Aim To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents. Design A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants’ school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle‐Ottawa Scale. Meta‐analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance. Results Eighteen studies were included. Of them, fifteen studies were used for the meta‐analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR = 1.44 95%CI: 1.24‐1.64) and poor school attendance (OR = 1.57 95%CI: 1.08‐2.05) than caries‐free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR = 1.51 95%CI: 1.10‐1.92) and poor school attendance (OR = 1.35 95%CI: 1.14‐1.57). Conclusions Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.

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Short title: periodontitis, quality of life and hypertension Conflict of InterestThe authors declare that there are no conflicts of interest in this study.A one-sentence summary describing the key finding(s) Periodontal disease predicted poor OHRQoL and mediated the link between smoking, socioeconomic status and OHRQoL in people with systemic arterial hypertension.

In the light of the scarcity of epidemiological studies on the oral health of the general population within the context of the Amazon region, this study aimed to estimate the prevalence of dental caries and gingivitis, as well as to evaluate the need for restorative treatment, among school students aged 15 to 19 years in the city of Manaus, AM, Brazil. A cross-sectional study was carried out on a sample of 889 students from within city limits who were enrolled in 26 public and private schools. Dental examinations were performed to obtain the DMFT index (decayed, missing and filled teeth) as well as to determine the treatments needed. The gingival index (Lõe & Silness) was used to classify gingivitis. The intra-examiner diagnostic concordance was 94% and the Kappa statistic was 0.91. The DMFT index found was 4.65 (+/- 0.12), without significant difference between the sexes or skin color groups. The prevalence of dental caries was 87.4%. Restoration of a dental surface was the greatest need (59.3%). Slight gingival inflammation was present in 78.5% and gingival bleeding following probing occurred in 53.3%. Although the DMFT index was lower than that observed for the northern region of Brazil, restorative dental services are lacking for this population. Additional studies are suggested to better understand the differences found.

Objectives To examine the association of contextual and individual determinants with non‐utilization of dental services among Brazilian adults. Methods Data were from adults aged 35‐44 years (N = 7,265) from the 2010 Brazilian Oral Health Survey (SB Brasil Project). Non‐utilization of dental services was assessed whether the individual has never had a dental visit over the whole life time. Independent variables were selected according to Andersen's behavioral model. Contextual variables included Human Development Index‐longevity (HDI‐Longevity) (predisposing demographic), HDI‐Education and Gini index (predisposing social), integration of oral health teams into Primary Care (enabling health policy), and HDI‐Income (enabling financing). Individual data were age and sex (predisposing demographic), ethnicity and schooling (predisposing social), family monthly income (predisposing enabling), perceived dental treatment (perceived need), and decayed teeth (evaluated need). The relationship of contextual and individual variables with non‐utilization of dental services was assessed through multilevel logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). Results The prevalence of non‐utilization of dental services was 4.7 percent. Adults living in cities with high HDI‐Income were less likely to never have a dental visit. The odds of non‐utilization of dental services were lower for adults living in cities with high HDI‐Longevity. Sex, skin color, dental treatment needs, poor socioeconomic characteristics, perceived dental treatment needs, and decayed teeth were also associated with non‐utilization of dental services. Conclusions The results suggest that contextual enabling and predisposing factors, individual sociodemographic, and needs‐related characteristics influence non‐utilization of dental services by Brazilian adults.

ResumoO objetivo deste artigo é analisar o processo de gestão da atenção básica, aí incluído o Programa de Saúde da Família (PSF), em cinco municípios da Amazônia Ocidental. A descentralização, entendida como meio de aprimoramento da gestão local, também foi investigada. Trata-se de um estudo qualitativo, que explorou o plano político-institucional dos sistemas de saúde dos municípios, através das dimensões projeto de governo, capacidade de

Background/Aims: This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents. Methods: A follow-up prevalence study was conducted involving 406 twelve-yearold adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ 11-14 ]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model. Results: The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents' self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents' self-reported oral health measures. Conclusions: Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.

Purpose: To evaluate the oral health conditions of pregnant women enrolled in the Prenatal and Birth Humanization Program of the Theomário Pinto Costa primary healthcare unit in the south-central zone of Manaus, Amazonas Methods: The population comprised 50 pregnant women, independent of pregnancy trimester. To assess the prevalence of dental caries, we used the DMFT Index, and for gingivitis, we used the Plaque Index and Gingival Bleeding Index. A questionnaire was used to investigate socioeconomic conditions, access to dental services and self-perception regarding oral health. Results: One hundred percent of the population presented with caries; the mean DMFT score was 10.0, and the M component (missing teeth) was predominant (4.28). Among the pregnant women examined, 62% presented with moderate gingival inflammation, and 64% presented with at least some plaque. With regard to educational level, 10% of the population had completed an elementary education, 20% had not completed an elementary education, 34% had completed a high school education, and 6% had not completed a university-level education. Conclusion: Considering the results, it can be seen that the oral health status of the population was unfavorable, although a majority considered their oral health to be normal or good.