How much does household food insecurity explain income inequalities in untreated dental caries?

BACKGROUND: The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear. AIM: To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI). DESIGN: A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PRc ) for dental caries and this measure adjusted by HFI (PRa ). RESULTS: The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI. CONCLUSIONS: Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families.

Association between untreated dental caries and household food insecurity in schoolchildren.

The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

Association between untreated dental caries and household food insecurity in schoolchildren / Associação entre cárie dentária não tratada e insegurança alimentar em escolares

Abstract The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

Resumo O objetivo deste estudo foi avaliar a associação entre cárie dentária não tratada (CDNT) e insegurança alimentar (IA) em escolares de diferentes estratos de renda. Foi realizado um estudo de base populacional com uma amostra de 584 escolares de 12 anos de idade. Exames clínicos bucais foram realizados e IA foi determinada por meio de uma escala validada. Outras variáveis foram analisadas por serem de interesse para a estratificação dos resultados (renda domiciliar per capita) ou como variáveis de confusão. A prevalência de CDNT e IA foi de 45% e 39%, respectivamente. Os modelos multivariados demonstraram que a CDNT foi significativamente mais prevalente entre as crianças com IA alimentar e renda per capita de até US$ 70,71 do que entre aqueles no mesmo estrato de renda que estavam livres de IA [RP = 1,52 (IC 95% = 1,01 -2,29)]. A IA foi associada com uma maior frequência de CDNT em escolares de baixa renda, porém não teve impacto significativo sobre esta variável entre crianças de diferentes estratos de renda. Diante disso, garantir o acesso a uma alimentação de qualidade pode representar uma boa estratégia para minimizar as iniquidades em saúde bucal e reduzir a experiência de cárie dentária em escolares de baixa renda.

The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1.

OBJECTIVE: To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). SUBJECTS AND METHODS: A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). RESULTS: The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. CONCLUSION: Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow.

The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1

ABSTRACT Objective To evaluate the influence of disease control, expressed by the mean values of glycated hemoglobin (HbA1c), in the oral health of children and adolescents with diabetes mellitus type 1 (T1DM). Subjects and methods A cross sectional study involving 87 children and adolescents (59 girls), 10 ± 2.6 years old. The participants were divided into three groups: HbA1c ≤ 8%, 8% < HbA1c ≤ 10% and HbA1c > 10%. The duration of the disease, age and average HbA1c were obtained from their medical records. Oral health was evaluated according to the following indexes: Simplified Oral Hygiene Index (OHI-S); Community Periodontal Index (CPI); Decayed, Missing or Filled Teeth Index (DMFT/dmft) for permanent and deciduous teeth; and the stimulated salivary flow rate (SSFR). Results The median SSFR was 1.1 mL/min in the group with HbA1c ≤ 8%, 0.7 mL/min in the intermediary group and 0.6 mL/min in the HbA1c > 10% group. A significant decrease in salivary flow was observed with an increase in HbA1c (p = 0.007). The DMFT/dmft and CPI indexes were higher in individuals with higher HbA1c values. More caries-free individuals were found in the group with HbA1c ≤ 8% compared to those with HbA1c > 10%. The group with HbA1c > 10% exhibited more caries and bleeding gums than the other groups. HbA1c values in girls were higher than in boys. Conclusion Children and adolescents with unsatisfactory glycemic control, represented by higher HbA1c concentrations, exhibited a higher frequency of caries and gingivitis, and a reduction in salivary flow. Arch Endocrinol Metab. 2015;59(6):535-40.

A map of Brazilian dental research in the last decade.

The aim of the present study was to analyze dental research trends in Brazil over the past nine years. All abstracts presented at the 26th Annual Meeting of the Brazilian Society for Dental Research in 2009 (n = 2648) were classified based on field of knowledge, home institution and geographic region. Data were compared with those previously published based on abstracts presented at various meetings. Between 2001 and 2006, five fields of knowledge had a greater than 10% representation among the total number of studies. These fields included restorative dentistry/dental materials (RD/DM), periodontics, endodontics, pediatric dentistry and population-based oral health. In 2009, only RD/DM maintained a greater than 10% proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8%). The majority of research studies were performed at public institutions, and the number of abstracts per state increased significantly in 2009 (Wilcoxon test, p < 0.001). The southeastern region of Brazil submitted the greatest number of abstracts; however, other regions also demonstrated increased participation in research (11%). The percentage distribution of abstracts between states remained constant (Wilcoxon test, p = 0.255; r s = 0.873). The results of the present study suggest a slight shift in the scientific research profile in Brazilian dentistry: fields related to professional disciplines have declined in relative research participation, while increasing interest has been observed in basic fields and new specialties.

A map of Brazilian dental research in the last decade

The aim of the present study was to analyze dental research trends in Brazil over the past nine years. All abstracts presented at the 26th Annual Meeting of the Brazilian Society for Dental Research in 2009 (n = 2648) were classified based on field of knowledge, home institution and geographic region. Data were compared with those previously published based on abstracts presented at various meetings. Between 2001 and 2006, five fields of knowledge had a greater than 10 percent representation among the total number of studies. These fields included restorative dentistry/dental materials (RD/DM), periodontics, endodontics, pediatric dentistry and population-based oral health. In 2009, only RD/DM maintained a greater than 10 percent proportion of meeting abstracts, and basic fields comprised the second position among those fields with greater representation (9.8 percent). The majority of research studies were performed at public institutions, and the number of abstracts per state increased significantly in 2009 (Wilcoxon test, p < 0.001). The southeastern region of Brazil submitted the greatest number of abstracts; however, other regions also demonstrated increased participation in research (11 percent). The percentage distribution of abstracts between states remained constant (Wilcoxon test, p = 0.255; r s = 0.873). The results of the present study suggest a slight shift in the scientific research profile in Brazilian dentistry: fields related to professional disciplines have declined in relative research participation, while increasing interest has been observed in basic fields and new specialties.

Validade e confiabilidade de kits para detecção dos níveis de estreptococos do grupo mutans e lactobacilos na saliva de crianças e adultos / Validity and reliability of kits for salivary detection of mutans streptococci and lactobacilli in infants and adults

Objetivo: Avaliar a validade e a confiabilidade dos resultados obtidos por meio de kits pré-fabricados disponíveis no mercado brasileiro para a detecção e quantificação dos níveis de estreptococos do grupo mutans e lactobacilos na saliva de crianças e adultos. Método: Amostras salivares de 15 crianças (12-24meses) e 14 adultos (17-35 anos) foram coletadas e analisadas quanto aos níveis salivares de estreptococos do grupo mutans e lactobacilos pelo uso dos kits Dentacult I e II (Laborclin) e por método microbiológico convencional, baseado em cultura em meios seletivos. Os resultados de ambos os métodos foram comparados pelo uso dos coeficientes Kappa ponderado (Kp) e de correlação de Spearman. Para a determinação da concordância inter e intraexaminador da leitura dos resultados obtidos com o uso dos kits, os dados foram comparados por meio do Kp. As análises estatísticas foram realizadas utilizando o software Minitab 15 (versão 15.1.0.0.). Foi adotado o nível de significância de 5%. Resultados: Os resultados apresentados pelo kit Dentalcult I apresentaram concordância regular e correlação não-significante com os obtidos com o método microbiológico convencional (rs=0,53; p maior que 0,05). Por outro lado, os resultados obtidos com o kit Dentalcult II apresentaram boa concordância e correlação estatisticamente significante com os do método convencional (rs=0,77; p menor que 0,05). Os kits Dentalcult I e II tiveram confiabilidade de leitura perfeita (Kp=1) em momentos distintos, independentes do examinador. A concordância interexaminadores foi perfeita para o kit Dentalcult II (Kp=1) e ótima para o Dentalcult I (Kp=0,94). Conclusão: O kit Dentalcult II pode ser indicado para a estimativa dos níveis salivares de estreptococos do grupo mutans em substituição aos métodos convencionais.

Objective: To compare the results of commercially available kits for determination of mutans streptococci (MS) and lactobacilli (LB) salivary levels in infants and adults. Method: Salivary samples of 15 children (aged 12-24 months-old) and 14 adults (aged 17-35 years-old) were collected and evaluated for salivary levels of MS and LB by using the Dentacult I and II kits, respectively (Laborclin) and conventional methods based on culture in selective media. The results of both methods were compared to those obtained by the weighted kappa coefficients (Kp) and Spearman's correlation. Statistical analysis was performed using Minitab software 15 (version 15.1.0.0). It was adopted a significance level of 5%. Results: The data obtained with the Dentalcult I kit showed regular agreement and no significant correlation with the conventional microbiological method (rs=0.53, p greater than 0.05). On the other hand, results provided by the Dentalcult II kit produced good agreement and were statistical significant correlated with those of the conventional method (rs=0.77, p less than 0.05). The kits Dentalcult I and II presented perfect reading reliability (Kp=1) in distinct moments, not -dependent on the examiner. The inter-examiner agreement was considered perfect for the kit Dentalcult II (Kp=1) and satisfactory for Dentalcult I (Kp=0.94). Conclusion: The kit Dentalcult II proved validity and reliability for detecting salivary MS.