Wagner Marcenes

The Relationship among Dental Status, Nutrient Intake, and Nutritional Status in Older People

Dental health status may influence nutrition. The objective of this part of the National Diet and Nutrition Survey was to assess if there is a relationship between dental status in people 65 years and older and intake of certain nutrients and any link between dental status and blood-derived values of key nutrients. Random national samples of independently living subjects and those living in institutions had dental examinations, interviews, four-day food diaries, and blood and urine analyzed. In the sample living independently, intakes of most nutrients were lower in edentate than dentate subjects. Intake of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C was significantly lower in edentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly of non-starch polysaccharide. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and plasma retinol were the only analytes significantly associated with dental status.

Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.

The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people

Este artigo objetivou revisar os achados do levantamento epidemiologico conduzido no Reino Unido, cuja finalidade foi avaliar a relacao entre saude bucal, ingestao de nutrientes e estado nutricional. Uma amostra representativa dos idosos institucionalizados e nao-institucionalizados foi examinada em relacao a saude bucal. Alem disso, amostras de sangue e urina foram coletadas e entrevistou-se os idosos, ocasiao em que se completou um diario alimentar de quatro dias. Na amostra de idosos nao-institucionalizados, o consumo de polissacarideos nao-amido (fibras), proteina, calcio, ferro nao-hemoglobina, niacina e vitamina C foi significantemente menor em edentulos do que em nao-edentulos. Idosos com a presenca de 21 dentes ou mais consumiram mais nutrientes, principalmente fibras. Acido ascorbico e retinol plasmatico estavam significantemente associados com saude bucal. Concluiu-se que manter uma denticao natural funcional, definida como ter 21 dentes ou mais, desempenha um importante papel em ter uma dieta saudavel rica em frutas, verduras e legumes, um estado nutricional satisfatorio e um Indice de Massa Corporal aceitavel.This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older peoples food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI). Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI.

The relationship between oral health status and Body Mass index among older people: a national survey of older people in Great Britain

Aims To assess the relationship between oral health status and Body Mass Index.Material and methods This paper relates to the free-living sample (participants who lived in their own home, rather than an institution) of the National Diet and Nutrition Survey: people aged 65 years and older.Subjects 629 adults.Data collection A probability random national sample of adults who had a dental examination, an interview and an anthropometric examination.Data analysis Fishers exact test and multivariate logistic modeling.Findings Being underweight was relatively uncommon in this population. People without teeth were significantly (P=0.05) more likely to be underweight than those with 11 or more teeth; 12.3% and 2.9%. A highly statistically significant (P=0.001) difference was observed in BMI between dentate people with 1-10 teeth and with more than 10 teeth; 24% and 2.9% were underweight. Dentate people with less than 21 natural teeth were on average more than 3 times more likely to be obese than those with 21-32 teeth (P=0.036). There was no significant difference in both the proportion of overweight and obese adults between those who were edentulous and dentate with 21 or more teeth. A similar pattern was observed when the number of posterior occluding pairs was compared with BMI categories. Results of multiple logistic regression were adjusted for the confounding effects of age, social class, region of origin and partial denture wearing.Conclusions Older people in Britain with more than 20 teeth are more likely to have a normal Body Mass Index.

The relationship between work stress and oral health status.

This study investigated whether oral health status is associated with work stress. 164 male workers aged from 35 to 44 years, equally distributed over four socio-economic groups took part in the study. Three work characteristics related to stress were studied: mental demand, control and variety. Age, socio-economic status, sugar consumption, frequency of dental attendance, toothbrushing frequency, type of toothpaste used, years of residence in Belo Horizonte and marital quality were considered in the data analysis. The results of simple regression analysis (dental caries data) and simple logistic regression analysis (periodontal data) showed a significant relationship between periodontal health status and work-related mental demand (P < 0.001), marital quality (P < 0.01) and socio-economic status (P < 0.05). Dental caries status was significantly associated with age (P < 0.001), socio-economic status (P < 0.05), sugar consumption (P < 0.01) and marital quality (P < 0.0001). Socio-economic status did not remain significantly associated with dental caries after adjusting for all the variables studied.

A Life Course Approach to Assessing Causes of Dental Caries Experience: The Relationship between Biological, Behavioural, Socio-Economic and Psychological Conditions and Caries in Adolescents

The objective of this study was to further elucidate the relationship between relevant biological, behavioural, socio-economic and psychological conditions, experienced in very early life and along the life course, and dental caries experience using the life course approach. A two-phase study was carried out in Brazil. In the first phase, 652 13-year-olds were clinically examined and interviewed. In the second phase, 330 families were randomly selected for interview to collect information on the teenagers’ early years of life. Clinical assessment included dental caries, periodontal and traumatic dental injury status. The data analysis involved multiple logistic regression analysis. Adolescents born in a non-brick house, those with a low birth weight and those who were the second or later child in the family were statistically significantly more likely to have a high DMF-T. In conclusion, the results of this study show that there is an association between socio-economic and biological factors in very early life and levels of caries in adolescents.

Calibração de examinadores para estudos epidemiológicos de cárie dentária

The aim of this study was describe a training and calibration exercise for dental caries and to discuss the use of validity and reliability statistical tests. Eight dentists examined seventeen 12 year-old schoolchildren using World Health Organization (1997) criteria. Data analysis included calculation of the DMF-T index, the percent agreement, and the kappa scores on a tooth-by-tooth basis. Inter-examiner agreement was tested against a gold standard examiner. Scores for measures of agreement calculated on a tooth-by-tooth basis were lower than those calculated for the whole mouth. The training and calibration exercise is a crucial step in cross-sectional epidemiological surveys, and the kappa test calculated on a tooth-by-tooth basis is the appropriate measurement to test agreement between examiners for dental caries.

Diferenças entre autopercepção e critérios normativos na identificação das oclusopatias

OBJECTIVEnTo evaluate the impact of objectively defined orthodontic needs (normative criteria) on the external aspect and mastigations satisfaction, and to compare these needs to self-perceived ones (subjective criteria) among adolescents.nnnMETHODSnA cross-sectional study was carried out among all 315 students aged 14-18 years who attended a highschool in Florianópolis, Brazil. A single dentist collected clinical data about malocclusion (Dental Aesthetic Index) and a questionnaire was applied to assess perceived aesthetic and masticatory satisfaction and need for orthodontic treatment. Data analysis included frequency distribution calculation and multiple logistic regression modeling.nnnRESULTSnThere were high participation of 95% (n=300) and intra-examiner agreement (Kappa 0.6-1.0). The prevalence of one form of malocclusion was 71.3%. Crowding in one or two incisal segments [OR=2.8 (1.6-4.9)] and overjet [OR=2,4 (1.4-4.3)] were risk factors associated with perceived aesthetic dissatisfaction. Adolescents who had anterior mandibular irregularity [OR=3.3 (1.6-6.9)], overjet [OR=1.7 (1.1-3.0)] and anterior diastema [OR=3.1 (1.4-6.9)] revealed the highest self-perceived need for orthodontic treatment.nnnCONCLUSIONSnThere are different degrees of objectively defined occlusal problems acceptable in the population which interfere with their decision to seek treatment and have a direct impact on the need of care. Subjective measures should be incorporated to clinical criteria currently used.

Prevalence and severity of dental caries and treatment needs in small Brazilian counties

O objetivo deste estudo foi conhecer a prevalencia e severidade da carie dental e necessidade de tratamento odontologico na populacao escolar de 6 a 12 anos de idade em dois pequenos municipios brasileiros. Utilizaram-se os criterios de diagnostico da Organizacao Mundial de Saude (1986) para se obter a prevalencia e severidade da carie, e realizou-se censo dos escolares de 6 a 12 anos de idade de Sao Joao do Sul (n = 803) e de Treviso (n = 382), ambas as cidades em Santa Catarina. As prevalencias de carie encontradas foram: 62,1% em Sao Joao do Sul e 63,6% em Treviso. Os indices CPO-Ds (numero de dentes cariados, perdidos e restaurados) foram de 1,91 para Sao Joao do Sul e de 1,84 para Treviso, para a faixa etaria de 6 a 12 anos. Em ambos os municipios a principal necessidade foi de tratamentos simples, principalmente o restaurador. Conclui-se que a prevalencia de carie em Sao Joao do Sul e Treviso e inferior a de outros pequenos municipios onde se realizaram estudos com metodologias semelhantes, com dados publicados na literatura, e que as necessidades de tratamento odontologico sao de pequena magnitude.

Projeto Bambuí: estudo de base populacional dos fatores associados com o uso regular de serviços odontológicos em adultos

A cross-sectional study was conducted in Bambuí, Minas Gerais, to identify factors associated with regular use of dental services. Participants were interviewed with a structured questionnaire and previously validated questions. 999/1,221 (81.8%) randomly selected individuals aged > 18 years participated in the Bambuí dental survey. Of these, 654 out of 656 individuals who had at least one natural tooth and had visited a dentist during their lifetime participated in the study. Results adjusted by multiple logistic regression showed that regular use of dental services was significantly related to having > 8 and 4-7 years of schooling (OR = 9.90; 95% CI = 2.90-33.77 and OR = 3.87; 95% CI = 1.11-13.51, respectively), having a preference for restorative treatment rather than extraction (OR = 4.91; 95% CI = 2.23-10.79), having no present need of dental treatment (OR = 4.87; 95% CI = 3.17-7.49), and belief that visiting the dentist prevents tooth decay and gum disease (OR = 1.73; 95% CI = 1.13-2.65). The results show that regular use of dental services was related to factors distributed in the Andersen and Newman model (1973) explaining use of dentistry services.A cross-sectional study was conducted in Bambui, Minas Gerais, to identify factors associated with regular use of dental services. Participants were interviewed with a structured questionnaire and previously validated questions. 999/1,221 (81.8%) randomly selected individuals aged > 18 years participated in the Bambui dental survey. Of these, 654 out of 656 individuals who had at least one natural tooth and had visited a dentist during their lifetime participated in the study. Results adjusted by multiple logistic regression showed that regular use of dental services was significantly related to having > 8 and 4-7 years of schooling (OR = 9.90; 95% CI = 2.90-33.77 and OR = 3.87; 95% CI = 1.11-13.51, respectively), having a preference for restorative treatment rather than extraction (OR = 4.91; 95% CI = 2.23-10.79), having no present need of dental treatment (OR = 4.87; 95% CI = 3.17-7.49), and belief that visiting the dentist prevents tooth decay and gum disease (OR = 1.73; 95% CI = 1.13-2.65). The results show that regular use of dental services was related to factors distributed in the Andersen and Newman model (1973) explaining use of dentistry services.