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Belotti L, Frazão P. Effectiveness of water fluoridation in an upper-middle-income country: A systematic review and meta-analysis. Int J Paediatr Dent 2022; 32:503-513. [PMID: 34564916 DOI: 10.1111/ipd.12928] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/01/2021] [Accepted: 08/12/2021] [Indexed: 11/27/2022]
Abstract
AIM To summarize the information on the effectiveness of community water fluoridation (CWF) on the reduction of dental caries in the context of the wide use of fluoridated toothpaste in Brazil. DESIGN A systematic review was conducted regarding the effect of CWF based on studies with Brazilian population groups using the following electronic databases: MEDLINE/PubMed, LILACS, SciELO, and SCOPUS. The literature search was conducted up to August 2019. Studies that compared caries experience in at least two areas, one fluoridated and the other non-fluoridated, by mean dmft/DMFT (decayed, missing, and filled teeth) index or caries prevalence (caries vs. caries-free) were included. Considering the beginning of widespread use of fluoride dentifrice and the time for producing dental caries decline, studies published before 1995 were excluded. Descriptive analysis and meta-analyses were carried out. The effect size was measured by mean difference for dmft and DMFT ± SD and odds ratios on a logarithmic scale for caries prevalence. RESULTS Of the 574 studies retrieved, 16 and 10 were included in the qualitative and quantitative analysis, respectively. Fluoridated areas exhibited lower mean dmft/DMFT than non-fluoridated areas did. The mean difference in the dmft between non-fluoridated and fluoridated areas was -2.28 (95% CI -3.26; -1.30) for children aged 5-8 years and -1.12 (95% CI -1.93; -0.32) for those aged 3-12 years; the mean difference in the DMFT was -0.61 (95% CI -0.80; -0.42) for the children aged between 7 and 12 years. The caries prevalence was 1.4 times and 57% lower, respectively, at primary and permanent dentition in fluoridated areas. Heterogeneity was observed in all age groups, ranging from 77.6% to 98.2%. CONCLUSION Community water fluoridation remains effective in preventing dental caries in children younger than 13 years, even with the widespread use of fluoridated toothpaste.
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Affiliation(s)
- Lorrayne Belotti
- Department of Politics, Management and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Paulo Frazão
- Department of Politics, Management and Health, School of Public Health, University of São Paulo, São Paulo, 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: 6] [Impact Index Per Article: 1.2] [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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Iheozor‐Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny A. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; 2015:CD010856. [PMID: 26092033 PMCID: PMC6953324 DOI: 10.1002/14651858.cd010856.pub2] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence. OBJECTIVES To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. SEARCH METHODS We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases. SELECTION CRITERIA For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water. DATA COLLECTION AND ANALYSIS We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation. MAIN RESULTS A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation. AUTHORS' CONCLUSIONS There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.
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Affiliation(s)
- Zipporah Iheozor‐Ejiofor
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Lucy O'Malley
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Jan E Clarkson
- University of DundeeDivision of Oral Health SciencesDental Hospital & SchoolPark PlaceDundeeUKDD1 4HR
| | - Richard Macey
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Rahul Alam
- The University of ManchesterInstitute of Population Health, Centre for Primary CareOxford RoadManchesterUKM13 9PL
| | - Peter Tugwell
- Faculty of Medicine, University of OttawaDepartment of MedicineOttawaCanadaK1H 8M5
| | - Vivian Welch
- University of OttawaBruyère Research Institute85 Primrose StreetOttawaCanadaK1N 5C8
| | - Anne‐Marie Glenny
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
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Lauris JRP, da Silva Bastos R, de Magalhaes Bastos JR. Decline in dental caries among 12-year-old children in Brazil, 1980–2005. Int Dent J 2012; 62:308-14. [DOI: 10.1111/j.1875-595x.2012.00124.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 04/23/2012] [Indexed: 11/26/2022] Open
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Rugg-Gunn AJ, Do L. Effectiveness of water fluoridation in caries prevention. Community Dent Oral Epidemiol 2012; 40 Suppl 2:55-64. [DOI: 10.1111/j.1600-0528.2012.00721.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Loc Do
- Adelaide University; Australia
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Arruda AO, Senthamarai Kannan R, Inglehart MR, Rezende CT, Sohn W. Effect of 5% fluoride varnish application on caries among school children in rural Brazil: a randomized controlled trial. Community Dent Oral Epidemiol 2011; 40:267-76. [DOI: 10.1111/j.1600-0528.2011.00656.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bastos RS, Silva RPR, Maia-Junior AF, Carvalho FS, Merlini S, Caldana ML, Lauris JRP, Bastos JRM. Dental caries profile in Monte Negro, Amazonian state of Rondônia, Brazil, in 2008. J Appl Oral Sci 2010; 18:437-41. [PMID: 21085797 PMCID: PMC4246372 DOI: 10.1590/s1678-77572010000500002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 09/28/2009] [Indexed: 12/04/2022] Open
Abstract
Objective This epidemiological survey assessed the dental caries profile in Monte Negro, a
small town in the Amazonian state of Rondônia, Brazil, and its relationship
with the northern region, national and global goals for oral health in the years
2000 and 2020. Material and Methods The groups randomly examined were composed of individuals aged 5, 12, 15 to 19, 35
to 44, 65 to 74 years, living in both rural and urban areas. Results The means dft (standard deviation) and DMFT (standard deviation) for the groups
were, respectively, 3.15 (3.12), 3.41 (2.69), 5.96 (4.19), 16.00 (7.30) and 25.96
(9.82). Caries-free individuals were 34.42%, 14.81% and 8.16% in the
preschoolchildren, schoolchildren and adolescent groups, respectively. The
Significant Caries Index percentages applied to the two younger groups were 6.65
and 6.70, and they increased to 32.00 in the individuals aged 65 to 74 years. Care
Index percentages for adolescents, adults and elderly groups were, respectively,
29.40, 25.00 and 1.41. The dental caries profile in Monte Negro in 2008 shows
that, 8 years after the year 2000, no FDI/WHO goal for any age settled in 1982 has
been achieved. Dental caries increased with age and the main dental problem of
adult and elderly groups was tooth loss. Conclusion Oral health promotion and prevention of oral disease policies are urgent needs.
Setting of oral health goals and targets to people living in Monte Negro or
Amazonia to be pursuit and achieved in a near future is an important action to do
because of the culture, sanitary conditions and socioeconomic aspects of this
particular population.
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Affiliation(s)
- Roosevelt Silva Bastos
- Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Tobias R, Parente RCP, Rebelo MAB. Prevalência e gravidade da cárie dentária e necessidade de tratamento em crianças de 12 anos de município de pequeno porte inserido no contexto amazônico. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2008. [DOI: 10.1590/s1415-790x2008000400009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O conhecimento da prevalência da cárie dentária em municípios inseridos no contexto amazônico é pouco observado na literatura científica. O presente estudo visa investigar a prevalência e necessidade de tratamento da população de crianças de 12 anos de Rio Preto da Eva, Amazonas no ano de 2007, segundo o sexo e o tipo de localidade (rural e urbana). O estudo transversal foi de natureza descritiva e exploratória com a coleta de dados primários da doença, cujo desenho teve como base o levantamento epidemiológico SB-Brasil 2003. A amostra foi constituída por 344 crianças nas residências e escolas na zona rural e urbana do município. O índice CPO-D geral encontrado foi de 3,73 (+0,17) com predomínio do componente cariado. O percentual de crianças livres de cárie nas zonas urbana e rural foi de 12,5 e 13,6, respectivamente. Não houve diferença estatisticamente significante entre os sexos e os tipos de localidade. Na zona rural existem cerca de duas vezes mais dentes com necessidade de tratamento do que na zona urbana. O tratamento restaurador representou a maior necessidade de tratamento desta população (86,2%). A prevalência de cárie na população de 12 anos de idade, em Rio Preto da Eva-AM, é moderada e o CPO-D médio encontrado está acima da meta estabelecida para o ano 2.000 pela FDI/OMS. Os dados evidenciam a necessidade de implementação de medidas de atenção à saúde bucal que sejam capazes de intervir nos determinantes da cárie dentária na população estudada.
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Peres SHDCS, Carvalho FSD, Carvalho CPD, Bastos JRDM, Lauris JRP. Polarização da cárie dentária em adolescentes, na região sudoeste do Estado de São Paulo, Brasil. CIENCIA & SAUDE COLETIVA 2008; 13 Suppl 2:2155-62. [DOI: 10.1590/s1413-81232008000900020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Indexed: 11/22/2022] Open
Abstract
A saúde bucal na maioria dos municípios brasileiros constitui ainda um grande desafio aos princípios doutrinários do SUS. Este estudo objetivou analisar a prevalência de cárie dentária (CPOD) e as diferenças quanto ao gênero e localização geográfica, Significant Caries Index (SiC) e a porcentagem de livres de cárie no município de Itaí, São Paulo, em 2006. Utilizou-se a metodologia da OMS (1997), em uma população constituída por 390; destes, 178 adolescentes aos 12 anos de idade e que correspondem a 46% dos adolescentes matriculados nas escolas do município. O exame foi realizado por um único examinador. O teste kappa foi calculado com valor de concordância de 0,95. O índice CPOD foi de 2, 45, o SiC de 5, 08, e 30% dos indivíduos se apresentaram livres de cárie. Observou-se que 34% dos adolescentes concentraram 70% da doença demonstrando a ocorrência da polarização da cárie dentária. Foram encontradas diferenças estatisticamente significantes na comparação do CPOD entre a localização geográfica e o mesmo não aconteceu com o gênero. Concluiu-se que está ocorrendo a polarização da cárie dentária em adolescentes, aos 12 anos, mas esta ocorrência não se apresenta de forma homogênea. Os problemas se intensificam em uma pequena parcela da população.
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Silva RHAD, Castro RFMD, Cunha DCS, Almeida CTD, Bastos JRDM, Camargo LMA. Cárie dentária em população ribeirinha do Estado de Rondônia, Região Amazônica, Brasil, 2005/2006. CAD SAUDE PUBLICA 2008; 24:2347-53. [DOI: 10.1590/s0102-311x2008001000015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Accepted: 02/25/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi analisar experiência de cárie dentária na população ribeirinha residente às margens dos rios Machado e Preto (Rondônia, Brasil), em 2005 e 2006. Foram examinados 469 indivíduos com formulário preconizado pela Organização Mundial da Saúde, sob luz natural e utilização de espátulas de madeira e sonda CPI. Na faixa etária de 4-5 anos de idade, ceod = 4,30 e 19,64% livres de cárie; 6-10 anos, CPOD = 1,04, ceod = 3,52, 17,05% livres de cárie; aos 12 anos, CPOD = 2,65 e 30,76% livres de cárie; aos 18 anos, CPOD = 5,41 e 19,51% livres de cárie; 35-44 anos, CPOD = 17,74 e 2,98% livres de cárie; 65-74 anos, CPOD = 21,56 e 4,34% livres de cárie. Na análise por componentes, constatou-se que o componente cariado tem maior prevalência nas idades de 0-3, 4-5, 6-10, 12 e 18 anos. Em adultos e idosos, o componente que mais contribui é o perdido. Conclui-se que a população apresenta índices de cárie dentária elevados, sendo necessária a atuação em âmbito educativo, preventivo e curativo.
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Santos NCND, Alves TDB, Freitas VS, Jamelli SR, Sarinho ESC. A saúde bucal de adolescentes: aspectos de higiene, de cárie dentária e doença periodontal nas cidades de Recife, Pernambuco e Feira de Santana, Bahia. CIENCIA & SAUDE COLETIVA 2007; 12:1155-66. [DOI: 10.1590/s1413-81232007000500012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 02/28/2007] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Caracterizar a saúde bucal de adolescentes nas cidades de Recife e Feira de Santana, pela avaliação de higiene bucal, cárie dentária e doença periodontal. MÉTODO: Foram avaliados 40 adolescentes com 10 a 18 anos de idade em Recife, em estudo exploratório, em 2005 e, em Feira de Santana, 971 adolescentes com 12 anos idade, num estudo de prevalência, em 2002. Avaliaram-se: cárie, pelo número de dentes cariados, perdidos e obturados; placa dentária visível, sangramento gengival e condição periodontal. Para análise, utilizaram-se os testes Quiquadrado, Kruskall-Wallis, Exato de Fisher, com intervalo de confiança de 95%. RESULTADOS: A maioria dos adolescentes realizavam higiene oral três vezes ao dia. Os valores do CPOD apresentaram mediana de 1,5 em Recife e médias de 1,89 nas escolas estaduais, 2,17 nas municipais e 2,39 nas particulares, em Feira de Santana. O sangramento gengival em Recife teve mediana de 27% e, em Feira de Santana, a média de sextantes sadios foi de 4,36, 4,08 e 5,16, nas escolas estaduais, municipais e particulares respectivamente. CONCLUSÃO: A freqüência da cárie dentária foi baixa, a maioria dos adolescentes relatou bons hábitos de higiene bucal e a condição periodontal nos adolescentes foi favorável.
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López R, Baelum V. Gender differences in tooth loss among Chilean adolescents: socio-economic and behavioral correlates. Acta Odontol Scand 2006; 64:169-76. [PMID: 16809195 DOI: 10.1080/00016350500514824] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate gender differences in tooth loss among Chilean adolescents and its association with selected socio-economic indicators and oral-health-related behaviors. MATERIAL AND METHODS Data on 9,163 Chilean adolescents obtained using multistage random cluster procedures. Clinical recordings included information on missing teeth and the participants provided information on socio-demographic factors and oral-related behaviors. Two eruption-time-adjusted logistic regression analyses were used to investigate the associations between gender, tooth loss and socio-economic position/oral-health-related behaviors. RESULTS The association between gender and tooth loss remained after adjusting for age, eruption times in both the socio-economic position regression model and the oral-health-related behaviors model. Tooth loss followed social gradients for the variables paternal income and achieved parental education, with students reporting a paternal income < 100,000 US dollars (OR = 2.0), and having a father (OR = 1.8) and a mother (OR = 2.0) who achieved only primary school education being more likely to experience tooth loss. The adjusted regression model for behavioral indicators revealed that students who reported brushing their teeth once a day (OR = 1.6) were more likely to have experienced tooth loss than those who reported more frequent toothbrushing. Students who visited a dentist rarely (OR = 0.8) or never (OR = 0.5) were less likely to have lost first molars and/or incisors. CONCLUSIONS The results demonstrate that gender differences in tooth loss among young Chileans are related to socio-economic position; and selected oral-health-related behaviors after adjusting for eruption time variation.
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Affiliation(s)
- Rodrigo López
- Faculty of Health Sciences, University of Aarhus, Aarhus, Denmark.
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Barros SFB, Matos DL. Prevalência de fluorose dentária em escolares de 12 anos de idade, Ouro Preto/MG - 2003. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2005. [DOI: 10.1590/s1415-790x2005000400011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: verificar a prevalência da fluorose dentária em escolares de 12 anos de idade em Ouro Preto. METODOLOGIA: estudo seccional incluindo 248 crianças selecionadas aleatoriamente em 11 escolas do município. A amostra foi calculada de acordo com a metodologia descrita no Projeto SB2000. Os exames foram realizados por cirurgião-dentista treinado e calibrado. Os índices utilizados para medir a fluorose foram: índice de Dean e índice comunitário de fluorose. RESULTADOS: De 248 crianças selecionadas, 159 (64,1%) participaram deste estudo. A prevalência de fluorose (índice de Dean) encontrada foi de 11,4%, sendo composta pela condição muito leve (10,1%) e leve (1,3%). A condição moderada e severa de fluorose não foi encontrada. Os dentes mais acometidos por fluorose foram os pré-molares, molares, incisivos e caninos. Não houve diferença entre os sexos quanto ao grau de fluorose, e o índice comunitário de fluorose foi de 0,29. CONCLUSÃO: a fluorose em crianças de 12 anos não é um problema de saúde pública em Ouro Preto, dado que a prevalência não é alta e quase todos os casos encontrados são muito leves.
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Affiliation(s)
| | - Divane Leite Matos
- Fundação Oswaldo Cruz; Universidade Federal de Minas Gerais; Secretaria Estadual de Saúde de Minas Gerais
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Gushi LL, Soares MDC, Forni TIB, Vieira V, Wada RS, de Sousa MDLR. Cárie dentária em adolescentes de 15 a 19 anos de idade no Estado de São Paulo, Brasil, 2002. CAD SAUDE PUBLICA 2005; 21:1383-91. [PMID: 16158143 DOI: 10.1590/s0102-311x2005000500010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Verificou-se a experiência da cárie dentária em adolescentes de 15 a 19 anos, considerando-se prevalência e severidade da doença, segundo idade, gênero, etnia e fluoretação das águas. Foi um estudo transversal realizado com dados do levantamento epidemiológico do Estado de São Paulo, Brasil, 2002, no qual 1.825 adolescentes foram examinados em seus domicílios, por 132 cirurgiões-dentistas em 35 municípios. Utilizaram-se os testes qui-quadrado, Kruskal-Wallis e Mann-Whitney (alfa= 5%). Com o SiC Index, definiu-se um terço dos indivíduos com maior experiência de cárie. O índice CPO-D foi 6,44 (dp = 4,60) e o SiC Index 11,68. O percentual de livres de cárie foi 9,6%. Não houve diferença entre o CPO-D dos municípios com e sem fluoretação, entretanto houve maior porcentagem de livres de cárie nos municípios com água fluoretada. O gênero masculino teve pior condição em relação à cárie que o gênero feminino. Os não-brancos tiveram maior percentual de dentes cariados e perdidos que os brancos. Sugere-se, portanto, a ênfase em estratégias que possam atenuar os danos causados pela progressão da doença, especialmente no grupo com maior experiência de cárie dentária.
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Affiliation(s)
- Lívia Litsue Gushi
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
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