxiété et les habitudes orales, en particulier celles augmentant la fonction des muscles masticateurs. La session éducative a été appréciée par 97,1% des personnes ayant répondu à l'enquête (66/68). Une réduction significative de l’OBC a été trouvée chez les sujets anxieux après 2 mois (GAD7≥5, n=14): ils avaient réduit leur utilisation de gomme à mâcher mais ont rapporté parallèlement une augmentation du bruxisme et des contractions des muscles masticateurs. Aucun changement significatif ne s'est produit dans les scores OBC ou DTM chez les sujets à anxiété minimale (GAD7<5, n=46), qui avaient des symptômes et des parafonctions minimales au départ par rapport aux sujets anxieux (DTM de 1,4±1,7 contre 0,6±1,0 p<0,05 et OBC de 20,0±12,1 contre 36,4 ±11,0 p<0,05). Conclusions: Les troubles anxieux devraient être dépistés chez les patients orthodontiques, en association avec une éducation préventive sur les habitudes orales, car tous deux ont une relation forte avec les DTM. Le bruxisme et les mouvements des muscles masticateurs associés pourraient nécessiter un soutien spécifique supplémentaire. / Introduction: Temporomandibular disorders (TMD) are a group of pathologic and dysfunctional conditions affecting the temporomandibular joints, masticatory muscles and contiguous tissues. TMD have a multifactorial origin, involving behavioral, psychosocial, genetic and orthodontic risk factors. Objectives: The aim of this research was to determine the prevalence of TMDs and their possible associations with oral parafunctions in an orthodontic population, and on the other hand, by a simple therapeutic education (oral presentation with illustrations and short videos), to make patients aware of these bad habits. Materials and methods: In a sample of orthodontic treatment candidates (n=101, mean age 15.4± 5.6 years-old), we screened for oral habits, TMD and anxiety using the Oral Behavior Checklist (OBC), Diagnostic Criteria for TMD (RDC/TMD) and GAD7 questionnaires. A 10 minutes prevention conference followed, in small groups. After 2 months, patients received new OBC and RDC/TMD questionnaires via an email survey. Results: TMD symptoms affected 21% of subjects, whereas 10% showed moderate to severe anxiety (GAD7≥10), with higher scores in females (p<0.05). Symptoms were not related to malocclusions but were positively correlated with anxiety and oral habits, especially those increasing masticatory muscles function. The educational session was appreciated by 97.1% who completed the survey (66/68). Significant reduction in OBC was found in anxious patents after 2 months (GAD7≥5, n=14): they had reduced their chewing-gum use but selfreported increased bruxism and clenching in the meantime. No significant change occurred in neither OBC nor TMD scores in the minimally anxious subjects (GAD7<5, n=46), whom had baseline minimal symptoms and habits compared to anxious subjects (TMD score 1.4±1.7 versus 0.6±1.0, p<0.05 and OBC score 20.0±12.1 versus 36.4 ±110 p<0.001). Conclusion: Anxiety disorders should be screened in orthodontic patients, in association with preventive education on oral habits, as both have a strong relation with TMD. Bruxism and related masticatory muscles movements might require additional specific support.

Background - Khat is a mild stimulant plant chewed by a limited segment of the population mainly in the eastern parts of Ethiopia for social facilitation and religious purposes. In recent decades, the use of khat has spread to all parts of the country and its social, economic and political impact has increased significantly at national level. In cities like Addis Ababa, the traditional purposes are superseded and it is now chewed mainly for recreational purposes. Following this development, many people have raised concerns on the potentially adverse socioeconomic and psychological effects of khat on the current generation, particularly the youth. The main issues raised are the misuse of income, the waste of productive time on chewing khat, and the adverse consequences on family cohesion and health. Those who argue in favor of khat cite its positive impact on increasing productivity, high economic returns and traditional values. These arguments on khat are not based on substantiated evidence and this research attempted to answer this question by assessing the ‘positive’ and ‘negative’ socioeconomic and psychological effects of khat on the chewers living in Addis Ababa. Drug control policies intersect with much of the 2030 Agenda for Sustainable Development and Ethiopia has not yet developed a policy on khat. This research intends to make its contribution to the development of the policy by highlighting the socioeconomic and psychological effects on the chewers. Objective –To assess the effects of khat on the income; use of time/time management/; productivity, and psychological well-being of chewers in the city of Addis Ababa. The study is related to policies of Ethiopia in relation to the production, marketing and consumption of khat. It makes policy recommendations based on the assessed costs and benefits. Methodology - The study, using snowball sampling, was conducted in 2018 with 84 khat users. The data collection methods employed were structured questionnaire focus group discussions, narrations of life stories and interviews with key informants. An extensive literature review was also conducted. Result – Respondents reported the diversion of financial resources to purchase khat compromising other personal and family needs and a waste of working hours on chewing khat. There were mixed results found on its effects on productivity. Users also reported that khat made them vulnerable to other addictions such as alcohol, cigarettes and hard drugs and to a number of social and psychological problems. Conclusion - Khat has a significant adverse impact on income and the efficient use of time of chewers. The findings on the effect on productivity are inconclusive. The reported physical and psychological effects on productivity need to be scientifically proven. Chronic use of khat is detrimental to mental health and leads to other serious health consequences. It distorts social and family relationships and inhibits the ability of the chewer to significantly execute his/her social responsibilities. It hurts the self-esteem of the chewers and makes them lose a sense of purpose in their lives. Thus, there is an urgent need to develop a national policy on khat. However, a comprehensive study should be conducted to exploit the potential benefits of khat (mood lifting and medicinal values) by using khat in a modest and controlled way. The social and economic interest of the suppliers; its religious and cultural significance, and environmental impacts should also be considered. / Development Studies / M.A. (Development Studies)