Depression and associated factors among Brazilian adults: the 2019 national healthcare population-based study.

BACKGROUND: Mental disorders represent a major public health challenge worldwide, affecting 80% of people living in low- and middle-income countries. Depression, a mental disorder, is a chronic disease of long duration that causes changes in the brain, resulting from a combination of genetic, physiologic, environmental, and behavioral factors. The aim of this study was to investigate possible factors associated with depression in Brazilian adults. METHODS: A population-based, cross-sectional study was carried out using the public domain database of the 2019 National Health Survey, conducted in Brazil. Depression was considered the dependent variable, and through hierarchical analysis, predictor variables were investigated such as, at the distal level-socioeconomic variables, at the intermediate level-variables related to lifestyle behavior, health condition, and history, and at the proximal level-demographic variables. Logistic regression analysis was used to obtain the adjusted Odds Ratio and the respective 95% confidence interval to identify possible factors associated with depression. RESULTS: The study included 88,531 participant records with 10.27% diagnosed with depression. The adjusted association measurements, after selecting the independent variables in the hierarchical analysis, showed the following factors associated with depression with differing magnitudes: age, brown and white race/skin color, female sex, poor, very poor, or regular self-reported health condition, diagnosis of cardiovascular disease, work-related musculoskeletal disorder, history of smoking habit, and macroeconomic region. CONCLUSIONS: An effective strategy for preventing and managing depression in Brazilian adults must include the control of health status and lifestyle behavior factors, with actions and programs to reduce people's exposure to these factors, understanding that socioeconomic-demographic differences of each population can potentially reduce the disease burden.

Variants in interferon gamma inducible protein 16 (IFI16) and absent in melanoma 2 (AIM2) genes that modulate inflammatory response are associated with periodontitis.

OBJECTIVE: Evaluate the association of genetic variants of the interferon gamma inducible protein 16 (IFI16) and absent in melanoma 2 (AIM2) genes with periodontitis. METHODS: The study involved 117 individuals with periodontitis and 389 without periodontitis, all Brazilians, miscegenated. Individuals with periodontitis presented at least 4 teeth with ≥ 1 site with probing depth ≥ 4 mm; clinical attachment level ≥ 3 mm on the same site and bleeding upon stimulus. Genotyping was performed using the Infinium Multi-Ethnic AMR/AFR-8 Bead Chip focused on Hispanic and African American populations with approximately 2 million markers of the human genome. Multivariate logistic regression was performed to identify associations in additive, dominant and recessive models adjusted for covariates age, obesity, mouth breathing, flossing, asthma, and ancestry. RESULTS: In IFI16, the rs75985579-A is positively associated with periodontitis in the additive (Odds Ratio adjusted (ORadjusted) 2.65, 95% confidence interval (CI):1.25-5.60, p value: 0.007) and dominant models (ORadjusted 2.56, 95%CI:1.13-5.81, p value: 0.017). In AIM2, the rs76457189-G, is associated negatively with periodontitis in two genetic models evaluated, additive (ORadjusted 0.21, 95%CI:0.05-0.94, p value: 0.022) and dominant (ORadjusted 0.21, 95%CI:0.05-0.94, p value: 0.022). CONCLUSIONS: These results have shown that variants in the IFI16 and AIM2 genes are associated with periodontitis. Individuals with at least one A (adenine) allele of the rs75985579 (IFI16) are more than twice as likely to have periodontitis, while individuals with the G (guanine) allele of rs76457189 (AIM2) are less likely to be diagnosed with periodontitis, providing a negative association with periodontitis.

Obesity in young women is positively associated with periodontitis.

OBJECTIVE: This cross-sectional study was performed to investigate the association between excess body weight and periodontitis in adults, stratified by sex and age, and using different criteria for obesity. MATERIAL AND METHODS: Enrolled in the study were 345 individuals with a minimum age of 18 years who had attended the Public Health Service in the city of Salvador, Bahia, Brazil. All individuals underwent a complete periodontal examination and anthropometric measurements and answered a questionnaire regarding their socioeconomic, demographic, health, and lifestyle conditions. Excess body weight (exposure factor) was defined using body mass index (BMI) and waist circumference (WC). Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were obtained by Poisson regression analysis with robust variance. RESULTS: Periodontitis was found in 74.2% of study participants, with the disease being more prevalent among those individuals with increased WC. The occurrence of overweight was 44.4% and that of obesity ranged from 29.9 to 70.8%, dependent upon the specific definition of obesity that was used. There was a positive association between obesity (WC > 88 cm) and periodontitis only among women, after adjustment for age, smoking habit, education level, diabetes, and family income (PRadjusted: 1.20; 95%CI: [1.01-1.44]). The magnitude of this positive association was higher among women aged 18 to 49 years when the outcome was severe periodontitis, and the exposure was obesity defined by WC. CONCLUSIONS: The findings draw attention to the high frequency of the diseases investigated: overweight, obesity and periodontitis. Moreover, obesity was positively associated with periodontitis in women and younger individuals, demonstrating that among those with obesity, there is a higher probability of having periodontitis. The smaller number study of men in the may have influenced the non-statistically significant association found in that group. CLINICAL RELEVANCE: Obese females and younger people are more likely to also have periodontitis. Periodontal evaluation and clinical management of individuals with obesity is recommended.

Periodontite materna e baixo peso ao nascer: revisão sistemática e metanálise / Maternal periodontitis and low birth weight: systematic review and meta-analysis

Resumo Evidências recentes apontam para a influência de processos inflamatórios periodontais na ocorrência de baixo peso ao nascer. Embora muitos estudos empregaram métodos robustos de investigação, ainda não existe consenso sobre o tópico. Analisar sistematicamente a relação entre a periodontite materna e o baixo peso ao nascer. A busca por estudos foi realizada até abril de 2019. Os delineamentos de estudos incluídos foram coorte e caso-controle que estimaram a associação entre a periodontite e o baixo peso ao nascer, sem limite quanto ao idioma ou data da publicação. Análise de heterogeneidade dos estudos, análises de subgrupo e metanálises com modelo de efeitos randômicos foram realizadas. Foram estimadas as medidas de associação sumária por meio da Odds Ratio bruta e ajustada, com respectivos intervalos de confiança a 95%. A inspeção visual de gráficos foi empregada para avaliar viés de publicação. Um total de 21 artigos foram identificados e todos foram selecionados para a metanálise. O modelo final aponta que a periodontite em gestantes se associou ao baixo peso ao nascer (ORbruta=2,13; IC95%=1,60-2,83; I2=80,0% e ORajustada=2,64; IC95%=2,04-3,42; I2=17,4%). Gestantes com periodontite podem ter mais que o dobro de probabilidade de terem filhos com baixo peso ao nascer.

Abstract Recent evidence points to the influence of periodontal inflammatory processes on the occurrence of low birth weight. Although many studies employed robust investigation methods, there is still no general agreement on the relationship between maternal periodontitis and low birth weight. The search for studies was conducted until April 2019. The studies included cohort and case-control studies that estimated the association between periodontitis and low birth weight, with no restriction on language or date of publication. Analysis of the heterogeneity of studies, subgroup analyses and meta-analyses with a random effects model were performed. Summary association measurements were estimated using the crude and adjusted Odds Ratio, with respective 95% confidence intervals. Visual inspection of graphs was used to assess publication bias. A total of 21 articles were identified, all of which were selected for the meta-analysis. The final model indicates that periodontitis in pregnant women was associated with low birth weight (ORgross=2.13; CI95%=1.60-2.83; I2=80.0% and ORadjusted=2.64; CI95%=2.04-3.42; I2=17.4%). Pregnant women with periodontitis may be more than twice as likely to have low birth weight babies.

What is the future of Periodontal Medicine?

In the last five decades, considerable progress has been made towards understanding the etiology and pathogenesis of periodontal diseases and their interactions with the host. The impact of an individual periodontal condition on systemic homeostasis became more evident because of this knowledge and prompted advances in studies that associate periodontitis with systemic diseases and conditions. The term Periodontal Medicine describes how periodontal infection/inflammation can affect extraoral health. This review presents the current scientific evidence on the most investigated associations between periodontitis and systemic diseases and conditions, such as cardiovascular diseases, diabetes, preterm birth and low birth weight, and pneumonia. Additionally, other associations between periodontitis and chronic inflammatory bowel disease, colorectal cancer, and Alzheimer's disease that were recently published and are still poorly studied were described. Thus, the aim of this review was to answer the following question: What is the future of Periodontal Medicine? Epidemiological evidence and the evidence of biological plausibility between periodontitis and general health reinforce the rationale that the study of Periodontal Medicine should continue to advance, along with improvements in the epidemiological method, highlighting the statistical power of the studies, the method for data analysis, the case definition of periodontitis, and the type of periodontal therapy to be applied in intervention studies.

Association between occupational exposure to domestic solid waste and dental caries: a cross-sectional study.

Studies have shown that domestic waste collectors are exposed to toxicants including infectious pathogens, which may be linked to their oral health conditions. This cross-sectional study evaluated the dental caries and its associated factors among domestic waste collectors. A total of 301 adult men who worked for a waste collection corporation were included; 171 men worked in direct contact with domestic solid waste and 130 did not. Sociodemographic data, working, and medical history were assessed. The decayed, missing, and filled permanent teeth (DMFT) index was examined. Logistic regression analysis was used to identify factors associated with dental status with a significance level of 5%. The overall mean DMFT score was 8.36±5.64. The mean DMFT, missing teeth (MT), and filled teeth (FT) were significantly higher in workers who did not have any direct contact with waste (p≤0.04). In the logistic analysis, DMFT ≥8 was only associated with older age (OR=8.41 [95% confidence interval (95%CI), 5.01-14.12], p<0.001). Decayed teeth (DT) ≥2 was associated with no previous oral hygiene instruction (OR=2.70 [1.50-4.81], p=0.001) and no daily dental flossing (OR=4.26 [1.92-9.43], p<0.001). MT ≥9 was associated with lower education level (OR=3.33 [1.57-7.10], p= 0.002). FT≥3 had a negative association with low income (OR= 0.42 [0.25-0.70], p<0.001) and no daily flossing (OR=0.42 [0.23-0.76], p=0.004). In conclusion, occupational exposure to domestic solid waste was not associated with poor dental status. Instead, age, education, income level, and oral hygiene were associated with dental health status. Missing teeth constituted the major component of the DMFT index. Therefore, prevention and oral rehabilitation programs are necessary to improve dental health.

An accuracy study of the clinical diagnosis of periodontitis in pregnant women.

BACKGROUND: There exists a diverse range of criteria used in epidemiological studies for the diagnosis of periodontitis. The results from these studies should be evaluated with consideration to the diagnostic criteria used, and this may account for differences between studies especially in some population groups such as pregnant females. The objective is to evaluate the diagnostic criteria used in a variety of epidemiologic studies of periodontitis in pregnant females. METHODS: An accuracy study with cross-sectional design was performed out from a database of 671 pregnant females, using six different sets of criteria for the diagnosis of periodontitis. Women were classified for periodontitis, as follows: Center for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP, 2012 criterion), the gold standard, Gomes-Filho et al.(2018) criterion, Albandar et al.(2007) criterion, Bassani et al.(2007) criterion, López et al.(2002) criterion, and Nesse et al.(2008) criterion. For comparison amongst the gold standard and the other criteria, sensitivity, specificity, predictive values, and likelihood ratio were determined. RESULTS: The frequency of periodontitis ranged from 25.0% to 90.2%. The Bassani et al. (2007) criterion was found to be more sensitive among the studies, and thus more suitable for diagnostic screening studies. Gomes-Filho et al.(2018), Albandar et al. (2007), López et al. (2002), and Nesse et al. (2008) criteria were considered more specific, which makes them more useful for studies of periodontitis with the aim of using diagnosis for confirmation of disease. CONCLUSIONS: A variation in the occurrence of periodontitis was observed. The criterion must be chosen according to the research aims and population characteristics.

Moderate and severe periodontitis are positively associated with metabolic syndrome.

OBJECTIVE: This study investigated the association between periodontitis severity (exposure) and metabolic syndrome (MetS - outcome), using two criteria for diagnosis of the outcome, since this relationship remains unexplored. MATERIALS AND METHODS: A case-control study was conducted with 870 individuals: 408 with first MetS diagnosis (cases) and 462 without MetS (controls). Participants' general information was obtained using a questionnaire and laboratory data was collected from medical records. Periodontitis severity criteria followed the Center for Disease Control and Prevention: none, mild, moderate, and severe. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by logistic regression analysis. RESULTS: Findings showed a positive association between moderate and severe periodontitis and MetS: ORadjusted = 1.64 (95% CI: 1.01 to 2.68) and ORadjusted = 1.94 (95% CI: 1.19 to 3.16), respectively, after adjustment for age, sex, schooling level, smoking habit, and cardiovascular disease. The adjusted measurements showed that among individuals with moderate or severe periodontitis, the probability of having MetS was around two times greater than among those without periodontitis, and that the chance was greater among participants with severe periodontitis than those with moderate periodontitis. CONCLUSION: An association between the severity of periodontal status and MetS was found, suggesting a possible relationship between the two diseases. CLINICAL RELEVANCE: MetS influences the etiology of cardiovascular diseases, one of the leading causes of mortality worldwide. The findings suggest that the greater the severity of periodontitis, the greater is the association magnitude with MetS. The health professional needs to recognize that the importance of periodontal disease may play in MetS.

What is the future of Periodontal Medicine?

Abstract In the last five decades, considerable progress has been made towards understanding the etiology and pathogenesis of periodontal diseases and their interactions with the host. The impact of an individual periodontal condition on systemic homeostasis became more evident because of this knowledge and prompted advances in studies that associate periodontitis with systemic diseases and conditions. The term Periodontal Medicine describes how periodontal infection/inflammation can affect extraoral health. This review presents the current scientific evidence on the most investigated associations between periodontitis and systemic diseases and conditions, such as cardiovascular diseases, diabetes, preterm birth and low birth weight, and pneumonia. Additionally, other associations between periodontitis and chronic inflammatory bowel disease, colorectal cancer, and Alzheimer's disease that were recently published and are still poorly studied were described. Thus, the aim of this review was to answer the following question: What is the future of Periodontal Medicine? Epidemiological evidence and the evidence of biological plausibility between periodontitis and general health reinforce the rationale that the study of Periodontal Medicine should continue to advance, along with improvements in the epidemiological method, highlighting the statistical power of the studies, the method for data analysis, the case definition of periodontitis, and the type of periodontal therapy to be applied in intervention studies.

Oropharyngeal colostrum immunotherapy and nutrition in preterm newborns: meta-analysis

ABSTRACT OBJECTIVE To investigated the effect of oropharyngeal colostrum immunotherapy in reducing the time required for very low birth weight preterm newborns (VLBW-PTNB: < 1,500g and < 37 weeks) to achieve full enteral nutrition. METHODS Literature search was conducted using four databases, including gray literature, with additional manual search of the references of selected articles. Eligibility criteria consisted of randomized clinical trials, without restriction regarding the date or language of the publication. Two independent reviewers performed the article selection and data extraction. The random-effects meta-analysis used a non-standard technique to assess the mean difference in days to achieve full enteral nutrition, carried out by the Stata 15 statistic program. RESULTS The systematic review comprised 10 studies, and five were selected for meta-analysis, with a population of 764 VLBW-PTNB and gestational age of birth between 25 and 32 weeks. The studies were conducted between 2011 and 2018 in North America, Asia and Africa, with only one conducted in South America. Altogether, they reported the number of days it took 708 VLBW-PTNB to achieve full enteral nutrition, with newborns treated with immunotherapy showing a shorter time in only three studies. Meta-analysis showed a mean difference of -4.26 days, (95% CI -7.44; -1.08d), with high heterogeneity (I2 = 83.1%). CONCLUSION The use of oropharyngeal colostrum immunotherapy can reduce the time for VLBW-PTNB to achieve full nutrition when compared to those who used a placebo or received routine care.

Novel synthetic peptide derived from Porphyromonas gingivalis Lys-gingipain detects IgG-mediated host response in periodontitis.

Porphyromonas gingivalis is a keystone pathogen in periodontitis. Analysis of the immunogenicity of its virulence factors may provide insight into the host response to this infection. The Kgp12 (IEDB Epitope ID 763561), an epitope of Lys-gingipain (Kgp) virulence factor from P. gingivalis ATCC 33277, elicits an immunoglobulin G (IgG) immunoreactivity with low cross-reactivity and, therefore, more specificity. The aim of the present study was to determine in silico the localization of Kgp12 within the protein and to evaluate the IgG host response to this novel Kgp peptide through its capacity to differentiate individuals with different periodontal status. Sera of 71 volunteers were tested by indirect ELISA to detect the IgG immunoreactivity specific to Kgp12, as well as to the protein HmuY and to the sonicated total extract of P. gingivalis ATCC33277, both used as gold standard. The participants had no systemic disease and were classified according to periodontal clinical parameters to comparison, firstly, into periodontitis (P) and without periodontitis (WP) groups and, secondly, into periodontitis (P), gingivitis (G) and clinically health (CH) ones. All the antigens tested, Kgp12 (p = 0.02), HmuY (p = 0.00) and P. gingivalis extract (p = 0.03), could differentiate P from WP groups considering IgG serum levels. P group also had higher IgG levels specific to Kgp12 (p = 0.03), HmuY (p < 0.01) and P. gingivalis extract (p = 0.01) when compared to G group. We conclude that the Kgp12 synthetic peptide was useful to detect the IgG-mediated host response signaling that it is a promising epitope to analyze the immunogenicity of P. gingivalis.

Is there association between stress and periodontitis?

OBJECTIVE: This study estimated the association between stress and periodontitis. MATERIALS AND METHODS: A cross-sectional study was conducted with a sample of 621 individuals. Information about individuals was obtained through a questionnaire. Stress was evaluated using the Perceived Stress Scale. The diagnosis of periodontitis was based on a complete periodontal examination including clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios (PR), crude and adjusted, and their respective 95% confidence intervals (95%CI) were estimated by Poisson regression analysis. RESULTS: In the final sample, 48.47% (301) of the individuals were classified as having stress, of which, 23.92% (72) had the diagnosis of periodontitis. Association measurements between stress and probing depth ≥ 4 mm (PRadjusted = 1.28, 95%CI [1.04 to 1.58]), stress and clinical attachment level ≥ 5 mm (PRadjusted = 1.15, 95%CI [1.01 to 1.31]), and stress and periodontitis (PRadjusted = 1.36, 95%CI [1.01 to 1.83]) showed that the frequency of these outcomes among those exposed to stress was 15-36% higher than those without the condition of stress, after adjustment for age, sex, schooling level, current smoking habit, pulmonary disease, and body mass index. CONCLUSIONS: The findings showed positive association between exposure to stress and the presence of periodontitis, reaffirming the need to prevent and control stress. CLINICAL RELEVANCE: Although there are limitations in this study, the results showed that an association exists between stress and periodontitis, signaling the necessity of a multidisciplinary attention when considering the psychological status in the management of oral and general health conditions of the individual.

Microbiological findings of the maternal periodontitis associated to low birthweight / Achados microbiológicos da periodontite materna associados ao baixo peso ao nascer

ABSTRACT Objective To determine the association between the presence of periodontal pathogens and low birthweight. Methods This observational and case-control study consisted of mothers of infants weighing <2,500g (Group A), and mothers of newborns weighing ≥2,500g (Group B), born at Hospital da Mulher in Feira de Santana (BA), Brazil. A semi-structured questionnaire covering demographic data, gestational history and aspects related to general and oral health was employed postpartum. Following a complete periodontal examination, biofilm samples were collected at six sites in the mouth. The participants were further categorized in terms of presence or absence of periodontitis. Differences between the groups were determined using Pearson's χ 2 test, odds ratio, and confidence intervals were obtained using the Mantel-Haenszel test. Results Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia and Prevotella intermedia were detected by polymerase chain reaction. A total of 303 postpartum women were evaluated, 224 (73.9%) in Group B. Statistically significant differences between the groups were found for age, body mass index and history of previous low birthweight babies. Group A had a higher frequency of periodontitis (33.34%) than Group B (16.22%). P. gingivalis and P. intermedia were detected more frequently among women with periodontitis (74.19% and 88.70%, respectively). Conclusion In this population, there was no association between the presence of maternal periodontal pathogens and the occurrence of low birthweight infants.

RESUMO Objetivo Determinar a associação entre a presença de patógenos periodontais e o baixo peso ao nascer. Métodos Trata-se de estudo observacional e caso controle. Participaram mães de bebês com peso <2.500g (Grupo A) e de recém-nascidos com peso ≥2.500g (Grupo B) nascidos no Hospital da Mulher, em Feira de Santana, (BA). Dados demográficos, história gestacional e aspectos relacionados à saúde geral e bucal foram obtidos por meio de questionário semiestruturado, aplicado no período pós-parto. Após exame periodontal completo, as amostras de biofilme foram coletadas em seis locais na boca. As participantes foram também categorizadas quanto à presença ou ausência de periodontite. As diferenças entre os grupos foram obtidas pelo teste do χ 2 de Pearson, odds ratio e os intervalos de confiança pelo teste de Mantel-Haenszel. Resultados Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia e Prevotella intermedia foram detectados por reação em cadeia de polimerase. Avaliaram-se 303 mulheres pós-parto, sendo 224 (73,9%) do Grupo B. Diferenças estatisticamente significativas entre os grupos foram observadas quanto à idade, ao índice de massa corporal e a história de partos prévios com bebês de baixo peso ao nascer. O Grupo A apresentou maior frequência de periodontite (33,34%) do que o Grupo B (16,22%). P. gingivalis e P. intermedia foram detectados com maior frequência em mulheres com periodontite (74,19% e 88,70%, respectivamente). Conclusão Nessa população, não houve associação entre a presença de patógenos periodontais maternos e a ocorrência de bebês com baixo peso ao nascer.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels.

Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

The effect of nonsurgical periodontal therapy on hepcidin and on inflammatory and iron marker levels

Abstract Serum hepcidin levels may increase in response to infection and inflammation. The present study investigated the effect of nonsurgical periodontal therapy (NSPT) on levels of serum hepcidin, inflammatory markers, and iron markers. An interventional study was conducted on 67 patients (age 30-65 years) without other diseases, except for chronic periodontitis (CP). Patients were allocated to either CP or control groups. The CP group received supragingival and subgingival scaling and root planing procedures, whereas the control group received supragingival scaling. Probing depth (PD), bleeding on probing, clinical attachment level (CAL), visible plaque index (VPI), serum hepcidin and interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP), hematological markers, and iron markers were measured at baseline and at 90 days after NSPT. The CP group had statistically significant lower mean values for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (p ≤ 0.05). The control group had statistically significant reductions in hemoglobin, hematocrit, MCV, and MCH (p ≤ 0.05). Serum hepcidin, IL-6, and erythrocyte sedimentation rate (ESR) levels were significantly decreased in both groups after NSPT. Periodontal markers were more markedly reduced in the CP group compared with the control group (p ≤ 0.05). These findings suggest that NSPT may reduce the serum levels of IL-6, hepcidin, and periodontal parameters.

Impacto da perda dentária na qualidade de vida relacionada a saúde bucal de adultos / Impact of tooth loss on oral health-related quality of life of adults

Introdução: a perda dentária parece impor alterações físicas, biológicas e psíquicas que podem impactar negativamente na qualidade de vida dos indivíduos. Objetivo: avaliar a associação entre perda dentária e a percepção do seu impacto negativo na qualidade de vida. Metodologia: estudo transversal, conduzido com 306 adultos, atendidos em serviços públicos de saúde, em Feira de SantanaBa. O impacto na qualidade de vida relacionada à saúde bucal foi mensurado pelo OHIP-14. Foi realizado exame bucal e aplicado questionário estruturado para obter informações relacionadas às características socioeconômicas, demográficas, de estilo de vida e condições de saúde geral e bucal. Foi empregado o Teste qui-quadrado e estimadas as Razões de prevalência e intervalos de confiança a 95% (IC95%). Resultados: dentre as dimensões do OHIP-14, a perda dentária (≥7 dentes) foi estatisticamente associada com a dimensão "incapacidade física" (RP: 1,50; IC95%: 1,18-1,90, p=0,003). Conclusão: houve associação entre alta perda dentária e impacto da saúde bucal na qualidade de vida, expressa pela incapacidade física.

Introduction: tooth loss seems to impose physical, biological and psychological alterations which could impact negatively on quality of life of individuals. Objective: was to evaluate an association between tooth loss and oral health-related quality of life. This crosssectional study examined a sample of 306 adults, attended at public health services, in Feira de Santana-Ba. Metodology: the 14-item Oral Health Impact Profile (OHIP-14) was used to capture the impact on their quality of life. Oral examination was performed and a structured questionnaire was applied to obtain more information related to socioeconomic and demographic variables, lifestyle one and general and oral health conditions. The chi-square test was used and the prevalence ratios (PR) and confidence intervals at 95% (IC95%) were estimated. Results: among the specific dimensions of the OHIP-14, tooth loss (≥7 teeth) was statistically associated with the dimension "physical disability" (RP: 1.50; IC95%: 1.18-1.90, p=0.003). Conclusion: there was association between high tooth loss and oral health-related quality of life, expressed by physical disability

Factors associated with dental caries, periodontitis and intra-oral lesions in individuals with HIV / AIDS.

This study aimed to investigate the factors associated with oral diseases in individuals with HIV/AIDS. A cross sectional study was carried out which included 312 individuals registered in the Specialized Care Services for HIV/AIDS in three municipalities of the State of Bahia: Feira de Santana, Santo Antonio de Jesus and Juazeiro, Brazil. Socioeconomic-demographic characteristics related to life style and to dental caries, periodontitis and intra-oral mucosal lesions were investigated in patients with HIV/AIDS infection. Prevalence Ratio with 95% Confidence Interval and significance level of 5% were employed for the statistical analysis. The majority of the individuals evaluated were male with a mean age (± standard deviation) of 41.5 ± 11.3 years, and a mean time of HIV infection diagnosis (± standard deviation) of 5.2 ± 4.4 years. The presence of dental caries was observed in 78.7% of the sample, periodontitis in 25.4% and 36.2% showed intra-oral lesions. Oral health status showed a statistically significant association with the following variables: gender, age, schooling level, current occupation, family income, past and current smoking, antiretroviral use time, latest viral burden dosage, latest CD4-positive T lymphocyte count, use of complete/partial dental prosthesis, need for dental prosthesis, and use of dental floss. With the exception of those factors directly related to HIV/AIDS i.e., antiretroviral use time, latest viral burden dosage and latest CD4-positive T lymphocyte count, the factors associated with oral diseases in this population were the same as those associated with oral diseases in the non-HIV/AIDS population.

Condição bucal de gestantes e puérperas no município de Feira de Santana, em três diferentes períodos entre os anos de 2005 e 2015 / Condición bucal de gestantes y puérperas en el municipio de Feira de Santana, en tres diferentes momentos entre los años 2005 y 2015 / Oral health status of pregnant and puerperal women in the municipality of Feira de Santana, at three different times between 2005 and 2015

Objetivo: avaliar a condição bucal de gestantes e puérperas, usuárias de serviços públicos de saúde de Feira de Santana, BA, Brasil, em três momentos distintos do período 2005-2015. Métodos: estudo sobre características socioeconômico-demográficas, condição e cuidado com a saúde, estilo de vida e condição bucal de 1.245 participantes, obtidas de banco de dados de três investigações - I Estudo de intervenção (2005-2007), II Estudo caso-controle (2010-2011), III Estudo caso-controle (2012-2015). Resultados: comparando-se os três períodos, as frequências de gengivite (24,41% versus 8,90% versus 5,77%; p<0,01) e periodontite (44,64% vs 9,16% vs 11,55%; p<0,01) diminuíram; relativamente à condição dentária, as piores situações no número de dentes presentes, hígidos, extraídos e índice CPO-D observaram-se no período III, comparativamente ao período II. Conclusão: a condição periodontal melhorou nos anos estudados, coincidentemente com o processo de implantação de políticas de assistência pré-natal, saúde da mulher e saúde bucal, e de redistribuição de renda no município.

Objetivo: evaluar la condición bucal de gestantes y puérperas, usuarias de servicios públicos de salud de la ciudad de Feira de Santana/BA, en tres momentos distintos comprendidos entre 2005 y 2015. Metodos: se trata de un estudio con información sobre características socioeconómicas-demográficas, de condición y cuidado com la salud, de estilo de vida y de condición bucal de 1245 participantes obtenidas en un banco de datos de tres investigaciones previas: I (2005-2007), II (2010-2011), III (2012-2015). Resultados: tanto la frecuencia de gingivitis (24,41% versus 8,90% versus 5,77%; p<0,01) y periodontitis (44,64% vs 9,16% vs 11,55%; p<0,01) disminuyó; em relación a la condición dental, las peores situaciones en cuanto al número de dientes presentes, hígidos, extraídos y el índice CPO-D se observaron en el período III, en comparación con las del período II. Conclusión: se há mejorado la condición periodontal a lo largo de los años, período que coincide com el proceso de implantación de políticas de salud de la mujer, salud bucal, así como redistribución de ingresos en el municipio.

Objective: to evaluate the oral health condition of pregnant/postpartum women attending public services in the city of Feira de Santana, BA, Brazil, at three different times between 2005 and 2015. Methods: this is a study socioeconomic and demographic characteristics, health condition and health care, lifestyle and oral health status of 1,245 participants obtained from a database of three previous investigations: I Intervention Study (2005-2007); II Case-Control Study (2010-2011); III Case-Control Study (2012-2015). Results: comparing the three periods, the frequency of gingivitis (24.41% versus 8.90% versus 5.77%; p<0.01) and periodontitis (44.64% vs 9.16% vs 11.55%; p<0.01) was found to decrease; the worst dental conditions regarding the number of teeth present, healthy and extracted and the DMFT index were found in period III compared to period II. Conclusion: an improvement was seen in the participants' periodontal condition over time, which coincides with the implementation of policies pertaining to women's health, oral health and income redistribution in this city.

Práticas alimentares e cárie dentária: uma abordagem sobre a primeira infância / Feeding practices and dental caries: approach on early childhood

O declínio da cárie dentária tem sido observado nos últimos anos. Entretanto, a alta prevalência da doença em crianças jovens é uma realidade em todo o mundo. Os principais fatores biológicos e comportamentais relacionados ao processo são a presença de biofilme cariogênico e a ingesta frequente de carboidratos fermentáveis, respectivamente. Os hábitos alimentares inadequados estabelecidos, especialmente, a partir do primeiro ano de vida, como o alto consumo de açúcares e bebidas adoçadas, o aleitamento materno sob livre demanda e alimentação noturna, ea falta de controle periódico de biofilme constituem importantes fatores de risco ao processo. Este trabalho apresenta uma revisão de literatura sobre a relação dieta e cárie dentária, focalizando os hábitos alimentares iniciados e estabelecidos no início da vida e sua repercussão ao longo da primeira infância. A estratégia da pesquisa envolveu Descritores em Ciências da Saúde, como hábitos alimentares na lactância e à cárie dentária em crianças, através de bases de dados especializadas,como PUBMED, LILACS and COCHRANE. Reconhecer o papel da dieta no controle da cárie nos primeiros anos de vida poderá auxiliar o profissional de Odontologia a adotar medidas efetivas para prevenção e controle da doença, nesse período de vida.

A decrease of dental caries occurrence has been observed on the last years. However, its prevalence is still high among younger children around the world. The main biological and behavior factors related to this process are the existence of cariogenic biofilms and frequent ingestion offermentable carbohydrates. Inadequate feeding habits, especially in the first year after birth, associatedto high use of sugars, sweet drinks, breastfeeding under spontaneous demand after 12months of age, nighty feeding habits and absence of periodic biofilm control configure important risk factors for caries occurrence. This study consists on a literature review about the correlation between feeding habits and dental caries prevalence focused on feeding routines initiated and established immediately after birth and its influence on primary childhood experience of dental caries. The research strategy involved oral health describers related to feeding habits during breastfeeding and dental caries prevalence during childhood, under databases of PUBMED, LILACS and COCHRANE. The known of feeding habits hole on caries control during the first stages of life canhelp dentists to adopt effective means to prevent and control dental caries prevalence in children.

Severity of Periodontitis and Metabolic Syndrome: Is There an Association?

BACKGROUND: Metabolic syndrome (MetS) is a major factor for the occurrence of cardiovascular events. Causal factors for MetS are not well defined or yet unidentified. Preliminary investigations suggest that infections and inflammation may be involved in the etiology of this syndrome. This study aims to estimate the association between the severity of periodontitis (exposure) and MetS (outcome). METHODS: A cross-sectional study was conducted with 419 participants recruited from the Diabetes and Hypertensive Treatment Center, Feira de Santana, Bahia, Brazil. After administration of a questionnaire, general and oral clinical examination and laboratory tests were performed. Diagnosis of periodontitis and MetS was performed according to various criteria. The analysis of the effect of periodontitis on MetS used logistic regression analysis with adjustment for confounders. RESULTS: The prevalence of periodontitis was found to be between 34.61% and 55.37%, depending on the classification definitions used, and the prevalence of MetS ranged from 60.86% to 67.06%. In the group with periodontitis, 14.08% had severe and 41.29% had moderate levels of periodontitis. There was an association between severe periodontitis and MetS after adjustment for sex, age, household density, alcoholic beverage consumption, smoking habit, and cardiovascular disease (odds ratio ORadjusted_6 = 2.11, 95% confidence interval = 1.01 to 4.40, P = 0.05). CONCLUSIONS: The results suggest that periodontitis is associated with MetS, and that MetS prevalence is related to severe periodontitis.