Oral Health Indicators Research Articles

Oral/dental items in the resident assessment instrument - minimum Data Set 2.0 lack validity: results of a retrospective, longitudinal validation study.

BackgroundOral health in nursing home residents is poor. Robust, mandated assessment tools such as the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) 2.0 are key to monitoring and improving quality of oral health care in nursing homes. However, psychometric properties of RAI-MDS 2.0 oral/dental items have been challenged and criterion validity of these items has never been assessed.MethodsWe used 73,829 RAI-MDS 2.0 records (13,118 residents), collected in a stratified random sample of 30 urban nursing homes in Western Canada (2007–2012). We derived a subsample of all residents (n = 2,711) with an admission and two or more subsequent annual assessments. Using Generalized Estimating Equations, adjusted for known covariates of nursing home residents’ oral health, we assessed the association of oral/dental problems with time, dentate status, dementia, debris, and daily cleaning.ResultsPrevalence of oral/dental problems fluctuated (4.8 %–5.6 %) with no significant differences across time. This range of prevalence is substantially smaller than the ones reported by studies using clinical assessments by dental professionals. Denture wearers were less likely than dentate residents to have oral/dental problems (adjusted odds ratio [OR] = 0.458, 95 % confidence interval [CI]: 0.308, 0.680). Residents lacking teeth and not wearing dentures had higher odds than dentate residents of oral/dental problems (adjusted OR = 2.718, 95 % CI: 1.845, 4.003). Oral/dental problems were more prevalent in persons with debris (OR = 2.187, 95 % CI: 1.565, 3.057). Of the other variables assessed, only age at assessment was significantly associated with oral/dental problems.ConclusionsRobust, reliable RAI-MDS 2.0 oral health indicators are vital to monitoring and improving oral health related quality and safety in nursing homes. However, severe underdetection of oral/dental problems and lack of association of well-known oral health predictors with oral/dental problems suggest validity problems. Lacking teeth and not wearing dentures should be considered an indicator for urgent oral/dental treatment needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0108-y) contains supplementary material, which is available to authorized users.

Oral health and human papillomavirus-associated head and neck squamous cell carcinoma.

Indicators of poor oral health, including smoking, have been associated with increased risk of head and neck squamous cell carcinoma, especially oropharyngeal squamous cell carcinoma (OPSCC), yet few studies have examined whether this association is modified by human papillomavirus (HPV) status. Data from interviews and tumor HPV status from a large population-based case-control study, the Carolina Head and Neck Cancer Study (CHANCE), were used to estimate the association between oral health indicators and smoking among 102 HPV-positive patients and 145 HPV-negative patients with OPSCC and 1396 controls. HPV status was determined by p16INK4a (p16) immunohistochemistry. Unconditional, multinomial logistic regression was used to estimate odds ratios (ORs) for all oral health indictors adjusting for important covariates. Routine dental examinations were associated with a decreased risk of both HPV-negative OPSCC (OR, 0.52; 95% confidence interval [CI], 0.35-0.76) and HPV-positive OPSCC (OR, 0.55; 95% CI, 0.36-.86). Tooth mobility (a proxy for periodontal disease) increased the risk of HPV-negative disease (OR, 1.70; 95% CI, 1.18-2.43) slightly more than the risk for HPV-positive disease (OR, 1.45; 95% CI, 0.95-2.20). Ten or more pack-years of cigarette smoking were strongly associated with an increased risk of HPV-negative OPSCC (OR, 4.26; 95% CI, 2.85-6.37) and were associated less with an increased risk of HPV-positive OPSCC (OR, 1.62; 95% CI, 1.10-2.38). Although HPV-positive and HPV-negative HNSCC differ significantly with respect to etiology and tumorigenesis, the current findings suggest a similar pattern of association between poor oral health, frequency of dental examinations, and both HPV-positive and HPV-negative OPSCC. Future research is required to elucidate interactions between poor oral health, tobacco use, and HPV in the development of OPSCC. Cancer 2017;71-80. © 2016 American Cancer Society.

Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172 630 participants from the prospective 45 and Up Study.

ObjectiveTo investigate the relationship between oral health and incident hospitalisation for ischaemic heart disease (IHD), heart failure (HF), ischaemic stroke and peripheral vascular disease (PVD) and all-cause mortality.DesignProspective population-based study of Australian men and women aged 45 years or older, who were recruited to the 45 and Up Study between January 2006 and April 2009; baseline questionnaire data were linked to hospitalisations and deaths up to December 2011. Study exposures include tooth loss and self-rated health of teeth and gums at baseline.SettingNew South Wales, Australia.ParticipantsIndividuals aged 45–75 years, excluding those with a history of cancer/cardiovascular disease (CVD) at baseline; n=172 630.Primary outcomesIncident hospitalisation for IHD, HF, ischaemic stroke and PVD and all-cause mortality.ResultsDuring a median follow-up of 3.9 years, 3239 incident hospitalisations for IHD, 212 for HF, 283 for ischaemic stroke and 359 for PVD, and 1908 deaths, were observed. Cox proportional hazards models examined the relationship between oral health indicators and incident hospitalisation for CVD and all-cause mortality, adjusting for potential confounding factors. All-cause mortality and incident CVD hospitalisation risk increased significantly with increasing tooth loss for all outcomes except ischaemic stroke (ptrend<0.05). In those reporting no teeth versus ≥20 teeth left, risks were increased for HF (HR, 95% CI 1.97, 1.27 to 3.07), PVD (2.53, 1.81 to 3.52) and all-cause mortality (1.60, 1.37 to 1.87). The risk of IHD, PVD and all-cause mortality (but not HF or ischaemic stroke) increased significantly with worsening self-rated health of teeth and gums (ptrend<0.05). In those reporting poor versus very good health of teeth and gums, risks were increased for IHD (1.19, 1.03 to 1.38), PVD (1.66, 1.13 to 2.43) and all-cause mortality (1.76, 1.50 to 2.08).ConclusionsTooth loss and, to a lesser extent, self-rated health of teeth and gums, are markers for increased risk of IHD, PVD and all-cause mortality. Tooth loss is also a marker for increased risk of HF.

Highlights of This Issue

Physical activity protects against breast cancer, possibly by inducing changes in adipokine levels. The WISER Sister Trial was a three-armed randomized controlled trial in which exercise intervention and adipokine levels were monitored in premenopausal women at increased risk of breast cancer. In this study, Sturgeon and colleagues observed significant linear trends for increased fitness capacity, increased body fat–adjusted adiponectin levels, decreased fat tissue-to-total tissue mass, and decreased body fat–adjusted leptin levels. This important study demonstrates that improved adipokine levels, achieved by aerobic exercise training, may help decrease breast cancer risk for high-risk premenopausal women.The association between oral health and risk of nasopharyngeal carcinoma (NPC) is largely unknown. Further understanding could shed light on potential pathogenic mechanisms and preventive measures. Liu and colleagues conducted a population-based case–control study in southern China using a structured questionnaire inquiring about oral health indicators and potential confounding factors. A higher number of filled teeth was associated with an elevated risk of NPC and a borderline significant positive association was detected with earlier age at first adult tooth loss, suggesting that improved oral hygiene might contribute to reducing NPC risk.Although genome-wide association studies (GWAS) have identified many genetic variants associated with lung cancer, these variants have low penetrance and are poor predictors of lung cancer in individuals. To increase the predictive value of germline variants, Qian and colleagues evaluated the cumulative effects of genetic variants in the context of biologic pathways. Compared to typical binomial prediction models, the pathway-based multinomial model significantly improved prediction performance. The authors propose pathway–exposure interactions as potentially powerful new contributors to risk inference.Cross-sectional studies have reported a novel set of hydroxylated ultra-long-chain fatty acids (ULCFAs) that are present at lower levels in colorectal cancer cases, compared to controls. Perttula and colleagues measured ULCFA levels in prediagnostic serum from incident colorectal cancer cases and controls. Levels of eight ULCFAs were compared between cases and controls with paired t tests and a linear model that used time to diagnosis (TTD) to determine whether case–control differences were influenced by disease progression. Paired t tests detected significantly lower levels of four ULCFAs in colorectal cancer cases, but the case–control differences diminished significantly with increasing TTD (7 days to 14 years). This work indicates that ULCFA levels are unlikely to represent exposures that protect against colorectal cancer.

Oral Hygiene and Risk of Nasopharyngeal Carcinoma-A Population-Based Case-Control Study in China.

The association between oral health and risk of nasopharyngeal carcinoma (NPC) is largely unknown. Further understanding could shed light on potential pathogenic mechanisms and preventive measures. We conducted a population-based case-control study in southern China between 2010 and 2014. We enrolled 2,528 incident NPC cases, aged 20-74 years, and 2,596 controls, randomly selected from the total population registers, with frequency matching to the 5-year age and sex distribution of the cases by geographic region. We interviewed subjects using a structured questionnaire inquiring about oral health indicators and potential confounding factors. We used unconditional logistic regression to estimate multivariate-adjusted ORs with 95% confidence intervals (CI). A higher number of filled teeth was associated with an elevated risk of NPC. Individuals with 1 to 3 and more than 3 teeth filled versus none had adjusted ORs of 1.25 (95% CI, 1.06-1.49) and 1.55 (95% CI, 1.13-2.12), respectively (Ptrend = 0.002). Conversely, the adjusted OR for those who brushed teeth twice or more per day versus once or less per day was 0.62 (95% CI, 0.55-0.70). We detected a borderline significant positive association with earlier age at first adult tooth loss. Our study suggested a positive association between some indicators of poor oral health and risk of NPC. Further studies are needed to confirm whether the findings are causal and, if so, to further explain the underlying mechanisms. Improvement of oral hygiene might contribute to reducing NPC risk. Cancer Epidemiol Biomarkers Prev; 25(8); 1201-7. ©2016 AACR.

Signs and symptoms of temporomandibular joint disorders in elderly population treated within the public hospital network of Medellin (Colombia)

Objective: To determine prevalence of temporomandibular joint disorders signs and symptoms of elderly adults in Medellin as well as related factors. Material and methods: The present was a crosssectional study conducted at the «Metrosalud» hospital network.The study was composed of 342 adult patients ≥ 65 years, (57.8% females) Variables: Socio-demographical and social support (Duke- 11); Self-perceived stress, mental health, self-perceived general health, satisfaction with respect to dental circumstances, self-perceived oralhealth, oral problems (previous 30 days), number of teeth present, presence of prostheses (upper/lower), Helkimo Anamnestic Index and clinical assessment. Prevalence of temporomandibular joint disorders- Helkimo Anamnestic Index was assessed with respect to health and socio-demographic variables, temporomandibular joint disorders was assessed according to clinical evaluation. Association between temporomandibular joint disorders-Helkimo Anamnestic Index and health indicators was evaluated as well as clinical temporomandibular joint disorders by means of logistic regression calculating crude and adjusted Odds Ratio with 95% (CI95%) confi dence intervals. Results: Prevalence of severe symptoms was higher in males (32%), females exhibited higher prevalence of mild symptoms (18.8%); differences were found according to socio-demographic factors. Subjects reporting symptoms tended to report higher prevalence of poor oral and general health indicators. Higher association was found for patients with dental problems in the previous 30 days. (aOR 3.57; CI95% 1.80-7.08) in the case of women and, for men, the indicator was poor mental health (aOR 2.83; CI95% 1.31-6.09) Even though females exhibited greater risk of reporting TMJ related problems (except for the presence of articular noises) no statistical signifi cant associations were found. Conclusions: Further epidemiological surveillance systems are required in order to suitably and clearly establish associations found in the present study.

More Harm than Healing? Investigating the Iatrogenic Effects of Mercury Treatment on Acquired Syphilis in Post-medieval London.

AbstractMercury was commonly used to treat syphilis in post-medieval Europe, but debate persists about whether it ameliorated infection or exacerbated it. As there are no in vitro studies on mercury’s effectiveness, Hg levels were characterized using an established technique, portable X-Ray Florescence Spectrometry (pXRF) in syphilitic skeletons (N=22) from six post-medieval London cemeteries. Levels were assessed against proxies for syphilitic infection severity (lesion type, episodic involvement, extent of involvement), oral health indicators, and age at death. The findings are equivocal, likely obfuscated by background poor oral health and high mortality, and cannot elucidate whether mercury ‘killed or cured’.

Oral Health in Appalachia: Regional, State, Sub-State, and National Comparisons

Abstract This study compares oral health measures within Appalachia, Appalachian states, and the rest of the United States to determine which geographic areas experienced the poorest oral health. We aggregated oral health indicators from the Behavioral Risk Factor Surveillance System to estimate prevalence of poor oral health indicators between Appalachian and non-Appalachian regions, as well as metropolitan and non-metropolitan differences within regions. Regional, state, sub-state, and national comparisons of oral health indicators and determinants of health are reported. Central and southern Appalachian regions (based on geographical description, not ARC designation) experienced poorer oral health than northern Appalachia. Mississippi and West Virginia scored especially low in oral health indicators. Oral health indicators were significantly worse in non-metropolitan areas of Appalachian states than in metropolitan areas, and all oral health measures were significantly worse in metropolitan areas of Appalachia than in metropolitan areas across the United States. However, Appalachian non-metropolitan residents were no more or less likely to have had a dental visit than non-metropolitan residents across the United States. It is important to emphasize that not all of Appalachia experiences poor oral health outcomes. While areas of Appalachia had some of the poorest oral health outcomes in the nation, other areas had better outcomes than poor rural areas in other states.

Report of the EGOHID I Project. Selecting a coherent set of indicators for monitoring and evaluating oral health in Europe: criteria, methods and results from the EGOHID I project.

The EGOHID I (European Global Oral Health Indicators Development) project started in 2002 under the European Health Monitoring Programme. The aim was to develop a set of indicators for monitoring and describing oral health morbidity and different facets of oral health care systems in Europe. The challenge was to define valid indicators that would cover common concerns and would have the same meaning throughout the different European health care systems. EGOHID included i) a review of existing recommendations on oral health indicators, ii) a European study of the availability of national/or regional statistics to construct recommended indicators; iii) a consensus process using aggregation of preferences methods to select a list of essential indicators; iv) the production of a catalogue for information users, including descriptions for all indicators. A set of 40 indicators in oral public health were identified which, even though restricted to a minimal essential list, still addressed four key dimensions. The 40 indicators were described in four categories. Part A. indicators for monitoring the oral health of children and adolescents; Part B. indicators for monitoring the oral health of general population; Part C. indicators for monitoring oral health systems and Part D. indicators for monitoring oral health quality of life. This work has enabled a feasibility study (EGOHID II, which is now in progress), which is an essential part of an overall project, since it will allow Member States to evaluate their capability to use these indicators. The EGOHID 1 project was successful in identifying a set of 40 indicators which drew on and consolidated previous work. Consensus was achieved from a wide group of stakeholders on precise indicators in areas where uncertainty about appropriate indicators was high; some areas were also targeted for future development.

Cognitive Ability as a Determinant of Socioeconomic and Oral Health Status among Adolescent College Students of Bengaluru, India.

Levels of oral health and economic status are unequally distributed throughout the population. Inequality has multiple causes and that the effect of Socio Economic Status (SES) and demographic factors, on oral health is mediated through several factors. Association between cognitive ability and oral health had been demonstrated in older age groups but adolescents and younger adults have received relatively little attention in this field. To establish the role of cognitive ability as a determinant of SES and oral health status among adolescent college students of Benagluru, Karnataka, India. A cross-sectional study was conducted among 1000 adolescents aged 17-19 years. Six government and six private first grade colleges were selected by multi-stage random sampling. Cognitive ability was assessed using digit symbol substitution test and digit span test. Dental caries and periodontal status were recorded by extent of bleeding, presence of calculus, periodontal pockets, loss of attachments using Community Periodontal Index, decayed, missing and filled teeth surfaces using Decayed, Missing, Filled Teeth and Surfaces Index. SES status was assessed using Kuppuswamy scale. Chi-square test was used to check the association of cognitive ability with oral health indicators and SES status. Regression analysis was performed to assess the effect of cognitive ability on oral health indicators after adjusting for SES and effect of SES status on oral health indicators after adjusting for indicators of cognitive ability. Significant association and negative correlation between cognitive ability and indicators for oral health was seen in the regression models. Cognitive ability attributed for nearly 30% changes in the indicators for oral health after adjusting for SES and SES attributed for nearly 25% variance in indicators for oral health after adjusting for cognitive ability. There is a potential role of cognitive ability in SES and oral health.

Association of parental health literacy with oral health of Navajo Nation preschoolers.

Health literacy is 'the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions'. Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale studies have assessed these relationships among American Indians, a population at risk for limited health literacy and oral health problems. This analysis was conducted as part of a clinical trial aimed at reducing dental decay among preschoolers in the Navajo Nation Head Start program. Using baseline data for 1016 parent-child dyads, we examined the association of parental health literacy with parents' oral health knowledge, attitudes, and behavior, as well as indicators of parental and pediatric oral health. More limited health literacy was associated with lower levels of oral health knowledge, more negative oral health attitudes, and lower levels of adherence to recommended oral health behavior. Parents with more limited health literacy also had significantly worse oral health status (OHS) and reported their children to have significantly worse oral health-related quality of life. These results highlight the importance of oral health promotion interventions that are sensitive to the needs of participants with limited health literacy.

Health investment behaviours and oral/gingival health condition, a cross-sectional study among Swedish 19-year olds

Objectives To test the hypothesis that certain individual, environmental and lifestyle factors are positively associated with beneficial health investment behaviours and oral/periodontal health among adolescents. Methods Five hundred and six randomly selected 19-year old subjects living in two different areas (Fyrbodal and Skaraborg) in the county council of Västra Götaland, Sweden participated in a clinical examination and answered questionnaires covering psycho-social and health behavioural issues. Two oral-health models were estimated with gingivitis score as an objective and self-perceived oral health as a subjective indicator. Three health- investment behaviour models were designed with indicators directly related to oral health and two with indicators related to general health as well. The explanatory variables included gender, upper secondary education programme, native country, living area, general self-efficacy and parents’ education level. Results In the objective oral-health model, theoretical studies and living in the Skaraborg area were both positively associated with a lower gingivitis score. For the subjective oral-health indicator, none of the explanatory variables showed statistical significance. In the investment-behaviour model with ‘tooth-brushing ≥ 2 times daily’ as a health indicator, female gender and theoretical studies showed statistically significant associations. With the indicators ‘no/few missed dental appointments’, ‘no tobacco use’ and ‘weekly exercise’, theoretical studies were statistically significant and positively associated. In the investment model with ‘perceived oral health care attention’ as an indicator, a high score of general self-efficacy was significantly associated with the feeling of taking good care of the teeth. Conclusions Individual, environmental and lifestyle factors are associated with young individuals’ oral health investment behaviours and gingival health conditions.

Indicadores de salud bucal de la comuna de Las Guaitecas e Islas Huichas, región de Aysén

Objetivo: Debido a la falta de información epidemiológica sobre salud bucal en la egión de Aysén y zonas aisladas de nuestro país, es que el objetivo de este estudio es evaluar los indicadores de salud bucal dependientes del COPD y ceod en la comuna de Las Guaitecas e Islas Huichas. Materiales y Métodos: Un total de 104 fichas odontológicas fueron consideradas en el estudio; 63 correspondientes a Guaitecas y 41 a Islas Huichas. 43 del programa de 6 años. 35 del programa odontológico de 12 años y 28 del programa de la gestante. Se registró el COPD y ceod según corresponda,calculando el Índice de Significancia de Caries, Porcentaje Libre de Caries, Prevalencia de Caries, con Historia de Caries y el Índice de Cuidados. Resultados: Los índices COPD, ceod, ambas comunidades, mientras que el índice de cuidados es bajo. Conclusiones: Todos los índices son deficientes al compararlos con los observados a nivel regional, nacional e internacional. El índice de cuidados demuestra una baja eficiencia estimada del sistema de salud odontológico. Ambas comunidades están muy lejos de alcanzar las metas internacionales respecto a salud bucal. El porcentaje de población que no tiene acceso a tratamientoodontológico integral, es muy alto en ambas islas.

DISTRIBUSI FREKUENSI KEHILANGAN GIGI BERDASARKAN KLASIFIKASI KENNEDY DITINJAU DARI TINGKAT PENDAPATAN MASYARAKAT KELURAHAN PEUNITI BANDA ACEH

Background: The missing teeth are substantially can influence the whole of general and oral health quality. That also can be the oral health indicator in a population. Partial edentulous teeth is a missing condition of one or several teeth that can cause the loosing of function which causing by a disease or specific condition. Kennedy classification is to classify the state division of some missing teeth include bilateral posterior Kennedy class I edentulous area (free end), Kennedy class II posterior unilateral edentulous area, Kennedy class III unilateral or bilateral edentulous (bounded), class IV Kennedy Single Edentulous Area used as the reference of anterior to see partial missing teeth area. Purpose: The study aims to see the frequency distribution of partial edentulous based on the Kennedy classification with income levels at the Peuniti Village society in Banda Aceh aged 35-44 years. Method: The study began the selection of the subject at the Peuniti Village in Banda Aceh with missing teeth oral examination and fill the questionaire. The study was using univariate analysis to see the frequency distribution of missing teeth in subject at Peuniti Village Banda Aceh. Result: The result showed that partial edentulous based on the Kennedy classification with income level at Peuniti Village society inBanda Aceh was higher in class III and found at age 35-44 years.

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A

ObjectiveTo evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations. DesignIn this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA. ResultsPoorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P<0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5–6mm were significantly higher in both diabetic groups compared to control group (P<0.05). Poorly controlled T2DM group had significantly higher sites with CAL≥7mm than other groups (P=0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P<0.05). In both diabetic groups, probing depths 5–6mm and CAL 5–6mm were associated with higher salivary CHGA concentration (P<0.05). ConclusionsThe findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL≥7mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.

Influence of scheduling in clinical dental care on indicators of oral health

Objective: Assess the oral health indicators in the Family Health Units (Unidades de Saúde da Família - USFs) with scheduled demand in comparison with Family Health Units with spontaneous demand in oral health care, in Piracicaba. Methods: 10 Family Health Units located in Piracicaba, were randomly chosen: 5 Units with spontaneous demand and 5 Units with scheduled demand. Secondary data in daily production spreadsheets were collected from the information system, from February to September 2013. These were organized into indicators: 1) access; 2) resolutivity; 3) ratio of dental emergency per inhabitant; 4) mean number of individual preventive and curative dental procedures; 5) ratio of dental extraction per dental procedure; 6) ratio of dental extraction per inhabitant; 7) mean number of supervised toothbrushing sessions. Data were compared and statistically analyzed with the BioStat 5.0 program, by applying the Student's-t test (p ≤ 0.05). Results: There were significant differences in the indicators of dental emergency, dental extraction per clinical procedure, and dental extractions per inhabitant, and these values were higher in Family Health Units with spontaneous demand. Conclusion: The model of scheduling the demand for dental care adopted by the USFs interferes in the number of users seeking dental emergency treatments and reasons for extractions.

Pay-for-performance: paying by results in oral health indicators.

Pay-for-performance: paying by results in oral health indicators.

Prevalence of Oral and Maxillofacial Trauma in Elders Admitted to a Reference Hospital in Northeastern Brazil

ObjectiveTo know the prevalence and etiology of oral and maxillofacial trauma in elders.MethodsAnalytical quantitative cross-sectional study conducted at a public trauma hospital located in Fortaleza-Ceará, Brazil. The study population comprised patients with trauma who were hospitalized from April to August 2014. Of these patients, patients with oral and maxillofacial trauma were chosen to be included in the research. A questionnaire was administered in order to obtain information on socio-demographics, systemic comorbidities, use of medication, deleterious habits (smoking and alcohol consumption), etiology of oral and maxillofacial trauma and type of pre-hospital care.ResultsOf the 280 elderly hospitalized with trauma, 47 had oral and maxillofacial trauma, with a prevalence of 16.8%. In this group, the age ranged from 60 to 88 years, with a mean age of 72.4 years (SD± 8.38). The elderly were mostly women (55.3%), self-declared pardos (53.2%), who presented with cardiovascular disorders (48.9%), and who received formal pre-hospital care (70.2%). Elderly who were in the 60–69 years age group, spent 6–9 years at school and drank alcohol were 2.64, 3.75, and 1.97, respectively, more likely to suffer oral and maxillofacial trauma. The main causes of trauma were physical aggression, traffic accidents, falls and domestic accidents. All of the physical aggressions resulted in oral and maxillofacial traumas, and the elderly who suffered traffic accidents were four times more likely to have oral and maxillofacial trauma.ConclusionThe prevalence of 16.8% and the lack of research on oral and maxillofacial traumas in the elderly is worrisome and should be included in the oral health indicators for the elderly population to support the importance of oral health.

Oral health and quality of life of children and adolescents with juvenile idiopathic arthritis according to their caregivers' perceptions.

The aim of this study was to assess the correlation between oral health indicators and oral health-related quality of life (OHRQoL) of children and adolescents with juvenile idiopathic arthritis (JIA) according to their caregivers' perceptions. Parents or guardians (mean age, 40.6 years; standard deviation [SD] = 10.97 years) of children and adolescents with JIA (n = 17; mean age, 9.8 years; SD = 2.86) and parents or guardians of healthy children and adolescents (n = 15; mean age, 10.7 years; SD = 2.16) filled the short form of the Brazilian Parental-Caregiver Questionnaire (SF: 13 - B-PCPQ). Dental evaluations were performed on all children. There was no significant difference in SF: 13 - B-PCPQ scores of the two groups. Children and adolescents with JIA had fewer caries in their primary dentition and more gingival bleeding after probing than those without JIA. The frequency of temporomandibular disorders was 50.0% for JIA patients and 46.7% for their healthy counterparts. There was no correlation between oral health indicators and SF: 13 - B-PCPQ scores. As perceived by caregivers, JIA did not negatively impact the well-being of their children and adolescents as related to oral health, and their OHRQoL did not correlate with oral health status.

Social Inequalities and the Oral health in Brazilian Capitals.

Despite the improvement of the lives of Brazilians, still persists a panorama of iniquities in health in Brazil. This ecological study evaluated the relationship of socioeconomic conditions and public health policy with oral health conditions in Brazilian capitals. Factor analysis was performed with the socioeconomic indicators, revealing two common factors: economic deprivation and socio-sanitary condition. Then, was executed multiple linear regression analysis for the oral health indicators (average DMFT 12 years, mean missing teeth and rate of decay of free population) with two factors in common and fluoridation of water supply. Multiple linear regression analysis to the DMFT of the capitals was estimated by the socio-sanitary conditions and fluoridation, adjusted by economic deprivation; whereas the model for the average missing teeth was estimated only for flu-oridation and economic deprivation, and finally, the model for the rate of caries-free population in the Brazilian capitals was estimated by economic and sociosanitary condition set by fluoridated water supplies. Therefore, the results indicate the need for social actions that impact on people's living conditions to reduce tooth decay.