Food processing and its association with dental caries: Data from NHANES 2011-2014.

OBJECTIVE: To assess whether proportional contribution of unprocessed or minimally processed, processed or ultra-processed foods to daily energy intake is associated with dental caries in US adults. METHODS: This secondary cross-sectional analysis included adults aged 20 to 59 years old with complete oral examinations, using data gathered from cycles 2011-2012 and 2013-2014 of the continuous National Health and Nutrition Examination Survey (NHANES). Dietary recall data were categorized according to the NOVA classification into four groups: unprocessed or minimally processed foods (Group 1), processed culinary ingredients (Group 2), processed foods (Group 3) and ultra-processed foods (Group 4). The proportional contribution of each of these groups to mean daily energy intake was calculated and then cut into quartiles (Group 1, Group 3 and Group 4) or tertiles (Group 2). Two separate measures were used to assess dental caries: the decayed, missing, filled teeth (DMFT) index and, after exclusion of edentulous participants, prevalence of untreated caries. Poisson regression was used to model DMFT, while logistic regression was used to model the prevalence of untreated dental caries. Models were calculated for each NOVA group. All models were controlled for age, gender, race/ethnicity, level of education, income, access to oral health services, body mass index, smoking status and total energy intake. Analyses took into account NHANES sampling weights. RESULTS: We analysed data from 5720 individuals, of whom 123 (2.2%) were edentulous. Mean DMFT was 9.7 (± 0.2), while the prevalence of untreated dental caries was 26.0%. Mean daily energy intake was 2170 kcal (± 17). Mean contribution to overall daily energy intake was 28.6% (± 0.5) for G1 foods, 4.3% (± 0.1) for G2 foods, 10.1% (± 0.2) for G3 foods and 56.9% (± 0.5) for G4 foods. A higher intake of G3 was associated with lower DMFT at the fourth quartile (0.89; 95%: CI 0.81-0.96), while a higher intake of G4 was associated with a higher DMFT at the fourth quartile (1.10; 95% CI: 1.04-1.16). In the adjusted models for untreated dental caries, no statistically significant associations were found with any of the NOVA groups. CONCLUSION: Higher proportional intake of NOVA groups is only weakly associated with dental caries. Widespread exposure to a highly ultra-processed diet may explain these weak associations.

Satisfaction and burden of mental health personnel: data from healthcare services for substance users and their families

Objective: To evaluate satisfaction and burden of mental health personnel providing mental health services for substance users and their families. Method: Five hundred twenty-seven mental health workers who provide treatment for substance users in five Brazilian states were interviewed. Data on sociodemographic characteristics and measures of satisfaction (SATIS-BR) and burden of mental health personnel (IMPACTO-BR) were collected. Results: Type of mental health service and educational attainment were associated with degree of satisfaction and burden. Therapeutic community workers and those with a primary education level reported being more satisfied with the treatment offered to patients, their engagement in service activities, and working conditions. Workers from psychosocial care centers, psychosocial care centers focused on alcohol and other drugs, and social care referral centers (both general and specialized), as well as workers with a higher education, reported feeling overburdened. Conclusion: This study offers important information regarding the relationship of mental health personnel with their work. Care providers within this sample reported an overall high level of job satisfaction, while perceived burden differed by type of service and educational attainment. To our knowledge, this is the first study with a sample of mental health professionals working with substance users across five Brazilian states.

Satisfaction and burden of mental health personnel: data from healthcare services for substance users and their families.

OBJECTIVE: To evaluate satisfaction and burden of mental health personnel providing mental health services for substance users and their families. METHOD: Five hundred twenty-seven mental health workers who provide treatment for substance users in five Brazilian states were interviewed. Data on sociodemographic characteristics and measures of satisfaction (SATIS-BR) and burden of mental health personnel (IMPACTO-BR) were collected. RESULTS: Type of mental health service and educational attainment were associated with degree of satisfaction and burden. Therapeutic community workers and those with a primary education level reported being more satisfied with the treatment offered to patients, their engagement in service activities, and working conditions. Workers from psychosocial care centers, psychosocial care centers focused on alcohol and other drugs, and social care referral centers (both general and specialized), as well as workers with a higher education, reported feeling overburdened. CONCLUSION: This study offers important information regarding the relationship of mental health personnel with their work. Care providers within this sample reported an overall high level of job satisfaction, while perceived burden differed by type of service and educational attainment. To our knowledge, this is the first study with a sample of mental health professionals working with substance users across five Brazilian states.

Four-year incidence rate and predictors of root caries among community-dwelling south Brazilian older adults.

OBJECTIVE: This study aimed to assess the incidence density (ID) of new root caries lesions and restorations among community-living south Brazilian older adults and to assess its association with predictor variables. METHODS: We conducted a prospective cohort with a random sample of elders from the municipality of Carlos Barbosa, in south Brazil. Trained dentists performed interviews and oral examinations in 388 individuals at baseline, of which 273 were retained at follow-up 4 years later. Our outcome was root caries ID, with 100 root-years as its unit of measure. Demographic, biological and lifestyle predictors were tested with Poisson regression. RESULTS: The mean number of roots at baseline among participants was 7.0 (SD ± 4.9) and the incidence rate per 100 root-year 4.9 (SD ± 8.9). Incidence of root caries among these older Brazilians was of 47.3%. The associated factors with the incidence of root caries were age, geographic location of residence, frequency of tooth brushing and stimulated saliva flow rate. CONCLUSION: Age, external environment, personal practices and oral status were predictors of the incidence of root caries. Preventive strategies including the use of fluorides and instruction to improve the attitude and behaviour towards oral hygiene are needed.