Marília Jesus Batista

Risk indicators for tooth loss in adult workers

Tooth loss continues to be a prevalent condition in Brazilian adults and elderly individuals. The aim of this cross-sectional study, conducted among workers in a wholesale grocery chain in the State of São Paulo, was to identify risk indicators for tooth loss in adults. The presence of caries and periodontal status were examined in 387 adults aged 20-64 years, according to World Health Organization criteria. Two outcomes were analyzed: loss of one or more teeth, and loss of four or more teeth. Independent variables analyzed were demographic and socioeconomic factors, clinical conditions, use of dental services, and self-perceived oral health. Poisson regression models were used for multivariate statistical analysis. Participants were missing a mean of 5.38 teeth, and 76.9% (n = 297) had lost at least one tooth; the most frequently lost teeth were permanent molars. Older age and the presence of visible dental biofilm were associated significantly with the two tooth loss outcomes (p < 0.05). Individuals who had visited the dentist 3 or more years previously showed a lower prevalence of tooth loss (prevalence ratio = 0.79; 95% confidence interval, 0.68-0.91). Those with lower household incomes were significantly more likely to have lost four or more teeth (prevalence ratio = 1.35; 95% confidence interval, 1.07-1.70). Study results indicated that age and dental biofilm were risk indicators for tooth loss, independently of socioeconomic factors. These risk indicators should be considered when planning oral health programs for adults.

Impact of tooth loss related to number and position on oral health quality of life among adults

BackgroundThe objective of this study was to evaluate the impact of tooth loss on oral health-related quality of life (OHRQoL) in adults with emphasis on the number of teeth lost and their relative position in the mouth.MethodsThe study population was a cross-sectional household probability sample of 248, representing 149,635 20–64 year-old residents in Piracicaba-SP, Brazil. OHRQoL was measured using the OHIP-14. Socioeconomic, demographic, health literacy, dental services use data and clinical variables were collected. Oral examinations were performed using WHO criteria for caries diagnosis, using the DMFT index; that is, the sum of decayed, missing and filled teeth (DMFT). An ordinal scale for tooth loss, based on position and number of missing teeth, was the main explanatory variable. The total OHIP score was the outcome for negative binomial regression and OHIP prevalence was the outcome for logistic regression at 5% level. A hierarchical modeling approach was adopted according to conceptual model.ResultsOHIP score was 10.21 (SE 1.16) with 48.1% (n=115) reporting one or more impacts fairly/very often (OHIP prevalence). Significant prevalence rate ratios (PRRs) for OHIP severity were observed for those who had lost up to 12 teeth, including one or more anterior teeth (PRR=1.63, 95%CI 1.06–2.51), those who had lost 13–31 teeth (PRR=2.33, 95%CI 1.49–3.63), and the edentulous (PRR=2.66, 95%CI 1.55–4.57) compared with fully dentate adults. Other significant indicators included those who only sought dental care because of dental pain (PRR=1.67, 95%CI 1.11–2.51) or dental needs (PRR=1.84, 95%CI 1.24–2.71) and having untreated caries (PRR=1.57 95%CI 1.09–2.26). Tooth loss was not significantly associated with OHIP prevalence; instead using dental services due to dental pain (PR=2.43, 95%CI 1.01–5.82), having untreated caries (PR=3.96, 95%CI 1.85–8.51) and low income (PR=2.80, 95%CI 1.26–6.42) were significant risk indicators for reporting OHIP prevalence.ConclusionOur analyses showed OHRQoL gradients consistent with the number and position of teeth missing due to oral disease. These findings suggest that the quantity of teeth lost does not necessarily reflect the impact of tooth mortality on OHRQoL and that future studies should take this into consideration.

Workers oral health: a cross-sectional study

Adults and elderly usually present an expressive tooth loss in household epidemiologic studies. Few studies were found to report oral health conditions in economically active adults. AIM: To describe the oral health status of adult workers in an extended range age (20-64 years old) of a supermarket chain. METHODS: This cross-sectional survey was conducted in a company in the state of Sao Paulo. A total of 386 workers aged 20 to 64 years old were examined following the guidelines recommended by the World Health Organization (1997) with respect to caries, treatment needs for caries, and need and use of dental prostheses. Age was stratified into groups for analysis. A descriptive analysis was performed and tooth loss rate was calculated. Kruskal Walis and Tukeys tests were used for the evaluation of differences in DMTF and chi-square test was used for treatment needs. RESULTS:The mean DMFT was 14.6 (± 8.3), and differences were found among the 3 groups, mainly due to missing teeth. DMFT was 10.8 (±6.95) in the 20-34year-old group, 19.6 (±6.13) in the 35-44-year-old group and 22.1(±7.32) in the 45-64-yearold group. Significant differences in tooth loss rate were observed between the age groups (tooth loss rate ranged from 18% to 81%). Among the adults, 53.5% had treatment needs for caries. CONCLUSIONS: The younger adult workers in this study showed better oral conditions and an increase in tooth loss was observed in the older individuals. Considering common risk approach, dentistry should work together with health promotion for the studied population of workers in order to meet the oral treatment needs and prevent new tooth losses.

Extrinsic Tooth Enamel Color Changes and Their Relationship with the Quality of Water Consumed

The quality of the consumed drinking water may affect oral health. For example, the presence of iron in drinking water can cause aesthetic problems related to changes in dental enamel color. This study assessed the prevalence of extrinsic enamel color changes and their relationship with the quality of the water in the town of Caapiranga/AM-Brazil. Three hundred and forty six residents of the urban area were examined, and they also answered a questionnaire on eating habits and self-perceived oral health. As the initial results indicated an insufficient number of observations for the application of variance analysis (one-way ANOVA), the Student t test was chosen to compare levels of iron content in the water coming from two sources. The change in tooth color had a prevalence of 5.78% (20 people). The majority of the population (n = 261, 75.43%) consumed well water. Those who presented extrinsic stains were uncomfortable with the appearance of their teeth (15.09%). We conclude that while there is excess of iron in the water in this region of Brazil, no association between extrinsic stains on the enamel and the level of iron in the water was found. There was a low prevalence of extrinsic stains in Caaparinga, being found only in children and adolescents. In the present study, an association between the presence of stains and the consumption of açai was determined, and those who presented them felt uncomfortable about their aesthetics.

Classificação das perdas dentárias: fatores associados a uma nova medida em uma população de adultos

This study evaluated tooth loss and factors associated with a new classification, which considers not only the number of teeth lost, but also the number and position that they occupied in the mouth. In Piracicaba, State of Sao Paulo, Brazil, 248 adults (20–64 year-olds) were examined using a household probability sample. The oral examinations followed the WHO criteria for caries and periodontal disease. Socioeconomic, demographic and dental service use data were collected. The tooth loss outcome, based on tooth position and number of missing teeth, was analyzed by hierarchical multinomial logistic regression using a conceptual model. The mean number of missing teeth was 8.52 (DP = 9.24). For those who had lost up to 12 posterior teeth, age (PR = 1.1) and low social class (PR = 2.6) were significant; for those who lost up to 12 including anterior teeth, age (PR = 1.1) and clinical attachment loss>4mm (PR = 2.9); and for tooth loss in excess of 13 teeth, age (PR = 1.3), low social class (PR = 3.8), and visiting a dentist due to emergency (PR = 9.4) were significant. Age was associated with tooth loss. The classification made it possible to differentiate variables in accordance with position or the number of teeth lost.

Perception of toothache in adults from state capitals and interior cities within the Brazilian geographic regions

BackgroundStudies emphasizing toothache in adulthood are scarce in Brazil. A greater understanding of both the prevalence and the self-perception of pain among individuals in this age group (35 to 44 years old) is important, especially considering that this is an economically active population. To describe reports of oral pain and oral pain-related aspects in from Brazilian state capitals and interior cities.MethodsThe sample comprised 9779 adults residing in the state capitals and interior cities from each Brazilian region in the SB Brazil 2010 report, regarding reports of oral pain and their intensity in the last 6 months. The descriptive analysis comparing pain reports between and within the regions and regression analysis of pain related to socioeconomic aspects per region were performed considering α=0.05 difference.ResultsThe highest prevalence of pain was found in the Southeast region (p<0.01), and there was also difference between the state capitals and interior cities in the South (p<0.01), where the prevalence was higher in the capitals, and in the Southeast, where the higher prevalence was in the interior cities (p=0.03). The Northern region had lower pain intensity than the Southeast and Midwest. Comparing pain intensity, only the Northeast region showed statistical difference between state capitals and the interior cities for pain intensity, where the interior cities had higher pain intensity than the three state capitals. Regarding dental office visitations, the Southeast capitals have the highest prevalence (100%) compared to the North and South. The toothache impact on daily activities was as follows: eating difficulty (29.8% to 72.7%), uncomfortable teeth brushing (over 50%), and sleep disturbance (above 13%). Between the Brazilian regions the socioeconomic aspects differ in relation to the pain; the exception being the association between pain, dental care and income, which occurred in the 5 regions. Users of public dental care services were more likely to present pain, comparing to private dental services, OR ranging from 1.72 in the Northeast to 2.85 in the Southeast.ConclusionThe prevalence of pain was higher among Brazilian adults, impacting some of the daily activities. The data also showed many differences in the prevalence and intensity of pain among both the Brazilian regions and the cities within the same region.

FATORES ASSOCIADOS À PREVALÊNCIA E INTENSIDADE DE ODONTALGIA EM CRIANÇAS DE MUNICÍPIOS DA REGIÃO DE CAMPINAS, SÃO PAULO

ABSTRACT Objective: The aim of this study was to evaluate the prevalence and intensity of dental pain in children according to size of municipality, associated factors and absenteeism. Methods: The sample consisted of children aged 12 years old from public and private schools drawn from eight cities in the region of Campinas (SP). A questionnaire was applied to obtain dental pain, demographic, socioeconomic data, and a clinical examination was carried out to evaluate the experience of having a cavity. The outcome for the logistic regression analysis was having pain and the outcome for the negative log-binomial regression was the intensity of pain. The significance level was 5%. Results: The sample consisted of 1,233 children, and 16.7% reported pain in the last six months. Dental pain was the cause of 46.4% of school absenteeism during this period. The prevalence of pain was lower among households with high income (p=0.023) and higher among nonwhites (p=0.027). Pain intensity was lower in medium-sized cities (p=0.02) and small cities (p=0.004), and higher in children whose parents had a lower educational level (p=0.003), children who sought out a dentist for the pain (p=0.04) and who had untreated cavities (p=0.04). Conclusions: The prevalence and intensity of dental pain in children aged under 12 are related to socioeconomic aspects of the family, such as low-income and parents with a low level of education, which impact daily activities as seen through school absenteeism. Pain intensity was lower in medium and small cities. Oral health promotion strategies in this age group should be encouraged to avoid dental pain.

Spatial distribuition of tooth loss in a population of adults

ABSTRACT IntroductionAlthough there has been an improvement in the oral health status of the population, tooth loss still aggravates the oral health of adults and is a matter of great relevance to dentistry. AimTo determine the spatial distribution of tooth loss in adults and correlate this with the Social Exclusion Index and proximity to public dental services. Material and MethodThis ecological study was based on epidemiological data of adults from Piracicaba municipality and from the Piracicaba Research and Planning Institute (IPPLAP). Data on dental evaluations were extracted from the Piracicaba epidemiological survey, which was a cross-sectional study with probabilistic sampling of 248 adults aged 20-64 years, representative of adults living in Piracicaba, Brazil. Oral examinations of the DMFT index were in accordance with the World Health Organization codes and criteria and were performed by a single examiner calibrated for this purpose. Data on social exclusion and the municipal health units that have dental services were extracted from IPPLAP. Georeferencing was performed of census tracts selected by draw, and the city health facilities that have dental services. For Spearman correlation analysis (p 1000m the census tract. ResultThere was a correlation between tooth loss and higher IEX, and r=

Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study

Objective To verify the incidence of tooth loss in extended age group of adults in 4 years. Materials and Methods The prospective cohort study assessed adults (20–64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20–44 years old) and older (45–64 years old) adults. Mann–Whitney U test (p < 0.05) was used to compare the means of incidence of tooth loss between age groups. Results After four years, 57.7% (n = 143) of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (p = 0.008), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (p = 0.844). Conclusion There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated.

Condição de saúde bucal e motivos para extração dentária entre uma população de adultos (20-64 anos).

The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.