Income at birth and tooth loss due to dental caries in adulthood: The 1982 Pelotas birth cohort.

OBJECTIVE: To estimate the effect of income at birth on adulthood tooth loss due to dental caries in 539 adults from the 1982 Pelotas birth cohort. METHODS: Family income was collected at birth. Tooth loss was clinically assessed when individuals were aged 31. Dental visit and oral hygiene at age 25 were considered mediators. Confounders included maternal skin color, and individual's skin color, sex, and income in adulthood. Marginal structural modeling was used to estimate the controlled direct effect of income at birth on tooth loss due to dental caries that was neither mediated by the use of dental service nor oral hygiene. RESULTS: Forty-three percent of the individuals of low income at birth lost one/two teeth, and 23% lost three or more; among those non-poor, the prevalence was 30% and 14%, respectively. Poor individuals at birth had a 70% higher risk for missing teeth in adulthood than those non-poor. The risk of losing one/two (risk ratio 1.68) and three or more teeth (risk ratio 3.84) was also higher among those of low income at birth. CONCLUSIONS: Economic disadvantage at birth had an effect on tooth loss due to dental caries at age 31 not mediated by individual risk factors.

Tooth loss in adults and income: Systematic review and meta-analysis.

OBJECTIVE: To systematically review the literature in order to identify an association between income and tooth loss in adults. METHODS: An electronic search was conducted on PubMed, Scopus, Embase, Web of Knowledge, Scielo and LILACS. Studies were included if they reported the relationship between socioeconomic status (assessed by income) and tooth loss (clinical examination or self-reported) among adults aged from 18 to 60-years-old. RESULTS: We, found 1007 articles through March 2014; 11 studies were then included. The results of meta-analyses with random-effects model that subjects of lower levels of income presented greater chance of tooth loss (OR 2.52; 95%CI 2.11-3.01). This association also remained significant when only adjusted results were pooled; however, attenuation in the magnitude of such association was noted (OR 1.66; 95%CI 1.48-1.86) as well as no heterogeneity. Meta-regression analysis revealed that the sample size explained about 9% of heterogeneity in the crude model. CONCLUSION: Our results evidenced a relationship between income and tooth loss in adults. Longitudinal studies with broader socioeconomic measures are encouraged.

Are obesity and overweight associated with gingivitis occurrence in Brazilian schoolchildren?

AIM: This cross-sectional study aimed to assess the relationship between weight status and gingival inflammation in Brazilian schoolchildren aged 8- to 12-year old, when controlling for potential confounders. METHODS: Overall, 1211 children aged 8- to 12-year old from public and private schools in Southern Brazil were selected by a two-stage cluster method. Questionnaires were used to assess socio-demographic data and oral hygiene habits. Oral examination evaluated presence of plaque and gingival bleeding. Anthropometric measures were collected to obtain body mass index. Multivariate Poisson regression was used for data analysis (Prevalence Ratio/95% Confidence Interval). RESULTS: Prevalence of gingivitis was 44.0%. Mean and median values of gingival bleeding sites were 3.10 and 2.0 respectively. Obese/overweight children totalized 34.6%. In multivariate adjusted analysis, sex (PR 0.86; 95%CI 0.75;0.98), maternal schooling (PR 1.09; 95% CI 1.01;1.18), plaque (PR 1.37; 95% CI 1.26;1.50), dental caries experience (PR 1.16; 95% CI 1.01;1.36) and bleeding during tooth brushing (PR 1.27; 95% CI 1.11;1.48) were associated with the outcome. In the sex-stratified analysis, overweight/obese boys presented a greater risk for gingivitis (PR 1.22 95% CI 1.01;1.48). CONCLUSIONS: Gingivitis was not associated with obesity/overweight in the total sample. Gender differences seem to influence the relationship between gingivitis and obesity/overweight; a stronger association was noted among boys than girls.