The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people

This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older people's food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI). Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI

Relationship between oral health status and marital quality and work stress

This study aims to investigate whether oral health status is associated with work stress and marital quality. The term stress was applied to define the stimuli themselves and not to the body reaction in response to a variety of physical or psychological stimuli. Marital quality is defined as the subjective evaluation of a married couple's relationship on a number of dimensions and evaluations (Spanier and Lewis, 1980). The hypothesis is that a given set of psychosocial factors, if favourable, will predispose family members to oral health, or alternatively, if unfavourable, will predispose to oral disease. It is hypothesised that families whose members experienced high levels of communication, companionship, and satisfaction with the partner and children are more likely to show better oral health status than families whose members experienced low levels of communication, companionship and satisfaction with the partner and children. In addition, fathers who experienced low levels of stress at work tend to have a better oral health status than fathers who experienced high levels of stress at work. The study was conducted in Belo Horizonte, Brasil. 164 families, equally distributed over four socio-economic groups, were randomly selected from children from private and state schools. The parents' age ranged from 35 to 44 years old. Each family had a child aged 13 years old. Data were analysed using multiple regression analysis (dental caries data) and logistic regression analysis (periodontal data). Age, socio-economic status, gender, dental attendance, toothbrushing frequency, sugar consumption and type of toothpaste were considered in the analysis. The results showed a highly significant linear relationship between marital quality and the father's, mother's and child's dental caries status. Work related mental demand, work control, and work variety were not significantly associated with fathers' dental caries status. A significant relationship between periodontal health status and marital quality was found for fathers and mothers and a significant relationship between work related mental demand and fathers' periodontal health status was also found. It was concluded that marital quality is an important determinant of oral health status - dental caries and periodontal disease - and that work related mental demand is an important determinant of periodontal health status

Can Tobacco consumption explain the association between SEP and chronic periodontitis in adults living in a deprived area of the UK? A secondary analysis of the ELOHI study data.

Aim: To assess whether there are social inequalities on periodontitis at the population level in a deprived area of the United Kingdom (UK) and further elucidate the relationship between socio-economic position, plaque accumulation, tobacco smoking, and chronic periodontitis in a representative sample of adults living in a multicultural and socially deprived area. Methods: The present sub study used the cross-sectional data previously collected in the East London Oral Health Inequality (ELOHI) study, conducted in the outer northeast boroughs of London, UK. A stratified two-staged sampling was performed which consisted of a sample of 2149 adults (16-65 years of age). Participants underwent an oral examination and answered a supervised questionnaire in their own homes. Data regarding information on the explanatory variables: socio-economic position (SEP), oral health behaviour and indicators were obtained from the ELOHI study. The main outcome variable for the present sub study was chronic periodontitis (presence of at least one site of a tooth with a pocket depth (PD) ≥4mm). Statistical analysis included conceptual hierarchical modelling and mediation analysis. The level of statistical significance was set at 0.05. Results: The prevalence of periodontitis in this area of East London was very high, 80.5% among males and 82% among females although these differences were not statistically significant. Hierarchical conceptual modelling analysis demonstrated that those in the manual/routine occupations category were 2.21 (95% CI 1.64-2.989) more likely to have chronic periodontitis than those in the professional category. The difference between those in the intermediate and the professional and managerial occupations category were not statistically significant after adjusting for demographic and behavioural variables. The results of mediation analysis, using the four steps proposed by Baron and Kenny demonstrated that the association between socio-economic position and periodontitis was partially mediated through smoking. Conclusion: A social gradient in periodontal diseases in part mediated by tobacco consumption may exist even in areas where there are highly socially deprived communities was identified. SEP as measured by NS-SEC was found to be associated with the chronic periodontitis experience (PD ≥ 4mm) with individuals placed higher in the NS-SEC ranking demonstrating a lesser risk of disease as compared to a lower NS-SEC ranking

Determinants of traumatic dental injuries in different genders

Objectives: This study aimed to identify the role of aetiological factors of traumatic dental injuries (TDI) in different genders. Material and Methods: A random sample of 3,180 female and 3,324 male fifteen-to-eighteen-year-olds from all senior high schools in Kaohsiung City, Taiwan, was selected. Each completed a supervised questionnaire and was examined using standard clinical procedures. Results: The participation rate was 90.4%. Those female adolescents that lived with at least a non-birth parent (p=0.026, OR=1.468, 95% CI=1.047, 2.058), that had a higher Adolescent Risk Taking Scale score (p=0.001, OR=1.072, 95% CI=1.030, 1.116), that had an overjet larger than five millimetres (p<0.001, OR=1.625, 95% CI=1.273, 2.074), or that showed inadequate lip coverage (p<0.001, OR=1.462, 95% CI=1.199, 1.784), were at greater risk of TDI. Contrarily, those male participants that had a family head with a secondary level of education (p=0.001, OR=1.372, 95% CI=1.130, 1.666), that had a higher Adolescent Risk Taking Scale score (p<0.001, OR=1.063, 95% CI=1.031, 1.097), that took more weekly hours of physical exercise (p=0.004, OR=1.020, 95% CI=1.006, 1.034), that had an overjet larger than five millimetres (p<0.001, OR=1.783, 95% CI=1.449, 2.194), or that showed inadequate lip coverage (p=0.016, OR=1.231, 95% CI=1.039, 1.457) had a higher risk of TDI. Conclusions: Males and females had different determinants of TDI. Family structure played a more relevant role in the occurrence of female adolescents' TDI, while family head's level of education and weekly hours of physical exercise were more important for the counterpart. In both genders, risk taking behaviour, overjet and lip coverage were associated with the occurrence of TDI

Outcomes in Trials for Management of Caries Lesions (OuTMaC):protocol

Background Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease. Methods To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy-makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel’s opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups. Discussion By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data. Trial registration Registered 12 April 2015 at COMET (http://www.comet-initiative.org

Impacto do tratamento restaurador na prevenção da perda de dentes

A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment.Um estudo transversal foi conduzido com o objetivo de analisar a perda dentária, pela razão cárie, em relação ao número de vezes que o dente extraído foi restaurado, tipo de cárie diagnosticada (primária ou secundária) e indicadores socioeconômicos de pacientes na cidade de Recife, Brasil. Dez centros do Sistema Público de Saúde e dez pertencentes a empresas de convênios foram sorteados. O tamanho da amostra foi calculado utilizando-se um erro padrão de 2.5%. O intervalo de confiança de 95% e uma prevalência de razões de extração na ordem de 50% foram usados para o cálculo da amostra. Uma amostra mínima requerida de 381 pacientes foi calculada, sendo examinados um total de 410 pacientes sorteados da lista de atendimento dos postos. 100% dos pacientes concordaram em participar da pesquisa, contudo, seis pacientes foram excluídos do estudo por apresentarem dados incompletos no questionário aplicado. Os pacientes foram examinados para a obtenção do CPOD e da razão das extrações. Cárie foi a principal razão para exodontia (p < 0,001). Analisando-se a relação entre o número de vezes que o dente foi restaurado e a razão da exodontia, observou-se um valor altamente significativo (p < 0,001), indicando que a maioria dos dentes extraídos pela razão cárie foram restaurados duas ou mais vezes. Foi observada uma relação altamente significativa estatisticamente entre um indicador de uso de serviços (O/CPOD) e exodontia devido a cárie (p < 0,001). Os achados demonstraram que é errônea a crença de que a perda dentária pode ser prevenida na população simplesmente pela restauração do dente

Poesia, história e modernização em Viva o povo brasileiro, de João Ubaldo Ribeiro

Este trabalho consiste na análise, do ponto de vista do realismo como figuração artística, do romance Viva o povo brasileiro (1984), de João Ubaldo Ribeiro, a partir da profunda relação entre literatura e história, já que o referido romance narra importantes acontecimentos da história do Brasil, desde a colonização à ditadura militar, tendo como um de seus motes principais a questão da escravidão. Nessa perspectiva, cumpre, ainda, pensá-lo como um romance histórico brasileiro, considerando-se sua organização estética e sua posição no sistema literário do país

Um pensamento interior e único – literatura e história em Machado de Assis

Ao se pensar a obra machadiana, desde a primeira fase, nota-se nela um modo particular e consistente de percepção e figuração estética da história brasileira, sobretudo dos acontecimentos mais representativos da sociedade ao final do século XIX. Machado de Assis demonstra uma visão crítica sobre a dinâmica social brasileira, suas contradições e, acima de tudo, sobre o movimento da história nacional, que caminhava a passos lentos e problemáticos rumo à modernidade. Com o intuito de reforçar essa hipótese de leitura, o estudo se volta ao romance Esaú e Jacó, de 1904, como obra exemplar acerca do quão presente estavam os fatos históricos e a realidade brasileira inscritos e analisados na produção machadiana