Relationship between tooth loss, nutritional status and consumption of macro and micronutrients in elderly people from southern Brazil

Maintaining a functional natural dentition plays an important role in keeping a satisfactory nutritional status. The aim of this study was to evaluate the relationship between oral health conditions determined by the presence of edentulism and the number of missing teeth, nutritional status and consumption of nutrients by the elderly. This cross-sectional study comprised 494 independent elderly of both genders, over 60 years of age, registered at the Brazilian public health service in Londrina, southern Brazil. The data collection included: oral examinations; anthropometric measurements by calculating the Body Mass Index (BMI); analysis of food consumption based on a multiple pass 24-hour dietary recall and a food intake frequency questionnaire; and structured interviews to obtain sociodemographic information. Multiple linear regression, the Fisher's Exact test, chi-square and Mann-Whitney tests, were applied at a 5% significance level. The prevalence of edentulism was 47.3%; this predominated in females, age group from 65 to 74 years, low education level and low/medium economic classification. A larger numberof underweight and fewer number of overweight elderly were recorded among the edentulous versus dentate participants (< 0.0001). Significantly lower consumption of several nutrients, as well as fruit, was recorded among the edentulous group. In particular, carbohydrates, vitamins (B1, B9 and C), and the majority of the minerals studied were associated with a larger number of missing teeth. In conclusion, tooth loss was associated with the food consumption pattern of some macro-and micronutrients and the nutritional status of the Brazilian elderly.

Sweetness Taste Preference Levels and Their Relationship to the Nutritional and Dental Caries Patterns among Brazilian Preschool Children

Objective: To evaluate the sweetness taste preference levels and their relationship with the nutritional and dental caries patterns among preschool children. Material and Methods: The participants of this cross-sectional study were 191 children aged 4 to 5 years, who were regularly attending public Child Education Centers of a city southern Brazil. Children's preference for sugar was evaluated by the Sweet Preference Inventory; caries prevalence, according to the World Health Organization criteria, and nutritional status, by anthropometric weight and stature measurements, in accordance with child growth standards of the World Health Organization. Results: High levels of sweetness preference were identified. The majority of children (67.5%) opted for the most concentrated sucrose solutions. Excess weight was recorded in 27.7% of the preschoolers. The prevalence of caries was 51.8%, with the mean dmf-t equal to 1.92 (± 2.72) and the decayed (c) component responsible for 94.2% of the index. No significant association between sweetness preference and the nutritional or the oral health patterns could be established. In addition, no association between excess weight and dental caries was identified. The diseases studied were only associated with sociodemographic variables. Excess weight was associated with maternal age (p=0.004) and caries experience with family income (p=0.013). Conclusion: No significant associations could be stablished between the sweetness taste preference and the diseases studied, nor between excess weight and dental caries. However, the findings of high patterns of sweet preference, excess weight and untreated caries experience, highlight the need for the implementation of integrated public policies aimed at controlling both nutritional and of oral health problems in the studied population.

Oral health promotion in patients with morbid obesity after gastroplasty: a randomized clinical trial / Promoção de saúde bucal em pacientes com obesidade mórbida após gastroplastia: ensaio clínico randomizado

ABSTRACT Background: The bariatric surgery may have negative repercussions on oral conditions. Aim: To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties. Method: The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow. Results: After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713). Conclusion: There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.

RESUMO Racional: A cirurgia bariátrica pode repercutir negativamente nas condições bucais. Objetivo: Avaliar o impacto de um programa educativo/preventivo em saúde bucal desenvolvido em pacientes submetidos à gastroplastia. Método: A amostra foi constituída por 109 pacientes aleatoriamente alocados em dois grupos: grupo de intervenção (GI), onde participaram do programa de promoção de saúde bucal com abordagens educativo-preventivas; grupo controle (GC), onde receberam cuidado da equipe da clínica, sem participação no programa. As condições bucais investigadas nos períodos pré e pós-operatório de um mês (1M) e seis meses (6M) foram: cárie dentária, doença periodontal, desgaste dentário, placa dentária e fluxo salivar. Resultados: Após a gastroplastia, pacientes do GI apresentaram: menor alteração em esmalte (6M: p=0,004), dentina (6M: p=0,005) e sangramento gengival (6M: p<0,0001); redução no índice de placa (1M, 6M: p<0,0001) e aumento do fluxo salivar (6M: p=0,039), quando comparados aos do GC. Desgaste dentário incipiente foi registrado em ambos os grupos (6M: p=0,713). Conclusão: Houve impacto positivo do programa implementado na prevenção dos principais problemas de saúde bucal em pacientes submetidos à gastroplastia, contribuindo para sua qualidade de vida.

Association between oral health status and central obesity among Brazilian independent-living elderly

Abstract The aim of this study was to investigate the association between oral health status and central obesity (CO) in Brazilian independent-living elderly. A cross-sectional study was carried out in a sample of 489 elderly, who were participants of the Study on Aging and Longevity, in Londrina, state of Parana. The number of natural teeth and use of prostheses were evaluated according to the World Health Organization criteria. The presence of CO was assessed using measures of waist circumference (WC) and waist-hip ratio (WHR). Information concerning sociodemographic profile and some systemic conditions was also collected. Data were analyzed using stepwise logistic regression, α=5%. According to WC and WHR measures, the prevalence of central obesity was 79.3% and 76.1%, respectively. CO according to WC was not associated with oral status. Considering the WHR measure, the following oral conditions were associated to CO: having fewer natural teeth (OR = 2.61; 95%CI = 1.17-5.80), being edentulous and wearing both upper and lower complete dentures (OR = 2.34; 95%CI = 1.11-4.93), and being edentulous wearing only the upper complete denture (OR = 2.64; 95%CI = 1.01-6.95). Traditional risk factors for CO such as gender, dyslipidemia, hypertension and diabetes were associated with both measures. A poor oral health due to extensive tooth loss, whether partial or complete, even if rehabilitated by removable prostheses, may be considered a good predictor of CO in Brazilian independent-living elderly.

Relação entre cárie dentária, edentulismo e autopercepção de saúde bucal em adolescentes, adultos e idosos de um município do nordeste brasileiro / Relationship between dental caries, edentulism and self-perception of oral health in adolescents, adults and elderly of a municipality in northeastern Brazil

O diagnóstico das condições e autopercepção da saúde bucal dos indivíduos é fundamental nas estratégias de planejamento e avaliação dos serviços de saúde. O objetivo deste estudo foi descrever a prevalência da cárie dentária, do edentulismo e a autopercepção em saúde bucal na população adolescente, adulta e idosa de um município de pequeno porte da região nordeste do Brasil. Adicionalmente, investigou-se a relação entre a autopercepção e as variáveis clínicas investigadas. Compuseram a amostra de estudo 139 indivíduos. Nos exames clínicos foi usado o índice CPO-D, segundo critérios da OMS e as informações sobre autopercepção foram obtidas por entrevistas. Na análise dos dados foram usados os testes Qui-quadrado, Mann Whitney e Exato de Fischer, com nível de significância de 5%. O índice CPO-D foi 6,57± 4,17 para adolescentes, 22,76±7,63 para adultos e 30,96±2,82 para idosos. Foi registrado predomínio da autopercepção negativa da saúde bucal entre adultos (58,6%) e positiva, entre idosos (57,7%). Autopercepções negativas da mastigação (p<0,001) e da fala (p=0,001) associaram-se ao aumento da idade. O índice CPO-D foi maior entre adolescentes com relato de dor (p=0,028). Nos adultos, a autopercepção negativa da saúde bucal (p=0,007), aparência de dentes/gengivas (p=0,003) e fala (p=0,046) associou-se ao maior número de dentes cariados presentes. Foi evidenciada a discrepância entre autopercepção positiva em saúde bucal e presença de edentulismo. Os resultados sugerem a necessidade do estabelecimento de políticas locais de saúde bucal, voltadas para a promoção da saúde, focadas na prevenção da cárie dentária e do edentulismo.

The diagnosis of conditions and self-perceived oral health status of individuals is fundamental in planning strategies and evaluation of health services. The aim of this study was to describe the prevalence of dental caries, edentulism and self-perception of oral health in adolescents, adults and elderly in a small city in northeastern Brazil. Additionally, we investigated the relationship between self-perception and the clinical variables studied. The study sample consisted of 139 subjects. In clinical examinations the DMFT index was used according to WHO criteria and information about self-perception was collected through interviews. The Chi-square, Mann Whitney and Fisher exact tests were used with 5% significance level . The DMFT index was 6.57 ± 4.17 for adolescents, 22.76 ± 7.63 for adults and 30.96 ± 2.82 for elderly. It was recorded predominance of negative self-perception of oral health among adults (58.6%) and positive self-perception among the elderly (57.7%). Negative self-perceptions of chewing (p <0.001) and speech (p = 0.001) were associated with increasing age. The DMFT index was higher among adolescents with a history of pain (p = 0.028). In adults, the negative self-perception of oral health (p = 0.007), appearance of teeth / gums (p = 0.003) and speech (p = 0.046) was associated with higher number of decayed teeth present. The discrepancy between positive self-perception of oral health and the presence of edentulism was highlighted. The results suggest the need to establish local policies for oral health aimed at promoting health and focused on preventing dental caries and edentulism.

Comportamento materno versus temperamento da criança: influência no padrão de saúde bucal / Maternal behavior versus child temper: influence on the oral health pattern

Objetivo: Verificar a relação entre cárie dentária, alterações faciais, comportamento materno e temperamento das crianças participantes do programa Clínica de bebês do município de Maringá/PR. Método: Foram examinadas 102 pares de mães e crianças na faixa etária entre 2 e 7 anos. Um questionário analisou os dados socioeconômicos da mãe, padrão de aleitamento, hábitos de sucção não nutritiva e por meio do exame clínico avaliaram-se a quantidade de biofilme presente (IHB), o índice de cárie (ceo-s) e alterações faciais. Avaliou-se, também, o temperamento da criança frente ao atendimento odontológico e o comportamento materno junto à criança. Os dados foram processados e analisados pelo software Statistic R, com nível de significância de 0,05%. Para a comparação das duas amostras foi utilizado o Teste de Mann-Whitney e a associação foi verificada pelo Teste Exato de Fisher. Resultados: Das crianças, 58,8% são do gênero masculino, 88 (86,2%) "livres de cárie" e ceo-s de 0,55 (±1,64). Quanto à presença de hábitos nocivos, 46 (45,1%) possui algum hábito e 21,5% possuíam alterações faciais. Houve diferença estatística para o IHB médio entre as crianças livres de cárie (0,8±0,86) e crianças com cárie (1,46±1,00) (p=0,010; Teste de Mann- Whitney). Quando comparado tempo do hábito nocivo e presença de alteração facial, as crianças que ainda possuíam hábito nocivo tiveram maior percentual de alteração facial. Para o temperamento da criança, a cárie mostrou-se mais presente para o definitivamente negativo (p=0,0499). Em relação ao hábito nocivo, este se mostrou mais presente para o definitivamente negativo (p=0,0434). Quando analisado o comportamento da mãe, 57,14% das crianças com cárie possuem mães consideradas "insensíveis" (p=0,0013). Conclusão: Programas que promovam o vínculo entre o profissional, à criança e a família, desde a idade precoce, com reforço educativo nas consultas...

Objective: To verify the relationship between dental caries, facial alterations, maternal behavior and temper of children attending the Baby Clinic Program of the city of Maringá/PR. Method: One hundred and two pairs of mothers and 2-7-yearold children. A questionnaire was used to evaluate the mothers socioeconomic data, nursing pattern and non-nutritive sucking habits. A clinical exam was done to evaluate the amount of biofilm (Oral Hygiene Index- OHI), the caries index (dfm-t) and the presence of facial alterations. The children's temper regarding the dental treatment and the mothers behavior with he children were also evaluated. The data were processed and analyzed using the Statistic R soft ware with significance level of 5%. The Mann-Whitney test was used for comparison of the two samples and the association between them was verified by the Fisher's Exact Test. Results: Among the children, 58.8% were male, 88 (86.2%) were "caries free" and the dmf-t was 0.55 (±1.64). Forty-six (45.1%) children had some kind of deleterious habits and 21.5% presented facial alterations. There was statistically significant difference for the mean OHI between the caries-free children (0.8±0.86) and children with caries (1.46±1.00) (p=0.010; Mann- Whitney test). When the duration of the deleterious habit and the presence of facial alterations were compared, the children that still presented the deleterious habit had higher percentage of facial alterations. Regarding the children's temper, caries disease was more prevalent for the definitively negative temper (p=0.0499). The prevalence of deleterious habits was also greater for the definitively negative temper (p=0.0434). Regarding the mothers behavior, 57.14% of the children with caries had mothers considered as "insensitive" (p=0.0013). Conclusion: Programs that promote a link between the dental professional, the family and the children since an early age, with educative reinforcement...