Development and validation of an educational comic book on healthy eating in early childhood Cristiano Carvalho Soares, Luciane Zanin, Marcelo Sperandio, Flávia Martão Flório Journal of Nutritional Science, 2026 The objective of this study was to develop and validate an educational comic book designed to promote healthy eating among caregivers of young children. The study was conducted in four phases: (1) literature review and script development; (2) creation of the initial version of the comic book, including illustrations, layout and design, and calculation of the Flesch Readability Index (FI); (3) expert validation of the initial version and calculation of the Content Validity Index (CVI); and (4) adaptation of the comic book based on expert suggestions, recalculation of the FI, and pilot testing (CVI) with a lay population. A total of 64 volunteers participated in the validation process, including 14 expert judges and 50 caregivers responsible for feeding children aged 0 to 5 years. Statistical analysis included descriptive measures and inferential testing using the Wilcoxon signed-rank test. The FI score for the initial version was 85.0%, indicating a reading level classified as “easy to understand.” After expert evaluation, the CVI reached 94%, reflecting high agreement among participants. In the revised version, the FI remained high at 84.7%, reinforcing the “easy to understand” reading level, while the CVI increased to 98% following the pilot test, demonstrating strong consensus among participants. A significant improvement in knowledge regarding healthy eating was observed after reading the comic book ( p < 0.05). The comic book was validated for appearance, content and readability, showing a positive impact on caregivers’ knowledge about healthy eating practices. It represents an accessible and effective resource that can be integrated into community-based nutrition education programmes.
Musical Visit project: satisfaction of companions of outpatient pediatric patients Micaella Emanuella Abreu Lago, Luciane Zanin, Flávia Martão Flório Revista Gaucha De Enfermagem, 2025 Objective: To assess the level of satisfaction among the companions of children awaiting elective medical care due to their participation in a Musical Visit project. Method: A quasi-experimental study with independent samples, conducted with companions of children awaiting outpatient care at a university hospital in Maranhão, Brazil, between January and April 2022. The participants were divided into two groups: exposed to the project (n=163) and control (n=163). All participants completed a Likert-type questionnaire assessing satisfaction regarding structure, comfort, hygiene, organization, waiting time for consultations and exams, and trust in the service. The exposed group also evaluated the Musical Visit project. Descriptive statistical analysis was performed, and the groups were compared using Chi-square and Fisher’s exact tests. Results: Satisfaction did not differ between groups for most of the items evaluated; however, waiting time for consultation and comfort in the office showed lower satisfaction in the exposed group (p<0.05). The ratings for the project were high (9.6±1.2). Conclusion: Both groups showed positive levels of satisfaction; however, regarding participation in the project, there was no difference in most of the evaluated items. Waiting time and comfort in the environment are aspects that require attention and improvement.
ICDA-S-II index improves early-stage diagnosis of carious lesions among schoolchildren in northern Brazil Dav Lavareda Corrêa, Flávia M Flório, Vânia Castro Corrêa, Suelen Lavareda Corrêa, Sue A Lavareda Corrêa Uchôa, et al. Acta Odontologica Latinoamericana, 2024 The Decayed, Missing and Filled Teeth (DMFT) index is widely used for detecting carious lesions, primarily focusing on established cavities, while the International Caries Detection and Assessment System (ICDA-S-II) is designed to identify incipient lesions. Aim: The aim of this cross-sectional study was to assess the diagnostic effectiveness of the DMFT index compared to the ICDA-S-II criteria designed for early-stage carious lesion diagnosis in schoolchildren from Belém (Brazil). Materials and Method: A cohort of 107 twelve-year-old schoolchildren from Belém (Brazil) underwent dental examinations by three calibrated examiners using the DMFT and ICDA-S-II indices. The ICDA-S- II assessment involved prophylaxis, relative isolation, and a standardized drying period. Statistical analyses included ANOVA, chi-squared and G tests. Results: No statistically significant differences were observed among examiners for either the DMFT (p = 0.699) or the ICDA-S-II (p = 1.000) indices. Gender did not influence results (DMFT: p = 0.697; ICDA-S-II: p = 0.310). Caries-free prevalence differed significantly, at 32% according to DMFT and 2.8% according to ICDA-S-II (p<0.001). Conclusions: The DMFT index consistently underestimated carious lesions, whereas the ICDA-S- II index enhanced the identification of incipient potentially reversible lesions. DMFT and ICDAS-II indices have demonstrated their efficacy in cavity detection, with the most significant distinction arising in ICDAS-II in the identification of early-stage carious lesions.
Validation of an educational comic book to guide conducts in situations of dental trauma Claudia Serrado Pereira de Medeiros, Luciane Zanin, Marcelo Sperandio, Almenara de Souza Fonseca Silva, Flávia Martão Flório Dental Traumatology, 2024 Background/AimChildhood dental trauma poses a prevalent concern, and the limited knowledge of lay caregivers toward the needed immediate actions can adversely affect a child's well‐being. This study aimed to create and validate an educational comic book for lay individuals, designed to guide immediate actions in dental trauma cases, and assess its effects toward enhancing reader knowledge.MethodologyThe four‐stage study involved: (1) Literature review and script development; (2) Version 1 of the comic book creation (including illustrations, layout, and design) and Flesch Readability Index (FI) calculation; (3) Version 1 validation by expert judges, assessed by the Content Validity Index (CVI); (4) Version 1 refinement based on the judges' feedback, recalculation of FI, and a pilot test (CVI) involving lay individuals who validated the final material (Version 2). The validation process involved 67 participants, including 13 specialist judges and 54 elementary school teachers.ResultsThe CVI for Version 1 was calculated at 0.89 (89%), indicating a favorable level of agreement on the evaluated criteria. The FI was determined as 91.1%, indicating a high level of readability. The FI for Version 2 was 92.1% (indicating a very easy level of comprehension). The CVI calculated for the target audience after the pilot test was 0.99 (99%), denoting a substantial agreement among the participants. In assessing the level of knowledge, a significant increase was observed in the rate of correct answers after the comic book was read by lay individuals (p < 0.05), inasmuch as the percentage rose from 50.5% before to 81.2% after reading it.ConclusionThe educational comic book proved valid in terms of readability, appearance, and content. Furthermore, it had a positive impact on gaining the knowledge needed to take the appropriate actions, thus making it a valuable tool for guiding the lay population in cases of dental trauma.
To evaluate high-risk pregnant women’s oral health perception and associated factors Vinícius da Penha Moreira Lugato, Flávia Martão Flório, Luciane Zanin de Souza Revista Brasileira De Saude Materno Infantil, 2024 Objectives: to evaluate high-risk pregnant women’s oral health perception and associated factors during dental prenatal care. Methods: observational cross-sectional study, developed in the city of Itapemirim-ES, with seventy-six high-risk pregnant women who answered a structured questionnaire with twenty questions, referring to the sociodemographic profile, pregnancy, use of dental services and perception of oral health, in the period of June to September 2021. Data were descriptively evaluated, and simple logistic regression models were estimated for each independent variable with the outcome, perception of oral health, grouped into very poor/poor and fair/good/excellent. Results: most women were over 20 years old (78.9%), housewives (60.5%), and considered their oral health to be excellent/good/regular (85.5%), understand that they should take better care of their teeth during pregnancy (92.1%), but 39.5% did not receive guidance on dental treatment during pregnancy. Pregnant women who do not feel that they should take better care of their teeth during pregnancy are more likely to consider their oral health to be very poor or poor (OR=7.75, CI95%= 1.33-45.12). Conclusions: pregnant women understand that care and habits related to oral health are important during pregnancy. Inadequate perception of the importance of oral care during pregnancy was associated with a negative self-perception of oral health.
Size effect in observational studies in Public Oral Health: importance, calculation and interpretation Flávia Martão Flório, Luciane Zanin, Leônidas Marinho dos Santos Júnior, Marcelo de Castro Meneghim, Gláucia Maria Bovi Ambrosano Ciencia E Saude Coletiva, 2023 The objective of this study was to analyze the scientific literature in public oral health regarding calculation, presentation, and discussion of the effect size in observational studies. The scientific literature (2015 to 2019) was analyzed regarding: a) general information (journal and guidelines to authors, number of variables and outcomes), b) objective and consistency with sample calculation presentation; c) effect size (presentation, measure used and consistency with data discussion and conclusion). A total of 123 articles from 66 journals were analyzed. Most articles analyzed presented a single outcome (74%) and did not mention sample size calculation (69.9%). Among those who did, 70.3% showed consistency between sample calculation used and the objective. Only 3.3% of articles mentioned the term effect size and 24.4% did not consider that in the discussion of results, despite showing effect size calculation. Logistic regression was the most commonly used statistical methodology (98.4%) and Odds Ratio was the most commonly used effect size measure (94.3%), although it was not cited and discussed as an effect size measure in most studies (96.7%). It could be concluded that most researchers restrict the discussion of their results only to the statistical significance found in associations under study.
In Vitro Effects of 2.5% Titanium Tetrafluoride on Streptococcus Mutans and Lactobacillus Casei in Dentin Followed by Self-Etching Adhesive Systems European Journal of Prosthodontics and Restorative Dentistry, 2015
In vitro evaluation of calcium and phosphorus concentrations in enamel submitted to an in-office bleaching gel treatment containing calcium General Dentistry, 2015
Evaluation of bond strength between leucite-based and lithium disilicate-based ceramics to dentin after cementation with conventional and self-adhesive resin agents. Acta Odontologica Latinoamericana AOL, 2014
Oral health conditions and self-perception among edentulous individuals with different prosthetic status Brazilian Journal of Oral Sciences, 2013
Effects of bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide on microhardness of enamel submitted to maintenance treatment: A twelve -month study Clinical Dentistry Research Compendium, 2013
Effects of bleaching agents containing 10% carbamide peroxide and 7.5% hydrogen peroxide on microhardness of enamel submitted to maintenance treatment: A twelve-month study International Journal of Clinical Dentistry, 2011
Antimicrobial activity of self-etching adhesive systems as a function of curing time and light sources International Journal of Clinical Dentistry, 2011
Effects of 10% carbamide peroxide associated with different thickening agents on enamel and dentin microhardness Perspectives on Clinical Dentistry, 2011
Morphology and microtensile bond strength of adhesive systems to in situ-formed caries-affected dentin after the use of a papain-based chemomechanical gel method American Journal of Dentistry, 2011
Comparative analysis of fluorescence of resin-based composites subjected to accelerated thermal cycling under visible light International Journal of Clinical Dentistry, 2010
Aluminum oxide air abrasion of dentin surface: Assessment of effects on marginal leakage of self-etching adhesive systems International Journal of Clinical Dentistry, 2010
Brazilian dentists' attitudes about medical emergencies during dental treatment Journal of Dental Education, 2010
In situ anticariogenic effect of adhesive systems containing fluoride and MDPB American Journal of Dentistry, 2010
Microtensile bond strength of etch-and-rinse and self-etch adhesive systems to demineralized dentin after the use of a papain-based chemomechanical method American Journal of Dentistry, 2010
Effects of 10% carbamide peroxide associated with different thickening agents on enamel and dentin microhardness International Journal of Clinical Dentistry, 2009
