title: Factors Associated with the Occurrence of Distoclusion in the Primary Dentition: A Hierarchical Analysis.
abstract: OBJECTIVE
  The aim of the present study was to identify factors associated with the occurrence of distoclusion among preschool children in southern Brazil.
  
  
  METHODS
  A cross-sectional study was carried out with a sample of 1026 children aged two to five years enrolled at public preschools in the city of Canoas, Southern Brazil. Interviews were held with parents/caregivers to acquire demographic, socioeconomic and behavioral data. Six examiners who had undergone a training and calibration exercise performed the oral examinations. Distoclusion was recorded when the cusp of the maxillary canine was in an anterior relation to the distal surface of the mandibular canine during centric occlusion. Statistical analysis involved simple and multivariate Poisson regression with robust variance.
  
  
  RESULTS
  The prevalence of distoclusion was 36.5% (375/1026). This condition was more frequent in younger children, those classified as white or brown, those who were breastfed for a shorter period of time, those who used a pacifier and those who were bottle fed. The multivariate analysis demonstrated that the likelihood of exhibiting distoclusion was greater among two-year-olds (P=0.038), three-year-olds (P=0.023), those classified as white (P=0.016), those who used a pacifier (P<0.001) and those who used to use a pacifier (P<0.001).
  
  
  CONCLUSIONS
  Counseling with regard to the duration of pacifier use could contribute toward reducing the prevalence of distoclusion and its consequences in preschool children.
authors.affiliation: From the Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Feldens
authors.affiliation: From the Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Renata Prestes
authors.initials: RP
authors.lastname: Martins
authors.affiliation: From the Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Renata Rocha
authors.initials: RR
authors.lastname: Maciel
authors.affiliation: From the Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Vargas-Ferreira
authors.affiliation: From the Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
authors.forename: Paulo Floriani
authors.initials: PF
authors.lastname: Kramer
mesh_terms: D000367:Age Factors; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D001942:Breast Feeding / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003481:Cuspid / Q000473:pathology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008310:Malocclusion / Q000453:epidemiology*; D009035:Mothers / Q000193:education; D041361:Pacifiers / Q000706:statistics & numerical data; D015995:Prevalence; D012923:Social Class; D014094:Tooth, Deciduous / Q000473:pathology*; D044465:White People / Q000706:statistics & numerical data
keywords: children; epidemiology; malocclusion; oral health