Socioeconomic status and oral health-related quality of life: A systematic review and meta-analysis.

OBJECTIVES: To systematically review observational studies assessing the association between socioeconomic status (SES) and oral health-related quality of life (OHRQoL) in children, adolescents and adults. METHODS: Electronic searches were performed in the PubMed, Embase, Web of Science, LILACS and Scopus databases for articles published up to September 2020. Two independent reviewers performed the search and critical appraisal of the studies. The inclusion criteria were observational studies that evaluated the effect of SES on the OHRQoL in all age groups using validated methods. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for meta-analysis followed by a meta-regression analysis. A random-effects model was used to estimate the pooled calculate prevalence ratio (PR) and respective 95% confidence intervals (CI) for each study. RESULTS: The search strategy retrieved 6114 publications. Some 139 articles met the eligibility criteria and were included in the systematic review. Of those, 75 were included in the general meta-analysis they represented a total sample of 109 269 individuals. People of lower SES had worse OHRQoL (PR 1.30; 95% CI 1.26-1.35). In the meta-analyses of different subgroups, an association was found between low SES and worse OHRQoL in countries of all economic classifications, in all age groups and irrespective of the socioeconomic indicator used. A socioeconomic gradient in OHRQoL was also observed, in which the lower the individuals' socioeconomic position, the poorer their OHRQoL. CONCLUSIONS: Individuals of low SES had poorer OHRQoL, regardless of the country's economic classification, SES indicator and age group. Public policies aiming to reduce social inequalities are necessary for better OHRQoL throughout life.

Gingival inflammation influences oral health-related quality of life in individuals living in a rural area of southern Brazil.

AIM: The aim of the present cross-sectional study was to evaluate whether the extent levels of gingival inflammation (GI) in whole mouth or restricted to the anterior region are independently associated with oral health-related quality of life (OHRQoL) in individuals living in a rural area of southern Brazil. MATERIALS AND METHODS: A probability sample of 688 individuals was submitted to a full-mouth periodontal examination at six sites on each tooth. Extent levels of GI in whole mouth and restricted to anterior region were dichotomously considered when bleeding on probing (BoP) occurred at 20% or more of whole-mouth sites and at 10% or more of anterior region sites, respectively, in individuals with probing depths ≤3 mm, totalling 121 individuals analysed, aged 15-82 years. OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14 ) questionnaire. Adjusted multilevel Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores. RESULTS: In the adjusted model, higher extent levels of full-mouth GI (RR = 1.23; 95% confidence interval [CI]: 1.06-1.44; p = .004) and GI restricted to the anterior region (RR = 1.29; 95% CI: 1.11-1.51; p ≤ .001) were significantly associated with poorer OHRQoL. CONCLUSIONS: The extent of GI in whole mouth (≥20% of sites with BoP) and in the anterior region (≥10% of sites with BoP) was independently associated with OHRQoL in individuals living in a rural area.

Periodontitis is associated with oral health-related quality of life in individuals with end-stage renal disease.

AIM: The aim of the present study was to evaluate whether periodontitis is independently associated with oral health-related quality of life (OHRQoL) in individuals with end-stage renal disease (ESRD). MATERIALS AND METHODS: Calibrated examiners assessed 180 adults with ESRD. A full-mouth periodontal examination was performed at six sites on each tooth. Periodontitis was considered a categorical variable (absent, mild/moderate or severe). OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14 ) questionnaire. Adjusted multivariate Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores for periodontitis according to the severity categories. RESULTS: In the adjusted model, mild/moderate and severe periodontitis were significantly associated with poorer OHRQoL compared to the absence of periodontitis [RR = 1.49 (95% confidence interval: 1.16-1.91) and RR 1.77 (95% CI: 1.36-2.30), respectively]. The adjusted domain-specific analysis revealed that mild/moderate periodontitis significantly impacted the psychological disability domain and severe periodontitis significantly impacted the physical pain, psychological discomfort, physical disability and psychological disability domains. CONCLUSIONS: Periodontitis exerts an influence on OHRQoL in individuals with ESRD, with a more severe condition impacting different domains.

Association Among Periodontitis and the Use of Crack Cocaine and Other Illicit Drugs.

BACKGROUND: Crack cocaine can alter functions related to the immune system and exert a negative influence on progression and severity of periodontitis. The aim of this study is to compare periodontal status between crack cocaine users and crack cocaine non-users and investigate the association between crack cocaine and periodontitis after adjustments for confounding variables. METHODS: This cross-sectional study evaluated 106 individuals exposed to crack cocaine and 106 never exposed, matched for age, sex, and tobacco use. An examiner determined visible plaque index (VPI), marginal bleeding index, supragingival dental calculus, probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Logistic regression was used to model associations between crack cocaine and periodontitis (at least three sites with CAL >4 mm and at least two sites with PD >3 mm, not in the same site or tooth). RESULTS: Prevalence of periodontitis among crack non-users and crack users was 20.8% and 43.4%, respectively. Crack users had greater VPI, BOP, PD ≥3 mm, and CAL ≥4 mm than crack non-users. Periodontitis was associated with age >24 years, schooling ≤8 years, smoking, moderate/heavy alcohol use, and plaque rate ≥41%. Crack users had an approximately three-fold greater chance (odds ratio: 3.44; 95% confidence interval: 1.51 to 7.86) of periodontitis than non-users. CONCLUSION: Occurrence of periodontitis, visible plaque, and gingival bleeding was significantly higher among crack users, and crack use was associated with occurrence of periodontitis.

Association of gingivitis with child oral health-related quality of life.

BACKGROUND: Child oral health-related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. METHODS: This cross-sectional study used multistage random sampling to enroll 1,134 12-year-old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full-mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11- to 14-Year-Old Children (CPQ11-14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain-specific CPQ11-14 scores. RESULTS: In general, children with bleeding in ≥15% of sites had higher total CPQ11-14 scores and domain-specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11-14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low-level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). CONCLUSION: The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.

Supragingival plaque removal with and without dentifrice: a randomized controlled clinical trial.

The aim of this study was to compare the efficacy of dental plaque removal by brushing with and without conventional dentifrice. Twenty-four students aged 17 to 28 years participated in this randomized controlled clinical trial. Quadrants 1-3 or 2-4 were randomly allocated to the test group (brushing without dentifrice) or control group (brushing with dentifrice). After 72 h of cessation of oral hygiene, Quigley & Hein (Turesky) plaque index was assessed before and after brushing by a calibrated and blind examiner. Overtime and intergroup comparisons were performed by Student's paired sample t-test at 5% significance level. The results showed that both groups after toothbrushing presented statistically significant reductions in plaque, with no differences between them (from 3.06 ± 0.54 to 1.27 ± 0.26 versus from 3.07 ± 0.52 to 1.31 ± 0.23). A separate analysis of the buccal and lingual aspects also showed no significant differences between groups. It may be concluded that the use of a conventional dentifrice during toothbrushing does not seem to enhance plaque removal capacity.

Supragingival plaque removal with and without dentifrice: a randomized controlled clinical trial

The aim of this study was to compare the efficacy of dental plaque removal by brushing with and without conventional dentifrice. Twenty-four students aged 17 to 28 years participated in this randomized controlled clinical trial. Quadrants 1-3 or 2-4 were randomly allocated to the test group (brushing without dentifrice) or control group (brushing with dentifrice). After 72 h of cessation of oral hygiene, Quigley & Hein (Turesky) plaque index was assessed before and after brushing by a calibrated and blind examiner. Overtime and intergroup comparisons were performed by Student's paired sample t-test at 5% significance level. The results showed that both groups after toothbrushing presented statistically significant reductions in plaque, with no differences between them (from 3.06 ± 0.54 to 1.27 ± 0.26 versus from 3.07 ± 0.52 to 1.31 ± 0.23). A separate analysis of the buccal and lingual aspects also showed no significant differences between groups. It may be concluded that the use of a conventional dentifrice during toothbrushing does not seem to enhance plaque removal capacity.

O objetivo deste estudo foi comparar a eficácia de remoção mecânica da placa dental através da escovação com e sem dentifrício. Vinte e quatro estudantes com idade de 17 a 28 anos participaram deste ensaio clínico randomizado. Os quadrantes 1-3 ou 2-4 foram randomizados para alocação no grupo teste (escovação sem dentifrício) ou grupo controle (escovação com dentifrício). Após 72 h de cessação de higiene bucal, o índice de placa de Quigley & Hein (Turesky) foi avaliado antes e após a escovação por um examinador cego e calibrado. Comparações intra e intergrupo foram realizadas pelo teste t pareado, a um nível de significância de 5%. Os resultados demonstraram que, após a escovação, ambos os grupos apresentaram redução significativa de placa, porém sem diferenças intergrupos (3,06 ± 0,54 a 1,27 ± 0,26 versus 3,07 ± 0,52 a 1,31 ± 0,23). Uma análise separada das faces vestibulares e linguais também não revelou diferenças entre os grupos. Conclui-se que a utilização de dentifrícios associado ao controle mecânico parece não contribuir para a remoção da placa dental.

The effect of 0.12% chlorhexidine gluconate rinsing on previously plaque-free and plaque-covered surfaces: a randomized, controlled clinical trial.

BACKGROUND: Previous in vitro studies showed little bactericidal effect on structured oral biofilm after exposure to chlorhexidine (CHX). In vivo evidence of a CHX effect against structured biofilm is scarce. The purpose of this study was to compare the efficacy of 0.12% CHX gluconate on previously plaque-free and plaque-covered surfaces. METHODS: This study had a single-masked, randomized split-mouth, 21-day experimental gingivitis design including 20 individuals who refrained from all mechanical plaque control methods for 25 days. On day 4 of plaque accumulation, the individuals had two randomized quadrants cleaned; the other two quadrants served as the plaque-covered surfaces. Also, on day 4, the individuals started rinsing with 0.12% CHX gluconate for 21 days. The Quigley and Hein plaque index (PI), gingival index (GI), and gingival crevicular fluid (GCF) volume were assessed at baseline and days 21 and 25. The PI also was assessed at days 4, 11, and 18. RESULTS: Intergroup comparisons showed statistically higher PI throughout the study on the plaque-covered surfaces compared to the plaque-free surfaces. When the inflammatory response over time was analyzed, a statistically greater increase in GI (from 0.21+/-0.02 to 0.93+/-0.03 versus from 0.18+/-0.01 to 0.52+/-0.03 on plaque-covered and plaque-free surfaces, respectively) and GCF volumes (from 48.09 to 94.28 microl versus from 46.94 to 64.99 microl on plaque-covered and plaque-free surfaces, respectively) occurred on plaque-covered surfaces after 21 days of plaque accumulation. CONCLUSIONS: A 0.12% CHX gluconate mouthrinse had little antiplaque and antigingivitis effect on previously plaque-covered surfaces. These results confirm the diminished effect of CHX on structured biofilm and reinforce the necessity of biofilm disruption before the initiation of CHX mouthrinse.