Objectives To systematically review observational studies assessing the association between socioeconomic status (SES) and oral health‐related quality of life (OHRQoL) in children, adolescents and adults. Methods Electronic searches were performed in the PubMed, Embase, Web of Science, LILACS and Scopus databases for articles published up to September 2020. Two independent reviewers performed the search and critical appraisal of the studies. The inclusion criteria were observational studies that evaluated the effect of SES on the OHRQoL in all age groups using validated methods. Quality assessment was conducted using the Newcastle‐Ottawa Scale. Data were extracted for meta‐analysis followed by a meta‐regression analysis. A random‐effects model was used to estimate the pooled calculate prevalence ratio (PR) and respective 95% confidence intervals (CI) for each study. Results The search strategy retrieved 6114 publications. Some 139 articles met the eligibility criteria and were included in the systematic review. Of those, 75 were included in the general meta‐analysis they represented a total sample of 109 269 individuals. People of lower SES had worse OHRQoL (PR 1.30; 95% CI 1.26‐1.35). In the meta‐analyses of different subgroups, an association was found between low SES and worse OHRQoL in countries of all economic classifications, in all age groups and irrespective of the socioeconomic indicator used. A socioeconomic gradient in OHRQoL was also observed, in which the lower the individuals' socioeconomic position, the poorer their OHRQoL. Conclusions Individuals of low SES had poorer OHRQoL, regardless of the country's economic classification, SES indicator and age group. Public policies aiming to reduce social inequalities are necessary for better OHRQoL throughout life.

A significant association was observed between periodontitis and breast cancer.

Aim To investigate the agreement between the 2018 EFP/AAP periodontitis case classification and the 2012 CDC/AAP criteria. Materials and Methods This cross‐sectional study assessed a population‐based sample from a rural area in southern Brazil. A complete periodontal examination was performed at six sites/tooth. The periodontitis case definition was estimated and compared according to the 2018 EFP/AAP classification and the 2012 CDC/AAP criteria (reference). Diagnostic tests included sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and area under ROC curve (AUC). Results Five hundred and eighty‐eight subjects with ≥6 teeth each were included. Based on the 2018 EFP/AAP classification, 71.1% of the subjects were classified as stage III/IV showing 100% agreement with 2012 CDC/AAP criteria for the severe category. For the moderate and severe classification, the 2018 EFP/AAP SN was 99.8% and 100%, SP 13.6% and 43.6%, PPV 83.4% and 47.4%, and NPV 93.7% and 100%, respectively. The AUC was 0.9059 (95% CI = 0.879–0.933) and the optimal cut‐off based on the curve was stage III. Conclusions The 2018 EFP/AAP periodontitis case classification showed high agreement with the 2012 CDC/AAP criteria in a rural sample with high periodontitis occurrence.

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Adjunctive therapy may improve the efficacy of SRP in reducing PD in diabetic subjects.

Objectives To explore the pathways through which the socioeconomic inequalities may influence gingival bleeding in adolescents, assessing the direct and indirect effects of material and psychosocial variables. Methods This cohort study followed a multistage, random sample of 1134 12‐year‐old adolescents from 20 public schools of Santa Maria, a city in southern Brazil. The percentage of teeth with gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding) at baseline and at 2‐year follow‐up. Biological (dental plaque, caries, and dental crowding), material (socioeconomic position [SEP] operationalized as family income and parents’ education), psychosocial (parents’ religiosity, self‐rated health, and happiness) and behavioural (use of dental service by adolescents) factors were collected at baseline. Structural equation modelling (SEM) was guided by the adapted Commission on the Social Determinants of Health model linking material, psychosocial, biological, and behaviour variables to health. The SEM was employed to estimate standardized direct, indirect, and total effects of material and psychosocial factors on gingival bleeding at follow‐up. Results A total of 770 14‐year‐old adolescents were reassessed (follow‐up rate of 68%). The lower SEP at baseline had a higher direct effect (standard coefficient [SC] = −0.17, P < 0.01) than a mediated effect on percentage of teeth with gingival bleeding at 2‐year follow‐up. The lower indirect effect (SC = −0.06, P < 0.01) from SEP to gingival bleeding at follow‐up ran through biological factors—dental plaque (baseline and follow‐up) and gingival bleeding at baseline. The lower religiosity of the parents as a psychosocial aspect had only a small direct effect (SC = −0.10, P = 0.03) on gingival bleeding at follow‐up. Conclusions Material factors such as SEP contributed most to explanations on inequalities in adolescents’ periodontal health because of their higher direct effect and additional shared (indirect) effect (through biological factors) on gingival bleeding. Religious practice as a psychosocial factor only explained part of percentage of teeth with gingival bleeding at follow‐up.

Aim This randomized clinical trial evaluated the effect of the frequency of self‐performed mechanical plaque control (SPC) on gingival health in subjects with a history of periodontitis. Materials and Methods Forty‐two subjects participating in a routine periodontal maintenance program were randomized to perform SPC at 12‐, 24‐ or 48‐hr intervals. Plaque index (PlI) and gingival index (GI) were evaluated at baseline, and days 15, 30 and 90 of study. Probing depths, clinical attachment levels and bleeding on probing were assessed at baseline, days 30 and 90. Mixed linear models were used for the analysis and comparison of experimental groups. Results Mean GI at baseline remained unchanged throughout study (90 days) only in the 12‐hr group (0.7 ± 0.1 versus 0.8 ± 0.1; p < .05). At the end of study, mean GI was significantly increased in the 48‐hr group over that in the 12‐ and 24‐hr groups. When GI = 2 scores were considered, only the 48‐hr group failed to maintain gingival health throughout the study (18.8%). Conclusion SPC performed at a 12‐ or 24‐hr frequency appears sufficient to controlling gingival inflammation whereas this clinical status was not maintained using a 48‐hr frequency in subjects with a history of periodontitis subject to a routine periodontal maintenance program (ClinicalTrials.gov: 50208115.9.0000.5346).

ABSTRACT: Introduction: Oral health-related quality of life (OHRQoL) is affected by different clinical conditions. The aim of this study was to evaluate the impact of gingivitis on OHRQoL in adolescents. Methodology: This cohort study consisted of a random sample of 1,134 schoolchildren enrolled during 2012, in Santa Maria, Brazil. After two years, 743 adolescents were follow-up (response rate: 65.5%). Clinical, socioeconomic and OHRQoL data were collected. OHRQoL was assessed by the short Brazilian version of the Child Perceptions Questionnaire 11-14 (CPQ11-14), and gingival bleeding through Community Periodontal Index. Gingivitis was considered with the presence of 15% or more bleeding sites. Poisson regression models were used to evaluate the association between gingivitis and overall and domain-specific CPQ11-14 scores. Prevalence of gingivitis at baseline was considered the main predictor for the OHRQoL at follow-up. Results: Gingivitis at baseline was associated with higher overall CPQ 11-14 score (RR = 1.07; 95%CI 1.01 - 1.14), and emotional well-being (RR = 1.17; 95%CI 1.04 - 1.31), independently of other oral conditions and socioeconomic variables. Conclusions: The findings indicate that gingivitis negatively impacts the adolescents’ OHRQoL. Moreover, gender, maternal schooling and household income were also associated with OHRQoL.