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Objectives: To evaluate the extent to which dental care factors in adulthood modify and, at the same time, mediate the association between race/ethnicity and social mobility from childhood to adulthood with two oral health outcomes in adults. Methods: In 2012, 1222 individuals 20–59 years old participated in the second wave of the Epi‐Floripa Study in Florianopolis, Brazil. Exposures included social mobility based on adulthood and childhood events, dental care in previous years, type of dental care coverage, reason for dental visits and race. The number of missing and decayed teeth were dichotomised as MT >0 and DT >0. Results: The prevalence of missing and decayed teeth was 61.9% and 23.0%, respectively. Age–sex adjusted inequalities in decayed and missing teeth among Black and White individuals were 41.2 percentage points (pp) (95% CI: 3.9–78.7) and 53.1 pp (19.5:86.7), respectively. Inequalities between those persistently higher and lower in socioeconomic position were 42.6 pp (14.6–70.7) and 90.0 pp (62.1–100). The Relative Excess of Risk due to Interaction (RERI) was not statistically significant (p < 0.05). Oaxaca‐Blinder decomposition analyses showed that dental care variables accounted for a small proportion of inequalities. Conclusions: This result implies that dental care is unlikely to significantly reduce or increase oral health inequalities in this particular population. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to describe caries prevalence and experience trends of permanent teeth among Singapore schoolchildren between 2007 and 2019. Methods: Anonymized records of all 6‐year‐old Primary 1 (P1), 11‐year‐old Primary 6 (P6) and 14‐year‐old Secondary 3 (S3) before the start of each school year were extracted from the Integrated Dental Electronic Assessment System (IDEAS) by school level, ethnicity and sex. Prais–Winsten regression was used to assess trends of mean decayed, missing and filled teeth (DMFT) and caries prevalence (% DMFT > 0) among the schoolchildren by school level, with reported Average Annual Percentage Change (AAPC) together with respective 95% confidence interval (CI). Results: In total, 519 471 P1, 566 573 P6 and 548 138 S3 were included during the above period, and the majority were comprised of Chinese children (P1: 67.2%, P6: 68.8% and S3: 71.0%, respectively). Overall, the prevalence of caries dropped from 6.9% in 2007 to 3.5% in 2019 among P1, from 34.5% in 2009 to 20.3% in 2019 among P6 and from 41.5% in 2007 to 33.5% in 2019 among S3 schoolchildren. The mean DMFT reduced from 0.11 to 0.05 among P1, 0.72 to 0.35 among P6 and 1.05 to 0.76 among S3 schoolchildren during the same period. Caries prevalence and mean DMFT were consistently higher among girls. On average, caries prevalence decreased 5% per year in P1 (AAPC −5.0 [95% CI: −6.1, −3.9]) and P6 (AAPC −4.9 [95% CI: −5.7, −4.1]) and 2% among S3 (AAPC −2.0 [95% CI: −3.5, −0.4]) schoolchildren. Caries prevalence decreased approximately 4% ~ 5% annually among P1 and P6 schoolchildren regardless of ethnicity. The average decrease in caries prevalence was lower (about 2%) among all ethnicities at S3 school level. Conclusion: Dental caries in permanent dentition of Singaporean schoolchildren had decreased from 2007 to 2019. However, the decrease observed among primary school students was more than double that among secondary schoolchildren. [ABSTRACT FROM AUTHOR]

Parâmetros psicossociais têm sido recomendados para avaliar o impacto dos problemas bucais na qualidade de vida das pessoas. O objetivo deste estudo foi avaliar o impacto da cárie e fluorose dentárias na satisfação com a aparência e com a mastigação em crianças. Foi realizado um estudo transversal com escolares (n = 695) de 12 anos de idade de Chapecó, Santa Catarina, em 1999. Foram examinadas cárie e fluorose dentária e investigados acesso à consulta odontológica e a hábitos de higiene bucal. Para a identificação dos fatores de risco, foi realizada análise de regressão logística múltipla não condicional. Nenhum dos fatores investigados foram associados à insatisfação com a aparência. Estudar em escola pública, apresentar-se com dentes anteriores e com pelo menos dois dentes posteriores comprometidos pela cárie e ser do sexo feminino foram fatores de risco independentes para a insatisfação com a mastigação. Pode-se concluir que a fluorose dentária não teve impacto sobre a satisfação com a aparência. Quanto maior a severidade da cárie, maior o impacto sobre a insatisfação com a mastigação, isso foi maior em crianças de escolas públicas.

OBJETIVO: Avaliar o impacto das necessidades ortodônticas tecnicamente definidas (critérios normativos) sobre a satisfação com a aparência e a mastigação e compará-las com as autopercebidas (critérios subjetivos) em um grupo de adolescentes. MÉTODOS: Foi realizado um estudo transversal com a totalidade dos alunos entre 14 e 18 anos de idade (n=315) de um colégio em Florianópolis, SC, Brasil, em 1999. Uma cirurgiã-dentista realizou os exames clínicos para diagnóstico das principais oclusopatias (Dental Aesthetic Index) e aplicou um questionário para conhecer a satisfação dos indivíduos quanto a aparência, mastigação e percepção das necessidades de tratamento ortodôntico. Foi utilizada análise de regressão logística múltipla para conhecer o impacto de cada oclusopatia sobre a percepção dos indivíduos a respeito dos problemas oclusais. RESULTADOS: Obtiveram-se alta taxa de resposta (95%) e alta concordância intra-examinadora (Kappa 0,6 a 1,0). A prevalência de pelo menos um tipo de oclusopatia foi de 71,3%. Presença de apinhamento incisal (OR=2,8 [1,6-4,9]) e overjet (trespasse horizontal) (OR=2,4[1,4-4,3]) foram fatores de risco para insatisfação com a aparência. Adolescentes que apresentaram irregularidade anterior da mandíbula (OR=3,3 [1,6-6,9]), overjet (OR=1,7 [1,1-3,0]) e diastema anterior (OR=3,1 [1,4-6,9]) apresentaram maior percepção para a necessidade de tratamento ortodôntico. CONCLUSÕES: Os resultados sugerem que existem graus de problemas oclusais tecnicamente definidos que são aceitáveis pela população e que devem influenciar na decisão de tratamento, interferindo diretamente na demanda para esse tipo de atendimento. Medidas subjetivas poderiam ser incorporadas aos critérios clínicos atualmente utilizados.

OBJETIVO: Conhecer os fatores de risco para a alta severidade de cárie dentária em crianças de 12 anos de idade. MÉTODOS: Partindo-se dos resultados obtidos no levantamento epidemiológico em saúde bucal, realizado em Florianópolis, em 1995, comparou-se algumas condições sociais e de comportamento entre dois grupos com severidades distintas da cárie dentária: um com alto/muito alto (n=50) e outro com muito baixos níveis da doença (n=50), através da análise de regressão logística multivariada. RESULTADOS/CONCLUSÕES: Os fatores de risco para alta severidade de cárie foram a freqüência de consumo de doces e a renda familiar. Crianças que consumiram produtos cariogênicos duas a três vezes ao dia, todos os dias, apresentaram 4,41 vezes mais chances de ter alta severidade de cárie quando comparadas com as que consumiram esses produtos no máximo uma vez ao dia -- IC95% (OR) = [1,18; 16,43]. A renda familiar foi o fator socioeconômico de maior importância. Crianças cuja renda familiar foi menor que 5 salários-mínimos tiveram 4,18 vezes mais chances de apresentar alta severidade de cárie quando comparadas com as que apresentaram renda familiar superior a 5 salários-mínimos -- IC95% (OR) = [1,16; 15,03]. Novos estudos acerca dos determinantes gerais da cárie dentária, como os diferentes aspectos da vida dos indivíduos, deveriam ser desenvolvidos, a fim de contribuir para implantar medidas amplas de promoção de saúde bucal.

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The purpose of this ecological study was to investigate the association between social and economic indicators at the municipal level and the presence of water fluoridation and time when water fluoridation was implemented in the 293 municipalities of Santa Catarina State in Southern Brazil. Several social and economic indicators were obtained from official Brazilian agencies as well as from UNICEF. Questionnaires were sent to local authorities and to the local government water supply Company to obtain information about the presence or not of a fluoridated water supply and the year when fluoridation was implemented. Differences in social and economic indicators between municipalities with and without fluoridated water and between those that have had this service for different lengths of time were compared by the Mann--Whitney U test. In addition, multiple logistic regression analyses was performed to identify associations between social and economic indicators at the municipal level and presence and time of implementation of water fluoridation. Results indicated that larger populations are associated with municipalities with fluoridated water. Larger populations, higher child development indexes and low illiteracy rates are associated with a longer time since the implementation of water fluoridation. The finding that less developed municipalities delayed the provision of water fluoridation corroborates the inverse equity hypothesis. [c] 2003 Elsevier Ltd. All rights reserved. Keywords: Health policy; Water fluoridation; Inequalities in health; Brazil; Inverse equity hypothesis

Background: This study aimed to investigate the effect of metabolic syndrome (MetS) on tooth loss in adults from a population-based sample.Methods: Cross-sectional analysis based on data from a cohort study (2009 to 2014) with adults from Southern Brazil. MetS (exposure), lack of functional dentition and number of lost teeth (outcomes) were assessed using self-reported, laboratory and clinical data. Possible confounders included sex, age, family income, education level, smoking status, and sugar consumption. The effect of MetS on the outcomes was estimated using conventional logistic or negative binomial regression models. Marginal structural modeling (MSM) with stabilized weights (a counterfactual analytical method) was also used to enhance group comparability and estimate causal effects.Results: A total of 1,283 participants had available information for the outcomes. Individuals with MetS were more likely to experience a lack of functional dentition than those without MetS (odds ratio [OR] from logistic regression, 1.7; 95% CI, 1.0 to 2.9; OR from MSM, 3.2; 95% CI, 2.3 to 4.6). Moreover, the number of teeth lost was 20% higher in participants with MetS compared with those without MetS in conventional analysis (mean ratio [MR], 1.2; 95% CI, 1.1 to 1.3). The MR increased to 1.7 (95% CI, 1.5 to 2.0) when using MSM.Conclusion: Our findings provide evidence on the effect of MetS on tooth loss. [ABSTRACT FROM AUTHOR]