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Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To examine the accuracy of a short version of the International Caries Detection and Assessment System (ICDAS) in predicting caries treatment need for children. Methods: The study is a validation study using data from three previously published cross‐sectional studies. Participants were children with different dentitions from Kuwait, Brazil, and Spain. Children were clinically examined using ICDAS criteria. Children were classified into preventive, non‐operative, and operative categories. Sensitivity and specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic (ROC) curve were used to measure the discriminative and diagnostic accuracy of the proposed short version of ICDAS compared to the full ICDAS. Results: Clinical dental examination data from a total of 3076 children aged 1–15 years were used. The proposed short ICDAS and the full ICDAS showed a very good agreement on caries treatment need determination with Kappa scores of more than 0.833 in all dentitions. The short ICDAS showed excellent operating characteristics in all dentitions. The area under the ROC was more than 90% in primary dentition, 89% in permanent dentition, and 86% in mixed dentition in different populations. Lowest area under ROC and sensitivity values were observed when discriminating between non‐operative and operative treatment categories. Conclusions: The proposed short version of the ICDAS showed good diagnostic accuracy in classifying children according to their caries treatment need. By reducing the number of surfaces examined and the time needed for clinical assessment, the short version of the ICDAS is a convenient alternative to the full ICDAS to be used in community settings. [ABSTRACT FROM AUTHOR]

Copyright of Universidade Estadual Paulista. Revista de Odontologia is the property of Universidade Estadual Paulista. Revista de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.

Relevant public policies in oral health have been implemented in Brazil since 2004. Changes in the epidemiological status of dental caries are expected, mainly in the child population. This study aimed to assess the dental caries experience and associated factors among 12-year-old children in the state of São Paulo, Brazil. A cross-sectional population-based study was conducted with data obtained from 415 cities, including a total of 26,325 schoolchildren who were included by the double-stage cluster technique, by lot and by systematic sampling. The statistical model included data from the São Paulo Oral Health Survey (SBSP 2015), the Human Development Index (HDI) and the Social Vulnerability Index (SVI). A theoretical-conceptual model categorized the variables into three blocks, namely, contextual (HDI, SVI, region of residence and fluoridation of water), individual (sex and ethnicity) and periodontal conditions (gingival bleeding, dental calculus and the presence of periodontal pockets), for association with the experience of caries (DMFT). Statistically significant associations were verified by hierarchical multivariate logistic (L) and Poisson (P) regression analyses (p < 0.05). The results showed that 57.7% of 12-year-old children had caries experience. Factors that determined a greater prevalence of dental caries in both models were nonwhite ethnicity (ORL = 1.113, ORP = 1.154) and the presence of gingival bleeding (ORL = 1.204, ORP = 1.255). Male children (ORL = 0.920 ORP = 0.859) and higher HDI (ORL = 0.022), ORP = 0.040) were associated with a lower prevalence of dental caries experience. Water fluoridation was associated with a lower DMFT index (ORP = 0.766). Dental caries experience is still associated with social inequalities at different levels. Policymakers should direct interventions towards reducing inequalities and the prevalence of dental caries among 12-year-old children. [ABSTRACT FROM AUTHOR]

Aim: To assess oral health-related quality of life (OHRQoL) and associated factors among the 12-year-old population of the state of Minas Gerais, Brazil. Methods: Cross-sectional data from the SB-Minas Gerais 2012 study were used. The presence of poor OHRQoL was assessed using the Oral Impact on Daily Performance (OIDP) and its dimensions (physical, psychological and social domains). Independent variables included sociodemographic factors and variables related to the use of dental care and oral health conditions. The association between the outcomes and the independent variables were tested using logistic regression and the results reported as odds ratio with 95% confidence interval. Results: Prevalence of poor OHRQoL was 31.4%; the psychological domain was the most affected (22.6%). Pain and dissatisfaction with oral health were associated with poor OHRQoL on overall OIDP and all its domains. Non-whites had greater poor OHRQoL than whites on overall OIDP and physical domain. Conclusion: Self-perceived oral health and social inequalities were associated with poor OHRQoL. [ABSTRACT FROM AUTHOR]

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To investigate tooth loss and its determinants in adolescents, considering the effect of extractions due to orthodontics reasons. Methods: This cross-sectional study was performed in students from public and private schools aged 15-19 years old from Passo Fundo, Brazil. The proportional randomly chosen sample included 736 adolescents. Clinical examinations and interviews were performed. Associations between prevalence of tooth loss and exposure variables studied were analysed by Poisson Regression with uni- and multivariate robust variance in two models. One model comprised students who had experienced tooth loss without orthodontic reasons and the other with all of the subjects presenting tooth loss. Results: Prevalence of tooth loss was 21.1% (mean of 0.42). Higher chances for tooth loss were found in the following features: non-whites (PR=1.72; CI95%:1.15-2.60), poorly schooling mothers (PR=2.2; CI95%:0.96-5.02), from public schools (PR=4.16; CI95%:0.98- 17.59), smokers (PR=1.91; CI95%:1.15-3.17). Conclusion: Demographic, socioeconomic and behavioural conditions were strongly associated with tooth loss. These associations were more evident when extractions for orthodontic reasons were not included in the analytical models. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

Objectives: To assess whether Brazilian middle-aged adults living in cities that experienced a relative increase on income inequality were more likely to have severe tooth loss and lack a functional dentition.Methods: Data on Brazilian adults aged 35-44 years from state capitals and Federal District from the 2010 Brazilian Oral Health Survey (SBBrasil 2010) were analyzed. Clinically assessed tooth loss outcomes were severe tooth loss (<9 remaining natural teeth) and lack of functional dentition (<21 natural teeth). Income inequality was assessed by Gini Index in 1991, 2000, and 2003 using tertiles of distribution. Variation in Gini Index was assessed by changes in the tertiles distribution between years. Multilevel logistic regression models were used to estimate odds ratios (ORs) and 95 percent confidence intervals (95 percent CI) between variation in income inequality and tooth loss outcomes adjusting for individual socio-demographic characteristics.Results: Prevalence of severe tooth loss and lack of functional dentition was 4.8 percent and 21.2 percent, respectively. Individuals living in cities with moderate and high increase in income inequality between 1991 and 2003 were more likely to have severe tooth loss and lack a functional dentition in 2010 compared with those living in cities with stable income inequality in the same period. Relationships between low family income and both tooth loss outcomes were significantly attenuated by relative increases in income inequality.Conclusions: Relative increases in income inequality were significantly associated with severe tooth loss and lack of a functional dentition in Brazilian middle-aged adults. [ABSTRACT FROM AUTHOR]

Objective: To determine the extent to which individual and contextual variables explain income inequities in tooth loss in Brazilian adults., Methods: A nationally representative sample of 65,784 Brazilian adults aged 18-59 who participated in the Brazilian National Health Survey 2019 was analyzed. Self-reported tooth loss was the outcome. Per capita income was the main exposure, and minimum wage was the cutoff point. Individual covariates included sex, race, and schooling, dental visits, smoking status, use of dental floss, and self-reported chronic conditions. Contextual covariates included access to treated water and geographic region of residence. Blinder-Oaxaca decomposition analysis was used to estimate the share of each factor in income-related tooth loss inequities by age groups., Results: Age-standardized tooth loss showed large income inequities. The average difference in tooth loss related to income inequities in the 18-34-year-old group was 0.50 (95% CI 0.39; 0.60), increasing to 4.51 (95% CI 4.09; 4.93) in the 45-59 years. Individual and contextual covariates explained almost 90% of income inequities in the 45-59 year group. Use of dental floss, schooling, and geographic region of residence (a proxy for human development level) had a higher proportion of contribution to the inequities examined., Conclusions: Individual and contextual covariates (proxy for human development level and water fluoridation coverage) explained a large share of income-related tooth loss inequities. Tailored strategies to act at both levels can help reduce tooth loss inequities among Brazilian adults., (© 2023 American Association of Public Health Dentistry.)

Objective: Studying the broader determinants of anterior open bite (AOB) may guide more equitable policies.This study estimates the prevalence of AOB in Brazilian adolescents and its association with contextual and individual determinants., Methodology: The data for dentofacial anomalies in 15- to 19-year-olds from the National Oral Health Survey SBBrasil 2010 were analysed (N = 4748). AOB was based on the Dental Aesthetic Index (AOB = 0; AOB > 0); the contextual variables were the Human Development Index (HDI) and the Gini Index (2010). The individual sociodemographic variables included sex (male, female), self-reported skin colour/race (white, black, brown, and indigenous + yellow), family income (≥4 minimum wage [MW]; 0-3 MW), and educational attainment (ideal, delayed). The individual clinical variables were decayed, missing, and filled teeth (DMFT) (0, ≥1), first permanent molar loss (0, ≤3, 4), and molar relationship (normal, half cusp, full cusp). Multilevel logistic regression models with random intercepts and fixed slopes were used to estimate odds ratios (ORs) and confidence intervals (95% CIs)., Results: AOB prevalence in Brazil was 8.78% (95% CI, 6.85-11.20) at 15 to 19 years of age. The lowest prevalence was in São Luis (2.63%; 95% CI, 0.58-11.03) and the highest was in João Pessoa (29.85%; 95% CI, 15.93-48.85), both capitals of the northeast Brazilian region. A higher prevalence of AOB (OR, 1.71; 95% CI, 1.04-2.80) was observed in municipalities with a lower HDI. Adolescents who declared their skin colour black, with lower family income, with delayed education, with DMFT ≥ 1, who lost 4 permanent first molars, and who had a complete molar cusp relationship were more likely to have AOB., Conclusions: AOB varied amongst Brazilian municipalities. The HDI plays an important role in the prevalence of AOB; individual social determinants have also been associated with AOB malocclusion in adolescents., Competing Interests: Conflict of interest None disclosed., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Copyright of Dental Press Journal of Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To explore contextual factors associated with overall dental service use, and investigate whether these factors influenced choice of the type of service according to the healthcare financing alternatives (public services; out-of-pocket services; and private health insurance), by adults and older individuals, based on the most recent Andersen's behavioural model., Methods: Cross-sectional study with individual data on 17,305 adults from 177 Brazilian municipalities in the National Oral Health Survey (SBBrasil 2010). Municipal-level information was obtained from health information systems and census data. Multilevel multinomial logistic regression was carried out for multivariable analysis., Results: In the previous year, 38.2% of the individuals visited the dentist; of which 21.4% used out-of-pocket spending, 11.6% used public services and 5.2% private dental insurance. Municipalities with population coverage of public primary dental care >80% had higher chances of using public services (OR = 1.28, 95%CI:1.00-1.64) than those with ≤60%, but lower chances of using private insurance (OR = 0.56, 95%CI:0.38-0.83). Municipalities with population coverage of private dental insurance > 5% had lower chances of using public services (OR = 0.62, 95%CI:0.47-0.81) than those with <1% coverage, and greater chances of using private insurance (OR = 4.33, CI:95% 2.02-9.29). These factors were not associated with out-of-pocket dental services., Conclusions: Municipal coverage of dental services is associated with dental care use, and this is different according to the type of financing system (public or private), as they may change the individual's choice of service. A large public healthcare system may increase public service use for those with reduced access and decrease private service use., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To evaluate reproducibility of visual exam under artificial lighting (VI) and DIAGNOdent™ (DD) exams, their validity and their association (VI+DD) in examining occlusal dental surfaces under epidemiological setting. Methods: One hundred and sixty five 12-year-old schoolchildren from public schools from Piracicaba, SP, Brazil, were examined under epidemiological setting using different diagnostic criteria (D1, D1+D3 and D3). Kappa statistics was adopted for reproducibility study, while sensibility, specificity and accuracy were adopted for validity study. Results: The intra/interexaminer Kappa for VI and DD exams at D1, D3 and D1+D3 criteria were 0.88/0.82 and 0.04/0.18, 0.91/0.85 and 0.36/0.35, 0.88/0.83 and 0.30/0.32, respectively. The VI was the most accurate exam at D1 (A=87.38%) and D1+D3 (A=82.45%) criteria, while VI+DD was the most accurate exam at D3 criterion (A=75.29%). Conclusions: Initial caries lesions can be satisfactorily detected by VI exam, while DD exam improved the VI exam sensitivity at D1 and D3 diagnostic criteria under epidemiological setting. [ABSTRACT FROM AUTHOR]

Copyright of RGO: Revista Gaúcha de Odontologia is the property of RGO: Revista Gaucha de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To evaluate caries experience and prevalence associated to social and preventive factors in 3-6-year-old children of a Pastoral Community from Limeira, Brazil. Methods: A cross-sectional study was carried out through an epidemiologic research about the oral conditions of 110 children registered at the Children's Pastoral Community from the city of Limeira, SP, Brazil. Intraoral examination was performed by a trained dentist and the parents/caregivers filled out a questionnaire in order to outline the children's profile with respect to gender, parental education and oral health. Results: Differences related to gender were not detected (p= 0.3404). The most frequent periods of breastfeeding were 0 to 2 months (36.36%) and 2 to 6 months (35.45%), corresponding to 71.81% of the cases. The time bottle feeding pointed to two most frequent categories: 1) more than 12 months (35.45%) and 2) between 2 and 6 months (22.63%). Regarding parental education, the majority of the sample has not completed primary school (38.32%). It was observed a larger number of decayed teeth in male children (63.39%). Caries experience was significantly higher in children who were breastfed for only 2 months of life (41.96%). Children that did not use baby bottle or did not use a baby bottle for more than 1 year presented a smaller dmft, corresponding to 29.17% and 28.33%, respectively. Time of use of bottle and pacifier presented a significant association (p<0.05). Conclusions: The implementation of adequate strategies and actions is needed to reinforce oral health conditions in risk groups. [ABSTRACT FROM AUTHOR]

Pattussi MP, Peres KG, Boing AF, Peres MA, da Costa JSD. Self-rated oral health and associated factors in Brazilian elders. Community Dent Oral Epidemiol 2010; 38: 348–359. © 2010 John Wiley & Sons A/S Objective: Self-rating provides a simple direct way of capturing perceptions of health. The objective of this study was to estimate the prevalence and associated factors of poor self-rated oral health among elders. Methods: National data from a cross-sectional population-based study with a multistage random sample of 4786 Brazilian older adults (aged 65–74) in 250 towns were analysed. Data collection included oral examinations (WHO 1997) and struct-ured interviews at elderly households. The outcome was measured by a single five-point-response-scale question dichotomized into ‘poor’ (fair/poor/very poor) and ‘good’ (good/very good) self-rated oral health. Data analyses used Poisson regression models stratified by sex. Results: The prevalence of poor self-rated oral health was 46.6% (95% CI: 45.2–48%) in the whole sample, 50.3% (48–52.5) in men and 44.2% (42.4–46) in women. Higher prevalence ratios (PR) were found in elders reporting unfavourable dental appearance (PR = 2.31; 95% CI: 2.02–2.65), poor chewing ability (PR = 1.64; CI: 1.48–1.8) and dental pain (PR = 1.44; CI: 1.04–1.23) in adjusted analysis. Poor self-perception was also associated with being men, black, unfavourable socioeconomic circumstances, unfavourable clinical oral health and with not using or needing a dental prosthesis. Conclusion: Assessment and understanding of self-rated oral health should take into account social factors, subjective and clinical oral symptoms. [ABSTRACT FROM AUTHOR]

Objective. To compare 12-year-old students from public and private schools in the city of Goiânia, Brazil, in terms of the prevalence of caries, periodontal conditions, dentofacial anomalies, and fluorosis. Methods. In 2003, the 2002-2003 Oral Health Conditions in the Brazilian Population project (SB Brasil) was expanded to Goiânia as a cross-sectional study, as described in the present article. The sample included 1 947 students from urban schools: 1790 (91.9%) attended public schools and 157 (8.1%) attended private schools. Data on the following oral conditions were collected through clinical examination: dental caries (decayed, missing, or filled teeth index, DMFT), periodontal condition (Community Periodontal Index, CPI), dentofacial anomaly (Dental Aesthetics Index, DAI), and dental fluorosis (Dean index). The groups were compared using the chi-square and Mann-Whitney U tests. Results. There were differences between the public and private schools for all the variables. DMFT, CPI, and DAI indexes were higher in children from public schools (P < 0.05). Fluorosis was more prevalent in students from private schools (P < 0.05). Conclusion. The type of school was associated with the oral health condition of the children in this sample. Investments in actions and services to mitigate this inequality and its effects should be made as part of the policies to promote oral health. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach., Methods: Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated., Results: Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks., Conclusion: The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures., Knowledge Transfer Statement: This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.

Aims: To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults., Methods and Results: A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL., Conclusion: Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL., (© 2021 Special Care Dentistry Association and Wiley Periodicals LLC.)

Homeless people are usually more exposed to traumatic events that may cause dental injuries than those with more stable housing. Previous studies on the oral health condition of this population group have shown high levels of dental caries, periodontal diseases, and tooth loss, but evidence on dental trauma is scarce. Furthermore, there is no report from Latin American countries. The aim of this study was to describe the prevalence of untreated traumatic dental injuries (TDI) among adult homeless people in a Brazilian capital city. A sample of 102 adults attending a public homeless shelter was clinically examined using the criteria of the 2010 Brazilian National Oral Health Survey. TDI was found in 10.8% of the participants, and the most common types of injury were enamel-dentin fractures and avulsion. The overall prevalence was relatively low, but the proportion of anterior tooth loss due to trauma and other reasons shows the need for more appropriate health care for this vulnerable population group., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To examine the relationship between contextual and individual determinants with the need for endodontic treatment in Brazilian adults., Methods: Individual-level data from 6897 adults aged 35-44 years living in the Brazilian state capitals who participated in the Brazilian Oral Health Survey (SBBrasil 2010 Project) were combined with city-level data. Individual- and city-level variables were selected to represent the structural and intermediate determinants of health according to the WHO model of social determinants of health. The association of independent variables with one or more teeth in need of endodontic treatment was evaluated using multilevel logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI)., Results: The prevalence of the need for endodontic treatment was 7.7%. Adults living in cities with better contextual socioeconomic conditions (OR 0.82; 95% CI = 0.72-0.93) and better specialized dental services (OR 0.85; 95% CI = 0.77-0.95) were less likely to need endodontic treatment. Younger age, greater schooling and use of private dental services reduced the odds of need for endodontic treatment. Number of people per room, type of dental service and reason for the last dental visit were also associated with need of endodontic treatment., Conclusion: Contextual and individual factors were relevant determinants of endodontic treatment needs in adults., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities., Methods: Data from the 2010 National Oral Health Survey of 9633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:< 0.699 versus high: > 0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed., Results: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95% CI: 7.93-11.13) and 6.95 (95% CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI., Conclusions: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

Objectives: To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics., Methods: A total of 6196 adults aged 35-44 years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self-reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self-reported need for treatment, dental pain in the last 6 months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate., Results: Pardos and Blacks were 1.25 (95% CI 1.10-1.42) and 1.73 (95% CI 1.41-2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics., Conclusions: Racial differences in dental service utilization were evident for middle-aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The aim of the present study was to analyse the factors associated with self-perceived need for dental treatment among adolescents., Methods: A representative sample in the state of São Paulo, Brazil, comprising 5558 adolescents, was evaluated in 2015. The adolescents were selected by probabilistic sampling by conglomerates in two stages. The outcome evaluated was self-perceived treatment need measured via a validated questionnaire. Independent variables included sociodemographic factors, type, frequency and reason for last dental visit, and examination of oral conditions. Statistical analysis was based on the multiple hierarchical logistic regression model., Results: Of the total sample, 3340 (62.6%) adolescents reported needing dental treatment. After fitting the model, the self-perceived need for treatment was associated with adolescents with family income of up to $1,500 BRL (OR 1.39; [95% CI = 1.20-1.60]; P < .001), who sought dental services solely for curative treatment (OR 1.58; [95% CI = 1.46-1.72]; P < .001), reported toothaches in the previous six months (OR 2.88; [95% CI = 2.53-3.28]; P < .001), were dissatisfied with the appearance of their teeth and mouth (OR 5.94; [95% CI = 5.03-7.01]; P < .001), had caries in the posterior teeth only (OR 3.04; [95% CI = 2.77-3.33]; P < .001) or had caries in the anterior teeth (OR 4.75; [95% CI = 4.05-5.56]; P < .001)., Conclusions: The self-perceived need for dental treatment among Brazilian adolescents was associated with normative and subjective needs, and sociodemographic context factors. This finding provides important evidence for collective health planning., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics., Methods: This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated., Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males., Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.

The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T 0 and T 3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Epidemiological inquiries study and evaluate the health status of the population. For dental caries, the World Health Organization (WHO) recommends the DMFT and DMFS indexes, which represent the sum of the decayed, missing and filled teeth, divided by the population studied. Traditionally these surveys are conducted using cellulose paper sheet. This study describes the development and presents the field performance of NutriOdonto, a software created for an Oral Health Survey carried out in 2018 and 2019 involving 2578 students from the municipal schools of Palmas/TO, located in the Brazilian Amazon region. This is a descriptive, applied research on the development of a software for the collecting, analysis, management and reproducibility of oral health epidemiological research. A software applied to the collecting, analysis and formation of the database was developed through the information obtained from the questionnaires applied to the participants of the study and the completion of the electronic oral examination form. Recent Information and Communication Technologies (ICT) are intelligently configured to create models and mobile applications (Apps) that can be useful to manage health issues, thus broadening the perspective of service provision in this sector. Some of these mobile devices, tablets and smartphones are being developed to generate information, for collection, recording, storage and analysis of oral health epidemiological research data. NutriOdonto contributed to the rapid collection, recording and storage of information, in the construction of the database and its analysis. Replacing paper forms with electronic forms minimized possible typos, reduced the use of cellulose paper and the financial costs, among other things. This software can contribute to decision making by managers and professionals and to improving the planning and implementation of actions in health promotion and oral disease prevention.

Objectives: The objective of this study was to evaluate the combined risk of oral problems in the oral health-related quality of life (OHRQoL) of adolescents aged 15 to 19 years in São Paulo state (Brazil) in the year of 2015., Materials and Methods: Data from the São Paulo State Oral Health Survey (SBSP-15) and the contextual characteristics of the cities of São Paulo state, evaluated in the year 2015 were accessed. Correlations were made between contextual factors (i.e., coverage of the family health team, average supervised tooth brushing, number of first dental appointments, and average income), individual sociodemographic variables (i.e., ethnicity, gender, and schooling) and dental problems (dental pain, caries, overjet, open bite, indication for endodontic and exodontic treatment, gingival bleeding, and dental trauma). These variables were correlated with the quality of life of the adolescents using the Oral Impacts on Daily Performance (OIDP) index. Multilevel Poisson regressions were performed to calculate the rate ratio (RR) with 95% confidence interval (CI)., Results: According to the bivariate analysis, the presence of low (RR, 1.62; 95% CI 1.07-2.46) and very intense (RR, 2.53, 95% CI 1.92-3.34) dental pain, indication for endodontic (RR, 1.31; 95% CI 1.05-1.63) or for exodontic (RR, 1.31; 95% CI 1.06-1.63) treatment, and gingival bleeding (RR, 1.41; 95% CI 1.11-1.80) reduced the quality of life of adolescents. All domains of OIDP scores were associated between healthy and unhealthy individuals (p < 0.001) increasing mean scores with combined oral health problems. Higher impact on quality of life was associated with simultaneous presence of dental pain, gingival bleeding, and indication for exodontic treatment (RR, 6.03; 95% CI, 4.02-9.04) in the adolescents., Conclusion: Individual and contextual factors and the various dental problems are independently associated with the quality of life of Brazilian adolescents aged 15 to 19 years, especially when they are associated with the perception of intense dental pain, gingival bleeding, and indication for exodontic treatment, with up to six times greater impact on OIDP., Clinical Relevance: The study highlighted the importance for an integral treatment in adolescents, considering that the associated risk of several dental diseases can progressively affect the quality of life of this population.

Objective: To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis., Methods: A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers' years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure., Results: Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school., Conclusion: Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile.

The aim of this study was to evaluate severe tooth loss and associated factors among the elderly. A homebased crosssectional study, using random probabilistic sampling, was conducted with elderly persons from Cruz Alta, Rio Grande do Sul, Brazil. Oral health was examined and a structured questionnaire was answered. Associations between severe tooth loss and independent variables were determined using Poisson regression with robust variance. The level of significance adopted was 5%. Overall, 287 elderly persons were included. Among the elderly, 86 (29.9%) were edentulous, and 282 (98.3%) had lost at least one tooth. In this sample, median tooth loss was 21 (mean±standard deviation: 19.69±8.21). The sample was dichotomized into two groups according to the definition of severe tooth loss: less than nine remaining teeth or ≥9 remaining teeth. The prevalence of severe tooth loss was 60.3% (n=173). Females were associated with higher prevalence ratio (PR) of severe tooth loss (PR; 95% CI: 1.77; 1.39 - 2.24). Higher level of education was associated with lower PR of severe tooth loss (PR; 95% CI: 0.48; 0.30 - 0.77). The lack of access to dental care was associated with severe tooth loss (PR; 95% CI: 1.38; 1.13 - 1.67). Conversely, frequency of toothbrushing was not significantly associated with severe tooth loss (PR; 95% CI: 0.88; 0.73 - 1.06). High prevalence of severe tooth loss among the elderly was observed and found to be associated with sex, level of education, and access to dental care.

Objectives: To examine the association of contextual and individual determinants with non-utilization of dental services among Brazilian adults., Methods: Data were from adults aged 35-44 years (N = 7,265) from the 2010 Brazilian Oral Health Survey (SB Brasil Project). Non-utilization of dental services was assessed whether the individual has never had a dental visit over the whole life time. Independent variables were selected according to Andersen's behavioral model. Contextual variables included Human Development Index-longevity (HDI-Longevity) (predisposing demographic), HDI-Education and Gini index (predisposing social), integration of oral health teams into Primary Care (enabling health policy), and HDI-Income (enabling financing). Individual data were age and sex (predisposing demographic), ethnicity and schooling (predisposing social), family monthly income (predisposing enabling), perceived dental treatment (perceived need), and decayed teeth (evaluated need). The relationship of contextual and individual variables with non-utilization of dental services was assessed through multilevel logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (95% CI)., Results: The prevalence of non-utilization of dental services was 4.7 percent. Adults living in cities with high HDI-Income were less likely to never have a dental visit. The odds of non-utilization of dental services were lower for adults living in cities with high HDI-Longevity. Sex, skin color, dental treatment needs, poor socioeconomic characteristics, perceived dental treatment needs, and decayed teeth were also associated with non-utilization of dental services., Conclusions: The results suggest that contextual enabling and predisposing factors, individual sociodemographic, and needs-related characteristics influence non-utilization of dental services by Brazilian adults., (© 2018 American Association of Public Health Dentistry.)

It has been postulated that oral health-related quality of life (OHRQoL) may be affected by the sense of coherence (SOC), but there are no epidemiological studies investigating this association in Brazilian adults. The present study was conducted among adults of a mid-sized Brazilian city, with the aim of looking into this association. The probability sampling consisted of 342 adults aged 35-44 years old, from a mid-sized Brazilian city, who were examined at their homes for caries (Decayed, Missing and Filled Teeth [DMFT] Index) and periodontal disease (Community Periodontal Index - CPI), according to WHO criteria. The questionnaire applied included demographic factors, socioeconomic information, use of dental services, behavior, SOC and the Oral Health Impact Profile (OHIP). The OHIP outcome, measured by prevalence of the impact, was analyzed by binary logistic regression using a hierarchical approach, a conceptual model, and a 5% significance level. A total of 67.9% of the respondents had one or more impacts on OHRQoL, and 54.4% showed a high SOC. The impact on OHRQoL was more prevalent in adults who had a manual occupation (PR = 2.47, 95%CI 1.24-4.93), those who perceived the need for dental treatment (PR = 2.93, 95%CI 1.67-5.14), and those who had untreated caries (PR = 1.93, 95%CI 1.07-3.47). Those with a low SOC had a twofold higher prevalence of impact on OHRQoL (PR = 2.19, 95%CI 1.29-3.71). This impact on OHRQoL was associated with a low SOC, even after adjusted by socioeconomic, behavioral and clinical factors. Future studies should consider the SOC in determining the oral health impact on quality of life.

Background: Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35-44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis.Methods: This study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3-5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health.Results: Nearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91-1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16-1.63 with prosthesis; PR = 1.62; 95%CI 1.19-2.20 without dental prosthesis).Conclusions: Individuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL. [ABSTRACT FROM AUTHOR]

Background/aims: Traumatic dental injuries (TDIs) stand out as one of the major public health problems worldwide, characterized by a high prevalence in children and adolescents. However, their association with the 15-19 years age group has not been fully described. The aim of this study was to evaluate TDIs in a population of Brazilian adolescents., Methods: An association study was performed with 5558 adolescents attending the São Paulo State Oral Health Survey (SBSP-15). Individual predisposing variables (gender, age, schooling, ethnic, overjet, and molar relationship); contextual predisposing (city size and Municipal Human Development Index); individual enabling (per capita income and type of service used); contextual enabling (number of dentists, family health team coverage, and family median income); individual need (satisfaction and perception regarding treatment) and contextual needs (average supervised brushing, number of visits, and dental extractions per city), as well as health behaviors were analyzed. Andersen's behavioral model was used for the data analysis. A multilevel logistic regression with fixed effects was performed to calculate the odds ratio (OR), with 95% confidence interval (CI)., Results: The prevalence of TDIs in adolescents was 1.42% (95% CI: 0.94-2.13). Individual and contextual factors of need, predisposing factors, facilitators, and health behaviors were associated with TDIs. In the adjusted analysis, gender (OR = 0.32, 95% CI: 0.18-0.53), mean family income (OR = 2.52, 95% CI: 1.35-4.69), number of dental visits (OR = 0.40, 95% CI: 0.19-0.84), and time of last visit (OR = 2.64, 95% CI: 1.46-4.77) remained significant concerning trauma., Conclusion: At least one variable of the individual and contextual predisposing, enabling, and need factors (except for individual enabling variables) were associated with dental trauma in Brazilian adolescents aged 15-19 years. This information may help with the planning of preventive actions and dental treatment, especially in mid-sized and large cities., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To evaluate whether socioeconomic position exerts a mediating and/or moderating effect on the association between oral clinical measures and oral health-related quality of life (OHRQoL) in adolescents., Materials and Methods: The study analysed data on 5,445 adolescents aged 15-19 years from the Brazilian Oral Health Survey (SBBrasil Project). The numbers of decayed and missing teeth, number of sextants with gingivitis and malocclusion were assessed through oral clinical examinations. Participant's age, sex, OHRQoL and socioeconomic position were also collected. Monthly family income was used to indicate the participant's socioeconomic position, and OHRQoL was assessed using the Oral Impacts on Daily Performance. Moderation was tested using Poisson regression models. Structural equation modelling and Sobel's test assessed the mediation effects., Results: Oral clinical measures, OHRQoL and socioeconomic position were significantly correlated (P < 0.001). The moderator effect of socioeconomic position on the association between all oral clinical measures and OHRQoL was observed. The impact of all oral clinical conditions on adolescents' OHRQoL was lower in the low-family-income groups compared with those with a better income. Socioeconomic position partially mediated the relationship between the four oral clinical measures and OHRQoL. Sobel's test confirmed these findings (P < 0.001)., Conclusions: The findings suggest the importance of socioeconomic position as a moderator and mediator factor between oral clinical measures and OHRQoL. Disadvantaged adolescents are likely to experience poor OHRQoL due to oral conditions. The reduction of the impact of oral conditions on quality of life in adolescents may be enhanced by addressing social inequalities related to oral health., (© 2018 FDI World Dental Federation.)

This study explored the relationships between sex, socio-economic status, social support, social network, dental clinical status, dental pain, oral health-related quality of life (OHRQoL), and self-rated oral health (SROH) in adolescents. A cross-sectional study involving 542 adolescents, aged 12-14 yr, was conducted in Dourados, Brazil, to collect dental clinical measures (dental caries, missing teeth, and dental trauma), as well as measures of social support, social network, dental pain, OHRQoL, and SROH. Information on family income and parental education were collected from participant's parents. Structural equation modeling showed that higher income predicted better dental status and better SROH. Greater social support was linked to better dental status and better OHRQoL. Having more social networks was directly linked to better dental status. Poor dental status was linked to dental pain and poor OHRQoL. Dental pain predicted poor OHRQoL and worse SROH. Poor OHRQoL predicted worse SROH. Family income, social support, and social networks indirectly predicted dental pain via dental status. The latter was indirectly linked to OHRQoL and SROH via dental pain. Social support and social networks indirectly predicted OHRQoL and SROH via dental status and dental pain. Socio-economic factors and social relationships should be considered when planning health promotion and dental care provision to improve an adolescent's oral health., (© 2019 Eur J Oral Sci.)

Objective: To describe the prevalence of oral health impact on quality of life and its association with the dental condition and sociodemographic factors of homeless people., Methods: The sample was composed of 116 adults, temporarily attended by a public institution in the municipality of Goiânia, state of Goiás. Interviews were carried out including the Oral Impact on Daily Performance instrument and sociodemographic aspects. Clinical examinations were done by a trained examiner considering criteria of the World Health Organization. We evaluated dental caries (DMFT index) and use or need to use some type of prosthesis. For the statistical analysis of data, we used Pearson's Chi-square and Fisher's exact tests and Poisson regression with robust variance., Results: Of the total respondents, 81.9% had at least one daily performance affected by dental problems in the six months prior the survey. The most prevalent dental conditions were: need for lower arch (76.7%) and upper arch prosthesis (69.0%); untreated caries (75.9%); and high DMFT (57.8%). In bivariate analysis, only the need for upper prosthesis variable was associated with the impact (high Oral Impact on Daily Performance). In the regression model, adjusted for time in the institution, age, and sex, this association remained significant (p = 0.015). Individuals without need for upper prosthesis had prevalence of high impact on daily performance 55% lower than those in need of this type of prosthesis (p = 0.018)., Conclusions: The prevalence of oral health impact on quality of life of homeless people was high and higher than that verified in the overall Brazilian population. The impact was associated with the need for upper prosthesis, regardless of sociodemographic characteristics of the individuals.

Objectives: The aims of this study were to explore the shape of the relationship of income and education with periodontal health, and to assess the interactions between them and race/ethnicity., Method: Individual level data from the Brazilian National Oral Health Survey in 2010 (Pesquisa Nacional de Saúde Bucal-SB Brasil 2010) were obtained for 9,779 subjects. Relations between per capita income and education with periodontal health were smoothed using Locally Weighted Scatter-plot Smoother (Lowess) technique. Multivariable logistic regression was used to assess independent effects of income, education, race/ethnicity adjusted for age, sex and time since last dental appointment., Results: Prevalence of adults with moderate to severe and severe periodontitis was 17.6 and 6.5%, respectively. The relationship between periodontal health and income was curvilinear, showing a threshold of no relationship for income levels higher than US$ 600/month. In multivariable analysis, after controlling for covariates, only income was significantly associated with periodontal health. There was no significant interaction of income with race or education, neither between race and education., Conclusion: The relation between periodontal health and income was curvilinear and indicated the presence of a threshold, supporting income transfer programs. Beyond the threshold, only education presented a negative linear relationship with moderate to severe periodontitis.

The scope of this study was to evaluate dissatisfaction with dental services among dentate and edentulous elderly Brazilians and its association with contextual and individual variables. The data from the National Oral Health Survey conducted in 2010 and contextual variables related to cities were used. Descriptive, bivariate and multilevel analysis was conducted among 1,989 elderly individuals. Of these, 11.2% of dentate and 22.1% of edentulous elderly people were dissatisfied. Among the dentate individuals, dissatisfaction was associated with contextual variables (location of municipality, human development index, GINI Index, the presence of Dental Specialty Centers and the coverage of oral health in public service) and persons related to health care and oral health conditions. For the edentulous individuals, no associated contextual variables were identified. Only the motive for the use of the service and satisfaction with teeth and mouth were associated with dissatisfaction with dental services. A considerable prevalence of dissatisfaction with the services was identified, being higher among edentulous elderly Brazilians. Among dentate elderly Brazilians, an association with contextual variables was detected.

The scope of this study was to identify if the absence of functional dentition (FD) is associated with a lack of commitment to oral functions/daily activities among Brazilian adults. For this purpose, data from the National Survey of Oral Health (referred to as SB Brasil 2010) was used. FD was evaluated by the criterion proposed by the WHO (at least 20 teeth in the mouth). The Oral Impacts on Daily Performance (OIDP) questionnaire was used to evaluate daily activities/oral functions. Descriptive, bivariate (chi-squared) and multiple (logistic regression) analysis was conducted, and the odds ratio estimated with a 95% confidence interval (OR/CI95%). The research evaluated 9,564 adults, of which 2,200 adults (20.5%) were considered to have poor FD, and at least one of the daily activities/oral functions evaluated had an impact among 55% of adults. The lack of FD between adults was associated (p ≤ 0.05) with the impact on speech (1.88/1.33-2.64) and being ashamed to smile or talk (1.35/1.00-1.83). A considerable prevalence of lack of FD was identified, this absence being associated with the lack of commitment to the daily activities/oral functions. Dental rehabilitation of patients with a lack of FD should consider the restoration of these lost oral functions (speech and being ashamed to smile or talk).

Few studies and epidemiological surveys are carried out in populations geographically and culturally isolated, such as rural and riverine communities. Riverine populations represent one of the typical populations of the Amazon region. This study aimed to evaluate the impact of dental caries and periodontal disease on the quality of life of adolescents and young adults from an urban area and from two riverine communities of the Amazon region located at different distances from the urban area. The occurrence of dental caries and periodontal disease was examined through the Decayed, Missing, Filled (DMFT) Index and the Community Periodontal Index (CPI). The impact of oral health conditions on quality of life was examined through the Oral Health Impact Profile (OHIP-14) questionnaire. The data were collected from 564 individuals (15-25 years old): 212 residents of the urban area of Abaetetuba-Pará-Brazil, were compared to 186 inhabitants of the nearest riverine community (Maracapucu) and 166 of another riverine community (Tucumanduba River) located further from the city. The OHIP-14 was analyzed as a dependent outcome, while dental caries, bleeding, calculus, the presence of periodontal pockets, as well as sex and age were analyzed as independent variables through Poisson analysis in a multilevel model. The worst indicators of OHIP-14 and the highest DMFT scores were found in the riverine populations, especially those from the riverine community farthest from the urban area. Based on the adjusted multivariate model, variables such as the contextual variable (location, RR 1.31), and individual demographic variables (sex and age), DMFT (RR 1.53), and the presence of periodontal pockets (RR 1.15) were significantly related to the OHIP (p<0.001). Our results confirm that dental caries and periodontal disease negatively impact oral health-related quality of life; however, these diseases seem to impact the individuals from remote communities more significantly., Competing Interests: The authors have declared that no competing interests exist.

The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the São Paulo State Oral Health Survey 2015 (SBSP-15)., Methods: This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes., Results: The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3-5mm) RR 1.43(CI 95% 1.10-1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44-0.99) and calculus RR = 0.75(CI 95% 0.60-0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00-1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78-0.99)., Conclusions: The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center)., Competing Interests: The authors have declared that no competing interests exist.

The prevalence of dissatisfaction with dental services and its association with normative and subjective oral health conditions among adult Brazilians was evaluated. This cross-sectional study used data from the last Brazilian National Oral Health Survey (SBBrasil), conducted in 2010. It was considered a representative sample of the adult Brazilian population. Data were analyzed by descriptive, univariate and multiple statistics (OR / 95% CI), with correction by the design effect. Among the 4539 adults included in the study, 614 (13.4%) reported dissatisfaction with dental services. Dissatisfaction was higher among adults who had any decayed teeth (1.61 / 1.06; 2.44), adults who were dissatisfied with their teeth and mouth (2.36 / 1.39; 4.02) and adults who had reported toothache in the previous six months (1.99 / 1.29, 3.07). The conclusion drawn was that the prevalence of dissatisfaction with dental services among Brazilian adults was low and associated to normative and subjective oral health conditions.

Background: Breastfeeding plays an important role in child health, including the development of normal dental occlusion, but large epidemiological findings on the association breastfeeding-malocclusion are lacking., Aim: To investigate the association between the proportion of breastfed children in the city level and the prevalence of malocclusion in the primary dentition at age 5., Design: This cross-sectional analysis used data from national population surveys on oral health and on breastfeeding practices. Data refer to 5278 5-year-old children and 44 Brazilian towns. Information on malocclusion and individual sociodemographic characteristics were obtained from the 2010 Brazilian Oral Health Survey. Breastfeeding rates during the first year of life were extracted from the Breastfeeding Prevalence Survey in Brazilian Towns. Population sociodemographic data were analysed as confounder. Multilevel Poisson analyses were performed., Results: Malocclusion prevalence was 63.3%. Towns exhibiting higher prevalence of breastfeeding among 9- to 12-month-olds presented lower prevalence of malocclusion among children at age 5 (PR 0.98; 95% CI 0.98-0.99)., Conclusions: Lower prevalence of malocclusion among 5-year-old children was associated with a higher proportion of children breastfed at ages 9 to 12 months at a city level, regardless of sociodemographic factors. These findings highlight the importance of encouraging breastfeeding during a child's first year., (© 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study aimed to evaluate the prevalence and distribution profile of malocclusion in Brazilian preschoolers and its association with macro-region, housing, gender, and self-reported race. In total, 6,855 children aged five years participating in the National Oral Health Survey (called SB Brasil 2010) were analyzed. Malocclusion was diagnosed according to the Foster and Hamilton index. We conducted descriptive, bivariate and multiple regression analyses (PR/CI95%). We identified that 63.2% of children had at least one of the occlusal problems evaluated: canines' key (22.9%), overjet (32.9%), overbite (34.6%), and posterior crossbite (18.7%) and, thus, were considered with malocclusion. Higher probability of the presence of malocclusion was identified among the residents of the Midwest (1.08/95%CI 1.01-1.15), Northeast (1.21/95%CI 1.14-1.28), Southeast (1.27/95%CI 1.20-1.34) and South (1.34/95%CI 1.26-1.42) regions when compared to residents in the North. It was also higher among female children (1.06/95% CI 1.02-1.09). No associations were identified concerning race and location of the municipality (capital/no capital). A high prevalence of malocclusion was identified in Brazilian preschoolers, and it was associated with gender and the macro-region. These findings may contribute to expanded public policies and greater access to treatment for this population.

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

Aim: To investigate the relationship of contextual and individual factors with periodontal disease in dentate adults and older people using the Andersen's behavioural model., Methods: Secondary individual data from 6011 adults and 2369 older people from the Brazilian Oral Health Survey (2010) were combined with contextual data for 27 cities. Attachment loss (AL) categories for each sextant were coded and summed to obtain the periodontal disease measure. The association of predisposing, enabling and need characteristics at city and individual level with periodontal disease was assessed using an adapted version of the Andersen's behavioural model. Multilevel Poisson regression was used to estimate rate ratios (RR) and 95% CIs., Results: Periodontal disease was associated with contextual predisposing (RR 0.93; 95% CI = 0.87-0.99) and enabling factors (RR 0.99; 95% CI = 0.98-0.99) in adults. Contextual predisposing was also associated with periodontal disease in older people (RR 0.82; 95% CI = 0.73-0.92). Individual predisposing (age, sex and schooling) and need characteristics (perceived treatment need) were common predictors of periodontal disease in adults and older people. Periodontal disease was also associated with behaviours in the latter age group., Conclusion: Contextual predisposing factors and individual characteristics influenced periodontal disease experience in adults and older people. Contextual enabling factors were also meaningful determinants of periodontal disease in the former age group., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)