Fernando Neves Hugo

Stress, cortisol, and periodontitis in a population aged 50 years and over.

Periodontitis and its relationship with psycho-neuro-immunological variables, such as psychological stress and cortisol, have been little explored. The objective of this study was to evaluate the extent and severity of chronic periodontitis and its association with the levels of salivary cortisol and the scores obtained with a stress questionnaire in a population aged 50 years and over. We studied 235 individuals in a cross-sectional study. They answered the Lipp’s Inventory of Stress Symptoms for Adults, were instructed to collect three saliva samples for cortisol analysis, and were examined for evaluation for periodontitis. Based on logistic regression, cortisol levels were positively associated with the following outcomes: means of clinical attachment level (CAL) > = 4 mm [OR = 5.1, 95%CI (1.2, 20.7)]; 30% of sites with CAL > = 5 mm [OR = 6.9, 95%CI (1.7, 27.1)]; and 26% of sites with probing depth > = 4 mm [OR = 10.7, 95%CI (1.9, 54.1)] after adjustment for confounding variables. The results suggest that cortisol levels were positively associated with the extent and severity of periodontitis.

Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study

OBJECTIVEnThe objective of this study was to evaluate the anxiety and salivary cortisol levels in patients with burning mouth syndrome.nnnSTUDY DESIGNnA case-control ed into 2 groups: BMS, with diagnosis of the syndrome, and control, without any complaint of burning mouth. Anamnesis, oral examination, sialometry, the application anxiety inventory, and 3 saliva samples for cortisol analysis were done in every patient.nnnRESULTSnStatistical difference for subjective xerostomia was found on the BMS group (P = .01), but salivary flow rate was normal in both groups. BMS group presented higher anxiety (P = .001) and salivary cortisol levels (P = .003) when compared with the control group.nnnCONCLUSIONnHigher anxiety and salivary cortisol levels were positively associated with the presence of BMS.

Association of chronic stress, depression symptoms and cortisol with low saliva flow in a sample of south-Brazilians aged 50 years and older

BACKGROUNDnFew studies have evaluated the relationship between depression symptoms, chronic stress or physiological measures of stress such as cortisol levels and saliva secretion.nnnOBJECTIVEnTo evaluate the association of low saliva flow with chronic stress, depression symptoms and cortisol in a population aged 50 years and older.nnnMETHODSnParticipants (n = 227) were recruited from community clubhouses and among dementia caregivers. Stress was assessed using the Lipps Stress Symptoms Inventory and salivary cortisol measurements. In addition, taking care of a relative with dementia was included as a proxy variable for chronic stress. Depression was assessed using the Beck Depression Inventory. Saliva flow rate was assessed by measuring unstimulated and chewing-stimulated saliva flow. Further saliva samples were collected (morning, noon, night) for cortisol analysis by means of radioimmunoassay.nnnRESULTSnGender, being a dementia caregiver, self-reported diabetes and prescriptive medication intake were independently associated with a low stimulated saliva flow. Prescriptive medication intake was also associated with a low unstimulated saliva flow.nnnCONCLUSIONnCaregiving, a proxy of chronic stress, was associated with low stimulated saliva flow, indicating that stress may have a potential role in salivary gland hypofunction.

Relação entre níveis de fluoreto na água de abastecimento público e fluorose dental

OBJETIVO: Avaliar a prevalencia da fluorose dentaria em escolares sujeitos a diferentes concentracoes de fluoreto na agua de abastecimento publico das suas cidades. METODOS: A amostra foi composta de 386 escolares de sete anos de idade, moradores de dois municipios do estado de Sao Paulo que realizaram heterocontrole da fluoretacao da agua de 1998 a 2002, um deles apresentando concentracao homogenea de fluoreto e o outro oscilante. Fluorose dental foi determinada examinando os incisivos superiores permanentes (secos) pelo indice de Dean, o grau de fluorose classificado como questionavel foi considerado como fluorose. Variaveis sociodemograficas e questoes sobre saude bucal foram avaliadas com questionario estruturado enviado aos pais/responsaveis. Associacoes foram verificadas por meio de regressao logistica multipla (p<0,05). RESULTADOS: Ambos os municipios apresentaram grau leve de fluorose. A prevalencia de fluorose no municipio com teores oscilantes de fluor na agua foi de 31,4% e no municipio com teores homogeneos foi de 79,9%. A prevalencia de fluorose foi associada com o municipio com teores de fluor homogeneos na agua (OR=8,33, IC 95%: 5,15;13,45) e nao possuir automovel (OR=2,10, IC 95%: 1,27;3,49) CONCLUSOES: Embora a prevalencia de fluorose tenha sido maior nas criancas do municipio que possuia melhor controle da concentracao otima de fluoreto na agua, esta nao afetou a estetica dental dos comprometidos.

Psychological distress in Brazilian caregivers of relatives with dementia

The authors evaluated stress, anxiety, depression, and feelings of hopelessness in caregivers of relatives with dementia. One hundred and twenty-nine caregivers and 145 non-caregivers who lived in metropolitan Porto Alegre, Brazil completed Lipps Inventory of Stress Symptoms for Adults, (ISSL), and Becks Anxiety (BAI), Depression (BDI), and Hopelessness (BHS) scales. Caregivers showed higher levels of anxiety, depression, hopelessness, resistance/pre-exhaustion stress than controls. This study indicates that constant caregiving may significantly increase the risk of physical and mental health problems for caregivers in Brazil.

Depressive Symptoms and Untreated Dental Caries in Older Independently Living South Brazilians

Background: The importance of psychological reactions in modifying oral health behaviors and salivary immunity has been shown previously, but few studies assessed whether psychological reactions are associated with caries in populations. Thus, the aim of this study was to examine the association of depressive symptoms with untreated caries using a hierarchal approach. Methods: In this cross-sectional study, a random sample of 390 South Brazilians aged 60 years or more was evaluated using a structured questionnaire assessing sociodemographic, behavior, health and depressive symptoms (Geriatric Depression Scale) data. Oral examinations were carried out in order to assess: (1) dental status, using the DMFT index; (2) dental plaque, using the Visible Plaque Index, and (3) unstimulated saliva flow, using the spit method. A hierarchical model based on the framework of caries was carried out to assess whether depressive symptoms were associated with prevalent untreated dental caries (or D >0). Results: Depressive symptoms, number of teeth and plaque accumulation were significant predictors of caries with respect to the D >0 outcome. Conclusion: Our findings suggest that depressive symptoms may act as determinants of caries, adding to the body of knowledge supporting the importance of psychological reactions in oral health/disease processes.

Polarization of dental caries among individuals aged 15 to 18 years

Objective: To evaluate the role of socioeconomic variables and self-perceived oral health in the polarization of caries among adolescents in Santa Bárbara DOeste, Brazil. Material and Methods: Cross-sectional study. Sampling was randomized and sample size was defined according to WHO criteria. Two hundred and seventy seven adolescents (15 to 18 year-old) were examined by five trained examiners that assessed DMFT index according to WHO criteria. Self-perceived oral health, access to dental services and socio-demographic variables were self-reported. Students t tests, chi-square tests, and multivariate logistic regression (with significant caries index (SiC) as the outcome), were performed. Results: Mean DMFT was 5.48 (±4.22) and the proportion of caries free subjects was 15.5%. Mean DMFT (9.71±2.85) and mean D (1.67±2.18) of SiC positive subjects were significantly higher than mean DMFT (2.88±2.17) and mean D (0.45±0.87) of SiC negative subjects (p<0.0001). Mean D of white (0.76±1.51) was significantly smaller than mean D of non-white subjects (1.32±2.01). The only variable independently associated with the SiC positive outcome was report of toothache within six months prior to the study [OR=1.83 (95%CI 1.08 to 3.12)], p<0.001. Conclusion: SiC was associated with report of toothache but not with sociodemographic variables in the studied population.

SP1-102 Oral status and its association with underweight and overweight/obesity in Brazilian independent-living older people

Introduction Evidence suggests that tooth loss may lead to changes in food choice due to eating difficulties. The relationship between use of dental prosthesis and changes in body mass index among elderly is still unclear. This study aimed at assessing the association between oral rehabilitation, self-perceived chewing ability and nutritional status in Brazilian elderly. Methods This study is part of a major project—the FIBRA study—carried out in Campinas, Brazil. The sample of this cross-sectional study was composed by 900 independent-living older people. Complete data were available for 545 persons. Dental prosthesis was assessed in accordance with the WHO criteria. Height and weight were used to generate body mass index (BMI) data. The data regarding dental prosthesis use and self-perceived limitation in the type or amount of food intake due to problems with prostheses or their lack generated a new variable, oral status. Participants were categorised into eutrophic, underweight or overweight/obesity. Multinomial logistic regression was used to model the relationship between oral status with underweight and overweight/obesity. Results The mean age was 72.7u2005years and the prevalence of overweight/obesity was 41.4%. Oral status wasnt associated with underweight. Participants who reported using prostheses in both arches with self-perceived limitation in the type or amount of food intake and subjects that rated their oral health as good were less likely to be overweight/obese. Conclusions Our findings suggest that dental prosthesis use with self-perceived limitation in food intake is associated with overweight/obesity but not with underweight.