Aim: The objective of this systematic review was to investigate whether breastfeeding decreases the risk of malocclusions.Methods: Six databases were systematically searched to the end of October 2014.Observational and interventional studies were included. Breastfeeding was evaluated in three categories: (i) ever versus never; (ii) exclusive versus absence of exclusive; and (iii) longer periods versus shorter periods. All types of malocclusion were considered as the outcome. Pooled adjusted odds ratio and its 95% confidence interval (95%CI) were obtained from meta-analyses. Heterogeneity was assessed with both the Q-test and the Isquare. Funnel plots and Egger's test were employed to assess publication bias.Results: Forty-eight studies were included in the systematic review, and 41 were included in the overall meta-analysis (n = 27 023 participants). Subjects who were ever breastfed were less likely to develop malocclusions than those never breastfed (OR 0.34; 95% CI 0.24; 0.48), those who were exclusively breastfed presented lower risk to present malocclusion than those with absence of exclusive breastfeeding (OR 0.54; 95% CI 0.38; 0.77), and subjects longer breastfed were less likely to have malocclusions than those shorter breastfed (OR 0.40; 95% CI 0.29; 0.54). Conclusion:Breastfeeding decreases the risk of malocclusions.

The aim of this study was to estimate self-reported prevalence of edentulism, severe tooth loss and lack of functional dentition in elders, and to identify potential associated factors. A population based cross-sectional study was carried out with 1,451 elders (≥60 years), in Pelotas, RS, Brazil. Crude and adjusted prevalence ratios were estimated using Poisson regressions. The prevalence of edentulism, severe tooth loss and lack of functional dentition was 39.3%, 60.9% and 82.7%, respectively. The factors positively associated with tooth loss in the three-degree severity were sex (females), older individuals, low familial income, low level of schooling and having the last dental visit longer than 24 months ago. The high prevalence of tooth loss in its different degrees of severity and the association with preventable factors highlight the need of programs focused on elders, emphasizing the prevention of tooth loss and need for prosthetic rehabilitation.

OBJECTIVETo analyze the effectiveness of motivational interviewing (MI) at improving oral health behaviors (oral hygiene habits, sugar consumption, dental services utilization or use of fluoride) and dental clinical outcomes (dental plaque, dental caries and periodontal status).METHODSA systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google Scholar bibliographic databases was conducted looking for intervention studies that investigated MI as the main approach to improving the oral health outcomes investigated.RESULTSOf the 78 articles found, ten met the inclusion criteria, all based on randomized controlled trials. Most studies (n = 8) assessed multiple outcomes. Five interventions assessed the impact of MI on oral health behaviors and nine on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets). Better quality of evidence was provided by studies that investigated dental caries, which also had the largest population samples. The evidence of the effect of MI on improving oral health outcomes is conflicting. Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect. In two interventions, the actual difference between groups was not reported or able to be recalculated.CONCLUSIONSWe found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counseling interventions.

OBJECTIVES: The distinct effect of exclusive and predominant breastfeeding on primary dentition malocclusions is still unclear. We hypothesized that exclusive breastfeeding presents a higher protective effect against malocclusions than predominant breastfeeding and that the use of a pacifier modifies the association between breastfeeding and primary dentition malocclusions.METHODS: An oral health study nested in a birth cohort study was conducted at age 5 years (N = 1303). The type of breastfeeding was recorded at birth and at 3, 12, and 24 months of age. Open bite (OB), crossbite, overjet (OJ), and moderate/severe malocclusion (MSM) were assessed. Poisson regression analyses were conducted by controlling for sociodemographic and anthropometric characteristics, sucking habits along the life course, dental caries, and dental treatment.RESULTS: Predominant breastfeeding was associated with a lower prevalence of OB, OJ, and MSM, but pacifier use modified these associations. The same findings were noted between exclusive breastfeeding and OJ and between exclusive breastfeeding and crossbite. A lower prevalence of OB was found among children exposed to exclusive breastfeeding from 3 to 5.9 months (33%) and up to 6 months (44%) of age. Those who were exclusively breastfed from 3 to 5.9 months and up to 6 months of age exhibited 41% and 72% lower prevalence of MSM, respectively, than those who were never breastfed.CONCLUSIONS: A common risk approach, promoting exclusive breastfeeding up to 6 months of age to prevent childhood diseases and disorders, should be an effective population strategy to prevent malocclusion. WHAT'S KNOWN ON THIS SUBJECT:Breastfeeding provides a protective effect against some malocclusions, and there is a strong inverse correlation between the duration of breastfeeding and the duration of pacifier use. WHAT THIS STUDY ADDS:The protective effects of predominant and exclusive breastfeeding against malocclusion are distinct: exclusive breastfeeding reduces the risk of malocclusions regardless of pacifier use, whereas the effect of predominant breastfeeding depends on the duration of the pacifier use. Dr K. Peres coordinated the oral health data collection, conceptualized the study, and drafted the initial manuscript; Dr Cascaes conducted all statistical analyses and reviewed and revised the manuscript; Dr M. Peres trained field workers and supervised data collection and critically reviewed the manuscript; Dr Demarco, together with Dr K. Peres, coordinated the oral health data collection, trained field workers and supervised data collection, and critically reviewed the manuscript; Dr Santos coordinated all stages of the birth cohort study and critically reviewed the manuscript; Dr Matijasevich critically reviewed the manuscript; and Dr Barros, together with Dr Santos, coordinated all stages of the birth cohort study and critically reviewed the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work. It is well known that b...

Brazilian adolescents reported a high negative impact of oral health on their quality of life. Inequalities in distribution should be taken into account when planning preventive, monitoring and treatment strategies for oral health problems in groups with the highest impact on their quality of life.

Abstract

Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.

Tabagismo no Brasil: desigualdades regionais e prevalência segundo características ocupacionaisTobacco smoking in Brazil: regional inequalities and prevalence according to occupational characteristicsResumo O estudo descreveu a prevalência do tabagismo diário segundo sexo, idade, renda domiciliar e ocupação dos moradores de 15 anos ou mais, no Brasil e regiões, baseado nos dados da Pesquisa Nacional por Amostra Domiciliar 2008 (PNAD/IBGE). A análise considerou o desenho da amostra e incluiu 252.768 indivíduos. A prevalência de fumo diário no Brasil foi 15,1%, variando de 12,8% na região Norte a 17,4% na região Sul, sendo 62% maior nos homens que mulheres. A prevalência de fumo foi inversamente proporcional à renda domiciliar, sendo 18,6% entre os 20% mais pobres e 11,5% entre os 20% mais ricos. As mesmas tendências para sexo, idade e renda foram observadas nas diferentes regiões do país. O consumo diário de cigarros foi 3% maior entre os trabalhadores comparados com não trabalhadores. Trabalhadores não manuais apresentaram prevalências de fumo abaixo de 10%, enquanto trabalhadores manuais relataram frequências acima de 20%. A associação entre tabagismo e ocupação permaneceu após ajuste para sexo, idade e renda. As desigualdades encontradas devem ser consideradas no planejamento e direcionamento de ações efetivas para redução do tabagismo. Os grupos ocupacionais mais expostos deveriam ter prioridade nas intervenções. Palavras-chave Tabagismo, Prevalência, Desigualdades em saúde, Ocupação Abstract This study describes the prevalence of daily tobacco smoking according to sex, age, per capita household income and occupation of residents aged 15 years or more in Brazil and regions using data from the 2008 National Household Sample Survey (PNAD/IBGE). The analysis was adjusted for the sampling design and included 252.768 individuals. Daily smoking prevalence in Brazil was 15.1%, varying from 12.8% in the North region to 17.4% in the South region, and it was 62% higher in men compared to women. Smoking prevalence was inversely proportional to household income, 18.6% among the poorest 20% and 11.5% among the wealthiest 20%. The same trends for gender, age and income were observed in the different regions of Brazil. Daily smoking was 3% higher among workers compared to non-workers. White collar workers presented a smoking prevalence below 10%, while blue collar workers had rates above 20%. The association between smoking and occupation persisted after the adjustment for sex, age and household income. The inequalities found should be considered when developing effective strategies for smoking reduction. The more exposed occupational groups should have priority in the interventions.