Association of sociodemographic factors with the prescription pattern of opioids for dental patients: a systematic review.

Aim To evaluate the association of patients' sociodemographic factors (sex, age, ethnicity, income, educational level, living environment and health insurance) with the prescription pattern of opioids provided by oral health practitioners.Methods Observational studies that evaluated the association of patients' sociodemographic factors and the likelihood of receiving an opioid prescription provided by an oral health practitioner were eligible. Electronic searches were conducted in Medline (PubMed), Embase, Scopus, Web of Science, LILACS, SciELO, Google Scholar, and OpenGrey up to March 2021. Two authors independently screened the studies, performed data extraction, and assessed the risk-of-bias using the critical appraisal tools developed by the Joanna Briggs Institute (JBI). Certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results Eight studies were included in this systematic review. Publication year ranged from 2011 to 2021. Narrative synthesis showed with very low certainty of evidence that younger individuals were more likely to receive a prescription of opioids than older individuals. Regarding the other sociodemographic factors and the prescriptions of opioids in dentistry, the evidence is controversial. Risk of bias was low for most items assessed in the included studies.Conclusion The available evidence suggests that there is an association between patients' sociodemographic factors and the prescription patterns of opioids provided by oral health practitioners.

Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial.

The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.

Impact of untreated dental caries severity on the quality of life of preschool children and their families: a cross-sectional study.

PURPOSE: Untreated dental caries is a persistent oral problem among preschool children. Although there is vast evidence regarding the impact of dental caries on oral health-related quality of life (OHRQoL) in this age group, evidence on the impact of untreated caries severity is scarce. The purpose of this study was to investigate the impact of untreated caries severity on the OHRQoL of preschool children and their families. METHODS: A cross-sectional study was conducted with 563 individuals in the city of Goiania, Brazil. Data were collected through interviews with parents/caregivers and clinical examinations of their children. The OHRQoL was measured by the Brazilian version of the Early Childhood Oral Health Impact Scale. Untreated dental caries severity was assessed using validated indices. Other independent variables were socioeconomic, toothache prevalence, and the questionnaire respondent. Statistical analysis involved bivariate comparisons and Poisson regression analyses. RESULTS: A higher prevalence of impact on OHRQoL was found among preschool children with untreated dental caries with clinical consequences (PR 1.31; 95% CI 1.01-1.70) compared to those without caries; those aged 5 years (PR 1.47; 95% CI 1.18-1.82), compared to those aged two; and those with a toothache (PR 1.54; 95% CI 1.34-1.76), compared to those without toothache. Moreover, fathers (PR 0.71; 95% CI 0.55-0.92) and other respondents (PR 0.70; 95% CI 0.52-0.96) perceived less impact on the OHRQoL in comparison to mothers. CONCLUSIONS: Severe untreated dental caries with clinical consequences had a negative impact on the children's OHRQoL, regardless of toothache and socioeconomic factors.

Healthy and cariogenic foods consumption and dental caries: A preschool-based cross-sectional study.

OBJECTIVE: To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. MATERIALS AND METHODS: A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. RESULTS: The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p = 0.05), whereas the latter maintained an association with lower caries rates (p = 0.01). CONCLUSION: A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.

Caries severity declined besides persistent untreated primary teeth over a 22-year period: Trends among children in Goiânia, Brazil.

BACKGROUND: Evidence of time trends in early childhood caries in low- and middle-income countries in the second decade of the year 2000 is scarce. AIM: To assess the trends in early childhood caries prevalence and severity in 2- to 5-year-old children over a 22-year period (1993-2015) in Goiânia, Midwest Brazil. Additionally, we aimed to investigate the changes regarding affected dental arches and teeth. DESIGN: A time-lag analysis of trends in caries was carried out using data from three cross-sectional studies based on the World Health Organization diagnostic criteria, in 1993 (N = 1362), 2001 (N = 1620), and 2015 (N = 548). RESULTS: Caries prevalence declined from 45.1% in 1993 to 29.0% in 2015. Prevalence of severe caries (dmft ≥ 6) in 2015 was nearly one-third of that found in 1993, and the SiC index (mean dmft of the highest tertile) decreased from 4.55 to 3.32. Decline was higher in the 1993-2001 than in the 2001-2015 time-lag. Posterior teeth and second molars had the greatest reductions. High proportions of untreated caries were found in all ages and survey years. CONCLUSION: There were significant changes in caries prevalence and severity, marked by a striking decline from 1993 to 2001, followed by a less prominent decrease up to 2015, and high levels of untreated caries.

Association of breastfeeding and malocclusion in 5-year-old children: Multilevel approach.

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.

Some Malocclusion Traits Significantly Reduce Quality of Life Among Adults.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Malocclusion traits and oral health-related quality of life in Finnish adults. Masood M, Suominen AL, Pietila T, Lahti S. Community Dent Oral Epidemiol 2017;45:178-88. SOURCE OF FUNDING: Finnish Dental Society Apollonia and the Finnish Dental Association TYPE OF STUDY/DESIGN: Cross-sectional study.

Metallothionein immunoexpression in selected benign epithelial odontogenic tumors.

BACKGROUND: Odontogenic tumors exhibited variable biologica behaviors. Metallothionein (MT) is correlated with the cellular homeostasis of essential metals, cellular differentiation, and proliferation. The core goals of this study are (i) to report and to compare MT expression among benign epithelial odontogenic tumors; (ii) to correlate MT with cellular proliferation index; and (iii) to evaluate the influence of the inflammatory infiltrate on MT expression. MATERIALS AND METHODS: Ten cases of solid ameloblastomas (SABs), 4 squamous odontogenic tumors (SOTs), 5 adenomatoid odontogenic tumors (AOTs), and 3 calcifying epithelial odontogenic tumors (CEOTs) were subjected to immunohistochemical to anti-MT, anti-Ki-67, and anti-PCNA. Statistical analysis was performed using BioEstat(®) 4.0. RESULTS: Metallothionein staining was found to be the highest in the SABs (93.1%), followed by SOTs (52.9%), AOTs (38.4%), and CEOTs (0%). MT staining exhibited statistically significant differences between the SABs and the SOTs (P = 0.0047) and the AOTs (P = 0.0022). A weak-to-strong positive correlation between IMT and IK or IP was observed in SABs and SOTs, whereas a strong negative correlation was observed in AOTs. No differences in IMT, IK, and IP were observed between inflammation groups A and B. CONCLUSIONS: The increased MT expression observed in the SABs might be correlated with clinical behavior (local invasiveness and high rate of recurrence). In the SABs and SOTs, MT plays a role in the stimulation of cellular proliferation. In contrast, MT can inhibit cellular proliferation in the AOT. The IMT, IK, and IP are not affected by inflammation.

Profile of usage of a reference diagnostic service on oral pathology: a 10-year evaluation.

BACKGROUND: Despite the professional and academic relevance of the Brazilian oral pathology diagnostic laboratories, no information about their usage profile is available in the English literature. The objective of the present study is to report data about the histopathological and immunohistochemical exams performed in a Brazilian regional reference laboratory of oral pathology, as well as its main users. METHODS: Information about all histopathological exams performed between 2002 and 2012 was retrieved from the files of the Oral and Maxillofacial Pathology Service of the School of Dentistry of Universidade Federal de Minas Gerais. Data collected included: 1) requestor of exam; 2) diagnosis classification; and 3) immunohistochemical tests. Descriptive statistical analyses were done. RESULTS: 13,522 histopathological exams were performed, mean 1,229/year. The Public Health System of the city of Belo Horizonte was the main requestor of exams (77.13%), followed by private professionals (19.26%), and other cities (2.03%). Most lesions were considered benign (12,599/ 93.17%), with 854 malignant lesions (6.32%). 469 immunohistochemical tests were performed; 324 (69.08%) were from benign diagnosis, and 145 (30.92%) from malignant diagnosis. The most used antibodies were against S100, vimentin, smooth muscle actin, actin muscle specific HHF-35, and pan-cytokeratin AE1/AE3. CONCLUSIONS: Public Health System is the major user of the diagnostic service on oral pathology in our institution. Most diagnoses were of benign lesions, although many malignant lesions were detected. Immunohistochemistry was particularly important in solving challenging cases.

Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil.

BACKGROUND: Studying the factors associated with the use of dental services can provide the necessary knowledge to understand the reasons why individuals seek out public healthcare services and the formulation of more appropriate public policies for the present-day reality. METHODS: This work was a cross-sectional epidemiological study consisting of a sample of adults found in a research databank concerning the conditions of the oral health of the population of the state of Minas Gerais, Brazil. This study examined both main oral health disorders and relevant socioeconomic aspects. The dependent variable was defined as the type of service used, categorized under public and private use. The independent variables were selected and grouped to be inserted in the analysis model according to an adaptation of the behavioral model described by Andersen and Davidson. A hierarchical model was used to analyze the data. The description of variables and bivariate analyses were performed in an attempt to verify possible associations. For each group of variables at each hierarchical level, the gross and adjusted odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated by means of logistic regression. The Complex Samples model from the SPSS statistics program, version 19.0, was used to analyze the sample framework. RESULTS: In the final model, the factors associated with the use of public healthcare services by adults were directly related to the socioeconomic and demographic conditions of the individuals, including: being of a dark-skinned black race/color, belonging to families with more than four household residents and with a lower income level, residing in small towns, having more teeth that need treatment. CONCLUSIONS: According to the findings from this study, socioeconomic and demographic factors, as well as normative treatment needs, are associated with the use of public dental services.

Dental Profile of Brazilian Patients with Rare Skeletal Genetic Disorders: Clinical Features and Associated Factors.

The aim of this study is to compare the dental profiles of Brazilian patients with rare genetic skeletal disorders and normotypical patients. A cross-sectional study was carried out with 210 individuals aged between 2 and 54 years old [105 with rare diseases (Mucopolysaccharidosis/MPS n = 27 and Osteogenesis Imperfecta/OI n = 78) and 105 without rare diseases] and their parents/caregivers. The parents/caregivers answered a questionnaire about individual aspects of their child and the dental profile was identified from questions related to dental history and the presence/absence of dental problems. The patients' oral cavity was also examined by three examiners for dental caries, malocclusion, gingivitis, and dental anomalies. The average age of individuals with a rare disease was 14.1 years (±12.2) and the median was 9.5 years. Participants who had already used the public health system (SUS) dental care services had a 2.24 times higher chance of belonging to the group with a rare disease (OR = 2.24; 95% CI: 1.07-4.89). Patients with rare diseases are 14.86 times more likely to have difficulty receiving dental treatment (OR = 14.86; 95% CI: 5.96-27.03) and 10.38 times more likely to have one or more dental problems (OR = 10.38; 95% CI: 1.95-35.17). Individuals with rare disorders have a greater history of difficulty in accessing dental treatment, using the SUS, and were diagnosed with more dental problems compared to normotypical individuals.

Stylohyoid complex ossification in temporomandibular disorder: a case-control study.

STATEMENT OF PROBLEM: Stylohyoid complex ossification (SCO) can be associated with temporomandibular disorder (TMD). However, this subject is poorly investigated in epidemiological studies. PURPOSE: The purpose of this study was to assess the association between TMD and SCO. MATERIAL AND METHODS: Seventy-eight individuals with TMD and 93 control individuals without TMD were enrolled in a case-control study and paired according to age and gender. Panoramic radiographs were made of all participants, and SCO was measured in millimeters (mm) by a blinded researcher. Ossification was held to begin at measurements of 30 mm or more. The association between symptoms (pain upon swallowing or turning the head and the sensation of a foreign body in the throat) and SCO was investigated. Pearson chi-square tests were used for the comparison of proportions, (α=.05). RESULTS: A total of 44.9% of those with TMD and 46.2% of the control population exhibited SCO (P=.858). TMD was associated with pain upon swallowing (P<.05) and upon turning the head P<.01), but there were no associations between the symptoms possibly related to SCO and the presence of ossification (pain upon swallowing P=.658; sensation of a foreign body in the throat P=.980; pain upon turning the head P=.405). CONCLUSIONS: The results suggest that there are no associations between TMD and SCO. Some symptoms classically associated with SCO also occur in TMD patients.

Association between management, human resources, and care provided to patients with special healthcare needs in dental specialty centers in Brazil: A cross-sectional study.

AIMS: This study aimed to identify the association between management and human resource factors with the performance of dental care provided to patients with special health care needs (SHCN) in secondary care in Brazil in the second cycle of the Program for Quality Improvement and Access to Dental Specialty Centers (PMAQ-CEO). METHODS AND RESULTS: This study is a secondary data analysis from the second cycle from PMAQ-CEO, which evaluated 1097 Dental Specialty Centers (DSCs), conducted in 2018. Seventeen independent variables taken from dentists' training, and dental team management characteristics were analyzed to assess their influence on the reported "Performance of care for SHCN patients". An estimated score was generated from their performance on 23 questions related to the physical and human structure and work processes in the oral health care of SHCN patients in the DSCs. Negative binomial regression model with values p ≤ 0.05 were considered significant. Data analysis included residual deviation to the degree of freedom and the chi-square test. The patient care performance score with SHCN increases significantly when the DSC has a manager (RR = 1.019; CI = 1.011-1.026) and goal monitoring and analysis (RR = 1.012; CI = 1.007-1.005). By contrast, the DSCs in which the dentist is a statutory public servant (RR = 0.998; CI = 0.997-1.000) and performs additional unhealthy or hazardous duties (RR = 0.998; CI = 0.996-0.999) are less likely to provide a higher quality care. CONCLUSION: The heterogeneity and low-performance scores for dental care provided to SHCN was identified in Brazilian health services. It was possible to verify that management and human resource factors of the DSCs were associated with the performance of dental care provided to SHCN patients.

Professional Factors Associated with Case Resolution without Referrals of Orofacial Pain Cases to Secondary Dental Care by Telehealth in Brazil: A Cross-Sectional Study in 2019 and 2020.

This study aimed to identify professional factors associated with case resolution without a referral of orofacial pain to secondary health care by Brazilian Primary Health Care (PHC) practitioners who demanded asynchronous teleconsulting, stratified by year, in 2019 and 2020 (the COVID-19 Pandemic burst). A cross-sectional study employed secondary databases from asynchronous teleconsulting Telehealth Brazil Networks from January 2019 to December 2020. The outcome was the dichotomous variable "If referral to secondary care was avoided." As covariates: sex, healthcare professions, and category of orofacial pain doubts. A negative binomial regression model estimated each covariate's unadjusted and adjusted PR (95%CI) and p values, stratified for 2019 and 2020. There was a difference in descriptive factors associated with case resolution without a referral from 2019 to 2020. Females prevailed in both years, and the total demand decreased to a third from 2019 to 2020. The rate of resoluteness decreased by 19.1%. In 2019, nurses (PR = 0.69 CI 95% 0.57-0.83) and other professionals (PR = 0.84 CI 95% 0.73-0.97) showed less frequency of case resolution without a referral than did general dentists. In 2020, oral-cavity-related doubts (PR = 1.18 CI 95% 1.06-1.32) and temporomandibular disorders (PR = 1.33 95% 1.15-1.54) surpassed other causes of orofacial pain in case resolution without a referral, and female professionals avoided referrals more frequently than men (PR = 1.24 CI 95% 1.21-1.38). In conclusion, in 2019, oral cavity doubts and the PHC profession influenced the case resolution. Female professionals and oral cavity doubts scored the higher case resolution without a referral for the service in 2020.

Access to oral health care services for individuals with rare genetic diseases affecting skeletal development.

OBJECTIVE: To identify factors associated with oral health care services for individuals with and without rare genetic diseases. MATERIALS AND METHOD: A cross-sectional study was undertaken, with 140 individuals paired by sex and age (70 with rare genetic diseases and 70 without), aged between 3 and 27 years, and their parents. The sample was selected from two reference hospitals for patients with rare genetic diseases in southeastern Brazil. The parents completed a questionnaire on individual aspects and their child's medical/dental history. Participants who did and did not suffer from rare genetic diseases were examined for dental caries, malocclusion, dental anomalies, and oral hygiene. The theoretical model Directed Acyclic Graphs (DAG) was used to identify possible confounding variables in the association between rare diseases and access to dental care. Descriptive analyses and non-matched and matched logistic regression models (p < 0.05) were carried out. RESULTS: The chance of individuals without rare genetic disease having access to oral health care service was 5.32 times higher (95% CI 2.35-12.01) than those with such conditions. Individuals who had not suffered upper respiratory tract infections had a 3.16 times greater chance of being in the group with access to oral health care service (95% CI 1.45-6.90). CONCLUSION: Individuals with no rare genetic diseases and no history of upper respiratory tract infections had a greater chance of belonging to the group of individuals with access to a dental service. Individuals with rare genetic diseases have less access to oral health care.

Biosafety in Dental Health Care During the COVID-19 Pandemic: A Longitudinal Study.

Background: The coronavirus disease 2019 (COVID-19) pandemic had quite an impact on dental health care. Concerns about the risk of SARS-CoV-2 transmission through contaminant fluids and droplet formation during several dental procedures highly impacted dental health care, drastically reducing the number of dental practices worldwide. To monitor SARS-CoV-2 contamination in dental clinics, a longitudinal study was carried out during the return of dental practice at university. Methods: Dental health care professionals [(DHCPs); teachers, undergraduate dental students, and dental assistants] and patients were screened for SARS-CoV-2 RNA in a dental school clinic environment from 11th January to 12th March 2021 (9 weeks). Serological testing was performed on DHCPs in two-time points. Additionally, samples with low Ct values were sequenced to identify the circulating SARS-CoV-2 variant and possible transmission clusters. Results: We found a low number of dental staff (5.8%), patients (0.9%), and environment sites (0.8%) positive for SARS-CoV-2. Most positive cases had asymptomatic to mild symptoms, and two asymptomatic DHCPs presented prolonged infection. In the first week after previous exposure to COVID-19, 16.2% of DHCPs had IgM or IgG antibodies against SARS-CoV-2, and 1/3 of them had undetected antibodies in the last weeks. The variant zeta (P.2) could be detected. No cross-infection was observed between participants. Conclusion: Our study suggests that dental practice can be safely executed when adequate control measures and biosafety protocols are applied. DHCP and patient testing, patient telemonitoring, proper use of personal protection equipment, and sanitization of surfaces are essential to avoid SARS-CoV-2 cross-infection in dental practice.

Metallothionein in the radicular, dentigerous, orthokeratinized odontogenic cysts and in keratocystic odontogenic tumor.

BACKGROUND: Metallothionein (MT) is a protein correlated with cellular differentiation and proliferation, as well as with the inhibition of apoptosis. The aims were to report and to compare the MT expression in odontogenic cysts and keratocystic odontogenic tumor (KOT); to correlate the MT with cellular proliferation; and to evaluate the influence of the inflammation in MT. METHODS: Nine cases of radicular cyst (RC), nine dentigerous cyst (DC), four orthokeratinized odontogenic cyst (OOC), and eight KOT were submitted to immunohistochemistry using anti-MT and anti-Ki-67. Indexes of MT (IMT) and Ki-67 (IK) were obtained. Lesions were grouped according to inflammation: mild-to-moderate (group A) and intense (group B). RESULTS: IMT proved to be highest in RC (91%), followed by DC (89%), KOT (78%), and OOC (63%). IMT was inversely correlated with IK in KOT, and OCC, but was positively correlated with RC and DC. No differences in IMT and in IK could be observed between groups A and B. CONCLUSIONS: The higher IMT found in RC and DC compared to OCC and KOT, as well as the differences between the last ones, is possibly correlated with their different histopathological features and clinical behavior. In RC and DC, MT may play a role in cellular proliferation. However, it seems that MT is either less or is not related to proliferation in OOC and in KOT. Moreover, inflammation does not seem to alter IMT and IK.

Risk factors in burning mouth syndrome: a case-control study based on patient records.

Burning mouth syndrome (BMS) is a multifactorial condition which is still poorly understood. The aim of this study was to evaluate a group of patients with BMS, as compared to a control group, and to describe related local and systemic factors. Records of patients referred to the Oral Pathology Service at the School of Dentistry over a period of 7 years were considered for the study, within which 32 patients with a diagnosis of BMS were found. A randomized group matched for age and gender was also evaluated for the study. Data were analyzed statistically using the SPSS 12.0 for Windows. Prevalence of BMS was 0.99% (32 BMS patients/3,243 records), considering that females were more commonly affected than were males and that the majority of the individuals were in their sixties. The univariate analysis performed comparing the two groups revealed statistical differences concerning the presence of gastrointestinal diseases (p = 0.003) and urogenital diseases (p = 0.012). The intake of H-2 receptor antagonist and proton pump inhibitor drugs (p = 0.015) also proved to be significant. Logistic regression analysis confirmed that gastrointestinal and urogenital problems were indeed risk factors that were solely associated with BMS. Although a diversity of related factors could be identified, gastrointestinal problems were the most prevalent, suggesting that the management of BMS patients requires attention and an appropriate approach to such disorders.

Demographic and Habitual Factors of Periodontal Disease among South Indian Adults.

The aim of this study was to evaluate the performance of a set of sociodemographic and habits measures on estimating periodontal disease among south Indian adults. This cross-sectional study was carried out among 288 individuals above 18 years old in Tamil Nadu, India. The outcome of the study was periodontal disease, measured by WHO criteria. The covariates were age, ethnicity, smoking and alcohol habit. The assessment of factors predicting periodontal disease was carried out by multiple logistic regression analysis using R version 3.6.1. The demographic factors like age group (AOR = 3.56; 95% CI 1.69-7.85), ethnicity (AOR = 6.07; 95% CI 2.27-18.37), non-alcoholic (AOR = 0.31; 95% CI 0.13-0.64) and non-smoking (AOR = 0.33; 95% CI 0.15-0.67) were found to be associated with the outcome. The maximum log likelihood estimate value was -30.5 and AIC was 385 for the final model, respectively. Receiver operating characteristic (ROC) curve for the periodontal disease was 0.737. We can conclude that sociodemographic factors and habits were useful for predicting periodontal diseases.

Perspectives on Social and Environmental Determinants of Oral Health.

Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.