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Silva IMV, Donaduzzi LC, Perini CC, Couto SAB, Werneck RI, de Araújo MR, Kurahashi M, Johann ACBR, Azevedo-Alanis LR, Vieira AR, Couto-Souza PH. Association of xerostomia and taste alterations of patients receiving antineoplastic chemotherapy: A cause for nutritional concern. Clin Nutr ESPEN 2021; 43:532-535. [PMID: 34024566 DOI: 10.1016/j.clnesp.2021.03.006] [Citation(s) in RCA: 2] [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: 07/16/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS The symptoms of xerostomia and taste alteration are adverse effects which frequently occur in patients under chemotherapy and once associated they can potentially impair their nutritional status. The aim of this study was to investigate the association of xerostomia and taste alterations in patients being treated by neoplastic chemotherapy. METHODS Fifty patients scheduled to receive neoplastic chemotherapy were followed for their first two chemotherapy cycles for solid tumors and the Chemotherapy-Induced Taste Alteration Scale (CiTAS) was adopted. Xerostomia was defined by the presence of dry mouth complaints reported by the patients and signs of hyposalivation identified during the intraoral examination. RESULTS Of the 50 patients, 33 were women, mean age; 61,48 ± 9,07 years, and 17 were men, mean age; 57,35 ± 11,50 years. The most common tumor was located in the breast affecting 15 patients (30%). The Mann-Whitney test showed that the mean scores of CiTAS were significantly higher for those patients who reported having xerostomia when compared with those without xerostomia after the first two chemotherapy cycles. The cofounding variables such as age, smoking habits and use of antidepressants were not statistically associated with taste alterations (p > 0.05). CONCLUSIONS Taste alterations were worse for patients who complained of xerostomia during the first two cycles of antineoplastic chemotherapy and the association of both symptoms can potentially impair their nutritional status and quality of life.
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Affiliation(s)
- Isabela M V Silva
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Liziane C Donaduzzi
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Carla C Perini
- Department of Nutrition, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Soraya A B Couto
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Renata I Werneck
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Melissa R de Araújo
- School of Dentistry, Universidade Federal do Paraná (UFPR), Av. Prefeito Lothário Meissner, 632 - Jardim Botânico, 80210-170, Curitiba, Brazil
| | - Maikol Kurahashi
- Oncology Service of the Santa Casa Hospital of Curitiba, Praça Rui Barbosa, 694 - Centro, 80010-030, Curitiba, Brazil
| | - Aline C B R Johann
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Luciana R Azevedo-Alanis
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Alexandre R Vieira
- Clinical Research for the School of Dental Medicine, University of Pittsburgh, 335 Sutherland Dr., Pittsburgh, PA, 1526, USA
| | - Paulo H Couto-Souza
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil.
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Bezamat M, Souza JF, Silva FMF, Corrêa EG, Fatturi AL, Brancher JA, Carvalho FM, Cavallari T, Bertolazo L, Machado-Souza C, Koruyucu M, Bayram M, Racic A, Harrison BM, Sweat YY, Letra A, Studen-Pavlovich D, Seymen F, Amendt B, Werneck RI, Costa MC, Modesto A, Vieira AR. Gene-environment interaction in molar-incisor hypomineralization. PLoS One 2021; 16:e0241898. [PMID: 33406080 PMCID: PMC7787379 DOI: 10.1371/journal.pone.0241898] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/22/2020] [Indexed: 01/12/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is an enamel condition characterized by lesions ranging in color from white to brown which present rapid caries progression, and mainly affects permanent first molars and incisors. These enamel defects usually occur when there are disturbances during the mineralization or maturation stage of amelogenesis. Both genetic and environmental factors have been suggested to play roles in MIH’s development, but no conclusive risk factors have shown the source of the disease. During head and neck development, the interferon regulatory factor 6 (IRF6) gene is involved in the structure formation of the oral and maxillofacial regions, and the transforming growth factor alpha (TGFA) is an essential cell regulator, acting during proliferation, differentiation, migration and apoptosis. In this present study, it was hypothesized that these genes interact and contribute to predisposition of MIH. Environmental factors affecting children that were 3 years of age or older were also hypothesized to play a role in the disease etiology. Those factors included respiratory issues, malnutrition, food intolerance, infection of any sort and medication intake. A total of 1,065 salivary samples from four different cohorts were obtained, and DNA was extracted from each sample and genotyped for nine different single nucleotide polymorphisms. Association tests and logistic regression implemented in PLINK were used for analyses. A potential interaction between TGFA rs930655 with all markers tested in the cohort from Turkey was identified. These interactions were not identified in the remaining cohorts. Associations (p<0.05) between the use of medication after three years of age and MIH were also found, suggesting that conditions acquired at the age children start to socialize might contribute to the development of MIH.
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Affiliation(s)
- Mariana Bezamat
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Juliana F. Souza
- Department of Stomatology, Federal University of Paraná, Curitiba, State of Paraná, Brazil
| | - Fernanda M. F. Silva
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emilly G. Corrêa
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Aluhe L. Fatturi
- Department of Stomatology, Federal University of Paraná, Curitiba, State of Paraná, Brazil
| | - João A. Brancher
- Graduate Program of Dentistry, Positivo University, Curitiba, State of Pará, Brazil
| | - Flávia M. Carvalho
- Department of Genetics, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tayla Cavallari
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Laís Bertolazo
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Cleber Machado-Souza
- Graduate Program of Applied Biotechnology to Child and Adolescent Health, Pequeno Príncipe College, Curitiba, State of Pará, Brazil
| | - Mine Koruyucu
- Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Merve Bayram
- Department of Pedodontics, Medipol Istanbul University, Istanbul, Turkey
| | - Andrea Racic
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Benjamin M. Harrison
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yan Y. Sweat
- Craniofacial Anomalies Research Center and Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Ariadne Letra
- Department of Diagnostic and Biomedical Sciences, and Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston, Texas, United States of America
| | - Deborah Studen-Pavlovich
- Department of Pediatric Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Figen Seymen
- Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Brad Amendt
- Craniofacial Anomalies Research Center and Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Renata I. Werneck
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Marcelo C. Costa
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Modesto
- Department of Pediatric Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Alexandre R. Vieira
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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Soares GH, Santiago PHR, Werneck RI, Michel-Crosato E, Jamieson L. A Psychometric Network Analysis of OHIP-14 across Australian and Brazilian Populations. JDR Clin Trans Res 2020; 6:333-342. [PMID: 32692286 DOI: 10.1177/2380084420939931] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/16/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach. METHODS Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated. RESULTS Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks. CONCLUSION The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures. KNOWLEDGE TRANSFER STATEMENT This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.
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Affiliation(s)
- G H Soares
- University of São Paulo Dental School, São Paulo, SP, Brazil
| | - P H R Santiago
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - R I Werneck
- School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil
| | | | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
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Soares GH, Mendonça I, Michel-Crosato E, Moysés SJ, Moysés ST, Werneck RI. Impact of oral conditions on the quality of life of incarcerated women in Brazil. Health Care Women Int 2019; 40:776-787. [PMID: 30901282 DOI: 10.1080/07399332.2019.1590362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Imprisoned women represent a growing population worldwide with important health needs. In this study, we aimed to analyze the impact of oral health conditions on the quality of life of female inmates in a maximum security correctional facility. Participants were examined and answered the OHIP-14 questionnaire. A total of 305 inmates were included in the study. Prevalence of untreated caries was 84%. Worse quality of life was associated with dental caries, dental pain, deep periodontal pocket, prosthetic use, and age. Sociodental indicators should be incorporated into healthcare and health policies in order to promote wellbeing among this vulnerable population.
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Affiliation(s)
- Gustavo H Soares
- School of Dentistry, Universidade de São Paulo , São Paulo , São Paulo , Brazil
| | - Iranilda Mendonça
- School of Health and Bioscience, Pontifícia Universidade Católica do Paraná , Curitiba , Paraná , Brazil
| | | | - Samuel J Moysés
- School of Health and Bioscience, Pontifícia Universidade Católica do Paraná , Curitiba , Paraná , Brazil
| | - Simone T Moysés
- School of Health and Bioscience, Pontifícia Universidade Católica do Paraná , Curitiba , Paraná , Brazil
| | - Renata I Werneck
- School of Health and Bioscience, Pontifícia Universidade Católica do Paraná , Curitiba , Paraná , Brazil
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Pereira FA, de Mendonça IA, Werneck RI, Moysés ST, Gabardo MC, Moysés SJ. Human Development Index, Ratio of Dentists and Inhabitants, and the Decayed, Missing or Filled Teeth Index in Large Cities. J Contemp Dent Pract 2018; 19:1363-1369. [PMID: 30602642] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM This study aimed to investigate the associations between human development and the demographic ratio of dentists with the prevalence of dental caries at 12 years of age in large Brazilian cities. MATERIALS AND METHODS Data were collected from 27 state capitals, Secondary databases were used: the municipal human development index (MDHI); the ratio of dentists qualified to exercise their profession according to the number of inhabitants; and the decayed, missing or filled teeth index (DMFT). Pearson correlation coefficient analysis and multiple logarithmic regression analysis were performed. RESULTS The MDHI showed a strong correlation with DMFT and explained 48.1% of the variation in the cities. The ratio of dentists to the number of inhabitants displayed an insignificant, weak correlation with the variations in the DMFT. CONCLUSION Social factors strongly influence the oral health/ disease process in Brazilian capitals, thus actions are needed for the promotion of health at more distal, or structural levels that modify the environment, thus enabling healthier choices for individuals. These results challenge traditional beliefs that only the ratio of professional dentists to inhabitants and the provision of dental services have beneficial effects on the prevention and control of oral health problems. CLINICAL SIGNIFICANCE The prevalence of dental caries is strongly correlated with social factors, as the MDHI.
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Affiliation(s)
- Fabio A Pereira
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Curitiba, Paraná, Brazil
| | - Iranilda A de Mendonça
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Curitiba, Paraná, Brazil
| | - Renata I Werneck
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Curitiba, Paraná, Brazil
| | - Simone T Moysés
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Curitiba, Paraná, Brazil
| | - Marilisa Cl Gabardo
- School of Health and Biological Sciences, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza, Curitiba, Paraná, Brazil, Phone: +55 41 3526-5121, e-mail:
| | - Samuel J Moysés
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, Curitiba, Paraná, Brazil
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Cavallari T, Salomão H, Moysés ST, Moysés SJ, Werneck RI. The impact of MUC5B gene on dental caries. Oral Dis 2017; 24:372-376. [PMID: 28944591 DOI: 10.1111/odi.12784] [Citation(s) in RCA: 7] [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] [Received: 11/25/2016] [Revised: 08/31/2017] [Accepted: 09/15/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify the impact of MUC5B polymorphisms on dental caries. METHODS A case-control study was performed with patients recruited at Pontifícia Universidade Católica do Paraná. These individuals were aged 12 years old or more. Dental caries was diagnosed using the International Caries Detection and Assessment System, and the effects of socioeconomic, dietary, and hygiene factors on dental caries were investigated. Furthermore, buccal cells were collected, and their DNA was extracted and amplified using PCR. Uni-, bi-, and multivariate analyses were performed. RESULTS Two hundred patients were recruited, 100 were assigned to the case group and 100 to the control group. In the bivariate analysis, the following variables showed significant results: ethnicity (p = .008), biofilm (p < .001), and gingivitis (p < .001). The MUC5B gene affected dental caries with the markers rs2735733 (p < .001), rs2249073 (p < .001), and rs2857476 (p < .001). In the multivariate analysis, the biofilm variable remained significant (p = .026), as did the following markers from the MUC5B gene: rs2735733 (p = .019), rs2249073 (p < .025), and rs2857476 (p < .005). CONCLUSION Genetic variations in the MUC5B gene can influence dental caries.
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Affiliation(s)
- T Cavallari
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - H Salomão
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - S T Moysés
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - S J Moysés
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - R I Werneck
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Ulinski SL, Moysés ST, Werneck RI, Moysés SJ. High-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil. Braz J Psychiatry 2016; 38:106-12. [PMID: 26785106 PMCID: PMC7111370 DOI: 10.1590/1516-4446-2014-1574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 05/14/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore high-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil. METHOD Data from 398 drivers on sociodemographic parameters, high-risk behaviors, experiences with traffic law, and traffic law violations were collected through interviews conducted at sobriety checkpoints. Exploratory-descriptive and analytical statistics were used. RESULTS The mean age of the participants was 32.6±11.2 years (range, 18 to 75 years). Half of the drivers reported having driven after drinking in the last year, predominantly single men aged 18 to 29 years who drive cars and drink alcohol frequently. Only 55% of the drivers who had driven after drinking in the last year self-reported some concern about being detected in a police operation. CONCLUSIONS A significant association was found between sociodemographic variables and behavior, which can help tailor public interventions to a specific group of drivers: young men who exhibit high-risk behaviors in traffic, such as driving after drinking alcohol, some of whom report heavy alcohol consumption. This group represents a challenge for educational and enforcement interventions, particularly because they admit to violating current laws and have a low perception of punishment due to the low risk of being detected by the police.
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Affiliation(s)
- Sandra L. Ulinski
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
| | - Simone T. Moysés
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
| | - Renata I. Werneck
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
| | - Samuel J. Moysés
- Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brazil
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Abstract
This article presents an integrative literature review that analyses the advances and challenges in oral health care of the Brazilian primary health care system, based on a political agenda that envisages re-organising the unified health system (SistemaÚnico de Saúde - SUS). It is presumed that the actions suggested by the Alma-Ata Conference of 1978 are still up-to-date and relevant when adapted to the situation in Brazil. Several studies and policies are reviewed, including works demonstrating the importance of primary care as an organising platform in an integrated health-care network, Brazil's strategy for reorganising the primary care network known as the Family Health Strategy, and the National Oral Health Policy. This review discusses results obtained over the last twenty years, with special attention paid to changes in oral health-care practices, as well as the funding of action programmes and assistance cover. The conclusion is that oral healthcare in the Brazilian primary health care system has advanced over the past decades; however, serious obstacles have been experienced, especially with regard to the guarantee of universal access to services and funding. The continuous efforts of public managers and society should focus on the goal of achieving universal coverage for all Brazilians.
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Werneck RI, Lázaro FP, Cobat A, Grant AV, Xavier MB, Abel L, Alcaïs A, Trevilatto PC, Mira MT. A major gene effect controls resistance to caries. J Dent Res 2011; 90:735-9. [PMID: 21364090 DOI: 10.1177/0022034510397614] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite recent advances revealing genetic factors influencing caries susceptibility, questions regarding the model of inheritance involved are yet to be addressed. We conducted a Complex Segregation Analysis on decayed teeth in a sample of homogenous, isolated families recruited from the Brazilian Amazon. A dominant, major gene effect controlling resistance to phenotype was detected. The frequency of the resistance allele "A" was 0.63; mean numbers of decayed teeth were 1.53 and 9.53 for genotypes AA/AB and BB, respectively. These results represent a step toward a description of the exact nature of the genetic risk factors controlling human susceptibility to caries.
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Affiliation(s)
- R I Werneck
- Core for Advanced Molecular Investigation, Graduate Program in Health Sciences, Center for Biological and Health Sciences, Pontifical Catholic University of Paraná, Imaculada Conceição St 1155 - CCBS/PPGCS, Prado Velho, CEP 80215-901 Curitiba, Paraná, Brazil
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Werneck RI, Lawrence HP, Kulkarni GV, Locker D. Early childhood caries and access to dental care among children of Portuguese-speaking immigrants in the city of Toronto. J Can Dent Assoc 2008; 74:805. [PMID: 19000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To determine the influence of accessibility of dental services and other factors on the development of early childhood caries (ECC) among Toronto children 48 months of age or younger with at least one Portuguese-speaking immigrant parent. METHODS This population-based case-control study involved 52 ECC cases and 52 controls (i.e., without ECC) identified from community centres, churches and drop-in centres by a process of network sampling. Caries status (dmft/s) was assessed by clinical examination. Access to dental care and risk factors for ECC were determined through a structured interview with the Portuguese-speaking parent. RESULTS Forty (77%) of the children with ECC but only 28 (54%) of controls had never visited a dentist. Thirty (58%) mothers of children with ECC but only 13 (25%) mothers of controls had not visited a dentist in the previous year. Bivariate analyses revealed that low family income, no family dentist, no dental insurance, breastfeeding, increased frequency of daily snacks and low parental knowledge about harmful child feeding habits were associated with ECC. Non-European-born parents and parents who had immigrated in their 20s or at an older age were 2 to 4 times more likely to have a child with ECC than European parents and those who had immigrated at a younger age. Lack of insurance, no family dentist and frequency of snacks were factors remaining in the final logistic regression model for ECC. CONCLUSIONS The strongest predictors of ECC in this immigrant population, after adjustment for frequent snack consumption, were lack of dental care and lack of dental insurance. These findings support targeting resources to the prevention of ECC in children of new immigrants, who appear to experience barriers to accessing private dental care and who are exposed to many of the determinants of oral disease.
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Affiliation(s)
- Renata I Werneck
- Health and Biological Sciences Centre, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
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Abstract
OBJECTIVE We examined the potential for research using administrative databases containing dentists' claims to identify both the type of health services research questions addressed and the strength of the evidence that is achieved in such studies. METHODS We searched Medline (1966 to March, 2003), retrieved additional reports from personal files, reviewed the literature cited in the relevant articles and conducted electronic searches on investigators' surnames. Information from relevant articles was abstracted into tables and the strength of the evidence for each was classified. RESULTS Thirty-eight studies met our inclusion criteria. Researchers have used administrative databases of dental records to examine provider practices, the longevity or consequences of dental interventions, the prevalence of dental conditions, and patient factors that determined care, and to establish quality assurance criteria or standards of care. The strongest designs were prospective or case-control (Level II-2). CONCLUSION Studies analyzing administrative databases have the advantage of size and economy but are subject to several threats to their validity and are seldom population-based. The strongest designs occurred with investigation of the longevity or consequences of care. Several studies demonstrated the benefit of linking the service data to patient or provider characteristics. The study of dentists' claims data appears under exploited, especially in the area of identifying and recommending changes in dental health care policies.
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Affiliation(s)
- James L Leake
- Community Dentistry, Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON, Canada M5G 1G6.
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