RESUMO
Dental caries, gingivitis, and excess weight are highly prevalent, interconnected chronic conditions. The association of oral health with the development of adiposity among children is sparsely addressed. We examined the association of oral health to the development of excess weight and central obesity in early adolescence during a 2-year follow-up period. This prospective study was conducted with 2702 children aged 9-12 years at baseline from the Finnish Health in Teens study. Their weight development was followed up for 2 years. Body mass index with age- and sex-specific cut-offs and the waist-height ratio indicated weight status and central obesity. Oral health data (caries experience and gingivitis/calculus) were collected from outpatient records of public dental services. Having both caries experience and gingivitis/calculus was considered burden of oral diseases. Of the sample, 74% were caries-free but 70% exhibited gingivitis and/or calculus, and 20% had both caries experience and gingivitis/calculus. During the follow-up period, 5.3% (n = 124) and 4.7% (n = 118) of the children became overweight/obese or centrally obese, respectively. Having both caries experience and gingivitis/calculus associated with the development of excess weight in a fully adjusted model (HR 1.75, 95% CI 1.03-2.97) but not of central obesity. Caries experience or gingivitis/calculus alone did not associate with adiposity development. CONCLUSION: Having burden of oral diseases without excess weight at early adolescence could imply future weight gain; thus, normal-weight individuals with both caries experience and gingivitis/calculus could be targeted with preventive measures. Our findings warrant further research to explore whether oral diseases and the development of obesity merely share risk factors or if their relationship is of causal nature. WHAT IS KNOWN: ⢠Association of excess weight with caries experience and gingivitis is known to exist both cross-sectionally and longitudinally in children and adolescents. WHAT IS NEW: ⢠Burden of oral diseases, that is, having both caries experience and gingivitis/calculus, was associated with becoming overweight or obese 2 years later during early adolescence. ⢠Normal-weight individuals with burden of oral diseases at early adolescence could be targeted with preventive measures against excess weight gain.
Assuntos
Cárie Dentária , Gengivite , Obesidade Infantil , Humanos , Masculino , Feminino , Criança , Estudos Longitudinais , Estudos Prospectivos , Finlândia/epidemiologia , Obesidade Infantil/epidemiologia , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Gengivite/epidemiologia , Gengivite/etiologia , Gengivite/diagnóstico , Adolescente , Fatores de Risco , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Seguimentos , Índice de Massa CorporalRESUMO
We examined cross-sectional and longitudinal associations of dietary factors with caries experience in a population sample of 487 children aged 6-9 years at baseline examinations of the Physical Activity and Nutrition in Children (PANIC) Study. Altogether, 406 of these children attended 2-year follow-up examinations. Food consumption and eating frequency were assessed using 4-day food records, diet quality using the Baltic Sea Diet Score (BSDS) and eating behaviour using the Children's Eating Behavior Questionnaire. Caries experience was examined clinically. The cross-sectional associations of dietary factors with caries experience at baseline were analysed using linear regression and the longitudinal associations of dietary factors with a change in caries experience over follow-up using generalised mixed-effects regression adjusted for other risk factors. A higher consumption of high-fibre grain products (standardised regression coefficient ß = -0·16, P = 0·003) and milk (ß = -0·11, P = 0·025) and higher BSDS (ß = -0·15, P = 0·007) were associated with lower caries experience, whereas a higher consumption of potatoes (ß = 0·11, P = 0·048) and emotional overeating (ß = 0·12, P = 0·025) were associated with higher caries experience. Higher snacking frequency (fixed coefficient ß = 0·07, P = 0·033), desire to drink (ß = 0·10, P = 0·046), slowness in eating (ß = 0·12, P = 0·027) and food fussiness (ß = 0·12, P = 0·018) were associated with higher caries experience, whereas enjoyment of food (ß = -0·12, P = 0·034) and higher BSDS (ß = -0·02, P = 0·051) were associated with lower caries experience.
RESUMO
BACKGROUND: The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. METHODS: We included 171 general dental practitioners and dental therapists (collectively referred to here as "dentists") from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. RESULTS: For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13-15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33-6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. CONCLUSIONS: The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.
Assuntos
Cárie Dentária , Cárie Dentária/terapia , Restauração Dentária Permanente , Dentina , Odontólogos , Humanos , Padrões de Prática Odontológica , Papel Profissional , Estudantes de OdontologiaRESUMO
Erosive tooth wear is defined as irreversible loss of dental tissues due to intrinsic or extrinsic acids, exacerbated by mechanical forces. Recent studies have suggested a higher prevalence of erosive tooth wear in males, as well as a genetic contribution to susceptibility to erosive tooth wear. Our aim was to examine erosive tooth wear by performing a genome-wide association study (GWAS) in a sample of the Northern Finland Birth Cohort 1966 (n = 1,962). Erosive tooth wear was assessed clinically using the basic erosive wear examination. A GWAS was performed for the whole sample as well as separately for males and females. We identified one genome-wide significant signal (rs11681214) in the GWAS of the whole sample near the genes PXDN and MYT1L. When the sample was stratified by sex, the strongest genome-wide significant signals were observed in or near the genes FGFR1, C8orf86, CDH4, SCD5, F2R, and ING1. Additionally, multiple suggestive association signals were detected in all GWASs performed. Many of the signals were in or near the genes putatively related to oral environment or tooth development, and some were near the regions considered to be associated with dental caries, such as 2p24, 4q21, and 13q33. Replications of these associations in other samples, as well as experimental studies to determine the biological functions of associated genetic variants, are needed.
Assuntos
Erosão Dentária/epidemiologia , Erosão Dentária/genética , Adulto , Estudos de Coortes , Cárie Dentária/genética , Feminino , Finlândia/epidemiologia , Genes , Loci Gênicos , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Prevalência , Fatores de Risco , Fatores Sexuais , Atrito DentárioRESUMO
OBJECTIVES: The aims of this randomised controlled laboratory trial were to determine the procedure time and immediate quality (surface porosity and marginal gaps) of fillings placed using the bulk-fill base technique and the conventional incremental technique in simulated clinical settings. METHODS: Forty-two dentists and dental students were randomly allocated to use either the bulk-fill base technique or the conventional incremental technique to fill an identical class II disto-occlusal cavity in a maxillary left first molar typodont tooth. We recorded the time the participants used to fill the cavity and evaluated the surface porosity and marginal gaps on the approximal surfaces of the fillings using a stereomicroscope and specific probes according to the FDI criteria for restoration evaluation. Data were analysed using the Mann-Whitney U, Kruskal-Wallis, and chi-square tests. RESULTS: The median time ± interquartile range was 186 ± 80 s for the bulk-fill base technique and 463 ± 156 s for the conventional incremental technique (p < 0.001). The quality of the fillings was better for the bulk-fill base technique than for the conventional incremental technique (X2 = 9.5, p = 0.002). Neither operator experience nor the usual technique of choice were associated with the procedure time or the quality of the fillings. CONCLUSIONS: Compared to the conventional incremental technique, the use of the bulk-fill base technique shortened the time to fill a cavity by 59.8 % or 4 min and 36 s, and it improved the immediate surface and marginal quality of the fillings, regardless of the operator's experience or technique preference. CLINICAL SIGNIFICANCE: The use of the bulk-fill base technique instead of the conventional incremental technique leads to significant time-savings when placing large class II composite fillings. Additionally, the use of the bulk-fill base technique instead of the conventional incremental technique improves the immediate quality of large class II composite fillings.
Assuntos
Resinas Compostas , Cárie Dentária , Humanos , Restauração Dentária Permanente/métodos , MicroscopiaRESUMO
Carbonic anhydrase VI (CAVI) is the only secreted isozyme of the α-carbonic anhydrase family, which catalyzes the reversible reaction [Formula in text]. It appears that CAVI protects teeth and gastrointestinal mucosa by neutralizing excess acidity. However, the evidence for this physiological function is limited, and CAVI may have additional functions that have yet to be discovered. To explore the functions of CAVI more fully, we generated Car6 (-/-) mice and analyzed Car6 (-/-) mutant phenotypes. We also examined transcriptomic responses to CAVI deficiency in the submandibular gland, stomach, and duodenum of Car6 (-/-) mice. Car6 (-/-) mice were viable and fertile and had a normal life span. Histological analyses indicated a greater number of lymphoid follicles in the small intestinal Peyer's patches. A total of 94, 56, and 127 genes were up- or down-regulated in the submandibular gland, stomach, and duodenum of Car6 (-/-) mice, respectively. The functional clustering of differentially expressed genes revealed a number of altered biological processes. In the duodenum, the significantly affected biological pathways included the immune system process and retinol metabolic processes. The response to oxidative stress and brown fat cell differentiation changed remarkably in the submandibular gland. Notably, the submandibular gland, stomach, and duodenum shared one important transcriptional susceptibility pathway: catabolic process. Real-time PCR confirmed an altered expression in 14 of the 16 selected genes. The generation and of Car6 (-/-) mice and examination of the effects of CAVI deficiency on gene transcription have revealed several affected clusters of biological processes, which implicate CAVI in catabolic processes and the immune system response.
Assuntos
Anidrases Carbônicas/deficiência , Duodeno/metabolismo , Mucosa Gástrica/metabolismo , Perfilação da Expressão Gênica , Glândula Submandibular/metabolismo , Animais , Camundongos , Análise em Microsséries , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
OBJECTIVES: The aim of this retrospective data collection study was to determine the effect size of dry mouth on the survival of restorations and teeth. METHODS: The data were collected from the electronic patient files of City of Oulu Public Dental Services (Finland). Study population consisted of 71 dry mouth patients and 142 control patients. The survival of 3208 restorations were analyzed using Kaplan-Meier survival curves and multivariate Cox regression analysis with shared frailty for patients. Separate analyses were performed for the survival of the teeth. RESULTS: The hazard ratio of restorations in dry mouth patients was 2.08 (95% CI: 1.65-2.63) compared to the control patients. For the dry mouth patients, the fixed prosthetic crowns outlasted composite fillings of all sizes, but the difference increased concomitantly with the filling size. The dry mouth patients had hazard ratio of 1.98 (95% CI: 1.02-3.82) for tooth extractions compared to the control patients. The teeth with fixed prosthetic crowns outlasted the teeth with direct restorative materials. CONCLUSIONS: The survival time of restorations and teeth are severely shortened in patients with dry mouth. Especially the survival time of the large composites is short in dry mouth patients whereas fixed prosthetic crowns have acceptable survival time also in dry mouth patients. CLINICAL SIGNIFICANCE: When informing a dry mouth patient on the expected survival of a restoration or tooth, one should take into account that dry mouth patients´ restorations and teeth have severely shortened survival time.
Assuntos
Restauração Dentária Permanente , Xerostomia , Resinas Compostas , Coroas , Materiais Dentários , Falha de Restauração Dentária , Humanos , Estudos Retrospectivos , Xerostomia/etiologiaRESUMO
OBJECTIVES: This study aimed to compare the knowledge attained by third-year dental students in physical ergonomics altering live lectures and videos in teaching. The second aim was to investigate implementation of the theoretical knowledge on ergonomics into practice. MATERIAL AND METHODS: Forty-five students divided into two groups attended a live lecture (45 min) or viewed videos (45 min). After the first teaching session, the groups changed parts. All students answered a questionnaire with 13 true or false-questions on ergonomics at baseline and immediately after both teaching sessions. Friedman's test and Wilcoxon signed rank test were used to compare questionnaire scores of the student groups. Additionally, we photographed 17 randomly selected students 3 months after baseline during a simulation workshop on endodontics. We analyzed the photographs for ergonomic postures using a specific 12-point checklist. RESULTS: At baseline, no difference in the knowledge between the two groups was discovered, when both scored 72%. After the first teaching session, significant improvement in both groups (p < .05) was found; and there was no statistically significant difference in the scores between the groups (88% in the lecture-first and 82% in the video-first group). After the second teaching session, the scores were similar in both groups. Overall all improvement in both groups was significant (p < .001). The photograph analysis showed half of the postures being in accord with the ergonomic guidelines. CONCLUSIONS: Both live lectures and videos showed similar outcomes in teaching ergonomics. Implementation of the knowledge on ergonomics is insufficient. Videos provide an easy-to-organize alternative to live lectures in teaching dental ergonomics. New means are needed to have dental students implement their knowledge on ergonomics into practice.
Assuntos
Educação em Odontologia/métodos , Ergonomia/métodos , Estudantes de Odontologia/estatística & dados numéricos , Ensino/estatística & dados numéricos , Gravação em Vídeo/métodos , Estudos Cross-Over , Currículo , Odontologia , Avaliação Educacional , Humanos , Estudantes de Odontologia/psicologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES/AIMS: This cross-sectional study aimed to examine oral health and oral health-related habits among prisoners at the Pelso Prison in Finland. MATERIALS AND METHODS: Participants in this cross-sectional study comprises 100 inmates. A calibrated dentist recorded the decayed, filled and missed teeth as well as periodontal status (bleeding-on-probing, pocket probing and Community Periodontal Index) among the participants (n=100). Fifty inmates were also interviewed for marital status, education and oral health-related habits. The Ethical Committee of the Northern Ostrobothnia Hospital District and the Criminal Sanctions Agency approved the study protocol. RESULTS: The participants were on average 35 years old and had 5 (s.d. 5.1) decayed teeth in need of restorative treatment, whereas DMFT was 17 (s.d. 8.9). Half of the study population had periodontal disease in need of professional treatment. Almost all reported brushing their teeth daily. Two-third ate sweets, one-third drank fizzy drinks and majority smoked every day. Almost two-third had used illicit drugs at some point of their lives. Almost all drunk alcohol once a week or more often. No statistically significant associations were discovered between dental treatment need and explanatory factors. DISCUSSION: Prisoners appear to be a homogenous group with poor oral health and harmful health behaviours.