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Changes in the oral status and periodontal pathogens in a Sardinian rural community from pre-industrial to modern time. Sci Rep 2022; 12:15895. [PMID: 36151274 PMCID: PMC9508227 DOI: 10.1038/s41598-022-20193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
The oral microbial profile in humans has evolved in response to lifestyle changes over the course of different eras. Here, we investigated tooth lesions and the microbial profile of periodontal bacteria (PB) in dental calculus of a Sardinian pre-industrial rural community. In total, 51 teeth belonging to 12 historical individuals buried in an ossuary in the early 1800s and 26 modern teeth extracted from 26 individuals from the same geographical area were compared to determine the oral health status, bacterial load and amount of most relevant PB. Total caries and bacterial genomes count appeared to be sex-related in historical samples. Historical females presented a higher incidence of caries, PB pathogens and a higher bacterial load than historical males. Furthermore, we compared the PB profile of the historical individuals with the modern ones, revealing a notable increase in modern individuals of PB belonging to “Red complex bacteria” often associated with periodontitis and other chronic diseases of modern life. Our findings could be explained through an analysis of environmental factors such as socioeconomic, hygienic and healthy conditions that can have a great impact on oral health and bacterial composition among individuals of the same and different eras.
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Montanha-Andrade K, Maia W, Pimentel ACP, Arsati YBDOL, Santos JND, Cury PR. Dental health status and its indicators in adult Brazilian Indians without exposition to drinking water fluoridation: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:34440-34447. [PMID: 31637613 DOI: 10.1007/s11356-019-06571-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Water fluoridation is considered a cost-effective and practical method for controlling and preventing dental caries in the general population. The objective of this study was to evaluate the dental health status and risk indicators for dental caries in adult Brazilian Indians without exposition to dental caries-preventive effects of water fluoridation. Decayed (DT), missing (MT), and filled (FT) permanent teeth (DMFT), as well as plaque index, unstimulated salivary flow rate, salivary buffering capacity, and fasting blood glucose were examined in 225 adult Indians. Smoking habits and sociodemographic data were evaluated using a structured questionnaire. Drinking water samples from 10 Indian villages were analyzed for the natural fluoride concentration. The mean DMFT was 10.33 ± 6.91 (DT, 4.19 ± 3.99; MT, 4.99 ± 5.64; FT, 1.14 ± 1.75). DMFT index ≥ 9 was associated with age ≥ 35 years (p = 0.000), lower education (p = 0.03), and plaque index > 40% (p = 0.003). DT was associated only with plaque index (p = 0.03). MT was associated with age (p < 0.001) and plaque index (p = 0.01). FT was negatively associated with age (p = 0.02) and income (p = 0.02). Fluoride concentration varied from 0.01 to 0.07 mg/L and was not associated with dental health status (p ≥ 0.29). In conclusion, poorer dental health status was associated with older age, higher plaque index, and lower education and income levels. The fluoride level in the drinking water of Kiriri villages was lower than the level recommended for preventing dental caries. Water fluoridation may be recommended for this population.
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Affiliation(s)
- Katia Montanha-Andrade
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | - Wolf Maia
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | | | - Ynara Bosco De Oliveira Lima Arsati
- Department of Biological Sciences, State University of Feira de Santana, Pc Purificação, 48, Santo Amaro, Feira de Santana, Bahia, 44200-000, Brazil
| | - Jean Nunes Dos Santos
- Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil
| | - Patricia Ramos Cury
- Department of Periodontics, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil.
- Faculdade de Odontologia, Av. Araújo Pinho, 62, Canela, Salvador, Bahia, 40110-150, Brazil.
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Trombley TM, Agarwal SC, Beauchesne PD, Goodson C, Candilio F, Coppa A, Rubini M. Making sense of medieval mouths: Investigating sex differences of dental pathological lesions in a late medieval Italian community. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:253-269. [PMID: 30924143 DOI: 10.1002/ajpa.23821] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/21/2019] [Accepted: 03/02/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Bioarchaeological investigations of sex-based differences in the prevalence of dental pathological lesions, particularly caries, have drawn considerable attention, and out of this work, two dominant models have emerged. Traditionally, the first model interprets sex-related patterns in caries as a product of gendered differences in diet. A more recent model interprets a generally higher propensity for caries prevalence in females in light of reproductive ecology. To test the hypothesis that females have higher risk of caries in accordance with reproductive ecology, we examined and analyzed caries prevalence and other potentially synergistic oral pathological lesions in a late medieval (A.D. 1300-1500) Italian archaeological sample. MATERIALS AND METHODS We examined sex- and age-related prevalence in caries and other oral pathological lesions in a late medieval Italian skeletal assemblage excavated from Villamagna consisting of 38 females and 37 males (n = 1,534 teeth). We examined age- and sex-related patterns in six dental traits: antemortem tooth loss, caries, calculus, periapical inflammation, tooth wear, and periodontitis. RESULTS Significant age-related increases in antemortem tooth loss, caries, calculus, and tooth wear were observed in both males and females. However, there was a lack of expected sex differences in oral pathological lesions, with instead older males exhibiting significantly more antemortem tooth loss and corrected caries than females. DISCUSSION Results are discussed in relation to the ethnohistoric context of medieval rural dietary practices as well as biomedical salivary literature, which suggest that dietary changes throughout the life course may have facilitated trade-offs that buffered females from higher rates of dental pathological lesions.
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Affiliation(s)
- Trent M Trombley
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Sabrina C Agarwal
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Patrick D Beauchesne
- Department of Behavioral Sciences, University of Michigan, Dearborn, Dearborn, Michigan
| | - Caroline Goodson
- Faculty of History, University of Cambridge, King's College, Cambridge, United Kingdom
| | - Francesca Candilio
- Anthropological Service, Soprintendenza Archeologia, Belle Arti e Paesaggio per la città metropolitana di Cagliari e le province di Oristano e Sud Sardegna, Cagliari, Italy.,Physical Anthropology Section, University of Pennsylvania Museum of Archaeology and Anthropology, Philadelphia, Pennsylvania
| | - Alfredo Coppa
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Mauro Rubini
- Department of Archaeology, Foggia University, Foggia, Italy.,Anthropological Service, S.A.B.A.P.-LAZ, Rome, Italy
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Arantes R, Welch JR, Tavares FG, Ferreira AA, Vettore MV, Coimbra CEA. Human ecological and social determinants of dental caries among the Xavante Indigenous people in Central Brazil. PLoS One 2018; 13:e0208312. [PMID: 30566453 PMCID: PMC6300322 DOI: 10.1371/journal.pone.0208312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 11/15/2018] [Indexed: 11/18/2022] Open
Abstract
This community study evaluates complex interactions between macro and micro determinants of oral health in a local Indigenous population based on a theoretical framework of demographic, economic, and healthcare transformation over the last half century. The study population included all residents of eight Xavante villages in Central Brazil. Our hypothetical model posited multiple direct and indirect associations between dental caries and village groups with differentiated territorial and oral care histories, as well as household socioeconomic indicators and food acquisition patterns, individual sociodemographic characteristics, use of dental health services, and oral hygiene practices. Structural equation modelling methods were used to evaluate direct and indirect associations linking exogenous factors and dental caries. Results include 18 direct and 14 indirect statistically significant pathways between determinant variables and dental caries. Significant links with dental caries were shown for socioeconomic indicators, oral healthcare variables, household food acquisition patterns, sex, and age. These findings suggest that the oral health of Xavante residents in the villages studied is associated with determinant factors of different epidemiological and historical scales. The specific historical frame of territorial circumscription and demographic crisis followed by rapid population increase since the 1970s should be considered a cause-of-cause determinant of the economic, healthcare, and sociodemographic profile contributing to oral health among the Xavante. Considering the limitations of cross-sectional studies, our findings underline the importance for oral health determination of historical currents affecting minority ethnic groups within national societies.
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Affiliation(s)
- Rui Arantes
- Fundação Oswaldo Cruz Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - James R. Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Felipe Guimarães Tavares
- Escola de Enfermagem Aurora de Afonso Costa, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Aline Alves Ferreira
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mario Vianna Vettore
- School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom
| | - Carlos E. A. Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Miranda KCDO, Souza TACD, Leal SC. Caries prevalence among Brazilian indigenous population of urban areas based on the 2010 National Oral Health Survey. CIENCIA & SAUDE COLETIVA 2018; 23:1313-1322. [PMID: 29694590 DOI: 10.1590/1413-81232018234.18082016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 07/13/2016] [Indexed: 11/22/2022] Open
Abstract
It is important to have an epidemiological understanding of oral diseases among indigenous persons, in order to contribute with the organization of health services for these populations. The SB Brasil 2010 database was used to compare the prevalence of dental caries among 308 self-identified indigenous and 37,211 non-indigenous individuals from urban areas, in the following age/age-groups: 5, 12, 15-19, 35-44, 65-74. The study also analyzed the effect of the complex sample design and the sample weight in the outcomes. Kruskal-Wallis, Wilcoxon Scores (Rank Sums), logistic and multiple linear regressions were used for statistical analysis. The mean dmft index for indigenous and non-indigenous children aged five were 4.02 ± 4.01 and 2.41 ± 3.35, respectively, and 46% of non-native and 30.8% of native children were caries-free. The mean DMFT for indigenous and non-indigenous were 10.90 ± 11.69 and 10.93 ± 11.58, respectively, for all age groups when not taking into account the sample weight effect. When considering the complex sample design and the sample weight effect, the study found a statistical significant difference. The results lend credence to suspicions that in Brazil there are disparities in the patterns of caries between self-identified indigenous and non-indigenous individuals.
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Affiliation(s)
| | | | - Soraya Coelho Leal
- Departamento de Odontologia, Universidade de Brasília, Brasília, DF, Brasil,
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Schuch HS, Haag DG, Kapellas K, Arantes R, Peres MA, Thomson WM, Jamieson LM. The magnitude of Indigenous and non-Indigenous oral health inequalities in Brazil, New Zealand and Australia. Community Dent Oral Epidemiol 2017; 45:434-441. [PMID: 28509420 DOI: 10.1111/cdoe.12307] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 04/10/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To compare the magnitude of relative oral health inequalities between Indigenous and non-Indigenous persons from Brazil, New Zealand and Australia. METHODS Data were from surveys in Brazil (2010), New Zealand (2009) and Australia (2004-06 and 2012). Participants were aged 35-44 years and 65-74 years. Indigenous and non-Indigenous inequalities were estimated by prevalence ratios (PR) and their corresponding 95% confidence intervals (CI), adjusting for sex, age and income. Outcomes included inadequate dentition, untreated dental caries, periodontal disease and the prevalence of "fair" or "poor" self-rated oral health in Australia and New Zealand, and satisfaction with mouth/teeth in Brazil (SROH). RESULTS Irrespective of country, Indigenous persons had worse oral health than their non-Indigenous counterparts in all indicators. The magnitude of these ratios was greatest among Indigenous and non-Indigenous Australians, who, after adjustments, had 2.77 times the prevalence of untreated dental caries (95% CI 1.76, 4.37), 5.14 times the prevalence of fair/poor SROH (95% CI 2.53, 10.43). CONCLUSION Indigenous people had poorer oral health than their non-Indigenous counterparts, regardless of setting. The magnitude of the relative inequalities was greatest among Indigenous Australians for untreated dental decay and poor SROH.
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Affiliation(s)
- Helena S Schuch
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Dandara G Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Rui Arantes
- Oswaldo Cruz Foundation (Fiocruz), Campo Grande, Mato Grosso do Sul, Brazil
| | - Marco A Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - W M Thomson
- Department of Oral Sciences, The University of Otago, Dunedin, New Zealand
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Crittenden AN, Sorrentino J, Moonie SA, Peterson M, Mabulla A, Ungar PS. Oral health in transition: The Hadza foragers of Tanzania. PLoS One 2017; 12:e0172197. [PMID: 28296885 PMCID: PMC5351833 DOI: 10.1371/journal.pone.0172197] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 02/01/2017] [Indexed: 11/26/2022] Open
Abstract
Conventional wisdom holds that a decline in oral health accompanies the transition from hunting and gathering to agriculture, given increased consumption of carbohydrates. This widely touted example of the mismatch between our biology and modern lifestyle has been intuited largely from the bioarchaeological record of the Neolithic Revolution in the New World. Recent studies of other populations have, however, challenged the universality of this assertion. Here, we present the first comprehensive study of oral health among a living population in transition from the bush to village life, the Hadza hunter-gatherers of Tanzania, to test the hypothesis that the shift from foraging to farming, or agricultural intensification, inevitably leads to increased periodontal disease, caries, and orthodontic disorders. Our results showed that women living in villages consuming a mostly agricultural diet exhibited more caries and periodontal disease than those living in the bush consuming a mostly wild-food diet. Furthermore, men living in the bush consuming mostly a wild-food diet had more than those living in the village consuming a mostly agricultural diet. These findings are explained by the high incidence of maize consumption in village settings, along with previously recognized variation in rate of caries between men and women. The unexpected discovery of high caries incidences for men in the bush is likely explained by heavy reliance on honey, and perhaps differential access to tobacco and marijuana. These data support the notions that mechanisms of cariogenesis are multifactorial and that the relationships between oral health and the shift from a predominantly wild-food diet to one dominated by cultigens are nuanced.
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Affiliation(s)
- Alyssa N. Crittenden
- Metabolism, Anthropometry, and Nutrition Laboratory, Department of Anthropology, University of Nevada, Las Vegas, Nevada, United States of America
| | - John Sorrentino
- D.M.D. Family and Cosmetic Dentistry, New York, United States of America
| | - Sheniz A. Moonie
- Epidemiology and Biostatistics, School of Community Health Sciences, University of Nevada, Las Vegas, Nevada, United States of America
| | | | - Audax Mabulla
- Department of Archaeology, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Peter S. Ungar
- Department of Anthropology, University of Arkansas, Fayetteville, Arkansas, United States of America
- * E-mail:
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Gonçalves ÉM, Cavalcanti LC, Firmino RT, Ribeiro GL, Granville-Garcia AF, Menezes VA. Dental caries experience among indigenous children and adolescents. J Oral Sci 2015; 57:123-9. [PMID: 26062861 DOI: 10.2334/josnusd.57.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Investigations into the oral health status of indigenous populations are scarce. The aim of this study was to evaluate caries experience and associated factors among 342 indigenous children and adolescents aged 5-15 years of the Xukuru community in the municipality of Pesqueira, Brazil. A cross-sectional census study was carried out using the criteria of the World Health Organization to determine caries experience. Examinations were performed by two calibrated dentists and a questionnaire was administered to parents/caregivers addressing socio-demographic data, diet and oral hygiene habits. Logistic regression analysis were performed, with dmft and DMFT as the dependent variables (P < 0.05). Caries experience (dmft/DMFT) was high in both the primary and permanent dentition (75.6% and 62.9%, respectively). Mean dmft and DMFT indices were 3.11 and 2.21, respectively. Caries experience in the primary dentition was associated with children residing in villages far from urban areas (P = 0.016), while caries in the permanent dentition was associated with older children (P < 0.001) and with children from villages at an intermediate distance and far from urban areas (P < 0.001). The indigenous subjects exhibited a high degree of caries experience, which was associated with age and group of villages. Public policies are needed to improve the oral health status of this population.
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Affiliation(s)
- Érica M Gonçalves
- Department of Dentistry, Caruaru Association of Technical Higher Education
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Alves Filho P, Santos RV, Vettore MV. Social and environmental inequities in dental caries among indigenous population in Brazil: evidence from 2000 to 2007. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2014; 16:692-704. [PMID: 24896282 DOI: 10.1590/s1415-790x2013000300013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 12/14/2011] [Indexed: 05/28/2023] Open
Abstract
This ecological study investigated the association between social and environmental inequities and dental caries among indigenous people in Brazil. Dental caries data were gathered from articles identified from electronic databases for the period between 2000 and 2007. Independent variables were obtained from the census of Health Information System for Sanitation Indigenous Populations. Multiple linear regression analysis was conducted to test the association between social and environmental characteristics and dental caries (DMFT index) according to the age group. Results were analyzed for 48 indigenous peoples from 19 selected studies. The occurrence of dental caries in particular age groups was inversely associated with the location of villages outside the Amazon region (12, 15 - 19, and 20 - 34 years), availability of electricity (15 - 19 and 20 - 34 years) and proportion of households covered with straw/thatch (20 - 34 years). The presence of schools was statistically associated with higher DMFT averages (15 - 19 and 20 - 34 years). It can be concluded that aspects of location and existing infrastructure in indigenous communities, which are linked to the availability of oral health services, are associated with the occurrence of dental caries in indigenous populations in Brazil.
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Affiliation(s)
- Pedro Alves Filho
- Secretaria de Estado de Saude do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ricardo Ventura Santos
- Museu Nacional, Escola Nacional de Saude Publica,, Fundacao Oswaldo Cruz, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mario Vianna Vettore
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saude Coletiva, Rio de Janeiro, RJ, Brazil
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Boing AF, Bastos JL, Peres KG, Antunes JLF, Peres MA. Social determinants of health and dental caries in Brazil: a systematic review of the literature between 1999 and 2010. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2014; 17 Suppl 2:102-15. [DOI: 10.1590/1809-4503201400060009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/12/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To review epidemiological studies conducted in Brazil that investigated the distribution of dental caries according to socioeconomic status and demographic characteristics. METHODS: The systematic review included articles published between 1999 and 2010 available in six bibliographic sources, without any other restriction. We analyzed the bibliometric and methodological characteristics of the studies, and the direction and statistical significance of associations tested. RESULTS: Of the 1,128 references identified, 67 were incorporated into this study. There was a higher percentage of publications in the last two years and most of the studies were conducted in the South and Southeast of the country with a young population. The cross-sectional design, using a complex sampling procedure, was the most commonly adopted. The DMFT and dmft indexes were the most commonly used to measure dental caries, while sex/gender, income, education, race/skin color and type of school were the most common socioeconomic exposures. CONCLUSIONS: Most studies identified a high rates of dental caries among the poorest, least educated, black and brown and female individuals. A more detailed methodological and theoretically sound study of the relationship between dental caries and socioeconomic conditions is needed.
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Affiliation(s)
| | | | - Karen Glazer Peres
- Universidade Federal de Santa Catarina, Brazil; The University of Adelaide, Australia
| | | | - Marco Aurélio Peres
- Universidade Federal de Santa Catarina, Brazil; The University of Adelaide, Australia
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Lukacs JR. Sex differences in dental caries experience: clinical evidence, complex etiology. Clin Oral Investig 2010; 15:649-56. [PMID: 20652339 DOI: 10.1007/s00784-010-0445-3] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Accepted: 07/01/2010] [Indexed: 11/30/2022]
Abstract
A sex difference in oral health has been widely documented through time and across cultures. Women's oral health declines more rapidly than men's with the onset of agriculture and the associated rise in fertility. The magnitude of this disparity in oral health by sex increases during ontogeny: from childhood, to adolescence, and through the reproductive years. Representative studies of sex differences in caries, tooth loss, and periodontal disease are critically reviewed. Surveys conducted in Hungary, India, and in an isolated traditional Brazilian sample provide additional support for a significant sex bias in dental caries, especially in mature adults. Compounding hormonal and reproductive factors, the sex difference in oral health in India appears to involve social and religious causes such as son preference, ritual fasting, and dietary restrictions during pregnancy. Like the sex difference in caries, tooth loss in women is greater than in men and has been linked to caries and parity. Results of genome wide association studies have found caries susceptible and caries protective loci that influence variation in taste, saliva, and enamel proteins, affecting the oral environment and the micro-structure of enamel. Genetic variation, some of which is X-linked, may partly explain how sex differences in oral health originate. A primary, but neglected, factor in explaining the sex differential in oral health is the complex and synergistic changes associated with female sex hormones, pregnancy, and women's reproductive life history. Caries etiology is complex and impacts understanding of the sex difference in oral health. Both biological (genetics, hormones, and reproductive history) and anthropological (behavioral) factors such culture-based division of labor and gender-based dietary preferences play a role.
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Affiliation(s)
- John R Lukacs
- Department of Anthropology, University of Oregon, Eugene, OR 97403, USA.
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Arantes R, Santos RV, Frazão P. Diferenciais de cárie dentária entre os índios Xavante de Mato Grosso, Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010. [DOI: 10.1590/s1415-790x2010000200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi avaliar níveis de experiência de cárie entre subgrupos Xavante que vivem em diferentes Terras Indígenas (T.I.) no Estado de Mato Grosso, Brasil, a fim de investigar a presença de desigualdades no interior de uma mesma etnia indígena. Os dados foram coletados através de um censo de saúde bucal realizados em 2004. Das sete T.I. Xavante existentes, foram investigadas quatro (Pimentel Barbosa, Sangradouro, Areões e Marechal Rondon), nas quais foram selecionadas a maior aldeia de cada. Foram adotados os critérios preconizados pela Organização Mundial da Saúde, e utilizado o índice CPOS. Para mensurar as diferenças entre as T.I. foi estimada a razão de prevalência (RP) por meio de análise de regressão de Poisson, efetuada na faixa etária entre 6 e 34 anos para cada sexo, incluindo a idade como covariável. Nesta faixa etária, as perdas variaram entre 26 a 30%. Pimentel Barbosa foi considerada como referência para comparações por apresentar menor prevalência de cárie em todas as faixas etárias analisadas. A maior disparidade foi notada entre as T.I. Pimentel Barbosa e Sangradouro, tanto em homens (RP 2,68- IC95% 2,41 a 2,97) como em mulheres (RP 2,03- IC95% 1,85 a 2,23). A RP do componente obturado em Areões e Marechal Rondon (diferença relativa a Pimentel Barbosa) é muito pequena em relação à carga de doença total nestas T.I., indicando menor presença de serviço odontológico restaurador. Conclui-se que a transição em saúde bucal não é homogênea entre os Xavante e que as diferenças podem estar associadas a particularidades do processo histórico de interação com a sociedade não-indígena. Determinantes locais e regionais, incluindo fatores demográficos, características econômicas e sócio-culturais específicas, acesso e utilização de serviços de saúde, podem ter determinado as desigualdades de ataque de cárie observadas entre os Xavante.
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