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Celeste RK, Boing AF, Peres KG, Peres MA. Life course social mobility, race and tooth loss in adulthood: The role of dental health services. Oral Dis 2024. [PMID: 38438701 DOI: 10.1111/odi.14918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVES To evaluate the extent to which dental care factors in adulthood modify and, at the same time, mediate the association between race/ethnicity and social mobility from childhood to adulthood with two oral health outcomes in adults. METHODS In 2012, 1222 individuals 20-59 years old participated in the second wave of the Epi-Floripa Study in Florianopolis, Brazil. Exposures included social mobility based on adulthood and childhood events, dental care in previous years, type of dental care coverage, reason for dental visits and race. The number of missing and decayed teeth were dichotomised as MT >0 and DT >0. RESULTS The prevalence of missing and decayed teeth was 61.9% and 23.0%, respectively. Age-sex adjusted inequalities in decayed and missing teeth among Black and White individuals were 41.2 percentage points (pp) (95% CI: 3.9-78.7) and 53.1 pp (19.5:86.7), respectively. Inequalities between those persistently higher and lower in socioeconomic position were 42.6 pp (14.6-70.7) and 90.0 pp (62.1-100). The Relative Excess of Risk due to Interaction (RERI) was not statistically significant (p < 0.05). Oaxaca-Blinder decomposition analyses showed that dental care variables accounted for a small proportion of inequalities. CONCLUSIONS This result implies that dental care is unlikely to significantly reduce or increase oral health inequalities in this particular population.
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Affiliation(s)
- Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Antonio Fernando Boing
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Karen Glazer Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco Aurelio Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Karam SA, Costa FDS, Correa MB, Bertoldi AD, Barros FC, Demarco FF. Socioeconomic inequalities related to maternal perception of children's oral health at age 4: Results of a birth cohort. Community Dent Oral Epidemiol 2023; 51:872-878. [PMID: 35906753 DOI: 10.1111/cdoe.12779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To estimate socioeconomic inequalities in the maternal perception of children's oral health from a birth cohort study in Brazil. METHODS The data from this study were collected through perinatal interviews and at the 48-month follow-up from the 2015 Pelotas Birth Cohort Study. The main outcome was the maternal perception of children's oral health, dichotomized into positive (good/very good) and negative (fair/bad/very bad). The secondary outcome was untreated dental caries (absence and presence, according to the ICDAS index - International Caries Detection and Assessment System). For the statistical analysis, the absolute inequality index (Slope Index of Inequality - SII) and the relative concentration index (Concentration Index - CIX) were used. Analyses were stratified by maternal educational level, family income and wealth index. RESULTS The prevalence of outcomes was 19.4% (95% CI 18.2; 20.7) for the negative maternal perception of children's oral health and 15.6% (95% CI 14.4; 16.8) for untreated dental caries. Socioeconomics inequalities were observed in negative maternal perception of children's oral health in both absolute and relative terms. A SII of -16.6 (95% CI -20.8; -12.5) was observed for family income, with higher prevalence in poor families. A higher prevalence of the negative maternal perception of children's oral health was observed in mothers without any educational level or a few years of study (CIX -21.1 [95% CI -24.5; -17.7]). CONCLUSIONS This study demonstrates socioeconomics disparities in the maternal perception of children's oral health and in the prevalence of untreated caries in children. A higher concentration of negative maternal perception of children's oral health was identified among the most socioeconomically vulnerable individuals. The findings reinforce the presence of socioeconomic inequalities in subjective measures about children's oral health.
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Affiliation(s)
- Sarah Arangurem Karam
- Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Graduate Program in Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | | | - Andréa D Bertoldi
- Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Graduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Graduate Program in Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
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Anjos SDD, Ferro RM, Laskawski BN, Haas AN, Prates RC, Steffens JP. Associations between physical activity domains and oral health: an analysis of a Brazilian population-based study. Braz Oral Res 2023; 37:e071. [PMID: 37436294 DOI: 10.1590/1807-3107bor-2023.vol37.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/17/2023] [Indexed: 07/13/2023] Open
Abstract
Physical activity comprises four domains (leisure, transportation, domestic, and work activities) that may be differently associated with oral health. The aim of this study was to assess the association between each physical activity domain and oral health conditions in Brazilian adults. A total of 38,539 participants in the 2019 Brazilian Health Survey aged 30 years or older were analyzed. The outcomes were self-perceived oral health (dichotomous) and self-reported number of missing teeth (counts). The presence, frequency, and time of activity in each domain and their combination were analyzed as main exposures. Odds ratios (OR) and mean ratios (MR) were estimated by fitting multivariable models. Higher leisure time physical activity was the only domain associated with better self-perception of oral health (OR = 1.32; 95%CI 1.26-1.38) and lower tooth loss (MR=0.88; 95%CI 0.86-0.90). Higher levels of work, transportation, and household activities were significantly associated with worse self-perception of oral health, while higher levels of work- and transportation-related physical activities were also associated with greater tooth loss. When the total recommended weekly physical activity time was analyzed, no significant associations were found. Sensitivity analysis suggested that this pattern persists in potential periodontitis-related cases, such as when selecting older age or excluding individuals with no tooth loss. In conclusion, leisure physical activity was the only domain with the potential of reflecting the benefits of physical activity on oral health. The inclusion of other domains can confound this association.
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Affiliation(s)
| | - Rafael Milani Ferro
- Universidade Federal do Paraná-UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Bernardo Novak Laskawski
- Universidade Federal do Paraná-UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul-UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre-RS-Brazil
| | - Rodolfo Coelho Prates
- Universidade da Região de Joinville-Univille, Postgraduate Program in Health and Environment, Joinville, SC, Brazil
| | - Joao Paulo Steffens
- Universidade Federal do Paraná-UFPR, Postgraduate Program in Dentistry, Curitiba, PR, Brazil
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Chisini L, Costa F, Horta B, Tovo-Rodrigues L, Demarco F, Correa M. Sweet Taste Receptor Gene and Caries Trajectory in the Life Course. J Dent Res 2023; 102:422-430. [PMID: 36609159 PMCID: PMC10041601 DOI: 10.1177/00220345221138569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This study aims to investigate whether the trajectory of dental caries in the life course is associated with rs307355 (TAS1R3) and rs35874116 (TAS1R2) and if there is an epistatic association between rs307355 (TAS1R3) and rs35874116 (TAS1R2). A representative sample of all 5,914 births from the 1982 Pelotas birth cohort was prospectively investigated, and the decayed, missing, and filled teeth (DMF-T) components were assessed at ages 15 (n = 888), 24 (n = 720), and 31 (n = 539) y. Group-based trajectory modeling was used to identify groups with similar trajectories of DMF-T components in the life course. Genetic material was collected, and rs307355 (TAS1R3) and rs35874116 (TAS1R2) were genotyped. Ethnicity was evaluated using ADMIXTURE. Generalized multifactor dimensionality reduction software was used to investigate epistatic interactions. Considering rs307355 (TAS1R3) in the additive effect, the genotype TT was associated with the high decayed trajectory group (odds ratio [OR] = 4.52; 95% confidence interval [CI], 1.15-17.74) and the high missing trajectory group (OR = 3.35; 95% CI, 1.09-10.26). In the dominant effect, the genotype CT/TT was associated with the high decayed trajectory group (OR = 1.64; 95% CI, 1.14-2.35). Allele T was associated with an increased odds of 64% (OR = 1.64; 95% CI, 1.20-2.25) for the decayed component and 41% (OR = 1.41; 95% CI, 1.04-1.92) for the missing component. No associations were observed between rs307355 (TAS1R3) and the filled component. rs35874116 (TAS1R2) was not associated with DMF-T components. Positive epistatic interactions were observed involving rs307355 (TAS1R3) and rs35874116 (TAS1R2) with the decayed component (OR = 1.72; 95% CI, 1.04-2.84). Thus, rs307355 (TAS1R3) genotypes and alleles seem positively associated with the trajectory of decayed and missing components in the life course. Epistatic interaction between rs307355 and rs35874116 may increase the decayed caries trajectory.
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Affiliation(s)
- L.A. Chisini
- Graduate Program in Dentistry, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
| | - F.D.S. Costa
- International Center for Equity in Health, Postgraduate Program of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - B.L. Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - L. Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - F.F. Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - M.B. Correa
- Graduate Program in Dentistry, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil
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Lara-Muñoz MDC, Torres-Escobar ID, Espinosa De Santillana IA, García-Solano M, Muñoz-Quintana G, Martínez-Hernández AM, Medina-Solís CE, Maupomé G. Association of tobacco and alcohol consumption with self-reported tooth loss among teenagers and young adults: a large-scale, cross-sectional study. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2114390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | | | - Mauro García-Solano
- School of Stomatology, Benemérita Universidad Autónoma de Puebla, Puebla City, Mexico
| | | | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Mexico
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata,” School of Dentistry, Autonomous University of the State of Mexico, Toluca, Mexico
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, Indiana, USA
- Indiana University Network Science Institute, Bloomington, Indiana, USA
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Demarco FF, Cademartori MG, Hartwig AD, Lund RG, Azevedo MS, Horta BL, Corrêa MB, Huysmans MCDNJM. Non-carious cervical lesions (NCCLs) and associated factors: A multilevel analysis in a cohort study in southern Brazil. J Clin Periodontol 2021; 49:48-58. [PMID: 34545588 DOI: 10.1111/jcpe.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/06/2021] [Indexed: 12/01/2022]
Abstract
AIM To investigate the prevalence of non-carious cervical lesions (NCCLs) and their association with individual and tooth-related factors in adults from the 1982 Pelotas Birth Cohort. MATERIALS AND METHODS Participants were interviewed and clinically examined at the age of 31. NCCL was defined as loss of dental tissue without bacterial involvement in the cervical region. Independent variables were the socioeconomic, demographic, behavioural, and clinical characteristics. Associations were tested using a multilevel Poisson regression model. RESULTS Five-hundred and thirty-nine participants were clinically examined, with a 26% prevalence of NCCLs, which were more prevalent in the maxilla (56.5%) and in premolars (72.9%). In the multilevel analysis, women presented lower prevalence than men [prevalence ratio (PR) 0.59 (0.48-0.73)]; those who reported smoking at both 22 and 30 years of age had more NCCLs than those who never smoked [PR 1.65 (1.31-2.07)]; and high-frequency brushers presented higher prevalence than low-frequency brushers [PR 1.26 (1.03-1.55)]. Gingival recession increased 10 times the prevalence of NCCLs [PR 10.03 (8.15-12.35)], while the presence of periodontal pockets (≥4 mm) reduced the prevalence of NCCLs [PR 0.43 (0.28-0.66)]. CONCLUSIONS NCCLs were more prevalent in males, smokers, and those with higher frequency of toothbrushing. While the presence of periodontal pockets was associated with a lower prevalence of NCCLs, gingival recession was a strong clinical indicator for the presence of NCCLs.
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Affiliation(s)
- Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Rafael Guerra Lund
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Bernardo Lessa Horta
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Celeste RK, Darin-Mattsson A, Lennartsson C, Listl S, Peres MA, Fritzell J. Social Mobility and Tooth Loss: A Systematic Review and Meta-analysis. J Dent Res 2021; 101:143-150. [PMID: 34448425 DOI: 10.1177/00220345211029277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study systematically reviews the evidence of the association between life course social mobility and tooth loss among middle-aged and older people. PubMed, Scopus, Embase, and Web of Science were systematically searched in addition to gray literature and contact with the authors. Data on tooth loss were collated for a 4-category social mobility variable (persistently high, upward or downward mobility, and persistently low) for studies with data on socioeconomic status (SES) before age 12 y and after age 30 y. Several study characteristics were extracted to investigate heterogeneity in a random effect meta-analysis. A total of 1,384 studies were identified and assessed for eligibility by reading titles and abstracts; 21 original articles were included, of which 18 provided sufficient data for a meta-analysis with 40 analytical data sets from 26 countries. In comparison with individuals with persistently high social mobility, the pooled odds ratios (ORs) for the other categories were as follows: upwardly mobile, OR = 1.73 (95% CI, 1.53 to 1.95); downwardly mobile, OR = 2.52 (95% CI, 2.19 to 2.90); and persistently low, OR = 3.96 (95% CI, 3.13 to 5.03). A high degree of heterogeneity was found(I2 > 78%), and subgroup analysis was performed with 17 study-level characteristics; however, none could explain heterogeneity consistently in these 3 social mobility categories. SES in childhood and adulthood is associated with tooth loss, but the high degree of heterogeneity prevented us from forming a robust conclusion on whether upwardly or downwardly mobile SES may be more detrimental. The large variability in effect size among the studies suggests that contextual factors may play an important role in explaining the difference in the effects of low SES in different life stages (PROSPERO CRD42018092427).
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Affiliation(s)
- R K Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A Darin-Mattsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - C Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - S Listl
- Department of Dentistry-Quality and Safety of Oral Health Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - M A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - J Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
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Souza ML, Nascimento GG, Chica DAG, Peres KG, Peres MA. A counterfactual approach on the effect of metabolic syndrome on tooth loss: A population-based study. J Periodontol 2021; 93:591-602. [PMID: 34389993 DOI: 10.1002/jper.21-0175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/08/2021] [Accepted: 08/09/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to investigate the effect of metabolic syndrome (MetS) on tooth loss in adults from a population-based sample. METHODS Cross-sectional analysis based on data from a cohort study (2009-2014) with adults from Southern Brazil. MetS (exposure), lack of functional dentition and number of lost teeth (outcomes) were assessed using self-reported, lab and clinical data. Possible confounders included sex, age, family income, educational level, smoking status and sugar consumption. The effect of MetS on the outcomes was estimated using conventional logistic or negative binomial regression models. Marginal structural modeling (MSM) with stabilized weights (a counterfactual analytical method) was also used to enhance group comparability and estimate causal effects. RESULTS 1,283 participants had available information for the outcomes. Individuals with MetS were more likely to experience a lack of functional dentition than those without MetS [odds ratio (OR) from logistic regression 1.7, 95% CI 1.0-2.9; OR from MSM 3.2, 95% CI 2.3-4.6]. Moreover, the number of teeth lost was 20% higher in participants with MetS compared to those without MetS in conventional analysis (mean ratio [MR] 1.2, 95% CI 1.1- 1.3). The MR increased to 1.7 (95% CI 1.5-2.0) when using MSM. CONCLUSION Our findings provide evidence on the effect of MetS on tooth loss. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Marina Leite Souza
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | | | - Karen Glazer Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore.,Oral Health ACP, Health Services and Systems Programme, Duke-NUS Medical School, Singapore
| | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore.,Oral Health ACP, Health Services and Systems Programme, Duke-NUS Medical School, Singapore
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