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1.
Cochrane Database Syst Rev ; 10: CD004346, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-33053198

RESUMO

BACKGROUND: There is ongoing debate about the frequency with which patients should attend for a dental check-up and the effects on oral health of the interval between check-ups. Recommendations regarding optimal recall intervals vary between countries and dental healthcare systems, but 6-month dental check-ups have traditionally been advocated by general dental practitioners in many high-income countries. This review updates a version first published in 2005, and updated in 2007 and 2013. OBJECTIVES: To determine the optimal recall interval of dental check-up for oral health in a primary care setting. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 17 January 2020), the Cochrane Central Register of Controlled Trials (CENTRAL; in the Cochrane Library, 2019, Issue 12), MEDLINE Ovid (1946 to 17 January 2020), and Embase Ovid (1980 to 17 January 2020). We also searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching. SELECTION CRITERIA: We included randomised controlled trials (RCTs) assessing the effects of different dental recall intervals in a primary care setting. DATA COLLECTION AND ANALYSIS: Two review authors screened search results against inclusion criteria, extracted data and assessed risk of bias, independently and in duplicate. We contacted study authors for clarification or further information where necessary and feasible. We expressed the estimate of effect as mean difference (MD) with 95% confidence intervals (CIs) for continuous outcomes and risk ratios (RR) with 95% CIs for dichotomous outcomes. We assessed the certainty of the evidence using GRADE. MAIN RESULTS: We included two studies with data from 1736 participants. One study was conducted in a public dental service clinic in Norway and involved participants under 20 years of age who were regular attenders at dental appointments. It compared 12-month with 24-month recall intervals and measured outcomes at two years. The other study was conducted in UK general dental practices and involved adults who were regular attenders, which was defined as having attended the dentist at least once in the previous two years. It compared the effects of 6-month, 24-month and risk-based recall intervals, and measured outcomes at four years. The main outcomes we considered were dental caries, gingival bleeding and oral-health-related quality of life. Neither study measured other potential adverse effects. 24-month versus 12-month recall at 2 years' follow-up Due to the very low certainty of evidence from one trial, it is unclear if there is an important difference in caries experience between assignment to a 24-month or a 12-month recall. For 3- to 5-year-olds with primary teeth, the mean difference (MD) in dmfs (decayed, missing, and filled tooth surfaces) increment was 0.90 (95% CI -0.16 to 1.96; 58 participants). For 16- to 20-year-olds with permanent teeth, the MD in DMFS increment was 0.86 (95% CI -0.03 to 1.75; 127 participants). The trial did not assess other clinical outcomes of relevance to this review. Risk-based recall versus 6-month recall at 4 years' follow-up We found high-certainty evidence from one trial of adults that there is little to no difference between risk-based and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (ICDAS 1 to 6; MD 0.15, 95% CI -0.77 to 1.08; 1478 participants); proportion of sites with gingival bleeding (MD 0.78%, 95% CI -1.17% to 2.73%; 1472 participants); oral-health-related quality of life (MD in OHIP-14 scores -0.35, 95% CI -1.02 to 0.32; 1551 participants). There is probably little to no difference in the prevalence of moderate to extensive caries (ICDAS 3 to 6) between the groups (RR 1.04, 95% CI 0.99 to 1.09; 1478 participants; moderate-certainty evidence). 24-month recall versus 6-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between 24-month and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (MD -0.60, 95% CI -2.54 to 1.34; 271 participants); percentage of sites with gingival bleeding (MD -0.91%, 95% CI -5.02% to 3.20%; 271 participants). There may be little to no difference between the groups in the prevalence of moderate to extensive caries (RR 1.05, 95% CI 0.92 to 1.20; 271 participants; low-certainty evidence). We found high-certainty evidence that there is little to no difference in oral-health-related quality of life between the groups (MD in OHIP-14 scores -0.24, 95% CI -1.55 to 1.07; 305 participants). Risk-based recall versus 24-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between risk-based and 24-month recall intervals for the outcomes: prevalence of moderate to extensive caries (RR 1.06, 95% CI 0.95 to 1.19; 279 participants); number of tooth surfaces with any caries (MD 1.40, 95% CI -0.69 to 3.49; 279 participants). We found high-certainty evidence that there is no important difference between the groups in the percentage of sites with gingival bleeding (MD -0.07%, 95% CI -4.10% to 3.96%; 279 participants); or in oral-health-related quality of life (MD in OHIP-14 scores -0.37, 95% CI -1.69 to 0.95; 298 participants). AUTHORS' CONCLUSIONS: For adults attending dental check-ups in primary care settings, there is little to no difference between risk-based and 6-month recall intervals in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period (high-certainty evidence). There is probably little to no difference between the recall strategies in the prevalence of moderate to extensive caries (moderate-certainty evidence). When comparing 24-month with either 6-month or risk-based recall intervals for adults, there is moderate- to high-certainty evidence that there is little to no difference in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period. The available evidence on recall intervals between dental check-ups for children and adolescents is uncertain. The two trials we included in the review did not assess adverse effects of different recall strategies.


Assuntos
Agendamento de Consultas , Assistência Odontológica/normas , Saúde Bucal , Adolescente , Adulto , Fatores Etários , Pré-Escolar , Cárie Dentária/epidemiologia , Dentição Permanente , Hemorragia Gengival/epidemiologia , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Retenção nos Cuidados , Fatores de Tempo , Dente Decíduo , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-32824705

RESUMO

Gingival bleeding (GB) is a common sign of gingival inflammation, which indicates the presence of periodontal diseases. This study aimed to describe the perception of French adults about their self-reported GB and answers of healthcare professionals regarding the GB reported by these interviewees. A questionnaire administered by one investigator in each of three public settings of four cities in France from September 2016 to November 2017. Among 794 adults interviewed, 502 (63.2%) reported a GB. Among them, 414 (82.5%) believed that GB is benign, and 309 (61.6%) declared one or more responses. The three main responses were to use mouthwash (29.3%), to change to a soft-bristle toothbrush (20.1%) and to modify the brushing technique (19.3%). Almost half (49.0%) questioned at least one healthcare professional concerning their GB: a dentist (43.0%), a physician (14.1%), and a pharmacist (8.0%). The main response of each healthcare professional was: for dentists: a "prescription of mouthwash", for physicians to say "gingival bleeding is not serious"; and for pharmacists: "to sell a mouthwash". Most of the participants considered their GB as benign and had inappropriate responses, which indicates their lack of knowledge regarding periodontal health. The same conclusions can be drawn for healthcare professionals, as reported by interviewees.


Assuntos
Hemorragia Gengival/psicologia , Adulto , Feminino , França/epidemiologia , Hemorragia Gengival/epidemiologia , Gengivite , Humanos , Masculino , Antissépticos Bucais , Escovação Dentária
3.
BMC Oral Health ; 20(1): 147, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429918

RESUMO

BACKGROUND: Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors of gingival bleeding and calculus among 12-year-old adolescents; (2) find predictive models for gingivitis management. METHODS: Four thousand five hundred twenty-five subjects aged 12 in Sichuan Province were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Chinese adolescents' gingival bleeding and calculus. RESULTS: 46.63% (95%CI: 40.71, 51.60) and 66.94% (95%CI: 56.85, 67.45) of the subjects presented gingival bleeding and calculus, respectively. For the gingival bleeding cases, the model showed the significant associated indicators were hukou (OR = 0.61, 95% CI: 0.52-0.72), family size (OR = 1.41, 95% CI: 1.19-1.68), parental educational level (father: OR = 0.53, 95% CI: 0.45-0.63; mother: OR = 0.71, 95% CI: 0.59-0.86), tooth-brushing frequency (OR = 0.35, 95% CI: 0.26-0.48), dental floss use (OR = 0.58, 95% CI: 0.41-0.83), sugar-containing drink consumption (OR = 2.11, 95% CI: 1.80-2.49), and dental visit (OR = 1.44, 95% CI: 1.19-1.74). It also confirmed that gender (OR = 1.32, 95% CI: 1.13-1.54), hukou (OR = 0.69, 95% CI: 0.59-0.82), family size (OR = 1.34, 95% CI: 1.12-1.59), parental educational level (father: OR = 0.46, 95% CI: 0.39-0.54; mother: OR = 0.65, 95% CI: 0.59-0.82), tooth-brushing frequency (OR = 0.57, 95% CI: 0.42-0.78), dental floss use (OR = 0.66, 95% CI: 0.48-0.90) and sugar-containing drink consumption (OR = 1.30, 95% CI: 1.11-1.53) were associated factors for dental calculus. CONCLUSIONS: Gingival bleeding and calculus were common in western Chinese adolescents. Socio-demographic factors including gender, hukou and family factors are strong determinants of gingival health in Chinese adolescents. In addition, health-related lifestyle behaviors such as healthy diet, good hygiene care and more dental visits are good predictors of better gingival status.


Assuntos
Cálculos Dentários/etnologia , Hemorragia Gengival/etnologia , Gengivite , Grupo com Ancestrais do Continente Asiático , Criança , Cálculos Dentários/epidemiologia , Feminino , Hemorragia Gengival/epidemiologia , Hemorragia Gengival/etiologia , Humanos , Masculino , Análise Multinível , Saúde Bucal
4.
Neurosurg Rev ; 43(2): 669-679, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30972514

RESUMO

Oral bacteria DNA has been found in intracranial aneurysms (IA) and a high prevalence of periodontitis was reported in IA patients. We investigated whether periodontitis associates with IA formation and aneurysmal subarachnoid hemorrhage (aSAH). First, we compared in a case-control setting the prevalence of periodontal disease in IA patients (42 unruptured IA, 34 ruptured IA) and in age- and gender-matched controls (n = 70) from the same geographical area (Health 2000 Survey, BRIF8901). Next, we investigated whether periodontitis at baseline associated with aSAH in a 13-year follow-up study of 5170 Health 2000 Survey participants. Follow-up data was obtained from national hospital discharge and cause of death registries. Univariate analysis, logistic regression, and Cox-regression were used. Periodontitis (≥ 4mm gingival pocket) and severe periodontitis (≥ 6mm gingival pocket) were found in 92% and 49% of IA patients respectively and associated with IAs (OR 5.3, 95%CI 1.1-25.9, p < 0.000 and OR 6.3, 95%CI 1.3-31.4, p < 0.001, respectively). Gingival bleeding had an even stronger association, especially if detected in 4-6 teeth sextants (OR 34.4, 95%CI 4.2-281.3). Severe periodontitis in ≥ 3 teeth or gingival bleeding in 4-6 teeth sextants at baseline increased the risk of aSAH during follow-up (HR 22.5, 95%CI 3.6-139.5, p = 0.001 and HR 8.3, 95%CI 1.5-46.1, p = 0.015, respectively). Association of periodontitis and gingival bleeding with risk of IA development and aSAH was independent of gender, smoking status, hypertension, or alcohol abuse. Periodontitis and gingival bleeding associate with increased risk for IA formation and eventual aSAH. Further epidemiological and mechanistic studies are indicated.


Assuntos
Aneurisma Roto/complicações , Hemorragia Gengival/epidemiologia , Aneurisma Intracraniano/complicações , Periodontite/epidemiologia , Hemorragia Subaracnóidea/complicações , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Sistema de Registros , Fatores de Risco , Fumar , Adulto Jovem
5.
Braz Oral Res ; 33: e090, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31531553

RESUMO

The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.


Assuntos
Gengivite/epidemiologia , Gengivite/etiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Índice de Placa Dentária , Feminino , Hemorragia Gengival/epidemiologia , Hemorragia Gengival/etiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Prevalência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , América do Sul/epidemiologia , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
6.
Oral Dis ; 25(8): 1995-2002, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31407451

RESUMO

OBJECTIVE: The aim of this study was to evaluate the orofacial parameters of systemic sclerosis (SSc) and its related systemic features. SUBJECTS AND METHODS: A descriptive case-control study was performed from November 2015 to October 2016. Ninety-three individuals were included and divided into SSc group (n = 50) and healthy controls (C, n = 43). RESULTS: Systemic sclerosis individuals were mostly women (43/50, 86%), with a mean age of 46 years (±11.6 years). Telangiectasia (42/50, 84%) and reduced mouth opening (35/50, 70%) were the most frequent orofacial findings. The periodontitis frequency was much higher in SSc individuals than in healthy controls (90.7% × 48.83%; p < .001). In addition, SSc individuals presented a distinctive pattern of periodontitis, with low probing pocket depth (2 ± 0.65 mm × 2 ± 0.24; p < .001), higher gingival recession (4 ± 2.13 × 0.14 ± 0,22; p < .001), higher periodontal attachment loss (6 ± 1.34 mm × 2 ± 0.43, p < .001), and lower gingival bleeding index values (7.05 ± 7.25 × 21.57 ± 15.66; p < .001). CONCLUSIONS: Orofacial manifestations were common in SSc and included a unique pattern of periodontal manifestation, characterized by lower gingival bleeding index, higher periodontal attachment loss, and low probing depth.


Assuntos
Hemorragia Gengival/epidemiologia , Perda da Inserção Periodontal , Doenças Periodontais/epidemiologia , Periodontite/epidemiologia , Escleroderma Sistêmico/complicações , Xerostomia/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Índice de Placa Dentária , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/complicações , Doenças Periodontais/diagnóstico , Escleroderma Sistêmico/epidemiologia
7.
Braz Oral Res ; 33: e036, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31141035

RESUMO

The aim of this study was to determine the occurrence of gingivitis and calculus and their predictors in a population of adults in Brazil. A representative sample of 758 adults from 35 to 59 years of age from Porto Alegre city was examined. A structured questionnaire was applied. The Gingival Bleeding Index and the presence of calculus were measured at 4 sites/tooth. Multivariable logistic models were fitted to determine the predictors for gingival bleeding at >20% of sites. Overall, 96.5% (95% confidence interval [CI]=95.1-98.0) of individuals had ≥ 1 bleeding site. The mean percentages of sites with gingivitis and calculus were 26.1% and 44.6%, respectively. The odds of gingivitis decreased by ∼45% for individuals ≥40 years old compared to younger adults. Individuals that never performed interproximal cleaning and non-whites had an approximately two times higher chance of gingivitis. Smokers had lower chances of gingivitis than never-smokers (odds ratio=0.40; 95% CI=0.24-0.68). Higher numbers of missing teeth were associated with higher chances of gingivitis. The percentage of calculus was significantly associated with skin color, education, proximal cleaning, smoking exposure, dental visits, and tooth loss. It can be concluded that the occurrence of gingivitis and calculus was high in this Brazilian population, and it was associated with age, skin color, education, self-reported proximal cleaning, smoking, dental care, and tooth loss.


Assuntos
Cálculos Dentários/epidemiologia , Cálculos Dentários/etiologia , Gengivite/epidemiologia , Gengivite/etiologia , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Prevalência , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores Socioeconômicos , Escovação Dentária/estatística & dados numéricos
8.
Cien Saude Colet ; 24(3): 953-961, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892516

RESUMO

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Saúde Bucal/estatística & dados numéricos , Adulto , Fatores Etários , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Renda , Lactente , Masculino , Análise Multivariada , Distribuição de Poisson , Inquéritos e Questionários , Adulto Jovem
9.
Acta Odontol Scand ; 77(5): 400-407, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30919709

RESUMO

OBJECTIVE: To examine if socioeconomic inequalities exist in periodontal disease among adult with optimal oral health behaviours. MATERIALS AND METHODS: Data were from the Adult Dental Health Survey 2009, a national survey of England, Wales and Northern Ireland. Overall, 4738 participants aged 35 years and older were included in the analysis. Periodontal disease indicated by pocket depth or loss of attachment ≥4 mm, and gingival bleeding were used as periodontal outcomes. Education and deprivation indicated socioeconomic position. Behavioural factors were dental visits, toothbrushing and smoking. The subset of adults with and without optimal health related behaviours included 2916 and 1822 participants, respectively. The associations between periodontal disease and socioeconomic position were tested adjusting for demographic and behavioural factors. Additional models stratifying the sample to those with and without optimal behaviour subgroup were constructed. RESULTS: Education and deprivation were significantly associated with periodontal disease in the partially adjusted models. In the analysis of those with optimal behaviours, only deprivation and highest level of education showed significant association with periodontitis (PD), but not with gingival bleeding. Among those without optimal behaviours, all socioeconomic factors were associated with all outcomes except deprivation and PD. CONCLUSIONS: Oral health behaviours marginally contributed to inequalities in gingival bleeding and periodontal disease. Socioeconomic inequalities were attenuated among those with optimal behaviours and persisted among those without optimal behaviours. Behaviours appeared to be an effect modifier for the relationship between periodontal outcomes and socioeconomic factors.


Assuntos
Disparidades nos Níveis de Saúde , Saúde Bucal/estatística & dados numéricos , Doenças Periodontais/epidemiologia , Fatores Socioeconômicos , Adulto , Idoso , Assistência Odontológica/estatística & dados numéricos , Inquéritos de Saúde Bucal/estatística & dados numéricos , Inglaterra , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Irlanda do Norte , Periodontite/epidemiologia , Fumar/epidemiologia , Escovação Dentária/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , País de Gales
10.
Ciênc. Saúde Colet ; 24(3): 953-961, mar. 2019. tab
Artigo em Português | LILACS | ID: biblio-989581

RESUMO

Resumo O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.


Abstract The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Humanos , Masculino , Feminino , Lactente , Adulto , Adulto Jovem , Saúde Bucal/estatística & dados numéricos , Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Brasil/epidemiologia , Distribuição de Poisson , Hemorragia Gengival/epidemiologia , Estudos Transversais , Análise Multivariada , Inquéritos e Questionários , Fatores Etários , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Renda
11.
Community Dent Oral Epidemiol ; 47(2): 177-184, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30569569

RESUMO

OBJECTIVES: To explore the pathways through which the socioeconomic inequalities may influence gingival bleeding in adolescents, assessing the direct and indirect effects of material and psychosocial variables. METHODS: This cohort study followed a multistage, random sample of 1134 12-year-old adolescents from 20 public schools of Santa Maria, a city in southern Brazil. The percentage of teeth with gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding) at baseline and at 2-year follow-up. Biological (dental plaque, caries, and dental crowding), material (socioeconomic position [SEP] operationalized as family income and parents' education), psychosocial (parents' religiosity, self-rated health, and happiness) and behavioural (use of dental service by adolescents) factors were collected at baseline. Structural equation modelling (SEM) was guided by the adapted Commission on the Social Determinants of Health model linking material, psychosocial, biological, and behaviour variables to health. The SEM was employed to estimate standardized direct, indirect, and total effects of material and psychosocial factors on gingival bleeding at follow-up. RESULTS: A total of 770 14-year-old adolescents were reassessed (follow-up rate of 68%). The lower SEP at baseline had a higher direct effect (standard coefficient [SC] = -0.17, P < 0.01) than a mediated effect on percentage of teeth with gingival bleeding at 2-year follow-up. The lower indirect effect (SC = -0.06, P < 0.01) from SEP to gingival bleeding at follow-up ran through biological factors-dental plaque (baseline and follow-up) and gingival bleeding at baseline. The lower religiosity of the parents as a psychosocial aspect had only a small direct effect (SC = -0.10, P = 0.03) on gingival bleeding at follow-up. CONCLUSIONS: Material factors such as SEP contributed most to explanations on inequalities in adolescents' periodontal health because of their higher direct effect and additional shared (indirect) effect (through biological factors) on gingival bleeding. Religious practice as a psychosocial factor only explained part of percentage of teeth with gingival bleeding at follow-up.


Assuntos
Hemorragia Gengival/epidemiologia , Saúde Bucal , Adolescente , Brasil , Estudos de Coortes , Feminino , Humanos , Masculino , Fatores Socioeconômicos
12.
Braz Oral Res ; 32: e112, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30379213

RESUMO

The aim of the present study was to verify if clinical signs of gingivitis such as color changes, edema, and bleeding in the anterior region influence the OHRQoL of adolescents. We followed a cross-sectional convenience sample of 67 adolescents aged 11 to 16 years receiving dental treatment at the Federal University of Santa Maria (UFSM), in southern Brazil. The participants were evaluated for the following clinical variables: edema, gingival color alteration, and marginal bleeding of the gingival tissues, collected at 6 sites per tooth in the anterior region of the mouth. Socioeconomic variables were collected through questionnaires and OHRQoL was evaluated through the Brazilian version of the Children Perception Questionnaire (CPQ 11-14) short form. A Poisson regression model was used to verify associations between clinical variables and general CPQ11-14 scores. In the unadjusted analysis, edema, color alterations, and marginal bleeding in the anterior region were associated with worse scores of OHRQoL. Edema and marginal bleeding remained associated after adjusting for clinical and sociodemographic variables. Adolescents with higher levels of marginal bleeding and edema in the anterior region had higher mean CPQ11-14 scores. Therefore, the presence of bleeding and gingival edema in the anterior region can be considered clinical signs of gingivitis that are associated with a worse OHRQoL in adolescents.


Assuntos
Hemorragia Gengival/epidemiologia , Gengivite/epidemiologia , Qualidade de Vida , Adolescente , Brasil/epidemiologia , Criança , Estudos Transversais , Edema/epidemiologia , Feminino , Hemorragia Gengival/patologia , Hemorragia Gengival/psicologia , Gengivite/patologia , Gengivite/psicologia , Humanos , Masculino , Saúde Bucal , Distribuição de Poisson , Qualidade de Vida/psicologia , Autoimagem , Inquéritos e Questionários
13.
Dent Med Probl ; 55(3): 313-320, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30328310

RESUMO

BACKGROUND: Bacterial plaque control plays a key role in the prevention of caries and periodontal diseases. Hygiene negligence in this respect may influence the state of gingiva, and - in the long term - the number of lost teeth. The recommended method of mechanical control of dental plaque is tooth brushing twice a day. OBJECTIVES: The aim of the study was to assess the frequency of tooth brushing, the use of various oral hygiene accessories, the number of preserved teeth, and the occurrence of gingival bleeding in adult Poles, based on a questionnaire study. MATERIAL AND METHODS: The prepared questionnaire consisted of a general part, assessing the socioeconomic and general medical status of respondents, as well as of specific questions about behavioral actions related to oral hygiene. The study was conducted in 10 Polish cities in Mobile Medical Units as part of the "Health First" campaign in 2017. RESULTS: The study included 713 respondents: 447 females and 264 males at an average age of 51.1 ±17.6 years. During the previous 6 months, 448 females and 265 males had visited the dentist. The average number of teeth among the respondents aged 35-44 years was 27, and for subjects >65 years old -13. There were statistically significant differences in the frequency of tooth brushing depending on sex and place of residence. The respondents used manual soft and medium toothbrushes more often than electric brushes (p < 0.05). Inhabitants of larger cities, compared to rural residents, used dental floss and toothpicks more frequently (p < 0.05). In total, 271 (50%) of the respondents reported gingival bleeding during tooth brushing. There was a statistically significant association of gingival bleeding with genetic load, and with the use of a manual soft toothbrush and mouthwash. CONCLUSIONS: Pro-health behaviors of adult Poles in maintaining optimal oral hygiene are unsatisfactory and need improvement.


Assuntos
Inquéritos de Saúde Bucal , Higiene Bucal/estatística & dados numéricos , Adulto , Idoso , Dispositivos para o Cuidado Bucal Domiciliar/estatística & dados numéricos , Feminino , Carga Genética , Hemorragia Gengival/epidemiologia , Humanos , Arcada Parcialmente Edêntula/epidemiologia , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais , Polônia/epidemiologia , População Rural/estatística & dados numéricos , Autorrelato , Escovação Dentária/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
14.
Chin J Dent Res ; 21(3): 195-203, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30255170

RESUMO

OBJECTIVE: To investigate the periodontal health status and associated factors of adolescents aged 12 to 15 years old in China. METHODS: A cross-sectional national oral health survey was conducted in 2015-2016. The multi-stage stratified cluster sampling was used to select participants in all 31 provinces, autonomous regions and municipalities in the mainland of China. Each participant received a clinical assessment including periodontal bleeding and calculus, and 15-year-old adolescents received additional examinations including for periodontal pocket depth and attachment loss, using the latest criteria from the Oral Health Survey Basic Methods, as recommended by the World Health Organization (WHO). A self-answered structured questionnaire was designed to collect the data of background information and associated risk factors. RESULTS: A total of 118,514 adolescents (14.0 ± 1.09 years old) completed all the oral examinations and the questionnaire. The prevalence of periodontal bleeding and calculus was 61.0% and 67.3% respectively. In the group of 15 year olds, 6.5% adolescents had periodontal pocket and 0.5% had attachment loss. Molars were often involved and, furthermore, calculus also occurred on lower incisors. The periodontal status of adolescents became worse as they grew up. The condition of girls was significantly better than boys. CONCLUSION: This survey illustrated a brief picture of periodontal status of adolescents in China showing that gingival bleeding and calculus were very common and frequent. Further actions on oral health education were necessary, especially for those in lower socio-economic classes.


Assuntos
Cálculos Dentários/epidemiologia , Hemorragia Gengival/epidemiologia , Perda da Inserção Periodontal/epidemiologia , Bolsa Periodontal/epidemiologia , Adolescente , Criança , China/epidemiologia , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Doenças Periodontais/epidemiologia , Índice Periodontal , Fatores de Risco , População Rural/estatística & dados numéricos , Distribuição por Sexo , População Urbana/estatística & dados numéricos
15.
Chin J Dent Res ; 21(4): 241-247, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30264040

RESUMO

OBJECTIVE: To assess the current periodontal status of 35 to 44-year-olds from the Chinese population and to analyse potential influence factors on periodontal disease. METHODS: The data of subjects were collected from both urban and rural areas of all 31 provinces, autonomous regions and municipalities of the mainland of China, as part of the 4th National Oral Health Survey. All subjects were aged 35 to 44 years old. In total, 4,410 subjects were enrolled in the present study. Each subject was asked to undergo a professional oral examination and to fill in a questionnaire. Periodontal health status was evaluated by probe bleeding, calculus, periodontal pocket depth and clinical attachment loss. The data were analysed using the chi-square test and binary logistic regression analysis. RESULTS: The prevalence of probe bleeding and calculus was 87.4% and 96.7% respectively among the 35 to 44-year-old population. Prevalence of shallow pockets (4 mm ≤ PD < 6 mm) and deep pockets (PD ≥ 6 mm) was 45.8% and 6.9% respectively among 35 to 44-year-old people. In addition, prevalence of clinical attachment loss (CAL > 3 mm) was 33.2%. Gender, educational level, smoking, teeth brushing frequency, dental floss and toothpick use were found relevant to periodontal condition. CONCLUSION: Periodontal disease was highly prevalent among 35 to 44-year-old Chinese adults. Gender, educational level, smoking, teeth brushing frequency, toothpick and dental floss use could be potential influence factors of periodontal health status.


Assuntos
Cálculos Dentários/epidemiologia , Escolaridade , Doenças Periodontais/epidemiologia , Bolsa Periodontal/epidemiologia , Fumar/epidemiologia , Escovação Dentária/estatística & dados numéricos , Adulto , China/epidemiologia , Dispositivos para o Cuidado Bucal Domiciliar , Inquéritos de Saúde Bucal , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Modelos Logísticos , Masculino , Higiene Bucal/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Sexuais
16.
Chin J Dent Res ; 21(4): 267-273, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30264043

RESUMO

OBJECTIVE: To understand the oral health knowledge, attitude, behaviour and oral health status of Chinese diabetic patients so as to facilitate the development of oral health education programmes for diabetic patients in China. METHOD: A face-to-face questionnaire was conducted for 1,024 diabetic patients and 8,030 non-diabetic people aged 55 to 74 years old in order to understand their oral health knowledge, attitudes, and behaviour. Oral health examination was implemented including caries, gingival bleeding, dental calculus, periodontal attachment loss, etc. according to the Oral Health Surveys Basic Methods 5th Edition. RESULTS: Compared with non-diabetic patients, those with diabetes had more oral health knowledge and more positive attitudes. The proportion of people who formed toothbrushing habits was higher in diabetic patients, but that of regular scaling and flossing is as low as that in non-diabetic people. The detection rate of deep periodontal pockets in diabetic patients was higher than that in non-patients, while the caries situation was better than that in non-patients. CONCLUSION: This study has shown that the oral health knowledge, attitude, behaviour and oral health status of the 55 to 64-year-old diabetic population are not optimistic. There is a great need for a systematic oral health education programme in China. The contradiction between a large number of diabetes patients and limited health resources requires us to give priority to the improvement of oral health behaviours, such as educating patients to develop toothbrushing and flossing habits.


Assuntos
Cálculos Dentários/epidemiologia , Cárie Dentária/epidemiologia , Diabetes Mellitus/epidemiologia , Hemorragia Gengival/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal , Idoso , Estudos de Casos e Controles , China , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Educação em Saúde Bucal , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Escovação Dentária
17.
Chin J Dent Res ; 21(4): 275-284, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30264044

RESUMO

OBJECTIVE: To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China. METHOD: Using the multistage, stratified, equal proportion, random sampling method in the 4th National Oral Health Survey of China conducted in 2015 to 2016, residents aged 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years respectively were recruited, clinically examined and answered a questionnaire. Utilisation of oral health services were assessed in all the age groups and the economic burden of oral diseases in the past 12 months were assessed in the 3 to 5 years and 35 to 74 year-old groups. Chi-squared tests, t tests, correlation analysis and a one-way ANOVA were used to determine the relationships of different factors with utilisation of oral health services and the economic burden of oral diseases. RESULTS: In the subject groups - 3 to 5 years, 12 to 15 years and 35 to 74 years - the prevalence of the utilisation of oral health services in the past 12 months was 14.6% (5,876/40,353), 23.6% (27,936/118,592), and 20.1% (2,708/13,461), respectively. In all three groups, receiving dental treatment was the most common reason for subjects' recent dental visit. The average dental cost in the past 12 months was 403.43 CNY (median = 100) for 3 to 5-year-old children and 850.83 CNY (median = 300) for adults aged 35 to 74 years old. Area, education and annual household income per person were the socio-economic influential factors. Oral health status, oral hygiene and attitudes to and knowledge of oral health affected the utilisation of oral health services and the economic burden of oral diseases. CONCLUSION: The percentage of dental service utilisation was relatively low, and the economic burden was high. The related factors for both utilisation of oral health services and the economic burden of oral diseases included living in area, educational attainment, household income, perceived oral health status, and oral hygiene.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Índice CPO , Dispositivos para o Cuidado Bucal Domiciliar , Serviços de Saúde Bucal/economia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal/economia , Higiene Bucal/estatística & dados numéricos , População Rural , Escovação Dentária/estatística & dados numéricos , População Urbana
18.
Braz Oral Res ; 32: e22, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29723334

RESUMO

The aims of this study were to describe the self-reported oral hygiene habits, dental visit frequency, and gingival bleeding perception in adult populations from three South American cities, and also to assess the association of these variables with sociodemographic data and with the clinical presence of plaque and gingival inflammation. Five-hundred and fifty adult subjects from each city (Porto Alegre, Brazil; Tucumán, Argentina; Santiago, Chile) received full mouth examinations to determine visible plaque and gingival index. A structured questionnaire on demographics, habits, attitudes and knowledge of oral health was also administered. The data were analyzed according to dental visit frequency, toothbrushing frequency, interproximal tooth cleaning frequency, subjects' perception of gum bleeding, and proportion of subject sites with VP and bleeding sites. Analysis of the association among the variables was performed using either a chi-square test or Fischer's exact test. Toothbrushing twice a day or more was reported by 84.2% of the subjects, but only 17.7% reported daily interdental cleaning, and 60.2% reported visiting a dental clinic only in an emergency. Only 2.97% had no bleeding sites, whereas 33.7% had 50% or more bleeding sites. Regular interdental self-cleaning and a dental visit every 3-6 months was associated with less plaque and less gingival bleeding. More than 12 years of education was associated with healthier habits, less bleeding and plaque scores. In conclusion, the oral health behavior of South American adult subjects from these cities is below the international recommendations, especially in relation to interdental cleaning and regular dental visits.


Assuntos
Inquéritos de Saúde Bucal/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Saúde Bucal/estatística & dados numéricos , Higiene Bucal/estatística & dados numéricos , Autorrelato , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Argentina/epidemiologia , Brasil/epidemiologia , Chile/epidemiologia , Cidades/epidemiologia , Estudos Transversais , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores Sexuais , Escovação Dentária/estatística & dados numéricos , Adulto Jovem
20.
Community Dent Oral Epidemiol ; 46(2): 169-177, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29178456

RESUMO

OBJECTIVES: To test whether maternal education has a direct effect on gingival bleeding in adolescents aged 12 and to assess whether oral health behaviours over time mediate that association. METHODS: Two oral health studies nested in the 1993 Pelotas (Brazil) birth cohort study were carried out in participants aged 6 (n = 359) and 12 years (n = 339). The proportion of teeth with bleeding on probing (BOP) and the median number of teeth with gingivitis at age 12 were recorded. Maternal education at birth was the exposure. Toothbrushing frequency and dental visit at ages 6 and 12 years were investigated as mediators of the association between maternal education at birth and gingival bleeding. Time-varying family income through childhood and adolescence was included as later confounder. Paternal education was taken as baseline confounder. The controlled direct effect (CDE) of maternal education at child's birth on gingival bleeding at age 12 was estimated using marginal structural models (MSM). Additionally, path analysis was employed to estimate standardized direct, indirect and total effects of maternal education at birth on gingival bleeding. RESULTS: Adjusted analyses using MSM showed that adolescents whose mothers had <8 years of education had 3.82 higher risk of having teeth with gingival bleeding above the median (rate ratio RR 3.82; 95% CI: 1.68-8.19). Low maternal education doubled the proportion of gingival bleeding at age 12 not mediated by dental visit and toothbrushing frequency (RR 1.99; 95% CI: 1.52-2.60). Path analysis revealed that maternal education had a direct effect on gingival bleeding independently of the mediators. CONCLUSIONS: The pattern of oral health behaviours does not explain the association between mother's education and adolescent's gingival bleeding. Individual-based approaches focused on oral health-related behaviours tend to fail to prevent gingival bleeding.


Assuntos
Escolaridade , Hemorragia Gengival/epidemiologia , Comportamentos Relacionados com a Saúde , Mães , Saúde Bucal , Adolescente , Brasil/epidemiologia , Criança , Feminino , Humanos , Masculino , Escovação Dentária
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