Dental caries and developmental defects of enamel in cerebral palsy: A meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to compare the occurrence of dental caries and developmental defects of enamel (DDE) in individuals with and without cerebral palsy (CP). MATERIALS AND METHODS: We conducted searches across five databases and the grey literature. Data were organized using EndNote 20. Reporting followed the MOOSE checklist. A random-effects model meta-analyses were conducted using RStudio, presenting results as mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). The risk of bias of studies was analyzed using the Newcastle-Ottawa Scale, and the certainty of evidence was assessed using GRADE. RESULTS: Among 1336 identified records, 25 studies involving 59,997 participants (mean age: 11.1 years) were included. Data of 12 were pooled into meta-analyses. No significant differences were found between CP and non-CP individuals across indices: DMFT (k = 7) (MD = 0.31; 95% CI [-0.42-1.05]), dmft (k = 4) (MD = 0.31; 95% CI [-0.50-1.14]), DMFS (k = 2) (MD = -0.61; 95% CI [-20.56-19.33]), dmfs (k = 3) (MD = 0.54; 95% CI [-1.09-2.17]), and DDE (k = 3) (OR = 0.80, 95% CI [0.09-7.31]). The certainty of evidence was very low. CONCLUSION: Individuals with CP do not appear to differ significantly from those without CP in terms of dental caries experience and DDE.

Malocclusion in individuals with osteogenesis imperfecta: A systematic review and meta-analysis.

OBJECTIVE: To evaluate whether individuals with osteogenesis imperfecta (OI) are more affected by malocclusion than individuals without OI. MATERIALS AND METHODS: Searches in PubMed, Ovid, Web of Science, Scopus, Lilacs and gray literature were performed. Data extraction was conducted by two researchers. Risk of bias assessment employing the Newcastle-Ottawa Scale and meta-analysis were conducted. Results were provided with mean difference (MD), odds ratio (OR) and 95% confidence interval (CI). Strength of evidence was determined. RESULTS: Six cross-sectional studies were included. In comparison with individuals without OI, the group with OI had 19.69-fold greater chance of exhibiting Angle Class III malocclusion (OR = 19.69, CI: 9.00-43.09) and presenting anterior crossbite greater (MD = 6.08, CI: 2.40-9.77). Individuals without OI had a significantly greater ANB angle (MD = 3.88, CI: 1.15-6.61) and SNA angle (MD = 2.11, CI: 0.24-3.98) in comparison with those with OI. No difference between groups was found for SNB (MD = -0.50, CI: -2.21 to 1.21) and open bite (MD = 0.98, CI: -0.29 to 2.25). Most studies included had moderate methodological quality. Strength of evidence was low or very low. CONCLUSIONS: The occurrence of Angle Class III malocclusion and anterior crossbite was greater among individuals with OI compared to those without OI. These findings can assist stakeholders about the occlusal abnormalities affecting OI individuals.

Oral mucosal lesions in pregnant women: A population-based study.

OBJECTIVE: To evaluate the prevalence of oral mucosal lesions (OML) and oral self-examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. METHODS: Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio-economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self-examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p-Value <0.05 was set to indicate statistical significance. RESULTS: Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non-white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1-1.6), while daily use of dental floss was positively associated with the prevalence of oral self-examination (PR 1.4; 95% CI 1.2; 1.5). CONCLUSIONS: Almost 20% of pregnant women presented OML, which were more prevalent in non-white individuals. Women with better oral care were more likely to perform oral self-examination.

Photobiomodulation-blue and red LED: protection or cellular toxicity? In vitro study with human fibroblasts.

Photobiomodulation is widely used in clinical practice, and there is increasing interest in using this tool to treat numerous dysfunctions in living organisms. Therefore, this study aimed to verify the action of blue and red light-emitting diode light in cells. Human fibroblast cell line (HFF-1) were irradiated by blue (470 nm) or red (658 nm) light at doses of 4 and 18 J/cm2, respectively. Laboratory analyses were carried out to check for viability, proliferation, cell death, and the formation of reactive oxygen and nitric oxide species. The blue light demonstrated cell protection potential by reducing free radical formation and protecting the cell membrane by decreasing double-stranded DNA strands. On the other hand, the red light showed less potential for cell protection due to the risk of associating more significant nitric oxide formation with increased reactive oxygen species formation, in addition to having a greater amount of extracellular DNA. Cell damage prevention is a potential beneficial effect of blue light at 18 J/cm2. Despite the consolidated effects of red light in treating wounds, there was a potential toxic effect of this wavelength in the doses studied. Given the above, new studies relating these parameters with pathological cells or aggressors that simulate damage may offer results that can better support clinical practice.

Oral health issues in children and adolescents with vision impairment: A systematic review and meta-analysis.

BACKGROUND: Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature. AIM: To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI. DESIGN: Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta-analyses. RESULTS: Fifteen cross-sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta-analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63-5.68, I2  = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58-1.02, I2  = 96%), gingivitis (MD = 0.69, 95% CI = 0.02-1.37, I2  = 100%), calculus (MD = 0.04, 95% CI = 0.03-0.06, I2  = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24-1.18, I2  = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68-1.13, I2  = 26%). CONCLUSION: Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.

Malocclusion characteristics amongst individuals with autism spectrum disorder: a systematic review and meta-analysis.

BACKGROUND: To estimate the prevalence of malocclusion in individuals with autism spectrum disorders (ASD) and to assess the relationship between ASD and malocclusion. METHODS: We searched electronic databases including PubMed, Scopus, Web of Science, Cochrane, Embase, SciELO LILACS, Proquest, OpenGrey and Google Scholar. There were no language or publication dates restrictions. Two researchers independently performed selection, data extraction and quality assessment. Quality assessment and risk of bias were evaluated through the Newcastle-Ottawa scale and ROBINS-E tool. Meta-analyses using random effect models were used to estimate pooled measures of prevalence of malocclusion characteristics in individuals with ASD and pooled odds ratio (OR) on the relationship between ASD and malocclusion characteristics. Subgroup meta-analyses were conducted according to children and adolescents, history of orthodontic treatment, and occurrence of other syndromes and medical conditions. RESULTS: Searching identified 5549 papers with 238 were selected for full assessment. Eighteen cross-sectional studies were included according to inclusion criteria. Of them, eleven studies were considered of moderate quality. A judgement of critical risk of bias occurred for thirteen studies. The most prevalent malocclusion characteristics in individuals with ASD were crowding (33%; 95% CI 22 to 44%) and increased maxillary overjet (39%; 95% CI 23 to 54%). Individuals with ASD had higher odds of Angle's Class II (OR 1.92; 95% CI 1.36 to 2.72), Angle's Class III (OR 2.33; 95% CI 1.29 to 4.23), open bite (OR 1.96; 95% CI 1.21 to 3.16), and increased maxillary overjet (OR 1.53; 95% CI 1.06 to 2.21) than individuals without ASD. CONCLUSIONS: Angle's Class II, Angle's Class III, anterior open bite and increased maxillary overjet were more prevalent in individuals with ASD than those without ASD. Further high-quality studies are needed.

Hematological and histopathological evaluation of meat-type quails fed Madagascar cockroach meal.

Aiming at the sustainability of meat production, insects can replace traditional ingredients in the diet of poultry. Studies evaluating performance in birds have emerged to ensure this ability, but few address the health parameters of animals. This study was carried out to evaluate the effects of the inclusion of Madagascar cockroach meal in traditional diets on hematological and histopathological traits of meat-type quails. The inclusion of Madagascar cockroach meal in the diet was evaluated in four levels: 0%, 6%, 12%, and 18%. Observations for hematological and histopathological traits from 6 repetitions on each group were recorded for both sexes at 35 days of age. Hematological parameters were not influenced by Madagascar cockroach inclusion on diet and quail's sex. Red and white blood cells count were within the normal range for poultry. No significant findings were observed during the histopathological evaluation of the pancreas, duodenum, jejunum, and ileum. Liver fatty degeneration was visualized in all treatments in the same intensity. Quail's diets containing up to 18% insect meal during the growth period did not affect the studied health parameters, so the Madagascar cockroach meal could be considered as an alternative to a protein ingredient for poultry production.

Pathways to anterior open bite after changing of pacifier sucking habit in preschool children: A cohort study.

BACKGROUND: Pacifier use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. AIM: To assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. DESIGN: This 2-year cohort study evaluated a random sample of preschool children (2-5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socio-economic and behavioural characteristics. Anterior open bite was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow-up (T2). RESULTS: Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow-up. The presence of AOB at follow-up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. CONCLUSION: These findings suggest that the non-habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood.

Effect of essential oils on Leishmania amazonensis: a systematic review.

This systematic review investigated the evidence for the therapeutic potential of essential oils (EOs) against Leishmania amazonensis. We searched available scientific publications from 2005 to 2019 in the PubMed and Web of Science electronic databases, according to PRISMA statement. The search strategy utilized descriptors and free terms. The EOs effect of 35 species of plants identified in this systematic review study, 45.7% had half of the maximal inhibitory concentration (IC50) 10 < IC50 ⩽ 50 µg mL-1 and 14.3% had a 10 < IC50µg mL-1 for promastigote forms of L. amazonensis. EOs from Cymbopogon citratus species had the lowest IC50 (1.7 µg mL-1). Among the plant species analyzed for activity against intracellular amastigote forms of L. amazonensis, 39.4% had an IC50 10 < IC50 ⩽ 50 µg mL-1, and 33.3% had an IC50 10 < IC50µg mL-1. Aloysia gratissima EO showed the lowest IC50 (0.16 µg mL-1) for intracellular amastigotes. EOs of Chenopodium ambrosioides, Copaifera martii and Carapa guianensis, administered by the oral route, were effective in reducing parasitic load and lesion volume in L. amazonensis-infected BALB/c mice. EOs of Bixa orellana and C. ambrosioides were effective when administered intraperitoneally. Most of the studies analyzed in vitro and in vivo for the risk of bias showed moderate methodological quality. These results indicate a stimulus for the development of new phytotherapy drugs for leishmaniasis treatment.

The effect of enamel fractures on oral health-related quality of life in adolescents.

BACKGROUND/AIM: Enamel fractures are the most common type of traumatic dental injury (TDI) in children and adolescents. Recognizing the impact of these fractures on oral health-related quality of life (OHRQoL) could contribute to the establishment of treatment protocols. The aim of this study was to assess and quantify the impact of enamel fractures on overall OHRQoL and domain scores in adolescents. MATERIALS AND METHODS: A cross-sectional study was conducted with 775 adolescents aged 11 to 14 years in the city of Santo Ângelo in southern Brazil. Sociodemographic variables were collected from parents/caregivers using a structured questionnaire. The adolescents answered the Child Perceptions Questionnaire (CPQ11-14 ). Physical examinations were performed by an examiner who had undergone training and calibration exercises for the investigation of TDI (Andreasen criteria), dental caries (WHO criteria), and malocclusion (Dental Aesthetic Index). Data analysis involved Poisson regression with robust variance. RESULTS: The prevalence of TDI was 11.9% and enamel fractures accounted for 79.3% of all injuries. In the multivariate analysis, adolescents with enamel fractures had 29% higher CPQ11-14 scores (worse OHRQoL) than those without TDI, even after adjustment for sociodemographic and clinical variables (mean ratio = 1.29; 95% CI: 1.09-1.53; P = .003). Enamel fractures exerted a negative impact on the functional limitation, emotional well-being, and social well-being domains. CONCLUSIONS: Enamel fractures exert a negative impact on the OHRQoL of adolescents, suggesting that subjective measures should be incorporated in the evaluation of patients with this traumatic injury.

Phagocytosis of Leptospira by leukocytes from mice with different susceptibility to leptospirosis and possible role of chemokines.

BACKGROUND: Leptospirosis is a widespread zoonosis caused by pathogenic prokaryotic microbes of the genus Leptospira. Although there are several reports in the literature, host-pathogen interaction is still poorly understood. The role of chemokine expression is important on the chemotaxis, activation and regulation of immune cells. Recent studies have shown that their expression profiles play an important role on the severity of leptospirosis outcome. We evaluated the phagocytosis of Leptospira by spleens cells from C3H/HeJ, C3H/HePas and BALB/c mouse strains, respectively susceptible, intermediate and resistant to leptospirosis, and by RAW 264.7 macrophages. Besides, we evaluated the effects of CCL2 treatment on the phagocytosis. The cells were incubated with or without CCL2 chemokine, and infected with virulent L. interrogans sv Copenhageni. Cells and culture supernatants were collected for subsequent analysis. RESULTS: The number of leptospires was higher in BALB/c cells, CCL2 pre-treated or only infected groups, when compared to C3H/HeJ and C3H/HePas cells. Indeed, CCL2 activation did not interfere in the phagocytosis of Leptospira. Expression of chemokines CXCL5 and CCL8 levels were significantly inhibited in infected BALB/c cells when compared to the non-infected control. CONCLUSIONS: Higher ability to phagocytosis and early modulation of some chemokines correlated with the resistance to leptospirosis disease. Exposure to CCL2 did not interfere on phagocytosis of Leptospira in our experimental conditions, but acted in the modulation of chemokines expression during Leptospira infection.

Use of Dental Care Among Pregnant Women in the Brazilian Unified Health System.

PURPOSE: To assess the prevalence of and factors associated with the use of public Unified Health System-based dental services by pregnant women and recent mothers. MATERIALS AND METHODS: In this cross-sectional study, face to face interviews were conducted to collect data on the outcome of interest (prevalence of use of dental care) and independent variables (sociodemographic, pregnancy, and prenatal care data). A total of 302 pregnant women seen at public dental services in the municipality of Canoas, southern Brazil, were interviewed. Statistical analysis was performed using the chi-squared test and hierarchical Poisson regression with robust variance (p < 0.05). RESULTS: The prevalence of use of dental care among pregnant women was 50% (n = 151). Pregnant women who initiated prenatal care in the first trimester showed a 34% higher likelihood of using dental care (prevalence ratio [PR] 1.34; 95% confidence interval [95%CI] 1.27-1.61); this likelihood was 12% higher among multiparous women (PR 1.12; 95%CI 1.03-1.23), and 40% higher among women who received guidance to seek dental care (PR 1.40; 95%CI 1.30-1.51). CONCLUSION: The present findings suggest that starting prenatal care in the first trimester, being multiparous, and receiving guidance to seek dental care significantly contributed to the use of public dental services during pregnancy in the population assessed. These factors should be considered when planning public health policies for this population.

Therapeutic Effects of Medicinal Plants on Cutaneous Wound Healing in Humans: A Systematic Review.

The pharmaceutical industry has made great strides in providing drugs that are able to stimulate the healing process, but only 1-3% of all drugs that are listed in Western pharmacopoeias are intended for use on the skin or cutaneous wounds. Of these, at least one-third are obtained from plants. We sought to review the therapeutic effects of medicinal plants on human skin lesions. For this systematic review, we searched the PubMed, Scopus, and Web of Science databases to identify clinical trials that were published from 1997 to 2017. We reviewed studies that described the use of medicinal plants for the treatment of skin lesions in humans. Ten studies were selected, eight of which were published from 2007 to 2016, with a total of 503 patients. Among the plant species that were used for the treatment of human skin lesions, 12 belonged to 11 families and were included in the analysis. All of the plant species that were studied presented high therapeutic potential for the treatment of cutaneous lesions.

Association of Pre- Peri- and Postnatal Factors with Developmental Defects of Enamel in Schoolchildren.

OBJECTIVE: This study estimated the prevalence, extent, buccal distribution and associated factors involving enamel defects in Brazilian schoolchildren. STUDY DESIGN: A cross-sectional study using a multistage cluster random sample of 1,206 8-12-year-old Brazilian schoolchildren was carried out in Pelotas, Brazil. The prevalence of enamel defects in the permanent dentition was determined using the modified Developmental Defects of Enamel index (DDE). Sociodemographic and health data were collected from their mothers using a semi-structured questionnaire. Data were analyzed using Poisson regression modelling for DDE prevalence and negative binomial regression modelling for the extent of DDE. RESULTS: The prevalence of any enamel defects was 64.0% (95% Confidence Interval: 61.4, 67.0); the main types were diffuse opacities (35.0%), demarcated opacities (29.5%) and hypoplasia (3.7%). In general, older children had a lower prevalence and extent of enamel defects than their counterparts (p<0.001). There were no other significant associations. CONCLUSION: Enamel defects are common, especially among younger children, but the role of pre-, peri- and postnatal exposures remains unclear.

Prevalence and Associated Factors of Tooth Erosion in 8 -12-Year-Old Brazilian Schoolchildren.

OBJECTIVE: This study estimated the prevalence, distribution and associated factors of tooth erosion in Brazilian schoolchildren. STUDY DESIGN: A cross-sectional study was carried out in a representative sample of children aged 8-12-years-old from public and private schools. Six calibrated examiners assessed tooth erosion (O'Sullivan index) and other oral conditions (dental trauma, enamel defects, plaque, dental caries and dental crowding). Socio-demographic and behavioral data were collected using questionnaires. Interviews were conducted in children and in parents. Data were analyzed using Poisson regression model considering the cluster sample (Prevalence Ratio-PR; 95% Confidence Interval-CI). RESULTS: A total of 1,210 children participated and were examined. Tooth erosion was observed in 25.1% of the children. Lesions were mostly observed in enamel and less than a half of the buccal surface was affected. The type of school and age were significant associated with higher prevalence of tooth erosion and dental crowding was associated with less probability of tooth erosion significantly. Acidic food or drinks were not associated with dental erosion. CONCLUSION: The prevalence of tooth erosion in the studied population was high. Erosive lesions were not severe, confined in enamel. Tooth erosion was associated with age, type of school, socioeconomic level and dental crowding.

Clarifying the Impact of Untreated and Treated Dental Caries on Oral Health-Related Quality of Life among Adolescents.

The aim of the present study was to investigate the effect of dental caries experience and the components of the decayed, missing and filled teeth (DMFT) index on oral health-related quality of life (OHRQoL) among adolescents in southern Brazil. A cross-sectional study was conducted with 509 adolescents aged 11-14 years enrolled at public schools in the municipality of Osório (southern Brazil). A calibrated examiner performed the clinical examination for caries (World Health Organization: DMFT index), malocclusion (Dental Aesthetic Index) and traumatic dental injuries [Andreasen et al., 2007]. The participants answered the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14) - Impact Short Form, and their parents/guardians answered a structured questionnaire addressing demographic and socioeconomic characteristics. Data analysis involved Poisson regression with robust variance, with the calculation of rate ratios adjusted for potential confounding variables. High severity of dental caries experience exerted a significant impact on OHRQoL, even after controlling for socioeconomic and clinical factors (rate ratio 1.30; 95% confidence interval, CI 1.12-1.51). All OHRQoL domains were affected by untreated dental caries. The multivariate analysis demonstrated that the CPQ11-14 scores were 33% higher among adolescents with untreated caries (rate ratio 1.33; 95% CI 1.17-1.50) and 24% higher among those with missing teeth (rate ratio 1.24; 95% CI 1.06-1.47). No difference in OHRQoL was found between adolescents with filled teeth and those without dental caries. In conclusion, dental caries experience, untreated dental caries and missing teeth exerted a negative impact on OHRQoL among the adolescents.

Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence.

The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.

Factors Associated with the Occurrence of Distoclusion in the Primary Dentition: A Hierarchical Analysis.

OBJECTIVE: The aim of the present study was to identify factors associated with the occurrence of distoclusion among preschool children in southern Brazil. STUDY DESIGN: A cross-sectional study was carried out with a sample of 1026 children aged two to five years enrolled at public preschools in the city of Canoas, Southern Brazil. Interviews were held with parents/caregivers to acquire demographic, socioeconomic and behavioral data. Six examiners who had undergone a training and calibration exercise performed the oral examinations. Distoclusion was recorded when the cusp of the maxillary canine was in an anterior relation to the distal surface of the mandibular canine during centric occlusion. Statistical analysis involved simple and multivariate Poisson regression with robust variance. RESULTS: The prevalence of distoclusion was 36.5% (375/1026). This condition was more frequent in younger children, those classified as white or brown, those who were breastfed for a shorter period of time, those who used a pacifier and those who were bottle fed. The multivariate analysis demonstrated that the likelihood of exhibiting distoclusion was greater among two-year-olds (P=0.038), three-year-olds (P=0.023), those classified as white (P=0.016), those who used a pacifier (P<0.001) and those who used to use a pacifier (P<0.001). CONCLUSION: Counseling with regard to the duration of pacifier use could contribute toward reducing the prevalence of distoclusion and its consequences in preschool children.

Socioeconomic status in life course is associated with dental appearance dissatisfaction.

The present study aimed to investigate the prevalence of dissatisfaction with dental appearance among 24-year-old Brazilian adults and the associated factors in life course. A subsample (n = 720) of the 1982 Pelotas Birth Cohort in southern Brazil was investigated at the ages of 15 and 24 years using clinical (caries and periodontal) examinations and interviews. The outcome was dissatisfaction with dental appearance at the age of 24 years. Covariate variables included socioeconomic factors, oral health, and dissatisfaction with general appearance collected during different periods of life. Poisson regression models with robust variance were applied. The prevalence of dissatisfaction with dental appearance was 43.5% (95%CI: 39.8-47.1). Individuals with downward income mobility (PR = 1.22, 95%CI: 1.07-1.79) and those always poor (PR = 1.21, 95%CI: 1.00-1.57) presented a higher prevalence of dissatisfaction with their dental appearance even after oral health variables and dissatisfaction with general appearance were controlled for. Moderate/severe malocclusion at 15 years (PR = 1.34, 95%CI: 1.13-1.59), highest experience of untreated dental caries at 24 years (PR = 1.82, 95%CI: 1.46-2.27), and dental pain experience at 24 years (PR = 1.29, 95%CI: 1.22-1.75) were associated with the outcome. Also, the prevalence of dissatisfaction with dental appearance was 20% higher (PR = 1.20, 95%CI: 1.01-1.43) among those dissatisfied with their general appearance. Our findings demonstrated a high prevalence of dissatisfaction with dental appearance among young adults. Lifetime economic disadvantage and dental problems (malocclusion at 15 years, untreated dental caries at 24 years, and dental pain at 24 years) were associated with dissatisfaction with dental appearance among young adults.

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

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