Demographics, smoking status, and systemic health factors associated with apical periodontitis in a Brazilian rural population: a cross-sectional study.

OBJECTIVE: To determine whether the systemic diseases diabetes mellitus (DM) and arterial hypertension (AH), and smoking status are associated with apical periodontitis (AP) in a representative rural population. MATERIALS AND METHODS: Cross-sectional study using a representative sample of individuals obtained from a population-based epidemiological survey carried out in the rural area of the city of Rosário do Sul, RS, Brazil, from March 2015 to May 2016. Data were collected through structured questionnaires and clinical examination. Binary logistic regression analysis was performed to identify variables independently associated with AP. RESULTS: Of the 584 individuals included in the study, 353 (60.4%) had AP. The presence of AP was independently associated with age ≥ 40 years (odds ratio [OR] = 1.867, 95% confidence interval [CI]: 1.193-2.923, p = 0.006), non-white ethnicity (OR = 1.509, 95% CI: 1.029-2.115, p = 0.035), active or former smoker (OR = 2.087, 95% CI: 1.241-3.510, p = 0.006) and DM or prediabetes (OR = 1.676, 95% CI: 1.150-2.443, p = 0.007). CONCLUSION: The study identified significant associations between AP and demographics, smoking status, and systemic disease in a Brazilian rural population. CLINICAL RELEVANCE: The study emphasized the significance of comprehending and managing associated factors in preventing and treating AP.

Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters.

OBJECTIVE: The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults. BACKGROUND: The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP. METHODS: We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test. RESULTS: The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14). CONCLUSION: Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.

Is chewable toothbrush effective in terms of dental plaque reduction in children? A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: To systematically evaluate randomized controlled trials (RCTs) on whether a chewable toothbrush (CTB) is more effective than a manual toothbrush (MTB) in terms of full-mouth dental plaque reduction in non-orthodontic children. MATERIALS AND METHODS: Six databases were searched by two independent reviewers according to pre-specified eligibility criteria up to October 2022. No restrictions regarding language, date of publication and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and GRADE for assessing the certainty of evidence. Random-effects pairwise meta-analysis compared the dental plaque change scores of CTB and MTB through mean differences (MDs) and associated confidence intervals (95% CI), and sensitivity analysis determined whether an individual study significantly affected the results. RESULTS: Seven eligible RCTs were retrieved, including data of 310 children aged 8-14 years. Five RCTs present some concerns and two have high RoB. No significant difference was detected between toothbrushes in terms of Turesky modification of the Quigley-Hein plaque index reduction (MD = -0.04, 95% CI: -0.26-0.18), with overall very low certainty on evidence. The pooled estimate remains unchanged when any RCT is omitted. CONCLUSION: There is very low-certainty evidence of no significant difference on plaque removal between MTB and CTB in non-orthodontic children. Due to unexplained high heterogeneity and low methodological quality of RCTs, we cannot determine the extent to which our finding reflects a true effect or bias arising from limitations of primary studies.

The alcohol harm paradox and tooth loss among Brazilian older adults.

OBJECTIVE: To investigate whether the association between alcohol consumption and tooth loss is modified across socioeconomic positions (SEPs) in Brazilian older adults. METHODS: We conducted a secondary analysis using data of The Brazilian Longitudinal Study of Ageing (ELSI-Brazil 2015-2016). Effect Measure Modification (EMM) analyses using multivariable Poisson regression models tested whether the association between heavy drinking and lack of functional dentition (FD) varies in magnitude and direction according to levels of Household Wealth index (HWI) and educational attainment, assessed by the Relative Excess Risk due to Interaction (RERI). Sensitivity analyses using lifetime exposure to alcohol were performed. RESULTS: The analytical sample comprised 8078 participants. Heavy drinkers living in low-wealth households and with lower education presented 7% (95% CI: 1.01-1.14) and 36% (95% CI: 1.28-1.44) higher prevalence of lack of FD, respectively, than their counterparts, and super-additive associations were detected [RERI for HWI: 0.12 (95% CI: 0.02-0.21); RERI for educational attainment: 0.20 (95% CI: 0.09-0.30)]. The associations were also super-additive in the sensitivity analyses when controlling for abstainer reference group bias. CONCLUSION: We suggest that alcohol consumption disproportionately impacts the prevalence of tooth loss in Brazilian older adults from lower SEP groups.