Nutritional status, tooth wear and quality of life in Brazilian schoolchildren.

OBJECTIVE: To evaluate the correlation among nutritional status, tooth wear and quality of life in Brazilian schoolchildren. DESIGN: The study followed a cross-sectional design. Nutritional status was measured via anthropometry using BMI and tooth wear was measured using the Dental Wear Index; both these assessments were carried out by a trained recorder according to standard criteria. A modified version of the Child Oral Impacts on Daily Performances was used to assess quality of life. SETTING: City of Bauru, in Brazil. SUBJECTS: A cluster sample of 396 schoolchildren (194 boys and 202 girls) aged 7-10 years. RESULTS: The anthropometric assessment showed similar situations for both sexes regarding underweight (31·40 % in boys and 30·20 % in girls) and overweight/obesity (33·96 % in boys and 33·17 % in girls). The underweight children showed a greater severity of tooth wear in the primary teeth (OR=0·72; CI 0·36, 1·42), although in the permanent dentition the obese children had a greater severity of tooth wear (OR=1·42; 95 % CI 0·31, 6·55). The tooth wear was correlated with age for both dentitions. CONCLUSIONS: Tooth wear in the primary and permanent dentition may be related to nutritional status. Tooth wear and obesity did not have a significant impact on the schoolchildren's perception of quality of life.

Periodontal status and pathogenic bacteria after gastric bypass: a cohort study.

AIM: The aim this study was to evaluate the influence of gastric bypass surgery (GBS) on periodontal disease and quantify the periodontopathogenic bacteria in patients undergoing this surgery. MATERIAL AND METHODS: This prospective study was composed of 50 patients who underwent bariatric surgery and the data collection was performed in three periods pre-operative, 6 (6M) and 12 months (12 M) postoperative. The oral clinical examination to assess periodontal disease; gingival fluid sample collection for quantification of the periodontopathogenic bacteria Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Prevotella intermedia using q-PCR; body mass index (BMI) and for collection of the individual's health-related data from medical files. RESULTS: There was a significant reduction in serum C-reactive protein (CRP) and glucose levels after surgery. The mean probing pocket depth (PPD) and clinical attachment level (CAL) increased significantly in the postoperative period of 6 months (p = 0.001). In the same period, the amount of P. gingivalis increased (p = 0.028) and the other bacteria decreased slightly (p > 0.050). In the presence of P. gingivalis, T. forsythia, T. denticola and P. intermedia, a poor periodontal condition was observed. CONCLUSION: The periodontal disease increased in severity and P. gingivalis increased after GBS. A systemic inflammation resolution due to bariatric surgery in obese subjects does not seem to affect the course of periodontal disease.

Impact of Pregestational Obesity on the Oral Health-Related Quality of Life in Brazilian Pregnant Women: A Cohort Study.

The oral health-related quality of life of pregnant women and its effects on health conditions are important topics to be investigated in scientific research. The objective of this study was to evaluate the impact of pre-pregnancy obesity on oral health-related quality of life (OHRQoL) in pregnant women. A prospective cohort study was carried out with 93 pregnant women who were evaluated in the 2nd trimester of pregnancy (T1) and after delivery (T2). The following were analyzed: dental caries (DMFT), OHRQoL (OHIP-14), anthropometric data (BMI), socioeconomic, demographic, oral hygiene behavioral habits and the use of dental services. Unadjusted and adjusted Poisson regression analyses were performed to determine the impact of predictors on OHRQoL. The results of the adjusted analysis showed lower education relative risk (RR) (1.37; 95%CI 1.02-1.83; <0.00), low income (RR 2.19; 95%CI 1.63-2.93; <0.00) and higher BMI pre-pregnancy (RR 1.03; 95% CI 1.01-1.04; <0.00) were associated with worse OHRQoL in postpartum pregnant women. Flossing was a predictor of better OHRQoL at T2 (RR 0.73; 95%CI 0.57-0.93; <0.01). Higher BMI, low education, low income and inadequate oral hygiene habits were predictors of worse OHRQOL of pregnant women after the birth of the baby.

The Relationship between Professional Variables and Burnout Syndrome in Brazilian Dentists during the COVID-19 Pandemic.

Burnout syndrome (BS) is a highly prevalent occupational disease among dentists who, during the COVID-19 pandemic, have been at greater risk of contracting the disease, generating stress and distancing. The aim of this study was to assess the association of social conditions, professional factors and perceptions of COVID-19 with Burnout Syndrome. This was a cross-sectional study of 302 Brazilian dentists working in the clinical and private sectors. The professionals completed the Oldenburg Burnout Inventory online and answered sociodemographic and professional questions and questions related to their perception of the pandemic. Poisson regression with unadjusted and adjusted robust variance was used to estimate the association between burnout syndrome (dependent variable) and the independent variables. The presence of BS was strongly associated with age, training in a private institution, professionals who claimed to have sufficient protective knowledge and fear of being contaminated by SARS-CoV-2 during patient care (p < 0.05). The findings of this study show that there has been an impact of the COVID-19 pandemic on the occurrence of Burnout syndrome in dentists, especially, those who worked in the public sector and those who were afraid to work with other health professionals.

Salivary Adiponectin and Albumin Levels on the Gingival Conditions of Patients Undergoing Bariatric Surgery: A Cohort Study.

This study analyzed the salivary proteomics, adiponectin and albumin, related to weight loss and periodontitis in patients undergoing bariatric surgery. This study included fourteen patients with morbid obesity (body mass index, BMI > 40 kg/m2) who underwent bariatric surgery Roux-en-Y gastric bypass (RYGB) in System Health Public in Brazil. Data on demographic and anthropometric measures were extracted from medical records preoperatively and 6 and 12 months post-surgery. The variables assessed were: probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and stimulated whole-mouth saliva. In this study, saliva samples were analyzed by electrophoresis and immunoblotting. The ELISA kit was used to measure the MMP8 levels to determine potential markers for obesity. Adiponectin and albumin levels were also evaluated. Weight loss was associated with significant changes in patients' periodontal clinical data. Although 7 out of 10 periodontal patients showed an increase in salivary adiponectin levels after root planning treatment, when analyzed by Western blotting, the increase was not statistically significant (21.1 ± 4.8 to 26.3 ± 9.4 arbitrary units, p > 0.99). There was no correlation between albumin levels and salivary adiponectin pre-surgery, nor 6 months or 12 months after surgery. Weight loss was not improved by low-grade inflammation in bariatric patients, since albumin levels were similar between periods. Periodontitis is an inflammatory disease that is modulated by several factors, among which adiponectin plays an important role for the treatment of periodontal disease.

Is There a Difference in the Proteomic Profile of Stimulated and Unstimulated Saliva Samples from Pregnant Women with/without Obesity and Periodontitis?

This study aimed to compare the proteomic profile of stimulated and unstimulated saliva samples from pregnant women with/without obesity and periodontitis. Pregnant women were allocated into four groups: with obesity and periodontitis (OP); with obesity but without periodontitis (OWP); with normal BMI but with periodontitis (NP); with normal BMI and without periodontitis (NWP). Stimulated saliva (SS) and unstimulated saliva (US) samples were collected, and salivary proteins were extracted and individually processed by proteomic analysis (nLC-ESI-MS/MS). Proteins involved with the immune response process, antioxidant activity, and retina homeostasis were decreased or absent in SS samples from all groups (i.e., Antileukoproteinase, Lysozyme C, Alpha-2-macroglobulin-like protein 1, Heat shock proteins-70 kDa 1-like, 1A, 1B, 6, Heat shock-related 70 kDa protein 2, Putative Heat shock 70 kDa protein 7, Heat shock cognate 71 kDa). Additionally, proteins related to the carbohydrate metabolic process and glycolytic and glucose metabolic process were absent in SS, mainly from OP and OWP (i.e., Frutose-bisphosphate aldose A, Glusoce-6-phosphate isomerase, Pyruvate kinase). Saliva stimulation decreased important proteins involved with immune response and inflammation process in all groups. Unstimulated salivary samples seem to be the best choice for the proteomic approach in pregnant women.

Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis.

This meta-analysis aimed to investigate the effects of propolis on the severity of coronavirus disease symptoms by reducing periodontal disease. PubMed, EMBASE, SciELO, Web of Science, and SCOPUS databases were systematically searched. Studies have been conducted analyzing propolis's effects on COVID-19 and periodontitis. The study was conducted according to the PRISMA statement and registered in PROSPERO. Risk of Bias (RoB) assessment and meta-analysis of clinical studies were performed (Review Manager 5, Cochrane). The certainty of the evidence was assessed using GradePro (GDT). Studies have shown propolis flavonoids inhibit viral replication in several DNA and RNA viruses, including coronaviruses. Propolis components have an aminopeptidase inhibitor activity that can inhibit the main proteases of SARS viruses and seem to inhibit protein spikes, which are sites of most mutations in SARS-CoV strains. The meta-analysis showed favorable results with the use of propolis on probing depth (95%CI: 0.92; p < 0.001), clinical attachment level (95%CI: 1.48; p < 0.001), gingival index (95%CI: 0.14; p = 0.03), plaque index (95%CI: 0.11; p = 0.23), and blending on probing (95%CI: 0.39; p < 0.001). The antibacterial activity of propolis could be mediated through its direct action on microorganisms or the stimulation of the immune system, activating natural defenses. Thus, propolis inhibits the replication of SARS-CoV-2 as well as its bacterial activity. Treatment with propolis improves general health and facilitates the activation of the immune system against coronavirus.

Evaluation of an Experimental Gel Containing Euclea natalensis: An In Vitro Study.

Objective. To evaluate the effect of an experimental gel containing Euclea natalensis extract on dentin permeability. Methods. Thirty-six dentin discs, 1-mm-thick. The discs were prepared from the coronal dentin of extracted human third molars that were divided into 3 groups (n = 10). The dentin discs in each group were treated with the groups following experimental materials: (FG): 1.23% fluoride gel, pH 4.1; (EG): Euclea natalensis extract gel, pH 4.1; (CG): control gel, pH 4.1. The gels were applied to the occlusal slide of the dentin under the following conditions: after 37% phosphoric acid and before 6% citric acid. The hydraulic conductance (HC) of each condition was determined four times using a fluid flow apparatus (Flodec). The data were analyzed using Two-way ANOVA and Tukey's test (P < 0.05). Results. The greatest mean reduction in HC was produced in group EG dentin discs (61.2%; P < 0.05). Even after acid challenge with 6% citric acid the great reduction occurred in group EG (66.0%; P < 0.05) than other groups (CG-77.1%, FG-90.8%). Conclusion. E. natalensis gel not only reduced dentin permeability, but also resisted posttreatment citric acid challenge without changing its permeability. Further research has to confirm this promising result in the clinical situation.

IMPACT OF BARIATRIC SURGERY IN ANXIETY AND ORAL CONDITION OF OBESE INDIVIDUALS: A COHORT PROSPECTIVE STUDY.

BACKGROUND: Obesity and bariatric surgery may be related with mental and oral disorders. AIM: To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients. METHODS: Eighty-nine patients were divided in two groups: Control Group (CG) - obese patients and Experimental Group (EG) - patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered. RESULTS: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG. CONCLUSION: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.

Label-Free Quantitative Proteomic Analysis Reveals Inflammatory Pattern Associated with Obesity and Periodontitis in Pregnant Women.

Obesity and pregnancy may have synergistic effects on periodontal condition, and proteomics could be an ideal approach to highlight the pathophysiological mechanisms associated with these outcomes. This study analyzed the salivary proteomics related to obesity and periodontitis in women during pregnancy (T1) and after delivery (T2). Initially, 126 women were recruited and forty were allocated into groups: with obesity and periodontitis (OP); with obesity, but without periodontitis (OWP); with normal BMI, but with periodontitis (NP); with normal BMI and without periodontitis (NWP). Whole-mouth saliva was collected in T1 and T2, and proteins were extracted and individually processed by label-free proteomics (nLC-ESI-MS/MS). The up-regulations of Heat shock 70 kDa protein 1A, 1B, and 1-like were related to both obesity and periodontitis, separately. Albumin and Thioredoxin were up-regulated in periodontitis cases, while Cystatins (mainly S, SA, SN) and Lactotransferrin were down-regulated. The high abundances of Submaxillary gland androgen-regulated protein 3B, Protein S100-A8, Matrix metalloproteinase-9, Heat shock 70 kDa protein 2 and 6, Putative Heat shock 70 kDa protein 7, Heat shock 71 kDa protein, Haptoglobin and Plastin-1 were significant in the combination of obesity and periodontitis. Obesity and periodontitis remarkably altered the proteome of the saliva during pregnancy with substantial alterations after delivery.

Assessment of Psychosocial Factors in Brazilian Dentists Facing Risk of SARS-CoV-2 Infection in the Public and Private Sectors.

Dentists are at high risk of SARS-CoV-2 infection due to their close proximity to patients. Thus, the fear of contamination or spreading the virus to family members, coupled with financial need, can lead professionals to experience significant overload and psychological suffering. We investigated the perceptions of dental professionals in the public and private sectors regarding fear and anxiety related to patient care and the risk of infection in the face of the COVID-19 pandemic. Based on the previous literature, we interviewed 302 dentists online using sociodemographic and professional questions. Among the professionals evaluated, 80.8% had suspended their activities for some time, 74.8% were afraid of infection at work, 86.1% feared transmitting the virus to their families, 30.1% had already been infected, 54% felt afraid when they heard the news of death caused by SARS-CoV-2, and 63.9% reported having the protective knowledge necessary to avoid infection. Dentists who worked only in the public sector and those who worked in both sectors were more afraid of being infected than professionals who worked only in private offices. Our results highlight the impact of the COVID-19 pandemic on emotional health in dentists. This study highlights the need for more support in the psychosocial field to enable dentists to overcome difficulties and maintain the provision of good dental care for the population. Continuing education should update professions with the requisite scientific and clinical knowledge to face the pandemic and achieve greater reflection on their role within this new context to improve their professional and emotional performance.

Salivary cytokines levels, maternal periodontitis and infants' weight at birth: A cohort study in pregnant women with obesity.

INTRODUCTION: Obesity and pregnancy may have synergistic effects on maternal periodontal tissues. In contrast, maternal obesity and periodontitis are antagonistic factors for the babies' weight at birth. This study evaluated, during pregnancy (T1) and after delivery (T2), periodontal parameters and salivary levels of cytokines in women with obesity, and the association of these outcomes with the baby's weight at birth. METHODS: After matching by age, socioeconomic status and systemic health, the sample was composed of pregnant women with obesity (GO = 25; BMI ≥30 kg/m2) and normal BMI (GN = 25; BMI between 18.5 and 24.99 kg/m2), who were evaluated regarding: periodontal parameters; salivary levels of TNF-α, IL-1ß and leptin (Luminex® assay); and babies' weight at birth. Mann-Whitney, Friedman, ANOVA; chi-square and Cochran's Q tests were applied (p < 0.05). RESULTS: GO showed higher prevalence of periodontitis in T1 and T2 (p <0.001), with higher salivary levels of TNF-α (p = 0.003) and IL-1ß (p = 0.009) in T1. IL-1ß significantly decreased after delivery in GO. No intergroup differences for leptin levels were found, but both groups had a significant reduction of leptin levels between periods (p <0.001). GO had children with lower birth weight (p = 0.022), being classified as low (<2,500 g) or insufficient (2,500-2,999 g) weight. DISCUSSION: It is suggestive that the inflammatory pattern caused by obesity and periodontitis, mainly related to high levels of TNF-α, impair the babies' weight at birth, resulting in more frequency of low/insufficient weight at birth.

Efficiency of different protocols for oral hygiene combined with the use of chlorhexidine in the prevention of ventilator-associated pneumonia.

OBJECTIVE: In ICU patients on mechanical ventilation (MV), ventilator-associated pneumonia (VAP) is a common infection. However, such infection can be prevented through oral care protocols. The objective of this study was to compare the efficiency of the use of chlorhexidine and oral hygiene protocols (brushing and clinical procedures) with that of the use of chlorhexidine alone (intervention group and control group, respectively) in decreasing the prevalence of VAP in patients ≥ 18 years of age admitted to the ICU and requiring MV. METHODS: In this systematic review and meta-analysis, studies were identified through searches of various national and international databases, as well as of the gray literature, and were selected in accordance with eligibility criteria. RESULTS: We evaluated six studies, involving a collective total of 1,276 patients. We classified the risk of bias as low in three studies, high in two, and uncertain in one; among the six risk domains evaluated, a low risk of bias was predominant in five. The results for random risks were similar in terms of direction and statistical magnitude-chi-square = 6.34; risk difference: -0.06 (95% CI: -0.11 to -0.02); I2 = 21%; p = 0.007. There was a decrease in the prevalence of VAP in the intervention group (n = 1,276) included in the meta-analysis. CONCLUSIONS: Protocols that include the mechanical removal of oral biofilm in combination with the use of chlorhexidine can reduce the incidence of VAP among ICU patients requiring MV.

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion.

INTRODUCTION: The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion. METHODS: The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. RESULTS: The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group. CONCLUSIONS: Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement.

Evaluation of systemic conditions, tooth loss, body image, and quality of life of women with obesity and women who underwent gastric bypass surgery.

AIM: To evaluate the systemic conditions, tooth loss, oral health, body image perceptions, and quality of life of women with obesity and women who underwent bypass surgery. METHODS AND RESULTS: Sixty women were classified into the gastric bypass (G1, n = 30) and obesity (G2, n = 30) groups, and their systemic condition, oral health perception, oral hygiene, tooth loss, body image perception (Stunkard scale), and quality of life (WHOQOL-bref) were evaluated. The t-test, Mann-Whitney, chi-square, and multiple linear regression were used for statistical analysis (P < .05). G2 presented higher prevalence of hypertension (P = .020) and G1 higher prevalence of anemia (P = .040). G2 demonstrated less favorable perceptions of oral health, primarily associated with chewing (P = .0007) and speech (P = .005), and a lower frequency of dental floss usage (P = .047); however, there were no intergroup differences regarding the prevalence of missing teeth (P = .180). G1 demonstrated greater satisfaction with regard to their body image (P < .0001), contrary to those in G2, who negatively perceived the same (P = .001), particularly considering the physical, psychological, and environmental parameters (P < .05). CONCLUSION: High body mass index (BMI) indicated a higher prevalence of hypertension and a negative impact on oral health perception and quality of life. However, bariatric surgery was associated with a positive body image perception and quality-of-life parameters.

ASSESSMENT OF ALVEOLAR BONE PATTERN IN OBESE AND NON-OBESE WOMEN, BEFORE AND AFTER BARIATRIC SURGERY: A PROSPECTIVE COHORT STUDY.

BACKGROUND: Right and left periapical radiographs in A eutrophic example of normal bone level; in B of morbidly obese before bariatric surgery, presenting bone loss; and in morbidly obese C after six months of the operation presenting great bone loss. Bariatric surgery may have a negative impact on oral bone structure. AIM: To verify the alveolar bone pattern through radiomorphometric indices of panoramic radiography and linear measurements performed in periapical radiographs in eutrophic and morbidly obese patients before and after bariatric surgery. METHODS: The sample consisted of 31 women aged 20-35 years old, divided into two groups: obese group (GO-obese grade III) and control group (GC-eutrophic). Twenty eutrophic and 11 obese morbidities were evaluated in the pre and postoperative bariatric surgery (six months). Radiomorphometric and plaque indices were evaluated at T0 (baseline) and T1 (six months) times, in both groups. In the radiographic analysis the trabecular pattern through the Lindh visual ladder and the bone loss were evaluated by calculating the distance from the cement-enamel junction to the bone crest in periapical radiographs. Panoramic radiographs were used to measure the mandibular cortical index (ICM), mentonian index (IM) and panoramic mandibular index (MPI), in addition to the Turesky plate index. RESULTS: There was a significant loss of bone in T1 in patients submitted to bariatric surgery, when compared to eutrophic patients (p<0.05). The trabecular pattern became sparser after surgery with a visual difference. The plate index showed a slight improvement after surgery and the eutrophic maintained similar values over time. CONCLUSION: The standard alveolar bone presents greater bone loss in obese patients and worsens this standard after bariatric surgery when compared to eutrophic patients. The same happens with the trabecular pattern that becomes sparser after bariatric surgery.

Periodontal status of women with excessive gestational weight gain and the association with their newborns' health.

OBJECTIVE: The aim of this study was to assess the association between high gestational weight gain and systemic and periodontal status of women between the 32nd and 36th gestational weeks of pregnancy (T1) and after delivery (T2), and the association of these factors with newborns' health. METHODS: The sample was divided into excessive gestational weight gain (GE = 25) and normal gestational weight gain (GN = 25) and was evaluated regarding: (i) socio-economic status; (ii) systemic and periodontal status; and (iii) newborns' health. The results were analysed using the Mann-Whitney U-test, the t-test, the Friedman test, analysis of variance (ANOVA) and Cochran's Q test (P < 0.05). RESULTS: Women with GE had lower household income (P = 0.010) and higher body mass index (BMI) at both T1 and T2. The prevalence of hypertension at T1 was higher in women with GE, but the condition resolved post-delivery (P = 0.001). Worsening in oral hygiene was observed at T2 in both groups (P < 0.001). Sixty-eight percent of women with GE and 16% of women with GN had periodontitis at T1, and 52% and 12%, respectively, had periodontitis at T2. In women with GE, the BMI of newborns was higher (P = 0.031). CONCLUSIONS: Women with high gestational weight gain also showed a high prevalence of hypertension and periodontitis during pregnancy, and persistent periodontitis after delivery. High gestational weight gain was related to high BMI of newborns.

Systemic conditions and oral health-related quality of life of pregnant women of normal weight and who are overweight.

OBJECTIVE: This study evaluated systemic and periodontal conditions and their association with quality of life in women in the third trimester of pregnancy, assisted by the Brazilian public health-care system, with excessive and normal weight. METHODS: Fifty pregnant women were allocated into two groups according to their pre-pregnancy body mass index (BMI): excessive (GE; n = 25; BMI ≥ 25.00 kg/m2 ); and normal (GN; n = 25; 18.00 ≤ BMI ≤ 24.99 kg/m2 ). Thereafter, variables such as socio-economic level, anthropometric parameters (body mass index and gestational weight gain), systemic conditions, periodontal status, and oral health-related quality of life using the short version of the Oral Health Impact Profile (OHIP-14), were evaluated. RESULTS: There was no significant difference between groups in schooling level, monthly household income and gestational weight gain (P > 0.05). The GE group showed a higher frequency of arterial hypertension (P = 0.018), sought dental services less frequently (P = 0.035), had a higher prevalence of periodontitis (P = 0.011), and had a higher OHIP-14 overall score (P = 0.004) characterised by physical and psychological impact. In the final binary logistic regression models, high maternal BMI was associated with arterial hypertension and periodontitis during pregnancy, while periodontitis was strongly associated with moderate and high impact on quality of life. CONCLUSION: Pregnant women in the third trimester with excessive weight, assisted by the Brazilian public health-care system, presented with a higher prevalence of arterial hypertension, worse periodontal conditions and consequent high impact on quality of life.

Association between excessive maternal weight, periodontitis during the third trimester of pregnancy, and infants' health at birth.

INTRODUCTION: Excessive weight is associated with periodontitis because of inflammatory mediators secreted by the adipose tissue. Periodontal impairments can occur during pregnancy due to association between high hormonal levels and inadequate oral hygiene. Moreover, periodontitis and excessive weight during pregnancy can negatively affect an infant's weight at birth. OBJECTIVE: This observational, cross-sectional study aimed to evaluate the association between pre-pregnancy overweight/obesity, periodontitis during the third trimester of pregnancy, and the infants' birth weight. METHODOLOGY: The sample set was divided into 2 groups according to the preconception body mass index: obesity/overweight (G1=50) and normal weight (G2=50). Educational level, monthly household income, and systemic impairments during pregnancy were assessed. Pocket probing depth (PPD) and clinical attachment level (CAL) were obtained to analyze periodontitis. The children's birth weight was classified as low (<2.5 kg), insufficient (2.5-2.999 kg), normal (3-3.999 kg), or excessive (≥4 kg). Bivariate analysis (Mann-Whitney U test, t-test, chi-squared test) and logistic regression (stepwise backward likelihood ratio) were performed (p<0.05). RESULTS: G1 showed lower socioeconomic levels and higher prevalence of arterial hypertension and gestational diabetes mellitus during pregnancy than G2 (p=0.002). G1 showed higher means of PPD and CAL (p=0.041 and p=0.039, respectively) and therefore a higher prevalence of periodontitis than G2 (p=0.0003). G1 showed lower infants' birth weight than G2 (p=0.0004). Excessive maternal weight and educational levels were independent variables associated with periodontitis during the third trimester of pregnancy (X2[2]=23.21; p<0.0001). Maternal overweight/obesity was also associated with low/insufficient birth weight (X2[1]=7.01; p=0.008). CONCLUSION: The present findings suggest an association between excessive pre-pregnancy weight, maternal periodontitis, and low/insufficient birth weight.

DENTAL WEAR AND TOOTH LOSS IN MORBID OBESE PATIENTS AFTER BARIATRIC SURGERY.

BACKGROUND: Obesity and its surgical treatment have been related with oral diseases. Aim: To evaluate and compare dental wear and dental loss in eutrophic and morbidly obese patients submitted to Roux-en-Y gastric bypass. METHOD: Observational and analytical study with gender and age matching. The sample consisted of 240 patients, divided into four groups: eutrophic (GC=60), morbidly obese (GO=60), operated with up to 24 months (G24=60) and operated on for more than 36 months (G36=60). The following variables were analyzed: race, schooling, economic class, hypertension, diabetes, triglycerides, cholesterol, BMI, weight loss, waist-hip ratio, smoking, alcoholism, tooth loss and tooth wear. RESULTS: GO presented lower economic class (p=0.012), hypertension (p<0.001), diabetes (p<0.001), cholesterol (p=0.001), BMI (p<0.001), waist-hip ratio (p<0.001) and percentage of weight loss percent (p<0.001) than groups G24 and G36. Dental wear was higher among the II and V sextants. CONCLUSION: Individuals submitted to Roux-en-Y gastric bypass, regardless of the surgery period, presented more dental wear on the incisal/occlusal surfaces, and the anterior teeth were the most affected. Dental wear was associated with age and number of missing teeth.