Social inequality in tooth extraction in a Brazilian insured working population

Reasons for Tooth Extractions and Related Risk Factors in Adult Patients: A Cohort Study

Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

Epidemiological profile of caries and need for dental extraction in a Kaingang adult Indigenous population

ABSTRACT: Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

The evolution of treatment over 80 years at the outpatient department of the Viennese school of dentistry

OBJECTIVES

The delivery of oral health services, diagnostics and treatment underwent significant changes in the 20th century thanks to achievements by pioneers in dentistry. The Golden Age of Dentistry in Vienna, Austria, was marked by renowned dentists like Bernhard Gottlieb in the 1930s. Data records from the outpatient department of this period have been found and served as a source from which to draw comparisons between those days and the present. To date, data supporting an overall perception of advances in dentistry during the last century in tooth preservation and patients' demands have been lacking. The aim of this study was to evaluate changes in treatments and patient characteristics between the interwar period and the present and to assess how treatments for dental emergencies developed.

METHODS

Patients' records were extracted from books handwritten from January to May 1933 and compared with electronically generated data from the same period in 2013. In total, patient data from 10 111 individuals (3878 in 1933 and 6233 in 2013) were analysed. Comparisons were undertaken for gender, age, place of residence, diagnosis and therapy.

RESULTS

Various statistically significant demographic and treatment differences were found between 1933 and 2013. Patients' mean ages in 2013 and 1933 were 42 and 31 years, respectively. In 2013, there were significantly more women than in 1933 (3378 vs 1936), with 54% women in 2013 and 50% women in 1933. In 2013, there were significantly fewer tooth extractions as dental emergency treatment than in 1933 (2% vs 34%).

CONCLUSIONS

Treatment in the outpatient department is much more conservative in the 21^st century. The characteristics of patients visiting the outpatient department have changed over the generations, and treatment needs should be evaluated accordingly.

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social.

The association between individual and contextual factors and functional dentition status among adults in Rio Grande do Sul State, Brazil: a multilevel study

Functional dentition plays an important role in maintaining masticatory function, which is closely related to the number of teeth present in the mouth. The objective of this study was to investigate the association between individual and contextual factors and functional dentition (defined as the presence of at least 20 teeth) in Brazilian adults. This was a multilevel cross-sectional population-based study with a two-level structure and a total sample of 10,407 adults from 84 municipalities (counties). The exposures at both levels were demographic, socioeconomic, and oral health treatment-related. Multivariate analyses showed that higher prevalence rates of functional dentition were associated (p < 0.01) with municipalities having higher mean income and fluoridated water supply and with individuals living in urban areas, younger adults, males, those with more schooling and higher income, those that reported having visited the dentist in the previous 12 months, and those with access to information on prevention. The findings suggest that research on tooth loss and functional dentition should take different socioeconomic factors into account.

Inequalities in oral health practices and social space: an exploratory qualitative study

This study analyzed the oral health practices and access to dental care of individuals according to their position in social space. The rationale was based on the hypothesis that different positions in social space may imply different habitus, in the sense conferred by Bourdieu. Such dispositions would influence practical behavior, choices and preferences in general and in this context, dental care. Twenty-two semi-structured interviews were carried out with individuals, as part of a multiple case study carried out in two municipalities in the state of Bahia, Brazil. Differences were found between the two study groups both with respect to actions of personal care and in seeking and using dental services. This, in addition to poor material and living conditions, and difficult access to restorative dental work in the public sector, may explain part of the pattern of tooth loss found in the adult Brazilian population. The adoption of effective communicative and educational actions by health professionals should be stimulated. However, the structural dimension of the social determinants requires transformations in the structures that generate the perceptions and practices of agents. The study discusses the implications of these data to public dental policies that are focused on reducing these inequalities.