A scoping review about LGBTQIAP+ people in oral health research

Abstract Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.

Early Childhood Caries Experience of Children from Poor Families Living Below and Above Poverty Line

ABSTRACT Objective: To evaluate the role of poverty and its related factors on early childhood caries (ECC) experience among deprived children. Material and Methods: This population-based cross-sectional study surveyed 418 children aged one to six years enrolled in Brazilian public preschools from an area of the country known for its high social deprivation. Intraoral examination of children evaluated dental caries experience (dmft). Parents/caregivers answered a questionnaire with sociodemographic indicators. Family income was dichotomized into below or above poverty line. Data analysis used Chi-square test, Mann-Whitney test, and Multivariate Logistic Regression analysis (p<0.05). Results: Predisposing variables for an increased chance of ECC were: age group 3-4 years (OR: 4.89; 95% CI: 2.32-10.31), age group 5-6-years (OR: 5.60; 95% CI: 2.60-12.04), being part of families living below poverty line (OR: 1.88; 95% CI: 1.04-3.38) and having mothers with less than nine years of schooling (OR: 2.86; 95% CI: 2.77-7.14). Children from families living below poverty line presented higher dmft (2.9 +3.8; p=0.001) and untreated dental caries (d component) (2.7 +3.7; p=0.002). Conclusion: ECC in a poor population was influenced by indicators of social deprivation. The poorest of poor children from mothers with less years of schooling were at higher risk.

Inquidades entre adolescentes brasileiros relacionadas a raça/etnia: a cárie dentária como indicador de saúde bucal / Inequalities among brazilian adolescents related to race/ethnicity: dental caries as oral health indicator

Esta tese contempla três estudos epidemiológicos e uma revisão sistemática cujo objetivo foi avaliar a iniquidade entre adolescentes brasileiros relacionadas à raça/etnia e experiência de cárie dentária, cárie não tratada, dentes perdidos e restaurados e, testar se indicadores socioeconômicos explicam as diferenças observadas. Realizou-se uma revisão sistemática nas bases de dados PubMed e Scopus para avaliar a associação entre raça/etnia e experiência de cárie. Os dados do Projeto SB Brasil 2003 (n=16.833) e 2010 (n=5.367) foram utilizados para análises de prevalência, teste qui-quadrado, modelo conceitual hierárquico e mediação. Entre 2003 e 2010 observou-se uma diminuição na prevalência de experiência de cárie, cárie não tratada, dentes perdidos e restaurados, e constatou-se a persistência das iniquidades relacionadas à raça/etnia. Brancos tiveram uma redução significativa de na experiência de cárie (19,4%) e apenas 10,2% de cárie não tratada, enquanto entre Indígenas houve uma diminuição de cárie não tratada (17,4%) e 15,5% entre Pardos. Entretanto, em 2003, Negros tiveram 19% menos chances, e em 2010, 32% mais chance de terem experiência de cárie do que Brancos. Ainda, em 2003, Pardos e Brancos tiveram chances semelhantes de terem experiência de cárie, e em 2010, Pardos tiveram 69% mais chance do que Brancos. E, em 2010, Negros, Pardos e Indígenas tiveram mais chance de terem dentes cariados não tratados do que Brancos. A prevalência de dentes perdidos diminuiu entre todos os grupos e observou-se uma redução de 17,2% de dentes restaurados entre Brancos e um aumento de 14,8% entre Pardos, sendo que em 2010, Pardos tiveram 21% mais chance de terem dentes restaurados do que Brancos. A análise do modelo conceitual hierárquico realizada nos dados do SB Brasil 2010 confirmou a associação entre a experiência de cárie, cárie não tratada, dentes perdidos e restaurados e raça/etnia. Pardos e Amarelos tiveram 1,44 e 1,81 vezes, respectivamente, mais chance de terem experiência de cárie; Pardos tiveram 1,52 vezes mais chance de terem dentes perdidos; e Negros e Pardos tiveram 0,67 e 0,85 vezes, respectivamente, menos chance de terem dentes restaurados quando comparados com Brancos. Os resultados da análise de mediação confirmaram que as iniquidades observadas foram mediadas através das variáveis educação e renda. A revisão sistemática sugere uma associação das iniquidades raciais/étnicas na experiência de cárie, sendo raça/etnia um constructo social que precisa ser combinado com outros fatores determinantes para melhor compreensão e abordagem. Apesar das políticas públicas vigentes no Brasil, as análises dos dados demonstraram uma persistência das iniquidades e os adolescentes Brancos têm se beneficiado mais da redução da cárie dentária, apresentando melhor condição de saúde bucal

This thesis includes three epidemiological studies and one systematic review, which aimed to assess inequalities among Brazilian adolescents related to race/ethnicity in dental caries experience, untreated caries, missing and filled teeth, and test whether socioeconomic indicators explain the observed differences. A systematic review was conducted in PubMed and Scopus databases to evaluate the association betweenrace/ethnicity and caries experience. Data from a Brazilian National Oral Health Survey (SBBrasil) conducted in 2003 (n=16,833) and 2010 (n=5,367) were used to prevalence analysis, chi-square test, hierarchical conceptual modelling, and mediation. Between 2003 and 2010, a decrease in the prevalence of caries experience, untreated caries,missing and filled teeth between 2003 and 2010 was observed, and a persistence of inequalities related to race/ethnicity.Whites had a significant 19.4% reduction in caries experience and only 10,2% reduction in untreated caries, while among Indigenous descents and Mixed Race there was a 17,4% and 15,5% reduction, respectively, inuntreated caries. However, in 2003, African descents were 19% less likely, and in 2010, 32% more likely to have caries experience thanWhites. Although in 2003, Mixed Race and Whites had similar chances of having caries experience, in 2010, Mixed Race was 69% more likely to have caries experience than Whites. Moreover, African descents, Indigenous descents, and Mixed Race were more likely to have untreated decayed teeth than whites in 2010. Missing teeth prevalence decrease between all groups and filled teeth had a reduction of 17.2% for Whites and a rise by 14.8% for Mixed Race, being the Mixed Race in 2010, 21% more likely to have filled teeth than Whites. Hierarchical conceptual modelling analysis performed in the SBBrasil 2010 data, confirmed the association between caries experience, untreated caries, missing and filled teeth and race/ethnicity. Compared to Whites, Mixed Race and East Asian Descents were 1.44 and 1.81 times, respectively, more likely to have caries experience; Mixed Race was 1.52 times more likely to have missing teeth, and African Descents and Mixed Race were 0.67 and 0.85 times, respectively, less likely to have filled teeth. Results of mediation analysis confirmed that the observed inequalities were mediated through education and income variables. The systematic review suggested an association of racial/ethnic inequalities in caries experience, being race/ethnicity a social construct that needs to be addressed with other determinant factors to better understand and effectively address oral health inequalities. Despite the existing policies in Brazil, data analysis demonstrated a persistence in race/ethnic inequalities and that White adolescents have benefited more from the reduction of dental caries and have a better oral health condition

Avaliação de um sistema de filtro domiciliar com estratégia para desfluoretação de água em uma zona rural endêmica para fluorose dentária em Minas Gerais, Brasil / Evaluation of a filter system as a strategy to water defluoridation in an endemic dental fluorosis rural area of Minas Gerais, Braszil

Objetivos: Altas concentrações de flúor são encontradas, naturalmente, na água em todo o mundo. Este estudo avaliou se um novo sistema de filtro domiciliar, com base em microesferas adsorventes do composto alumina-carvão ativado, é apropriado para reduzir altas concentrações de flúor na água de abastecimento, de uma zona endêmica para fluorose dentária. Métodos: um estudo de intervenção foi conduzido em uma comunidade rural, durante 22 semanas, em 4 municípios com 20 residentes, entre crianças, adolescentes e adultos, em zona endêmica para fluorose dentária, no norte do Estado de Minas Gerais, Brasil...