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Nascimento GG, Li H, Malhotra R, Leite FRM, Peres KG, Chan A, Peres MA. Chewing Disability Is Associated With Cognitive Impairment Among Older Adults: A Population-Based Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae074. [PMID: 38441299 DOI: 10.1093/gerona/glae074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Chewing disability is associated with impaired quality of life, potentially leading to depression, and cognitive impairment. Although the chewing-ability-cognition relationship has been explored, examining whether depression mediates this relationship remains unclear. We investigated the association between chewing disability and cognitive impairment development and a potential mediation via depression among older persons. METHODS Older persons without cognitive impairment at baseline (n = 973) from the 3 waves of the Panel on Health and Ageing of Singaporean Elderly were investigated. The outcome was incident cognitive impairment by the end of the study, while the exposure was chewing disability over the study period. Time-varying depression was the mediator. Time-fixed confounders included sex, ethnicity, education, marital status, living arrangement, and housing type, and time-varying confounders included age, smoking, cardiovascular diseases, diabetes, number of teeth, and denture wearing. We used marginal structural modeling to evaluate the effect of chewing disability on cognitive impairment development. RESULTS After 6 years, 11% developed cognitive impairment, and chewing disability was reported by 33%. Chewing disability was associated with higher odds of developing cognitive impairment (OR 1.43, 95% CI: 1.09, 1.87), of which 85.3% was explained by the controlled direct effect of chewing disability, whereas the remaining 14.7% could be eliminated if there was no depression. CONCLUSIONS Our findings indicate an association between chewing disability and cognitive impairment, while the role of depression could not be fully elucidated. Oral health should be incorporated as part of older persons' care for its potential to assess the risk for other systemic conditions.
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Affiliation(s)
- Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Fábio R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Programme, Duke-NUS Medical School, Singapore
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Agostini BA, Sarkis-Onofre R, Ortiz FR, Correa MB, Peres MA, Peres KG, Santos IS, Matijasevich A, Barros FCLF, Demarco FF. Structural Relationships between Asthma and Dental Caries in Children: A Birth Cohort Study in Southern Brazil. Caries Res 2024; 58:63-71. [PMID: 38194934 DOI: 10.1159/000535953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION There is an inconclusive causal association between asthma symptoms and dental caries in the primary dentition. This study aimed to investigate, using SEM (structural equation modeling), a possible causal relation between asthma and dental caries in the primary dentition. METHODS Using data from the 2004 Pelotas Birth Cohort Study, a sub-sample of 1,303 individuals was selected. Dental caries was clinically evaluated at 5 years old based on decayed, missing, and filled tooth (dmft) index criteria. Asthma-related symptoms (wheezing and shortness of breath) at 1- and 4-year-olds composed a latent variable and were the main exposures to caries occurrence. SEM was used to identify possible direct, indirect, and mediated effects of asthma in primary dentition dental caries. RESULTS The general prevalence of caries at age 5 was 1.95 (SD: 3.56). When comparing the dmft values for children with asthma symptoms and those without, they presented similar values in both periods where asthma symptoms were evaluated (1- and 4-year-old). SEM analysis showed that asthma was neither directly nor indirectly related to dental caries. CONCLUSION Asthma, using a latent variable constructed based on asthma symptoms, showed no causal effect on dental caries occurrence in the primary dentition.
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Affiliation(s)
| | | | - Fernanda R Ortiz
- Post Graduate Program in Dentistry, ATITUS Educação, Passo Fundo, Brazil
| | - Marcos B Correa
- Graduate Program in Dentistry, Federal Universidade Federal de Pelotas, Pelotas, Brazil
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Iná S Santos
- Graduate Program in Epidemiology, Federal Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alícia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, Brazil
| | - Fernando C L F Barros
- Graduate Program in Epidemiology, Federal Universidade Federal de Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal Universidade Federal de Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Federal Universidade Federal de Pelotas, Pelotas, Brazil
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Karam SA, Costa FDS, Peres KG, Peres MA, Barros FC, Bertoldi AD, Santos IS, Tovo L, Matijasevich A, B Menezes AM, Gonçalves H, Correa MB, Demarco FF. Two decades of socioeconomic inequalities in the prevalence of untreated dental caries in early childhood: Results from three birth cohorts in southern Brazil. Community Dent Oral Epidemiol 2023; 51:355-363. [PMID: 35362631 DOI: 10.1111/cdoe.12747] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/24/2022] [Accepted: 03/22/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To estimate the socioeconomic disparities in untreated dental caries in early childhood according to socioeconomic characteristics in three birth cohorts in Southern Brazil. METHODS The socioeconomic data to this study were collected at the 48-month follow-up and oral health studies of 1993, 2004 and 2015 Pelotas birth cohort studies. The outcome was untreated dental caries in children aged 6 (1993 cohort), 5 (2004 cohort) and 4 years (2015 cohort), dichotomized into absence/presence. Analyses were stratified by maternal skin colour/race, maternal education and family income. For statistical purposes, the prevalence difference, relative risk and absolute and relative indices of health inequality (Slope Index of Inequality-SII and Concentration Index-CIX) were used. RESULTS The prevalence of untreated dental caries in primary dentition was 63.4%, 45.5% and 15.6%, in 1993, 2004 and 2015 cohorts, respectively. The prevalence of untreated dental caries was concentrated in the poorest quintile and lower maternal education group in both absolute (SII) and relative (CIX) measures of inequality, being characterized as a pro-poor event. A higher risk of untreated caries was found in the poorest quintile of family income compared with the richest quintile in the 1993 cohort (RR 1.44 [95% CI 1.05; 1.98]). That risk was higher considering the 2004 Cohort (RR 1.78 [95% CI 1.42; 2.23]) and 2015 cohort (RR 4.20 [95% CI 2.97; 5.94]) data. CONCLUSIONS Over the course of two decades, a higher prevalence of untreated dental caries is concentrated among the most socioeconomically deprived children.
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Affiliation(s)
- Sarah Arangurem Karam
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Center Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Center Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Fernando C Barros
- Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil
| | | | - Iná S Santos
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luciana Tovo
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Faculty of Medicine, Department of Preventive Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Ana M B Menezes
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Helen Gonçalves
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Flávio Fernando Demarco
- Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
- Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
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Peres MA, Peres KG, Chan A, Wu B, Mittinty M. Investigating the causal effect of cognition on the self-reported loss of functional dentition using marginal structural models: The Panel on Health and Ageing of Singaporean Elderly study. J Clin Periodontol 2023; 50:408-417. [PMID: 36384159 DOI: 10.1111/jcpe.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
AIM To assess the effect of cognition on the loss of functional dentition. MATERIALS AND METHODS We used data from the three waves of the Panel on Health and Ageing of Singaporean Elderly study (n = 4990 at baseline, 774 complete cases analysed) over 6 years (2009-2015). The outcome was the loss of functional dentition (<21 teeth). The exposure was cognitive impairment, while baseline confounders included age, sex, education, and ethnicity. Time-varying confounders included income, living arrangements, smoking, diabetes, depressive symptoms, cardiovascular disease, and body mass index. We used marginal structural mean models with inverse probability treatment weighted. RESULTS The mean age of the participants was 70.2 years at baseline. The proportion of participants with loss of functional dentition increased from 74.6% to 89.9% over 6 years. Women, ethnic Chinese, less educated, smokers, people with diabetes, and individuals with depression had a higher proportion of loss of functional dentition than their counterparts. Loss of functional dentition was 1.8 times higher (odds ratio 1.80; 95% confidence interval 0.88-3.69) among those with cognitive impairment after taking well-known confounders into account. CONCLUSIONS After accounting for the time-varying exposure and confounding evidence, the association between cognition and functional dentition among the elderly in Singapore remains uncertain.
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Affiliation(s)
- Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Bei Wu
- Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Murthy Mittinty
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Peres MA, Huihua L, Antunes JLF, Perea LME, Iyer NG, Peres KG. Time trend and Age-Period-Cohort analysis of potentially HPV-related oral and pharyngeal cancer incidence in Singapore between 1968 and 2017. Oral Oncol 2023; 136:106272. [PMID: 36516662 DOI: 10.1016/j.oraloncology.2022.106272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/14/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine trends and age-period-cohort effects (APC) on oral and pharyngeal cancers incidence in Singapore between 1968 and 2017 by human papillomavirus (HPV) status. METHODS All diagnosed oral and pharyngeal cancers and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore, respectively. Anatomical subsites were used as a proxy for HPV infection. Prais-Winsten regression assessed trends of age-standardised incidence rate (ASIR) (per 100,000 person-years); Poisson regression assessed APC effects on HPV-related and HPV-unrelated cancers. RESULTS Over 50 years, 1,618 HPV-related and 2,977 HPV-unrelated oral and pharyngeal cancers were diagnosed, with the highest ASIR in Indians (6.93), followed by Chinese (2.81), and Malays (1.81). Overall, ASIR HPV-related cancers were stable while HPV-unrelated cancers decreased. The male-female ASIR ratio reduced from 5.82 (1968-1977) to 4.0 (2008-2017) for HPV-related cancers, and from 2.58 (1968-1977) to 1.52 (2008-2017) for HPV-unrelated cancers. HPV-unrelated ASIR in males decreased, but in females only among Indians. HPV-related ASIR decreased only among Indian females. The cohort born between 1983 and 1992 had the lowest incidence of HPV-related cancers in males but the highest in HPV-unrelated cancers. Period effect mainly contributed to HPV-related cancer among males with increased incidence after 1997. Overall, the age effect was more pronounced in males. CONCLUSIONS HPV-related cancers accounted for 1/3 of oral and pharyngeal cancers. A significant decline was observed only for HPV-unrelated cancers. The cohort effect was mainly attributed to HPV-unrelated cancer incidence, while the period effect largely contributed to HPV-related cancer incidence, but only among males.
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Affiliation(s)
- Marco 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.
| | - Li Huihua
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore; Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | | | | | | | - Karen G 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
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Nascimento GG, Leite FRM, Gonzalez-Chica DA, Peres KG, Peres MA. Dietary vitamin D and calcium and periodontitis: A population-based study. Front Nutr 2022; 9:1016763. [PMID: 36618706 PMCID: PMC9815180 DOI: 10.3389/fnut.2022.1016763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Aim This study aimed to explore the relationship between dietary vitamin D and calcium intake and periodontitis among adults and whether it differs from males to females. Methods Cross-sectional analysis of a population-based cohort study with adults aged 20 to 60 from Southern Brazil. Intake of vitamin D and calcium were gathered in 2012 using two 24h-dietary recalls. Clinical examination assessed the clinical attachment level and bleeding on probing. Confounders included sex, age, family income, smoking, and obesity. The controlled direct effect of vitamin D and calcium on periodontitis was examined using marginal structural modeling. Analyses were also stratified by sex. Results Of the 1,066 investigated adults (mean age 35 ± 11.7 years; 49% females), 12.3% (95%CI 10.2;14.7) had periodontitis. Calcium intake had a direct protective effect on periodontitis (risk ratio (RR) 0.61; 95%CI 0.45;0.83), whereas no association between vitamin D and periodontitis was observed (RR 1.13; 95%CI 0.82;1.56). Stratified analyses revealed a null association between both vitamin D and calcium intake and periodontitis among men, but a protective association between calcium and intake and periodontitis among women (RR 0.56; 95%CI 0.38;0.79), while vitamin D remained without any association (RR 1.07; 95%CI 0.72;1.61). Conclusion Our findings suggest a protective association between dietary calcium intake and periodontitis among women.
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Affiliation(s)
- Gustavo G. Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore,Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore,*Correspondence: Gustavo G. Nascimento, ,
| | - Fábio R. M. Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore,Oral Health ACP, Duke-NUS Medical School, Singapore, Singapore
| | - David A. Gonzalez-Chica
- Discipline of General Practice, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Karen G. Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A. Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Schuch HS, Peres KG, Haag DG, Boing AF, Peres MA. The independent and joint contribution of objective and subjective socioeconomic status on oral health indicators. Community Dent Oral Epidemiol 2022; 50:570-578. [PMID: 34882815 DOI: 10.1111/cdoe.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/14/2021] [Accepted: 11/24/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The understanding of how subjective socioeconomic status (SSS) relates to objective socioeconomic status (OSS), and how both conditions act together in oral health outcomes is still unclear. This study aims to test the independent and joint association between OSS and SSS with oral health, to assess the role of socioeconomic status discrepancies, and to evaluate the role of SSS in the association between OSS and oral health. METHODS Data from 1140 adults from a population-based study in Southern Brazil were used. We applied diagonal reference models DRM to disentangle the effects of OSS (education) and SSS (MacArthur Scale) to oral health outcomes. The outcomes were functional dentition clinically evaluated (FD ≥20 teeth) and self-reported oral health SROH. We also examined the discrepancy between OSS and SSS to oral health indicators and the effect measure modification (EMM) of SSS on the association between OSS and oral health. RESULTS Subjective socioeconomic status and OSS contributed equally to SROH, while OSS explained a substantially higher amount of FD than SSS (0.85 vs 0.15). An EMM of SSS was found on the association between OSS and fair/poor SROH, with a relative excess risk due to interaction (RERI) of 1.08. Less evidence of EMM was found for FD (RERI = 0.14). Individuals with lower SSS and OSS had four times the risk of the outcomes than the reference group. CONCLUSIONS Adults with concordant lower SSS and OSS have a worse oral health than those with concordant higher status. There was evidence that the association between OSS and SROH is modified by SSS.
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Affiliation(s)
- Helena S Schuch
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Dandara G Haag
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Antonio F Boing
- Department of Public Health, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
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Peres KG, Nascimento GG, Gupta A, Singh A, Cassiano LS, Rugg-Gunn AJ. Scoping Review of Oral Health-Related Birth Cohort Studies: Toward a Global Consortium. J Dent Res 2022; 101:632-646. [PMID: 35012400 PMCID: PMC9125142 DOI: 10.1177/00220345211062475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The multidisciplinary nature and long duration of birth cohort studies allow investigation of the relationship between general and oral health and indicate the most appropriate stages in life to intervene. To date, the worldwide distribution of oral health-related birth cohort studies (OHRBCSs) has not been mapped, and a synthesis of information on methodological characteristics and outcomes is not available. We mapped published literature on OHRBCSs, describing their oral health-related data and methodological aspects. A 3-step search strategy was adopted to identify published studies using PubMed, Embase, Web of Science, and OVID databases. Studies with baseline data collection during pregnancy or within the first year of life or linked future oral health data to exposures during either of these 2 life stages were included. Studies examining only mothers' oral health and specific populations were excluded. In total, 1,721 articles were suitable for initial screening of titles and abstracts, and 528 articles were included in the review, identifying 120 unique OHRBCSs from 34 countries in all continents. The review comprised literature from the mid-1940s to the 21st century. Fifty-four percent of the OHRBCSs started from 2000 onward, and 75% of the cohorts were from high-income and only 2 from low-income countries. The participation rate between the baseline and the last oral health follow-up varied between 7% and 93%. Ten cohorts that included interventions were mostly from 2000 and with fewer than 1,000 participants. Seven data-linkage cohorts focused mostly on upstream characteristics and biological aspects. The most frequent clinical assessment was dental caries, widely presented as decayed, missing, and filled teeth (DMFT/dmft). Periodontal conditions were primarily applied as isolated outcomes or as part of a classification system. Socioeconomic classification, ethnicity, and country- or language-specific assessment tools varied across countries. Harmonizing definitions will allow combining data from different studies, adding considerable strength to data analyses; this will be facilitated by forming a global consortium.
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Affiliation(s)
- K G 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
| | - G G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - A Gupta
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Australia
| | - A Singh
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - L Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - A J Rugg-Gunn
- The Borrow Foundation, Waterlooville, UK.,School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Reher V, Reher P, Peres KG, Peres MA. Fall of amalgam restoration: a 10-year analysis of an Australian university dental clinic. Aust Dent J 2020; 66:61-66. [PMID: 33197295 DOI: 10.1111/adj.12807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The use of amalgam in Dentistry has decreased since the 1980s. This study aimed to (i) assess the time trend in the usage of amalgam and composite in posterior teeth at Griffith University Dental Clinic from 2010 to 2019; (ii) to test whether this trend varied according to the dental health provider. METHODS We analysed clinic records from 2010 to 2019. Prais-Winsten analyses were performed, and the average annual percentages change (AAPC) for amalgam and composite was estimated. RESULTS There were 397,013 procedures, including 80,995 direct posterior restorations. Amalgam use decreased from 12.9% in 2010 to 0.5% in 2019 among students, while composite use increased from 87.1% to 99.5% of posterior restorations. The annual increase of the composite was 1.4% per year for students, while amalgam decreased by 30.2% per year on average. A similar trend was noted among the dentists. CONCLUSIONS A significant decrease in the use of amalgam was observed over time for both students and professionals. This trend raises questions about curriculum reviews, focusing on the repair, maintenance and safe removal of amalgam while reinforcing the learning on Minimally Invasive Dentistry and composite restorations based on the patient's caries risk.
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Affiliation(s)
- V Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - P Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - K G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - M A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
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Carrillo-Larco RM, Di Cesare M, Hambleton IR, Hennis A, Irazola V, Stern D, Ferreccio C, Lotufo P, Perel P, Gregg EW, Ezzati M, Danaei G, Miranda JJ, Aguilar-Salinas CA, Alvarez-Váz R, Amadio MB, Baccino C, Bambs C, Bastos JL, Beckles G, Bernabe-Ortiz A, Bernardo CDO, Bloch KV, Blümel JE, Boggia JG, Borges PK, Bravo M, Brenes-Camacho G, Carbajal HA, Castillo Rascon MS, Ceballos BH, Colpani V, Confortin SC, Cooper JA, Cortés-Valencia A, Cortes S, Cunha RS, d'Orsi E, Dow WH, Espeche WG, Fuchs FD, Fuchs SC, Gimeno SGA, Gomez-Velasco D, Gonzalez-Villalpando C, Gonzalez-Villalpando ME, Gonzalez-Chica DA, Grazioli G, Guerra RO, Gutierrez L, Herkenhoff FL, Horimoto ARVR, Huidobro A, Koch E, Lajous M, Lima-Costa MF, Lopez-Ridaura R, Maciel ACC, Manrique-Espinoza BS, Marques LP, Mill JG, Moreira LB, Ono LM, Muñoz OM, Oppermann K, Peixoto SV, Pereira AC, Peres KG, Peres MA, Rodriguez NI, Rojas-Martinez R, Rosero-Bixby L, Rubinstein A, Ruiz-Morales A, Salazar MR, Salinas-Rodriguez A, Sanchez RA, Schneider IJC, Silva TLN, Silva NAS, Smeeth L, Spritzer PM, Tartaglione F, Tartaglione J. Cohort Profile: The Cohorts Consortium of Latin America and the Caribbean (CC-LAC). Int J Epidemiol 2020; 49:1437-1437g. [PMID: 32888015 PMCID: PMC7746413 DOI: 10.1093/ije/dyaa073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022] Open
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Abstract
AIMS To report the experience of coronal dental caries in the Australian adult population. METHODS Dentate people aged 15 years and over were online or telephone interviewed, and dental examined (n = 5022). The number of decay, missing and filled surfaces (DMFS) were recorded. Independent variables were demographic, socioeconomic conditions and dental care characteristics. Proportions of DMFS >0, average DMFS and its components were calculated. RESULTS Overall, 32.1% had decayed surfaces, with a higher proportion found in males (34.7%) and 40% higher in those living in remote areas than in those living in major city and regional areas. The prevalence of decayed surfaces varied from 37.4% (lowest income group) to 25.0% (highest income group). The mean number of decayed surfaces was three times higher in the lowest income group compared to the highest one. Uninsured people had a higher prevalence of decayed surfaces and lower mean of filling surfaces than insured group. Participants with an unfavourable pattern of dental visiting had two times higher prevalence of decay than their counterparts. Overall, three quarters (77.4%) had at least one filling in their permanent dentition. This percentage increased from 61.6% among 15-34 year olds, to 88.0% among those aged 55-74 years. CONCLUSION Socioeconomic inequalities in caries experience persist in Australia.
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Affiliation(s)
- Karen G Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Diep H Ha
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Sofia Christofis
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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12
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Peres KG, Thomson WM, Chaffee BW, Peres MA, Birungi N, Do LG, Feldens CA, Fontana M, Marshall TA, Pitiphat W, Seow WK, Wagner Y, Wong HM, Rugg-Gunn AJ. Oral Health Birth Cohort Studies: Achievements, Challenges, and Potential. J Dent Res 2020; 99:1321-1331. [PMID: 32680439 DOI: 10.1177/0022034520942208] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Birth cohorts are those among observational studies that provide understanding of the natural history and causality of diseases since early in life. Discussions during an International Association for Dental Research symposium in London, United Kingdom, in 2018, followed by a workshop in Bangkok, Thailand, in 2019, concluded that there are few birth cohort studies that consider oral health and that a broader discussion on similarities and differences among those studies would be valuable. This article aims to 1) bring together available long-term data of oral health birth cohort studies from the low, middle, and high-income countries worldwide and 2) describe similarities and differences among these studies. This work comprises 15 studies from all 5 continents. The most studied dental conditions and exposures are identified; findings are summarized; and methodological differences and similarities among studies are presented. Methodological strengths and weaknesses are also highlighted. Findings are summarized in 1) the negative impact of detrimental socioeconomic status on oral health changes over time, 2) the role of unfavorable patterns of dental visiting on oral health, 3) associations between general and oral health, 4) nutritional and dietary effects on oral health, and 5) intergenerational influences on oral health. Dental caries and dental visiting patterns have been recorded in all studies. Sources of fluoride exposure have been documented in most of the more recent studies. Despite some methodological differences in the way that the exposures and outcomes were measured, some findings are consistent. Predictive models have been used with caries risk tools, periodontitis occurrence, and permanent dentition orthodontic treatment need. The next steps of the group's work are as follows: 1) establishing a consortium of oral health birth cohort studies, 2) conducting a scoping review, 3) exploring opportunities for pooled data analyses to answer pressing research questions, and 4) promoting and enabling the development of the next generation of oral health researchers.
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Affiliation(s)
- K G 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
| | - W M Thomson
- Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - B W Chaffee
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California-San Francisco, San Francisco, CA, USA
| | - 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
| | - N Birungi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - L G Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - C A Feldens
- Lutheran University of Brazil, Canoas, Brazil
| | - M Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - T A Marshall
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - W Pitiphat
- Chronic Inflammatory Diseases and Systemic Diseases Associated with Oral Health Research Group, and Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - W K Seow
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Y Wagner
- Department of Orthodontics, Jena University Hospital, Jena, Germany
| | - H M Wong
- Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - A J Rugg-Gunn
- The Borrow Foundation, Waterlooville, UK.,School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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13
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Do LG, Peres KG, Ha DH, Roberts-Thomson KF. Oral epidemiological examination - protocol: the National Study of Adult Oral Health 2017-18. Aust Dent J 2020; 65 Suppl 1:S18-S22. [PMID: 32583582 DOI: 10.1111/adj.12760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 11/28/2022]
Abstract
The National Study of Adult Oral Health (NSAOH) 2017-18 aimed to collect data on population oral health status of the Australian adult population. This complex nation-wide project required reliable data collection procedures. The NSAOH 2017-18 Oral Epidemiological Examination Protocol has been developed based on internationally accepted examination procedures. Examiners have been trained and calibrated in using the protocol. Details of the clinical examination components are provided. Examiner reliability has been tested and presented.
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Affiliation(s)
- Loc G Do
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dentistry and Oral Health, Griffith University, Brisbane, Gold Coast, Australia
| | - Diep H Ha
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kaye F Roberts-Thomson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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14
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Nascimento GG, Seerig LM, Schuch HS, Horta BL, Peres KG, Peres MA, Corrêa MB, Demarco FF. Income at birth and tooth loss due to dental caries in adulthood: The 1982 Pelotas birth cohort. Oral Dis 2020; 26:1494-1501. [PMID: 32348632 DOI: 10.1111/odi.13373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To estimate the effect of income at birth on adulthood tooth loss due to dental caries in 539 adults from the 1982 Pelotas birth cohort. METHODS Family income was collected at birth. Tooth loss was clinically assessed when individuals were aged 31. Dental visit and oral hygiene at age 25 were considered mediators. Confounders included maternal skin color, and individual's skin color, sex, and income in adulthood. Marginal structural modeling was used to estimate the controlled direct effect of income at birth on tooth loss due to dental caries that was neither mediated by the use of dental service nor oral hygiene. RESULTS Forty-three percent of the individuals of low income at birth lost one/two teeth, and 23% lost three or more; among those non-poor, the prevalence was 30% and 14%, respectively. Poor individuals at birth had a 70% higher risk for missing teeth in adulthood than those non-poor. The risk of losing one/two (risk ratio 1.68) and three or more teeth (risk ratio 3.84) was also higher among those of low income at birth. CONCLUSIONS Economic disadvantage at birth had an effect on tooth loss due to dental caries at age 31 not mediated by individual risk factors.
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Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lenise M Seerig
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Helena S Schuch
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo L Horta
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Karen G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia.,National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - Marco A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia.,National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore.,Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - Marcos B Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flavio F Demarco
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
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15
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Leite FRM, Nascimento GG, Peres KG, Demarco FF, Horta BL, Peres MA. Collider bias in the association of periodontitis and carotid intima‐media thickness. Community Dent Oral Epidemiol 2020; 48:264-270. [DOI: 10.1111/cdoe.12525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Fábio R. M. Leite
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
| | - Gustavo G. Nascimento
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
| | - Karen G. Peres
- School of Dentistry and Oral Health Griffith University, Gold Coast Campus Southport QLD Australia
| | - Flávio F. Demarco
- Graduate Program in Dentistry Federal University of Pelotas Pelotas Brazil
- Graduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil
| | - Bernardo L. Horta
- Graduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil
| | - Marco A. Peres
- School of Dentistry and Oral Health Griffith University, Gold Coast Campus Southport QLD Australia
- Menzies Health Institute Queensland Griffith University, Gold Coast Campus Southport QLD Australia
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16
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Peres KG, Luzzi L, Harford J, Peres MA. Socioeconomic gradients in toothache experience among Australian adults: A time trend analysis from 1994 to 2013. Community Dent Oral Epidemiol 2019; 47:324-332. [PMID: 31044449 DOI: 10.1111/cdoe.12461] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify time trend pattern in toothache and to estimate whether toothache prevalence differs by socioeconomic position and residential location over time. METHODS Data from nine successive National Dental Telephone Interview Surveys (NDTIS) from 1994 (n = 6907) to 2013 (n = 6778) performed in Australia among individuals aged 15 years or over were used. The dependent variable was toothache reported very often, often or sometimes during the previous 12 months. Independent variables were age group, household income (tertiles), insurance/cardholder status and geographical remoteness. Prais-Winsten analyses were performed, and the average annual percentage change (AAPC) for toothache prevalence was estimated. RESULTS Toothache affected slightly more than 10% of the overall population in 1994 (11.6%) and 1995 (11.4%), reaching approximately one-sixth (16.2%) of individuals in 2013. Overall, there was a significant increase in toothache prevalence over time (AAPC = 2.0% [95% CI 0.7;1.34]) and in those aged 25-44 (AAPC 2.1% [95% CI 0.6;3.6]) and 45-64 (AAPC 3.4% [95% CI 1.5;5.3]) years and markedly among those in the lowest income group (AAPC 3.4% [95% CI 0.1;6.7]). All geographic locations except for remote/very remote areas had upward toothache prevalence over time. Insured status was not associated with increased toothache prevalence during the investigated period. CONCLUSIONS Toothache prevalence increased from 1994 to 2013 in Australian adults particularly among the lowest socioeconomic group.
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Affiliation(s)
- Karen G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jane Harford
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Marco A Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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17
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Abstract
Breastfeeding is important for health and development. Yet, the interaction between breastfeeding duration and usage of fluoridated water on caries experience has not been investigated. This study examined exposure to fluoridation as an effect modifier of the association between breastfeeding duration and caries. The 2012 to 2014 national population-based study of Australian children involved parental questionnaires and oral epidemiological assessment. Children were grouped by parent-reported breastfeeding duration into minimal (none or <1 mo), breastfed for 1 to <6 mo, breastfed for 6 to 24 mo, and sustained (>24 mo). Residential history and main water source used for the first 2 y of life were collected to group children into exposed (WF) and nonexposed (NF) to fluoridation. Socioeconomic status, infant formula feeding, and sugar-sweetened beverage (SSB) consumption data were collected. The prevalence and severity of caries in children aged 5 to 6 y were primary outcomes. Multivariable regression models with robust error estimation were generated to compute prevalence ratios (PRs) and mean ratios (MRs) for 3 breastfeeding groups against the reference (breastfed for 6-24 mo). Of the 5- to 6-y-old children, 2,721 were in the WF and 1,737 were in the NF groups. The groups had comparable distributions of socioeconomic factors, infant formula feeding, and SSB consumption. There were U-shape distributions of caries experience among breastfeeding groups, being more pronounced among NF children. Among NF children, the minimal and sustained breastfeeding groups had significantly higher PR (1.4 [1.1-1.9] and 1.8 [1.4-2.4]) and MR (2.1 [1.4-3.3] and 2.4 [1.4-4.1]) than the reference group. However, among the WF children, this association between breastfeeding duration and caries attenuated after adjustment for other factors. The study contributes evidence of a nonlinear (U-shape) association between breastfeeding duration and dental caries. Early life exposure to fluoridated drinking water attenuated the potential cariogenic effect of both lack of and sustained breastfeeding.
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Affiliation(s)
- D H Ha
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - A J Spencer
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - K G Peres
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia.,2 School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
| | | | - J A Scott
- 4 School of Public Health, Curtin University, Perth, Australia
| | - L G Do
- 1 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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18
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Nascimento GG, Leite FRM, Peres KG, Demarco FF, Corrêa MB, Peres MA. Metabolic syndrome and periodontitis: A structural equation modeling approach. J Periodontol 2018; 90:655-662. [PMID: 30447085 DOI: 10.1002/jper.18-0483] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/10/2018] [Accepted: 11/04/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study aimed to investigate the association between metabolic syndrome (MetS) and periodontitis among young adults, and also to compare results using observed and latent variables for MetS and periodontitis. METHODS Data from the 1982 Pelotas Birth Cohort, Brazil, were used. Metabolic syndrome at the age of 23 years was measured using clinical and biochemical analysis and set as the main exposure. Periodontitis at the age of 31 years was clinically measured and set as the outcome. Confounding variables included sex and maternal education, assessed at birth, family income at 23 years, and smoking status at the age of 23 and 30 years. Factor analyses (exploratory and confirmatory) were performed to define latent variables for MetS and periodontitis. In addition, both conditions were also defined as categorical observed variables. The association between MetS and periodontitis was tested in structural equation models. RESULTS Two latent periodontal variables were identified: "initial" and "advanced" periodontitis, while one latent variable was identified for MetS. Metabolic syndrome is positively associated with "advanced" (coefficient 0.11; P value < 0.01), but not with "initial" (coefficient -0.01; P value = 0.79) periodontitis. When MetS and periodontitis were set as observed variables in the structural equation models, no association was found irrespective of the criteria used for periodontitis classification. CONCLUSIONS There was a positive association between metabolic syndrome and "advanced" periodontitis, when the multiple dimensions of both diseases were accounted in latent variables. Nevertheless, when MetS and periodontitis were treated as observed variables, no association was detected irrespective of the criteria used for periodontitis classification.
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Affiliation(s)
- Gustavo G Nascimento
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fábio R M Leite
- Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Karen G Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas
| | - Marcos B Corrêa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marco A Peres
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University
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19
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Nascimento GG, Gastal MT, Leite FRM, Quevedo LA, Peres KG, Peres MA, Horta BL, Barros FC, Demarco FF. Is there an association between depression and periodontitis? A birth cohort study. J Clin Periodontol 2018; 46:31-39. [DOI: 10.1111/jcpe.13039] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/16/2018] [Accepted: 11/26/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gustavo G. Nascimento
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University AarhusDenmark
| | - Márcia T Gastal
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - Fábio R. M. Leite
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - Luciana A. Quevedo
- Postgraduate Program in Health and Behavior Catholic University of Pelotas PelotasBrazil
| | - Karen G. Peres
- School of Dentistry and Oral Health Griffith University Gold Coast QueenslandAustralia
| | - Marco A. Peres
- School of Dentistry and Oral Health Griffith University Gold Coast QueenslandAustralia
- Menzies Health Institute Queensland Griffith University Gold Coast QueenslandAustralia
| | - Bernardo L. Horta
- Menzies Health Institute Queensland Griffith University Gold Coast QueenslandAustralia
| | - Fernando C. Barros
- Postgraduate Program in Health and Behavior Catholic University of Pelotas PelotasBrazil
| | - Flávio F. Demarco
- Section of Periodontology Department of Dentistry and Oral Health Aarhus University AarhusDenmark
- Graduate Program in Epidemiology Federal University of Pelotas Pelotas Brazil
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20
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Abstract
To identify and map the caries risk management protocols with multiple strategies, which were used in Australia and New Zealand and reported in the existing literature, a scoping review was carried out by electronically searching PubMed, Web of Science, Scopus, Embase and Dentistry and Oral Science. Studies on caries risk management protocols, written in English, limited to Australia and New Zealand and published up to March 2018 were included in the review. There was no restriction on participants' age. Of 257 studies identified, seven were included in the review. These seven studies were reported in Australia and all but six were based on the caries management system (CMS). There were two descriptive studies, one 3-year multicentre cluster randomized controlled trial (RCT), one 2 to 4-year post-RCT follow-up and two cost-effective evaluations based on Markov decision analytic models. While concentrating on assessing individual behavioural risk factors for dental caries, studies indicated that the CMS would be more cost-effective if its protocol was properly adhered to. Future studies on caries risk management protocols are suggested to consider both the individual characteristics and the social context of different population groups in view of enhancing the effectiveness of oral care.
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Affiliation(s)
- N Amarasena
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - D Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,BetterStart Child Health and Development Research Group, School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - K G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dentistry and Oral Health, Griffith University, Australia
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21
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Goettems ML, Nascimento GG, Peres MA, Santos I, Matijasevich A, Barros AJD, Peres KG, Demarco F. Influence of maternal characteristics and caregiving behaviours on children's caries experience: An intergenerational approach. Community Dent Oral Epidemiol 2018; 46:435-441. [DOI: 10.1111/cdoe.12406] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 06/18/2018] [Accepted: 06/24/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Marília L. Goettems
- Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Brazil
| | - Gustavo G. Nascimento
- Section of Periodontology; Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health; Adelaide SA Australia
| | - Ina S. Santos
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine; Faculty of Medicine; University of São Paulo; São Paulo Brazil
| | - Aluisio J. D. Barros
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
| | - Karen G. Peres
- Australian Research Centre for Population Oral Health; Adelaide SA Australia
| | - Flávio F. Demarco
- Graduate Program in Dentistry; Federal University of Pelotas; Pelotas Brazil
- Postgraduate Program in Epidemiology; Federal University of Pelotas; Pelotas Brazil
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22
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Schuch HS, Peres KG, Demarco FF, Horta BL, Gigante DP, Peres MA, Do LG. Effect of life-course family income trajectories on periodontitis: Birth cohort study. J Clin Periodontol 2018; 45:394-403. [PMID: 29178171 DOI: 10.1111/jcpe.12845] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Abstract
AIMS To quantify the impact of life course income trajectories on periodontitis in adulthood. MATERIALS AND METHODS Data from the 1982 Pelotas Birth Cohort Study, Brazil, were used. Information on family income was collected at birth and ages 15, 19, 23 and 30 years. Group-based trajectory modelling was used to identify income trajectories. Periodontal measures were assessed through clinical examination at age 31. Log-Poisson regression models were used to estimate prevalence ratios (PRs) of any and moderate/severe periodontitis, as outcomes. RESULTS Prevalence of any periodontitis and moderate/severe periodontitis was 37.3% and 14.3% (n = 539). Income trajectories were associated with prevalence of moderate/severe periodontitis. Adjusted PR in participants in low and variable income trajectory was 2.1 times higher than in participants in stable high-income trajectory. The unadjusted association between income trajectories and prevalence of any periodontitis was explained by the inclusion of behavioural and clinical variables in the model. CONCLUSIONS Low and variable life course income increased the prevalence of moderate/severe periodontitis at age 31 years. The findings may inform programmes in identifying and targeting potentially at-risk groups during the life course to prevent periodontitis.
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Affiliation(s)
- Helena S Schuch
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Karen G Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Flavio F Demarco
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Denise P Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marco A Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G Do
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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23
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Peres MA, Nascimento GG, Peres KG, Demarco FF, Menezes AB. Oral health-related behaviours do not mediate the effect of maternal education on adolescents' gingival bleeding: A birth cohort study. Community Dent Oral Epidemiol 2017; 46:169-177. [PMID: 29178456 PMCID: PMC5887883 DOI: 10.1111/cdoe.12350] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 10/17/2017] [Indexed: 12/17/2022]
Abstract
Objectives To test whether maternal education has a direct effect on gingival bleeding in adolescents aged 12 and to assess whether oral health behaviours over time mediate that association. Methods Two oral health studies nested in the 1993 Pelotas (Brazil) birth cohort study were carried out in participants aged 6 (n = 359) and 12 years (n = 339). The proportion of teeth with bleeding on probing (BOP) and the median number of teeth with gingivitis at age 12 were recorded. Maternal education at birth was the exposure. Toothbrushing frequency and dental visit at ages 6 and 12 years were investigated as mediators of the association between maternal education at birth and gingival bleeding. Time‐varying family income through childhood and adolescence was included as later confounder. Paternal education was taken as baseline confounder. The controlled direct effect (CDE) of maternal education at child's birth on gingival bleeding at age 12 was estimated using marginal structural models (MSM). Additionally, path analysis was employed to estimate standardized direct, indirect and total effects of maternal education at birth on gingival bleeding. Results Adjusted analyses using MSM showed that adolescents whose mothers had <8 years of education had 3.82 higher risk of having teeth with gingival bleeding above the median (rate ratio RR 3.82; 95% CI: 1.68‐8.19). Low maternal education doubled the proportion of gingival bleeding at age 12 not mediated by dental visit and toothbrushing frequency (RR 1.99; 95% CI: 1.52‐2.60). Path analysis revealed that maternal education had a direct effect on gingival bleeding independently of the mediators. Conclusions The pattern of oral health behaviours does not explain the association between mother's education and adolescent's gingival bleeding. Individual‐based approaches focused on oral health‐related behaviours tend to fail to prevent gingival bleeding.
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Affiliation(s)
- Marco A Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Gustavo G Nascimento
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Flavio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Ana B Menezes
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Collares K, Opdam NJ, Peres KG, Peres MA, Horta BL, Demarco FF, Correa MB. Higher experience of caries and lower income trajectory influence the quality of restorations: A multilevel analysis in a birth cohort. J Dent 2017; 68:79-84. [PMID: 29169969 DOI: 10.1016/j.jdent.2017.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/14/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the quality of posterior restorations (amalgam or composite) placed in adults from a birth cohort and its association with clinical and socioeconomic determinants experienced during their life course. METHODS A representative sample (n=539) of all 5914 births occurring in Pelotas (Brazil) in 1982 was prospectively investigated. Quality of posterior restorations (satisfactory or unsatisfactory) was assessed at 31 yrs-old, using modified USPHS criteria. Trained and calibrated dentists performed clinical examination. Explanatory variables included demographic and socioeconomic, oral health and dental service utilization patterns during the life course. Tooth related variables (type of tooth, material, size of cavity) were also analyzed. Untreated caries and socioeconomic status were assessed by group-based trajectories analyses. Multilevel Regression models were used to determine factors associated with restoration outcomes. RESULTS In total 2123 restorations (53% composite) were evaluated of which 107 (5%) were assessed as failed. The main reasons for failure were tooth/restoration fracture (50.5%) and secondary caries (30.7%). Failures in posterior restorations showed a significant association with socioeconomic aspects (lower tertile of income at age 30 - prevalence ratio (PR) 2.21 [95% CI 1.19-4.09]), clinical variables (trajectory of higher untreated caries - PR 2.11 [95% CI 1.23-3.61]) and also with tooth-related factors (Restorations involving three or more surfaces - PR 5.51 [95% CI 3.30-9.19]) after adjustment for each other. CONCLUSIONS These findings suggest that, although tooth-related variables have an important role in restoration longevity, patient-related factors, such as socioeconomic variables and untreated caries are also associated with failure and should be taken into account when evaluating longevity of posterior restorations. CLINICAL SIGNIFICANCE This was the first study assessing long-term trajectory of untreated caries, showing an association between higher experience of caries during the life-course and unsatisfactory restorations. The findings suggest that individual related factors should be considered when planning treatment and in future research evaluating the longevity of dental restorations.
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Affiliation(s)
- Kauê Collares
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Niek J Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Marco A Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marcos B Correa
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Peres KG, Chaffee BW, Feldens CA, Flores-Mir C, Moynihan P, Rugg-Gunn A. Breastfeeding and Oral Health: Evidence and Methodological Challenges. J Dent Res 2017; 97:251-258. [PMID: 29108500 DOI: 10.1177/0022034517738925] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breastfeeding is a powerful health-promoting behavior. A 2016 Lancet global collaboration to review the health implications of breastfeeding was among the first to consider oral health outcomes. While a role was suggested for breastfeeding in preventing malocclusion, caries was the only included disease condition unfavorably associated with breastfeeding. The present critical review examines the evidence connecting breastfeeding practices to these outcomes and discusses the methodological challenges inherent in reaching causal conclusions. Published systematic reviews show some evidence of a protective effect of breastfeeding against primary dentition malocclusion but no supportive evidence for mixed dentition and permanent dentition malocclusions. Regarding caries, well-conducted studies report a benefit with breastfeeding up to 12 mo but a positive association between caries and breastfeeding of longer duration, at times that vary between 12 and 24 mo, as well as nocturnal feeding. Future studies would be methodologically stronger if focused on specific malocclusion traits that are plausibly associated with sucking movements rather than using general malocclusion indices. Studies should use detailed and consistent terminology for breastfeeding definition, including frequency, intensity, and timing. Analytical studies should be carried out to distinguish between confounders (e.g., prematurity) and mediators (e.g., use of pacifier). Regarding a link to caries, standard terminology for exposures (e.g., nocturnal feeding) is recommended. Statistical analyses must account for known confounding factors (e.g., socioeconomic conditions) but avoid inappropriate adjustment for variables on a causal path between exposure and outcome or for variables not associated with breastfeeding (e.g., tooth brushing), as can be guided using tools such as direct acyclic graphs. For dental practice, the potential caries risk of long-duration breastfeeding should be part of individual patient counseling that incorporates patient values and circumstances. Given the unquestioned overall health benefits of breastfeeding, the dental community should support World Health Organization guidelines that encourage and promote breastfeeding.
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Affiliation(s)
- K G Peres
- 1 Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Australia
| | - B W Chaffee
- 2 Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, University of California San Francisco, San Francisco, CA, USA
| | - C A Feldens
- 3 Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
| | - C Flores-Mir
- 4 Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - P Moynihan
- 5 School of Dental Sciences, Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - A Rugg-Gunn
- 6 Newcastle University, Newcastle upon Tyne, UK
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26
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Leite FR, Peres KG, Do LG, Demarco FF, Peres MA. Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information. J Periodontol 2017; 88:731-743. [DOI: 10.1902/jop.2017.160607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fábio R.M. Leite
- Currently, Department of Dentistry and Oral Health, Section of Periodontology, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; previously, Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen G. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G. Do
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Flávio F. Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas
- Postgraduate Program in Dentistry, Federal University of Pelotas
| | - Marco A.A. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
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Ghorbani Z, Peres MA, Liu P, Mejia GC, Armfield JM, Peres KG. Does early-life family income influence later dental pain experience? A prospective 14-year study. Aust Dent J 2017; 62:493-499. [DOI: 10.1111/adj.12531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Z Ghorbani
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
- Community Oral Health Department; Dental School; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - MA Peres
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
| | - P Liu
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
| | - GC Mejia
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
| | - JM Armfield
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
| | - KG Peres
- Australian Research Centre for Population Oral Health; University of Adelaide; Adelaide South Australia Australia
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28
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Nascimento GG, Peres MA, Mittinty MN, Peres KG, Do LG, Horta BL, Gigante DP, Corrêa MB, Demarco FF. Diet-Induced Overweight and Obesity and Periodontitis Risk: An Application of the Parametric G-Formula in the 1982 Pelotas Birth Cohort. Am J Epidemiol 2017; 185:442-451. [PMID: 28174825 DOI: 10.1093/aje/kww187] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 07/01/2016] [Indexed: 12/21/2022] Open
Abstract
We aimed to estimate hypothetical effects of habits (smoking, alcohol consumption, and fat and carbohydrates consumption) combined with diet-induced overweight/obesity on the risk of periodontitis. The risk of any periodontitis, moderate/severe periodontitis, and the combination of bleeding on probing (BOP) and clinical attachment loss (CAL) was estimated using the parametric g-formula in adults aged 31 years from the 1982 Pelotas Birth Cohort in Brazil. Individuals in this cohort have been followed since birth. Hypothetical conditions were set independently for each risk factor and in combination for the entire population. A total of 539 participants had oral examinations in 2013. The cumulative 31-year risk under no intervention was 33.3% for any periodontitis, 14.3%, for moderate/severe periodontitis, and 14.7%, for BOP and CAL. According to our statistical approach, diet-induced overweight/obesity increased the risk of all outcomes: 11% (overweight) and 22% (obesity) higher risk of periodontitis; 12% (overweight) and 27% (obesity) higher risk of moderate/severe periodontitis; 21% (overweight) and 57% (obesity) higher risk of CAL and BOP. When overweight/obesity was combined with other unhealthy habits, the risk was even greater. Our findings suggest that the combination of diet-induced obesity with other risk factors may increase the risk of periodontitis. Further research in the field is required to corroborate our study.
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Nascimento GG, Peres KG, Mittinty MN, Mejia GC, Silva DA, Gonzalez-Chica D, Peres MA. Obesity and Periodontal Outcomes: A Population-Based Cohort Study in Brazil. J Periodontol 2017; 88:50-58. [DOI: 10.1902/jop.2016.160361] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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30
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Schuch HS, Peres KG, Singh A, Peres MA, Do LG. Socioeconomic position during life and periodontitis in adulthood: a systematic review. Community Dent Oral Epidemiol 2016; 45:201-208. [DOI: 10.1111/cdoe.12278] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/27/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Helena Silveira Schuch
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Karen G. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Loc G. Do
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
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31
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da Silva L, Kupek E, Peres KG. General health influences episodes of xerostomia: a prospective population-based study. Community Dent Oral Epidemiol 2016; 45:153-159. [DOI: 10.1111/cdoe.12271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/14/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Luciana da Silva
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
| | - Emil Kupek
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
| | - Karen G. Peres
- Department of Public Health; Federal University of Santa Catarina; Florianópolis Santa Catarina Brazil
- Australian Research Centre for Population Oral Health; Adelaide Dental School; The University of Adelaide; Adelaide Australia
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32
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Peres MA, Sheiham A, Liu P, Demarco FF, Silva AER, Assunção MC, Menezes AM, Barros FC, Peres KG. Sugar Consumption and Changes in Dental Caries from Childhood to Adolescence. J Dent Res 2016; 95:388-94. [PMID: 26758380 DOI: 10.1177/0022034515625907] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There are no prospective studies investigating the effects of sugar-related feeding practices on changes in dental caries from early childhood to young adulthood. The aim of this study was to assess whether sugar-related feeding practices affect dental caries between the ages of 6 and 18 y. This birth cohort study was initiated in 1993 in Pelotas, Brazil. There were 3 dental clinical assessments; at ages 6 y (n = 359), 12 y (n = 339), and 18 y (n = 307). Sugar-related feeding practices were assessed at ages 4, 15, and 18 y. Covariates included sex and life course variables, such as family income, breast-feeding, mother's education, regularity of dental visit, and child's toothbrushing habits. Group-based trajectory analysis was performed to characterize trajectories of time-varying independent variables that had at least 3 time points. We fitted a generalized linear mixed model assuming negative binomial distribution with log link function on 3-time repeated dental caries assessments. One in 5 participants was classified as "high" sugar consumers, and nearly 40% were "upward consumers." "Low consumers" accounted for >40% of the sample. High and upward sugar consumers had higher dental caries prevalence and mean DMFT in all cohort waves when compared with low sugar consumers. Caries occurred at a relatively constant rate over the period of study, but in all sugar consumption groups, the increment of dental caries was slightly higher between ages 6 and 12 y than between 12 and 18 y. Adjusted analysis showed that dental caries increment ratio between ages 6 and 18 y was 20% and 66% higher in upward and high sugar consumer groups as compared with low consumers. The higher the sugar consumption along the life course, the higher the dental caries increment. Even the low level of sugar consumption was related to dental caries, despite the use of fluoride.
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Affiliation(s)
- M A Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - A Sheiham
- Department of Epidemiology and Public Health, The University College London, London, UK
| | - P Liu
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - F F Demarco
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - A E R Silva
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - M C Assunção
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - A M Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - F C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - K G Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia
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33
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Ghorbani Z, Peres KG. Is the association between socioeconomic status and nonreplaced extracted teeth mediated by dental care behaviours in adults? Community Dent Oral Epidemiol 2015; 43:532-9. [PMID: 26087774 DOI: 10.1111/cdoe.12178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/21/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate whether the association between socioeconomic status (SES) and number of nonreplaced extracted teeth (NRET) is mediated by dental care behaviours (DCBs) in adults. METHODS A random sample of adults, who participated in the 2010 dental telephone survey (n = 1100) in Tehran, Iran, was investigated. The outcome was self-reported NRET due to dental caries or periodontal diseases. The main exposures were wealth index and education; and the potential mediators were the frequency of tooth brushing and flossing, and dental visiting in the previous year of the study. Multivariable regression analysis was applied to test mediation using the count ratios (CR) and 95% confidence intervals (CI). RESULTS The response rate was 73%. The mean age was 38.99 (SD=13.83), and 50.8% were female. The mean NRET were 1.28 (95% CI 1.14; 1.41). NRET were greater among participants who had less than 12 years of schooling [CR = 4.26 (95% CI 3.52; 5.52)] and those in the poorest quintile [CR = 1.89 (95% CI 1.36; 2.61)] compared with those in the most educated and wealthiest groups, respectively. People who brushed their teeth less than twice a day [CR = 1.38 (95% CI 1.17; 1.62)] and did not use dental floss daily [CR = 1.47 (95% CI 1.24; 1.75)] were more likely to present NRET. After controlling for DCBs, a slight decrease in the CRs was observed for both the poorest (13.3%) and the less than 12 years of schooling (7.6%) groups compared to the reference groups. CONCLUSIONS Although DCBs were associated with both SES and NRET, they could only be partially accountable for the observed socioeconomic inequalities in NRET.
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Affiliation(s)
- Zahra Ghorbani
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia.,Community Oral Health Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
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Nascimento GG, Leite FRM, Do LG, Peres KG, Correa MB, Demarco FF, Peres MA. Is weight gain associated with the incidence of periodontitis? A systematic review and meta-analysis. J Clin Periodontol 2015; 42:495-505. [PMID: 25952821 DOI: 10.1111/jcpe.12417] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2015] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to conduct a systematic review assessing the effects of weight gain on the incidence of periodontitis in adults. METHODS Electronic searches in four databases were performed up to and including February 2015. Only prospective longitudinal studies assessing the association between weight gain and the incidence of periodontitis in adults were eligible to be included in this study. All studies should state a clear description of nutritional status (Body Mass Index; Waist Circumference) as well as the case definition of periodontitis. Pooled relative risks (RR) for becoming overweight and obese on the incidence of periodontitis were estimated by meta-analysis. Quality was assessed with the Newcastle-Ottawa scale for cohort studies. RESULTS Five articles were included in this review and meta-analysis with 42,198 subjects enrolled. Subjects who became overweight and obese presented higher risk to develop new cases of periodontitis (RR 1.13; 95%CI 1.06-1.20 and RR 1.33 95%CI 1.21-1.47 respectively) compared with counterparts who stayed in normal weight. CONCLUSIONS A clear positive association between weight gain and new cases of periodontitis was found. However, these results are originated from limited evidence. Thus, more studies with longitudinal prospective design are needed.
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Affiliation(s)
- Gustavo G Nascimento
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Fábio R M Leite
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G Do
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Marcos B Correa
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marco A Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
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Peres MA, Luzzi L, Peres KG, Sabbah W, Antunes JL, Do LG. Income-related inequalities in inadequate dentition over time in Australia, Brazil and USA adults. Community Dent Oral Epidemiol 2015; 43:217-25. [PMID: 25611323 DOI: 10.1111/cdoe.12144] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess changes over time of the absolute and relative household income-related inequalities in inadequate dentition (ID) among Australians, Brazilians and USA adults. METHODS This study used nationwide oral health survey data from Australia (n = 1200 in 1999; n = 2729 in 2005), Brazil (n = 13 431 in 2003; n = 9779 in 2010) and USA (n = 2542 in 1999; n = 1596 in 2005). Absolute income inequalities were calculated using Absolute Concentration Index (ACI) and Slope Index of Inequality (SII), while relative inequalities were calculated using Relative Concentration Index (RCI) and Relative Index of Inequality (RII). RESULTS Prevalence of ID in the studied period dropped from 8.7% to 3.1% in Australia; from 42.1% to 22.4% in Brazil; and remained stable in USA, nearly 8.0%. Absolute income inequalities were highest in Brazil, followed by the USA and Australia; relative inequalities were lower in Brazil than in Australia and the USA. ID was higher among Brazilian females (2010) and for the poorest group in all countries and periods. A remarkable reduction in absolute inequalities were found in Australia [Slope Index of Inequality (SII) and AIC 60%] and in Brazil (SII 25%; ACI 33%) while relative inequalities increased both in Australia (RCI and RII 40%) and in Brazil (RCI 24%; RII 38%). No changes in absolute and relative income inequalities were found in the USA. CONCLUSION There were still persistent absolute and relative income inequalities in ID in all examined countries. There has been a reduction in absolute income inequalities in ID but an increase in relative income inequalities.
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Affiliation(s)
- Marco A Peres
- Australian Research Centre for Population Oral Health, Faculty of Health Sciences, School of Dentistry, University of Adelaide, Adelaide, SA, Australia
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Tan H, Peres KG, Peres MA. Do people with shortened dental arches have worse oral health-related quality of life than those with more natural teeth? A population-based study. Community Dent Oral Epidemiol 2014; 43:33-46. [DOI: 10.1111/cdoe.12124] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 07/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Haiping Tan
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; Adelaide SA Australia
| | - Karen G. Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; Adelaide SA Australia
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; Adelaide SA Australia
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Correa MB, Peres MA, Peres KG, Horta BL, Barros AJ, Demarco FF. Do socioeconomic determinants affect the quality of posterior dental restorations? A multilevel approach. J Dent 2013; 41:960-7. [DOI: 10.1016/j.jdent.2013.02.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/15/2013] [Accepted: 02/16/2013] [Indexed: 10/27/2022] Open
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Del Duca GF, Nahas MV, de Sousa TF, Mota J, Hallal PC, Peres KG. Clustering of physical inactivity in leisure, work, commuting and household domains among Brazilian adults. Public Health 2013; 127:530-7. [PMID: 23706706 DOI: 10.1016/j.puhe.2013.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/09/2013] [Accepted: 02/28/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To identify the clustering of physical inactivity in leisure, work, commuting and household contexts, and the sociodemographic factors associated with the clustering of inactive behaviour in different domains among Brazilian adults. STUDY DESIGN Cross-sectional population-based study. METHODS The study was performed in Florianopolis, capital of Santa Catarina, one of the southern states of Brazil, from September 2009 to January 2010. Adults aged 20-59 years were interviewed. Physical inactivity in each domain was defined as non-participation in specific physical activities, using a validated Brazilian questionnaire. Clustering of physical inactivity was identified by the ratio between observed prevalence and expected prevalence of 16 different combinations. Multinomial logistic regression was used in the analysis of sociodemographic factors associated with clustering of physical inactivity. RESULTS Of the 1720 interviewees, the greatest differences between the observed and expected proportions were observed in simultaneous physical inactivity in the leisure and household domains for men, and physical inactivity in the leisure domain alone for women (59% and 88%, respectively); these differences were higher than expected if the behaviours were independent. Physical inactivity in two or more domains was observed more frequently in men and in individuals with a higher per-capita family income. Ageing was associated with physical inactivity in three or four domains. CONCLUSIONS Physical inactivity was observed in different domains according to gender. Men and older individuals with a higher per-capita family income were more likely to exhibit physical inactivity when all domains were considered together.
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Affiliation(s)
- G F Del Duca
- Graduate Program in Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil.
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Silva DAS, Peres KG, Boing AF, González-Chica DA, Peres MA. Clustering of risk behaviors for chronic noncommunicable diseases: a population-based study in southern Brazil. Prev Med 2013; 56:20-4. [PMID: 23123860 DOI: 10.1016/j.ypmed.2012.10.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 09/26/2012] [Accepted: 10/24/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the prevalence and identify factors associated with simultaneous risk behaviors for chronic noncommunicable diseases in adults in a southern capital in Brazil. METHOD A cross-sectional, population-based study was carried out with 1720 adults in Florianópolis, Brazil. The simultaneous occurrence of tobacco smoking, abusive drinking, inadequate or unhealthy diet, and physical inactivity during leisure was assessed. The independent variables were demographic and socioeconomic characteristics. RESULTS Only 8.3% of the respondents did not have any of these factors, whereas the simultaneous occurrence of two or more risk behaviors was 59.4%. The simultaneous presence of four risk behaviors (3.4%) was 220% higher of what would be expected by combining the individual prevalence of these factors (1.5%). The likelihood of individuals having two or more risk behaviors simultaneously was greater in young men, with black skin color, living without a partner, with lower household per capita income, and lower education. CONCLUSION It is necessary to implement programs that reduce the risk behaviors for chronic noncommunicable diseases among adults in Brazil, especially between young men with low education and income.
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Affiliation(s)
- Diego A S Silva
- Federal University of Santa Catarina, Post-Graduate Program in Physical Education, Florianópolis, Brazil.
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Boeira GF, Correa MB, Peres KG, Peres MA, Santos IS, Matijasevich A, Barros AJD, Demarco FF. Caries is the main cause for dental pain in childhood: findings from a birth cohort. Caries Res 2012; 46:488-95. [PMID: 22813889 DOI: 10.1159/000339491] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 04/27/2012] [Indexed: 11/19/2022] Open
Abstract
AIM The aim of the study was to evaluate the prevalence of dental pain in preschool children and its association with socioeconomic, demographic, clinical, and behavior variables. SUBJECTS AND METHODS The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Exploratory variables included demographics, socioeconomic status, mothers' oral health status and associated behaviors, and caries in primary teeth. Data were analyzed using multivariable Poisson regression. RESULTS The prevalence of dental pain was 16.5% (95% CI: 14.4-18.8). Multivariate analysis showed that dark-skinned children (prevalence ratio, PR = 1.6, 95% CI: 1.1-2.4) from low socioeconomic level (PR 1.9, 1.2-3.0) whose mothers had less than 4 years of education (PR 1.9, 1.0-3.6), from mothers with less than 10 teeth in at least one arch (PR 1.7, 1.2-2.5) and less than 10 in two arches (PR 1.6, 1.0-2.6), and those with high caries prevalence at the age of 5 years (PR 4.8, 3.3-7.1) were more likely to experience dental pain. CONCLUSIONS Unrestored caries is the main factor associated with dental pain in childhood. Socioeconomic aspects and family context in which dental pain occurs should also be taken into account when dental pain preventive measures are implemented.
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Affiliation(s)
- G F Boeira
- Postgraduate Programs in Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Peres MA, Tsakos G, Barbato PR, Silva DAS, Peres KG. Tooth loss is associated with increased blood pressure in adults - a multidisciplinary population-based study. J Clin Periodontol 2012; 39:824-33. [DOI: 10.1111/j.1600-051x.2012.01916.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2012] [Indexed: 01/28/2023]
Affiliation(s)
- Marco A. Peres
- Oral Epidemiology and Dental Public Health Research Group; Post-Graduate Program in Public Health; Federal University of Santa Catarina; Florianópolis; Brazil
| | - Georgios Tsakos
- Department of Epidemiology and Public Health; University College London; London; UK
| | - Paulo R. Barbato
- Oral Epidemiology and Dental Public Health Research Group; Post-Graduate Program in Public Health; Federal University of Santa Catarina; Florianópolis; Brazil
| | - Diego A. S. Silva
- Post-Graduate Program in Physical Education; Federal University of Santa Catarina; Florianópolis; Brazil
| | - Karen G. Peres
- Oral Epidemiology and Dental Public Health Research Group; Post-Graduate Program in Public Health; Federal University of Santa Catarina; Florianópolis; Brazil
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Constante HM, Bastos JL, Peres KG, Peres MA. Socio-demographic and behavioural inequalities in the impact of dental pain among adults: a population-based study. Community Dent Oral Epidemiol 2012; 40:498-506. [PMID: 22607027 DOI: 10.1111/j.1600-0528.2012.00701.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 04/02/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess socio-demographic and behavioural inequalities in the impact of dental pain on daily activities, as well as to estimate the prevalence and intensity of dental pain. METHODS A population-based cross-sectional study was carried out in Florianopolis, Southern Brazil, with 1720 adults aged 20-59 years in 2009-2010. Interviews were performed at adults' households, which included socio-demographics and behavioural characteristics, such as smoking status and alcohol abuse, along with mental health, self-reported health, number of retained teeth, dental pain occurrence (including its intensity and its impact on daily life). The association between the impact of dental pain and the covariates was tested using multinomial logistic regression. RESULTS The global prevalence of dental pain was 14.8% (95% CI, 12.9-16.7). Adjusted analysis showed that women, those who self-classified as dark-skinned Blacks, those with low family income, current smokers and those with common mental disorders reported a higher impact of dental pain than their counterparts. Among subjects reporting dental pain, 12.7% indicated the maximum intensity, whereas 6.0% had some daily activity disrupted by it, such as difficulties in chewing certain foods (38.0%), sleep disturbance (21.0%), difficulty to work (21.0%) and difficulty in performing household tasks (8.0%). Prevalence ratios of impact of dental pain between the poorest income group and richest income group (2.4), between the highest and lowest schooling group (2.6), and between dark-skinned Blacks and Whites (2.1) were of higher magnitude than the dental pain prevalence ratios among the same groups (1.7, 1.3 and 1.4, respectively). CONCLUSIONS The impact of dental pain showed a social gradient. Inequalities between socio-economic groups found in this study should be taken into account, as the impact of dental pain leads to reduced daily activities and poor quality of life.
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Affiliation(s)
- Helena M Constante
- Dental School, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Peres MA, Peres KG, Cascaes AM, Correa MB, Demarco FF, Hallal PC, Horta BL, Gigante DP, Menezes AB. Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults. J Periodontol 2012; 83:369-78. [PMID: 21859320 PMCID: PMC3605763 DOI: 10.1902/jop.2011.110250] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. METHODS Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. RESULTS Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. CONCLUSION Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.
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Affiliation(s)
- Marco A Peres
- Research Group in Oral Epidemiology and Public Health Dentistry, Postgraduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Peres MA, Peres KG, Frias AC, Antunes JLF. Contextual and individual assessment of dental pain period prevalence in adolescents: a multilevel approach. BMC Oral Health 2010; 10:20. [PMID: 20707920 PMCID: PMC2928166 DOI: 10.1186/1472-6831-10-20] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 08/13/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite evidence that health and disease occur in social contexts, the vast majority of studies addressing dental pain exclusively assessed information gathered at individual level. OBJECTIVES To assess the association between dental pain and contextual and individual characteristics in Brazilian adolescents. In addition, we aimed to test whether contextual Human Development Index is independently associated with dental pain after adjusting for individual level variables of socio-demographics and dental characteristics. METHODS The study used data from an oral health survey carried out in São Paulo, Brazil, which included dental pain, dental exams, individual socioeconomic and demographic conditions, and Human Development Index at area level of 4,249 12-year-old and 1,566 15-year-old schoolchildren. The Poisson multilevel analysis was performed. RESULTS Dental pain was found among 25.6% (95%CI = 24.5-26.7) of the adolescents and was 33% less prevalent among those living in more developed areas of the city than among those living in less developed areas. Girls, blacks, those whose parents earn low income and have low schooling, those studying at public schools, and those with dental treatment needs presented higher dental-pain prevalence than their counterparts. Area HDI remained associated with dental pain after adjusting for individual level variables of socio demographic and dental characteristics. CONCLUSIONS Girls, students whose parents have low schooling, those with low per capita income, those classified as having black skin color and those with dental treatment needs had higher dental pain prevalence than their counterparts. Students from areas with low Human Development Index had higher prevalence of dental pain than those from the more developed areas regardless of individual characteristics.
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Affiliation(s)
- Marco A Peres
- Oral Epidemiology and Public Health Dentistry, Post-graduate Program in Public Health, Department of Public Health, Universidade Federal de University of Santa Catarina, Florianópolis, Brazil
| | - Karen G Peres
- Oral Epidemiology and Public Health Dentistry, Post-graduate Program in Public Health, Department of Public Health, Universidade Federal de University of Santa Catarina, Florianópolis, Brazil
| | - Antônio C Frias
- Department of Social Dentistry, Faculty of Dentistry, Universidade de São Paulo, São Paulo, Brazil
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Peres MA, Peres KG, Thomson WM, Broadbent JM, Gigante DP, Horta BL. The influence of family income trajectories from birth to adulthood on adult oral health: findings from the 1982 Pelotas birth cohort. Am J Public Health 2010; 101:730-6. [PMID: 20558788 DOI: 10.2105/ajph.2009.184044] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed whether 3 models of life course socioeconomic status (critical period, accumulation of risk, and social mobility) predicted unsound teeth in adulthood among a Brazilian cohort. METHODS Life course data were collected on the 5914 live-born infants in the 1982 Pelotas Birth Cohort study. Participants' oral health was assessed at 15 (n = 888) and 24 (n = 720) years of age. We assessed family income trajectories and number of episodes of poverty in the life course through Poisson regressions, yielding unadjusted and adjusted prevalence ratios for number of unsound teeth at age 24 years. RESULTS The adjusted prevalence ratio for participants born into poverty was 30% higher than for those who were not. Participants who were always poor had the highest prevalence of unsound teeth; those who were downwardly or upwardly mobile also had more unsound teeth than did other participants, after adjustment for confounders. More episodes of poverty were associated with greater prevalence of unsound teeth in adulthood. CONCLUSIONS Poverty at birth and during the life course was correlated with the number of unsound teeth at 24 years of age.
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Affiliation(s)
- Marco A Peres
- Oral Epidemiology and Public Health Dentistry Research Group, Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.
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Peres KG, Peres MA, Araujo CLP, Menezes AMB, Hallal PC. Social and dental status along the life course and oral health impacts in adolescents: a population-based birth cohort. Health Qual Life Outcomes 2009; 7:95. [PMID: 19930601 PMCID: PMC2785763 DOI: 10.1186/1477-7525-7-95] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Accepted: 11/22/2009] [Indexed: 11/10/2022] Open
Abstract
Background Harmful social conditions in early life might predispose individuals to dental status which in turn may impact on adolescents' quality of life. Aims To estimate the prevalence of oral health impacts among 12 yr-old Brazilian adolescents (n = 359) and its association with life course socioeconomic variables, dental status and dental services utilization in a population-based birth cohort in Southern Brazil. Methods Exploratory variables were collected at birth, at 6 and 12 yr of age. The Oral Impacts on Daily Performances index (OIDP) was collected in adolescence and it was analyzed as a ranked outcome (OIDP from 0 to 9). Unadjusted and adjusted multivariable Poisson regression with robust variance was performed guided by a theoretical determination model. Results The response rate was of 94.4% (n = 339). The prevalence of OIDP = 1 was 30.1% (CI95%25.2;35.0) and OIDP ≥ 2 was 28.0% (CI95%23.2;32.8). The most common daily activity affected was eating (44.8%), follow by cleaning the mouth and smiling (15.6%, and 15.0%, respectively). In the final model mother schooling and mother employment status in early cohort participant's life were associated with OIDP in adolescence. As higher untreated dental caries at age 6 and 12 years, and the presence of dental pain, gingival bleeding and incisal crowing in adolescence as higher the OIDP score. On the other hand, dental fluorosis was associated with low OIDP score. Conclusion Our findings highlight the importance of adolescent's early life social environmental as mother schooling and mother employment status and the early and later dental status on the adolescent's quality of life regardless family income and use of dental services.
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Affiliation(s)
- Karen G Peres
- Research Group in Public Health Dentistry Post-Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.
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Abstract
OBJECTIVES The aim of this study was to estimate toothache prevalence and associated factors among adult residents in Pelotas, a southern Brazilian city. METHODS A cross-sectional population-based study was carried out in individuals aged > or = 20 years (n = 3353). A multi-stage sampling scheme was adopted, and data collection was performed at participants' homes through standardized pre-tested questionnaires. Toothache in the past 6 months was regarded as the outcome. Socioeconomic and demographic data as well as health-related behavioural data were collected. All analyses were undertaken with a Poisson regression model, following a hierarchical conceptual model. RESULTS The response rate was 93.5% and toothache prevalence was 17.7% (95% CI 16.0-19.3). Multivariable analyses revealed that toothache was more likely to be reported by those with low educational attainment and low family income. Younger subjects, women and black people were also more likely to report toothache. Current smokers and problem drinkers were at increased risk of experiencing toothache in the past 6 months. CONCLUSIONS The toothache prevalence reported in the present study is not negligible and should initiate the formulation of preventive policies and support the planning of local oral health services.
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Affiliation(s)
- J L Bastos
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
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Peres MA, Peres KG, Traebert J, Zabot NE, Lacerda JTD. Prevalence and severity of dental caries are associated with the worst socioeconomic conditions: a Brazilian cross-sectional study among 18-year-old males. J Adolesc Health 2005; 37:103-9. [PMID: 16026719 DOI: 10.1016/j.jadohealth.2004.08.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2004] [Accepted: 08/03/2004] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of the present study was to assess the prevalence and severity of dental caries among 18-year-old Brazilian males and to test the associations between dental caries and socioeconomic conditions. METHODS It was carried out a cross-sectional study among 18-year-old male conscripts of the Brazilian Army in Blumenau, Southern Brazil. The main outcomes measured were the occurrence of dental caries (decayed, missing and filled teeth [DMFT] > or = 1) and high dental caries (DMFT > or = 8). Socioeconomic variables were collected by interviews. Simple and multiple regression analysis were performed. RESULTS The mean DMFT was 5.7 (95% confidence interval [CI] 5.3-6.1), the proportion of caries-free subjects was 11.4% (95% CI 8.5-14.3) and the proportion of subjects with all 28 natural teeth was 67.2% (95% CI 63.0-71.4). In the multiple regression analysis, mothers' educational level remained associated with dental caries after being controlled by conscripts' schooling. It was observed that the lower the mothers' and the conscripts' schooling, the stronger the risk of the conscripts to show a high dental caries status. CONCLUSION A gap between socioeconomic groups was observed. Subjects from families with low educational level presented poorer dental health. Mothers' schooling could be a good predictor for dental caries in young adults.
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Affiliation(s)
- Marco A Peres
- Department of Public Health, Health Science Centre, Federal University of Santa Catarina, Florianópolis, Brazil.
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Abstract
OBJECTIVE The aim of this study was to assess the prevalence and severity of dental erosion among 12-year-old schoolchildren in Joaçaba, southern Brazil, and to compare prevalence between boys and girls, and between public and private school students. METHODS A cross-sectional study was carried out involving all of the municipality's 499, 12-year-old schoolchildren. The dental erosion index proposed by O'Sullivan was used for the four maxillary incisors. Data analysis included descriptive statistics, location, distribution, and extension of affected area and severity of dental erosion. RESULTS The prevalence of dental erosion was 13.0% (95% confidence interval = 9.0-17.0). There was no statistically significant difference in prevalence between boys and girls, but prevalence was higher in private schools (21.1%) than in public schools (9.7%) (P < 0.001). Labial surfaces were less often affected than palatal surfaces. Enamel loss was the most prevalent type of dental erosion (4.86 of 100 incisors). Sixty-three per cent of affected teeth showed more than a half of their surface affected. CONCLUSION The prevalence of dental erosion in 12-year-old schoolchildren living in a small city in southern Brazil appears to be lower than that seen in most of epidemiological studies carried out in different parts of the world. Further longitudinal studies should be conducted in Brazil in order to measure the incidence of dental erosion and its impact on children's quality of life.
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Affiliation(s)
- K G Peres
- Universidade do Sul de Santa Catarina (UNISUL), Tubarão, Brazil.
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Abstract
OBJECTIVE To identify social and behavioral conditions that could act as risk factors to the severity of dental caries in 12-year-old children. METHODS Based on the oral health survey data obtained in Florianópolis, Brazil, in 1995, social and behavior conditions were compared between two 12-year-old children groups with dental caries with different severity: high and very high severity, and very low severity. In the interview, there were questions about each family were part of the interview, besides social-economic conditions and behavior aspects. RESULTS/CONCLUSIONS The multivariate logistic regression analysis showed that the risk factors for dental caries with high severity were candy intake and family income. Children who consumes cariogenic products 2 or 3 times a day on a daily basis has 4.41 more chance of having dental caries with high severity when compared to children who consumes these same products only once a day - CI (OR) = [1.18; 16.43] ). Family income was the most important socialeconomic factor. Children whose family income is lower than five minimum wages has 4.18 more chance of having high severity dental caries when compared to children whose family income is higher than five minimum wages - CI (OR) = [1.16; 15.03]. The purpose of this study was to have a a better knowledge of dental caries occurrence in 12-year-old children who, in most cases, have a complete permanent dentition that showed the illness history.
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Affiliation(s)
- K G Peres
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
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