Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, depriving people of health, wellbeing, and the ability to achieve their full potential. By virtue of their high prevalence, the most consequential oral diseases affecting global health are: dental caries, periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers, we describe the scope of the global oral disease epidemic, describe its origins in social and commercial determinants, and its costs in terms of human suffering and societal impact. Even though oral diseases are largely preventable, they persist with high prevalence as a reflection of pervasive social and economic inequalities, along with inadequate funding for prevention and treatment, particularly in low and middleincome countries (LMIC). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Poor children, socially marginalised groups, and older people suffer the most from oral diseases and have more limited access to dental care. In many LMIC oral diseases remain largely untreated as the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and include unremitting pain, sepsis, reduced quality of life, lost school days, family disruption, and decreased work productivity. The societal costs of treating oral diseases are a very high economic burden to families and the health care system. Oral diseases are truly a global public health problem with particular concern over rising prevalence in many LMIC linked to wider social, economic and commercial changes. By describing the extent and consequences of oral diseases, their roots in social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgency of addressing oral diseases as a global health and NCD priority. 4 Key messages  Oral health is an integral element of overall health and wellbeing enabling individuals to perform essential daily functions.  Oral diseases include a range of chronic clinical conditions that affect the teeth and mouth including dental caries (tooth decay), periodontal (gum) disease and oral cancers.  Despite being largely preventable, oral diseases are highly prevalent conditions affecting over 3.5 billion people around the world, with dental caries being the most common disease globally with increasing prevalence in many low and middle-income countries (LMIC)  Oral diseases disproportionally affect poorer and marginalised groups in society being very closely linked to socioeconomic status and the broader social determinants of health.  Oral diseases have a significant impact causing pain, sepsis, reduced quality of life, lost school days, family disruption, decreased work productivity, and the costs of dental treatment can be considerable for both individuals, and the wider health care system.  Oral conditions share common risks with other non-communicabl...

Given that breastfeeding is a protective factor for other diseases of infancy, our findings indicate that the common risks approach is the most appropriate for the prevention of posterior cross bite in primary or initial mixed dentition.

O objetivo deste estudo foi estimar a prevalência de perdas dentárias em adultos de 35 a 44 anos de idade. Além disso, foram testadas associações entre as perdas dentárias e condições demográficas, sócio-econômicas e com utilização de serviços odontológicos. Foram analisados os dados de 13.431 participantes do estudo epidemiológico nacional de saúde bucal realizado em 2002-2003. O número de perdas dentárias (£ 12 e > 12) foi o desfecho investigado. As variáveis independentes incluíram localização geográfica, gênero, cor da pele, idade, renda per capita, escolaridade, tempo decorrido desde a última consulta odontológica e tipo de serviço utilizado. Foram estimadas as razões de prevalência bruta e ajustada através de regressão de Poisson. Edentulismo atingiu 9% da amostra; a mediana de dentes perdidos foi igual a 11. Perdas dentárias foram fortemente associadas com indivíduos residentes em zona rural, com as mulheres, com os mais pobres, com os de menor escolaridade e com aqueles de idade mais avançada. Usuários do serviço público e aqueles que consultaram dentista há mais tempo também apresentaram maior prevalência do agravo mesmo após o ajuste por variáveis sócio-econômicas e demográficas.

ABSTRACT

The aim of this study was to investigate the impact of treatment for Enamel-Dentin Fracture (EDF) on the daily activities of adolescents. This was a case-control study (1:4). The case group was composed of 40 adolescents from 11 to 17 years of age, presenting definitive restoration treatment for EDF for over 6 months. The control group was made up of 160 adolescents with no history of dental trauma and belonging to the circle of friends of the participants of the case group, matched by gender, age, and socioeconomic level. The outcome variable 'impact' was assessed through the Oral Impact on Daily Performances (OIDP). The independent variables were collected for being of interest to the study (dental trauma) or for acting as potential confounding factors (malocclusion, decay, and mother's education). Descriptive, univariate, simple and multiple logistic regression analyses were performed. Among the cases, the impact prevalence was 40.0%, whereas among the controls it was 16.9%. The more affected daily activities were showing the teeth (18.0%), eating (6.5%), speaking (2.0%), and cleaning the mouth (0.5%). The odds ratio of adolescents treated for EDF of presenting an impact on daily activities was 3.3 times (confidence interval 95%: 1.4-7.7) greater than among adolescents without dental trauma, controlling for mother's education, decay and the presence of malocclusion. Adolescents whose teeth have been esthetically treated for EDFs run a greater risk of presenting OIDP when compared to adolescents that have never suffered dental injuries.

Prolonged breastfeeding increases the risk of having dental caries. Preventive interventions for dental caries should be established as early as possible because breastfeeding is beneficial for children's health. Mechanisms underlying this process should be investigated more deeply.

ABSTRACT:Objective: To investigate polypharmacy among the elderly living in the urban area of Florianopolis, in the state of Santa Catarina, Brazil, estimating the prevalence and associated factors. Methods: This is a crosssectional population-based study with a sample of 1,705 individuals aged 60 years old or older, between 2009 and 2010. The dependent variable was polypharmacy (defined as "use of five or more medications"). The following exploratory variables were utilized: sociodemographic data, use of health services and self-rated health status. Prevalence ratios (PR) were estimated by multivariate analysis using the Poisson regression. Results: The mean for the medications used by the elderly population was 3.8 (ranging from 0 to 28). The prevalence of polypharmacy was 32%, with 95% confidence interval (95% CI) 29.8 -34.3. The characteristics presenting a positive association with polypharmacy were: female gender (PR = 1.27; 95%CI 1.03 -1.57), increasing age (PR = 1.38; 95% CI 1.08 -1.77), negative self-rated health status (PR = 1.99; 95% CI 1.59 -2.48) and medical appointments in the 3 months prior to the interview (PR = 1.89; 95% CI 1.53 -2.32). The groups of medication most utilized by the elderly individuals in polypharmacy were those indicated for the cardiovascular system, digestive tract and metabolism, as well as the nervous system. Conclusion: The pattern of medication use among this elderly population is within the national average. The prevalence of polypharmacy and the characteristics associated with it were similar to those found in other regions of Brazil.

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