Obesity is associated with lack of access to dental care and physical activity among older adults: a cross-sectional study / Obesidade está associada com falta de acesso a serviços odontológicos e atividade física em idosos: um estudo transversal

OBJECTIVE: This study evaluated the prevalence of obesity and associated factors among older adults. METHODS: This was a household-based cross-sectional study involving 282 individuals aged ≥ 60 years recruited in the city of Veranópolis, Brazil, using random probabilistic sampling. Participants underwent a clinical oral examination and completed a structured questionnaire. Obesitywas determined based on body mass index (BMI). Individuals were divided into two groups based on the presence (BMI ≥ 30 kg/m2) or absence of obesity (BMI < 30 kg/m2). Uni- and multivariate analyses were performed using Poisson regression with robust variance. RESULTS: The prevalence of obesity was 34% (n = 96). Each 1-year increase in age resulted in a 3.09% decrease in the likelihood of being classified as having obesity (prevalence ratio [PR] = 0.969; 95% confidence interval [95%CI] 0.949 ­ 0.989). Older adults that reported walking < 5 or ≥ 5 times per week were 39.65 and 37.20% less likely to be classified as obese. The PRs of obesity in former and non-smokers were 4.40 and 5 times higher, respectively, than in current smokers (p < 0.05). Older adults with no access to dental care were 51.72% (p = 0.013) more likely to present with obesity. CONCLUSIONS: There was a high prevalence of obesity among older adults. Obesity was associated with lower age, smoking status, no access to dental care, and a lack of physical activity

OBJETIVO: O presente estudo avaliou a prevalência de obesidade e fatores associados em idosos. METODOLOGIA: Um estudo transversal domiciliar, com amostragem probabilística, foi realizado com 282 indivíduos de idade ≥60 anos de Veranópolis, Brasil. Um exame clínico de saúde bucal foi realizado e um questionário estruturado foi aplicado. A obesidade foi determinada pelo Índice de Massa Corporal (IMC). Os indivíduos foram categorizados com obesidade (IMC ≥ 30kg/m2) e sem obesidade (IMC < 30kg/m2). Análises uni e multivariadas foram feitas por meio de regressão de Poisson com variância robusta. RESULTADOS: A prevalência de obesidade foi de 34% (n = 96). Cada ano de aumento na idade resultou em uma diminuição de 3,09% (razão de prevalência [RP] = 0,969; intervalo de confiança de 95% [IC95%] = 0,949 ­ 0,989) na RP de ser do grupo de obesos. Idosos que reportaram caminhar < cinco ou ≥ cinco vezes por semana apresentaram menor RP para obesidade, 39,65 e 37,20%, respectivamente. Ex-fumantes e não fumantes obtiveram, respectivamente, 4,40 e 5 vezes maior RP de serem do grupo de obesos quando comparados aos fumantes (p < 0,05). Idosos sem acesso a serviços odontológicos demonstraram 51,72% (p = 0,013) maior RP de serem do grupo com obesidade. CONCLUSÕES: Houve uma alta prevalência de obesidade em idosos, que foi associada com menor idade, estado de fumo e ausência de acesso ao dentista e atividade física.

Concern with dental appearance and associated factors among the elderly of two southern Brazilian cities: a cross-sectional study

Aim: This study aimed to evaluate the prevalence of concern with dental appearance (DA) and associated factors among the elderly of two southern Brazilian cities. Methods: A cross-sectional study was conducted in the cities of Cruz Alta and Veranópolis, Brazil. Oral health examination and a structured questionnaire were applied. Questions from the PCATool-SB Brasil tool and the Questionnaire about Teeth Appearance, both validated to Brazilian samples, were used. The collected independent variables were: sex, age, ethnicity, education level, marital status, retirement, health problem, use of medication, smoking exposure, alcohol exposure, access to the dentist, toothbrushing frequency, use of dental floss, edentulism, use of and need for dental prosthesis. Concern with DA was dichotomized into yes/no. Associations between dependent and independent variables were assessed by Chi-square or Mann-Whitney tests. Moreover, uni- and multivariate analyses were conducted by Poisson regression with robust variance. Level of significance was established as p<0.05. Results: The prevalence of concern with DA was 18.8% (n=107). The prevalence ratio (PR) of concern with DA decreased 5.8% for each year increase (PR:0.942; 95% confidence interval [95%CI]:0.911­0.973). Elderly without access to the dentist in the last 12 months presented 62.5% (p=0.006) higher PR of concern with DA when compared to those with access to dental care. Dentate elderly showed 219% higher PR for concern with DA (PR:2.197; 95%CI:1.364­3.539) in comparison to edentulous individuals. Conclusion: Prevalence of concern with DA was low and associated with demographics, access to dental care and edentulism

Correção de assimetria dentogengival com finalidade estética: Relato de caso clínico / Correction of dentogingival asymmetry with aesthetic purpose in a patient with gingival smile: case report

Introdução: a estética do sorriso pode ser alcançada por um conjunto de fatores que incluem a anatomia dentária, a anatomia gengival e as características faciais do paciente. Um sorriso agradável é baseado na harmonia desses fatores (estética branca-vermelha) e não somente na reabilitação dentária. O sorriso gengival é uma das principais queixas de pacientes que procuram o consultório odontológico, considerando que tal situação pode influenciar na sua vida pessoal ou profissional Objetivo: o propósito deste trabalho foi relatar o caso clínico de uma paciente com sorriso gengival e desarmonia entre a margem gengival e alinhamento das coroas clínicas de dentes anterossuperiores. Relato de Caso: paciente do sexo feminino, 58 anos de idade, com boa saúde geral, procurou consultório odontológico particular com o objetivo de melhorar a estética do sorriso. Ao exame clínico foi constatado sorriso gengival e necessidade de substituição presença de coroas metalo-cerâmicas. Considerações finais: a abordagem multidisciplinar envolvendo a técnica cirúrgica (retalho com osteotomia) e restauradora (confecção de facetas feldspáticas e coroas de porcelana pura na região anterossuperior) proporcionou o sucesso do tratamento reabilitador em questão, devolvendo à paciente um sorriso harmonioso com estética dentária e gengival agradáveis.

Introduction: smile's aesthetics can be achieved by a set of factors that include the dental anatomy, gingival anatomy and facial features of the patient. A pleasant smile is based on the harmony of these factors (white-red aesthetics) and not only on dental rehabilitation. The gingival smile is one of the main complaints of patients who seek the dental office, considering that such a situation may influence their personal or professional life. Objective: the purpose of this study was to report the clinical case of a patient with gingival smile and disharmony between the gingival margin and the alignment of the clinical crowns of anterosuperior teeth. Case Report: a 58-yearold female patient with good general health sought a private dental office with the aim of improving the aesthetics of the smile. The clinical examination revealed gingival smile and the need to replace the presence of metal-ceramic crowns. Final considerations: The multidisciplinary approach involving the surgical technique (restorative flap with osteotomy) and restorative (creation of feldspar facets and pure porcelain crowns in the anterior superior region) provided the success of the rehabilitation treatment in question, giving the patient a harmonious smile with aesthetics tooth and gum.