BackgroundThe aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil.MethodsA random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05.ResultsThe mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life.ConclusionThis study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.

OBJECTIVE:Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.METHODS:A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15–19-year-old (n = 5,558), 35–44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect.RESULTS:The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact.CONCLUSIONS:Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.

Carbonic anhydrase VI is a secreted enzyme that catalyzes the hydration of carbon hydroxide in saliva and other body fluids. This enzyme has been implicated in taste and gastrointestinal dysfunctions, tooth erosion, and caries. The purpose of this study was to analyze the allele and genotype distribution of three polymorphisms in the coding sequences of (CA6) gene and check for possible associations with salivary buffer capacity, number of decayed, missing, and filled teeth in deciduous and permanent teeth (dmft/ DMFT, Decayed/Missing/Filled Teeth), plaque index (PI), and the plaque pH variation (DpH) in children aged 7-9 years. Two hundred and forty-five children from both genders, residents in area with fluoridated water (Piracicaba, São Paulo, Brazil) were divided into two groups: caries free and with caries. The clinical examinations were conducted by a single previously calibrated examiner (k ¼ 0.91) in an outdoor setting using a mirror and a probe, according to WHO criteria index (dmft/DMFT). Approximately 2 h after the first daily meal, the buffer capacity (BC) and the plaque pH were analyzed by means of a pH meter and an ion selective electrode. Plaque pH was measured immediately and 5 min after a mouth rinse with a 10% sucrose solution. The data were submitted to w 2 , Student's, and Mann-Whitney tests (a ¼ 0.05). The PI and DpH of the upper and lower teeth were significantly higher in the carious group than control (Po0.05). There was no difference between the groups in relation to BC. There was no association between the alleles and genotypes distributions for polymorphisms in the CA6 gene exons 2 and 3 and caries experience (P40.05). There was a positive association between buffer capacity and the rs2274327 (C/T) polymorphism. The allele T and genotype TT were significantly less frequent in individuals with the highest buffer capacity (P ¼ 0.023 and 0.045, respectively). This finding encourages future studies relating CA6 gene polymorphisms and their association with malfunctions, such as taste and gastrointestinal alterations, or the differential effect of chemical modulators on the protein products originated from the distinct genotypes of the CA6 gene.

BackgroundOral disorders may negatively affect the quality of life (QoL) of adolescents.To investigate how social vulnerability and oral-health status factors affect QoL in 15–19 years olds who participated in the “SB São Paulo 2015” state survey.MethodsThe relationship of several independent variables, namely Paulista Social Vulnerability Index (PSVI) score, gender, skin color, family income, age, untreated caries, tooth loss [determined by the Decayed, Missing, Filled-Teeth (DMF-T) index], toothache, periodontal condition [determined by the Community Periodontal Index (CPI)], and malocclusion (maxillary overjet, cross bite, or open bite) affect daily life, measured by the Oral Impacts on Daily Performance (OIDP) instrument. Logistic regression analyses were carried out based on a hierarchical model.ResultsThe final sample consisted of 5402 adolescents. The prevalence of at least one negative impact of oral health on QoL was 37.3%. After adjustment, demographic factors that were found to influence this impact significantly (p < 0.01) were female gender [odds ratio (OR) 1.78, 95% confidence interval (CI) = 1.59–2.0], non-white skin color (OR 1.66, 95% CI = 1.47–1.88), and a low family income (OR 1.28, 95% CI = 1.28–1.29). Additionally, oral conditions associated with oral health impact on QoL included the presence of at least one untreated tooth decay lesion (OR 1.42, 95% CI = 1.25–1.61), loss of at least one tooth (OR 1.49; 95% CI = 1.25–1.78), toothache (OR 4.87, 95% CI = 4.25–5.59), bleeding on probing (OR 1.45, 95% CI = 1.25–1.68), and severe maxillary overjet (OR 1.68, 95% CI = 1.15–2.45).ConclusionSocial vulnerability (PSVI score) was not associated with the OIDP score, but oral health conditions and socio-demographic variables, including gender, skin color, and income, were found to affect adolescents’ daily activities. Strategies that consider the perceptions of this segment of the population should be implemented to strengthen their autonomy and totality of care.

The aim of this study was to evaluate the performance of the Centers for Dental Specialties (CDS) in the country and associations with sociodemographic indicators of the municipalities, structural variables of services and primary health care organization in the years 2004-2009. The study used secondary data from procedures performed in the CDS to the specialties of periodontics, endodontics, surgery and primary care. Bivariate analysis by χ2 test was used to test the association between the dependent variable (performance of the CDS) with the independents. Then, Poisson regression analysis was performed. With regard to the overall achievement of targets, it was observed that the majority of CDS (69.25%) performance was considered poor/regular. The independent factors associated with poor/regular performance of CDS were: municipalities belonging to the Northeast, South and Southeast regions, with lower Human Development Index (HDI), lower population density, and reduced time to deployment. HDI and population density are important for the performance of the CDS in Brazil. Similarly, the peculiarities related to less populated areas as well as regional location and time of service implementation CDS should be taken into account in the planning of these services.

BackgroundInvestigate the individual and contextual variables related to caries in underprivileged adolescents, and the disparity in distribution of the disease.MethodsCross-sectional analytical study, conducted in the city of Piracicaba, SP, Brazil, in 2012. The probabilistic sample was composed of 1,179 adolescents from 15–19 years of age, randomly selected from 21 state schools and 34 Primary Health Units – Family Health (PHU-FH). The dependent variables studied were number of decayed teeth and caries experience (DMFT). The independent variables were classified into individual (clinical, sociodemographic, psychosocial, self-perception, impact on oral health, access to services, and quality of life) and contextual (social exclusion index, total number of residents in suburb, literacy rate, and the following variables given in percentages: residences in the home ownership category, provision of domestic sewerage, trash collection, families with income of over 1 minimum wage per month, and families without monthly income) variables. The multilevel regression model was estimated by the PROC GLIMMIX (Generalized Linear Models-Mixed) procedure, considering the individual variables as Level 1 and the contextual variables of the suburbs as Level 2. Adjustment of the model was evaluated by -2 Res Log Likelihood with α = 0.05.ResultsAs regards the individual variables, adolescents who declared having a prison inmate in the Family and resided in homes with a larger number of persons, showed a higher number of decayed teeth. There were a larger number of decayed teeth, a higher DMFT value, and worse self-perception as regards the health of their teeth and mouth. Other variables, such as being of the female gender, age and time since last visit to the dentist were related to the DMFT index. As regards the contextual variables, the DMFT was lower in suburbs with greater access to domestic sewage, and the number of decayed teeth was higher in suburbs with the worst social exclusion indices.ConclusionIndividual and contextual variables were associated with the presence of caries and DMFT index in underprivileged adolescents, indicating that they must be taken into consideration in the formulation of policies directed towards oral health promotion and prevention activities in this group.

The goal of this study was to evaluate a 15-month educational program designed to children. The sample consisted of 60 six-year olds, randomly assigned into control and experimental group. The control consisted of tooth brushing training, once a year. The experimental group received intensive individual tooth brushing training every three months and guidance on oral health. Initially, both groups were assessed using plaque, gingival, dmfs and DMF-S indexes every three months. In the control, no statistically significant difference was observed for plaque and gingival indexes. The experimental group showed a statistically significant reduction in mean values for two indexes. The caries indexes showed no statistically significant difference. The proposed educational program developed was efficient in reducing gingival and plaque indexes as well caries incidence.

BackgroundThe objective of this study was to compare the socioeconomic and family characteristics of underprivileged schoolchildren with and without curative dental needs participating in a dental health program.MethodsA random sample of 1411 of 8-to-10 year-old Brazilian schoolchildren was examined and two sample groups were included in the cross-sectional study: 544 presented curative dental needs and the other 867 schoolchildren were without curative dental needs. The schoolchildren were examined for the presence of caries lesions using the DMFT index and their parents were asked to answer questions about socioenvironmental characteristics of their families. Logistic regression models were adjusted estimating the Odds Ratios (OR), their 95% confidence intervals (CI), and significance levels.ResultsAfter adjusting for potential confounders, it was found that families earning more than one Brazilian minimum wage, having fewer than four residents in the house, families living in homes owned by them, and children living with both biological parents were protective factors for the presence of dental caries, and consequently, curative dental needs.ConclusionsSocioeconomic status and family structure influences the curative dental needs of children from underprivileged communities. In this sense, dental health programs should plan and implement strategic efforts to reduce inequities in oral health status and access to oral health services of vulnerable schoolchildren and their families.