Knowledge of bidirectional relationship between diabetes and periodontal disease among diabetes patients: A systematic review.

INTRODUCTION: The bidirectional relationship between diabetes mellitus and periodontal disease has been reported in the literature, suggesting that poor glycemic control is strongly associated with increased risk of developing periodontal disease. Therefore, this systematic review evaluated the level of knowledge of this bidirectional relationship among patients with diabetes. METHODS: This systematic review (protocol CRD42018117902) was conducted according to PRISMA guidelines. The following databases were considered: Medline/PubMed, Scopus, and Web of Science. Search strategy (April 05th , 2021) considered proper combination of keywords and eligibility criteria. The quality of studies was evaluated using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS: Among the 328 records identified in the initial search, 24 studies were selected, considering a total of 8,693 patients. All studies used a cross-sectional design. Among the included studies, only five showed prevalence of knowledge higher than 50%, ranging from 5.8% to 75.9%. Interestingly, 58.0% of patients reported that they brush their teeth at least 1x/day, but only four studies reported that the dentist was the main source of information. In terms of methodology and result quality, just one study clearly showed all information evaluated by the AXIS tool. Most of studies did not report sample size calculations and did not used validated questionnaires to assess patient knowledge. CONCLUSION: The results show that less than half of people with diabetes have knowledge about their increased risk for periodontal disease, and often the dentist is not the main source of information to motivate them.

Sociodemographic determinants of edentulism in the elderly population: A systematic review and meta-analysis.

OBJECTIVE: To provide a systematic review on the demographic and socioeconomic factors associated with edentulism among older persons. BACKGROUND: Edentulism (complete loss of the natural teeth) is one of the main problems affecting the oral health of the elderly individuals. Many unfavourable socioeconomic factors are considered important predictors of edentulism. MATERIALS AND METHODS: This review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The search for published studies was conducted on PubMed, Web of Science, SciELO, Google and Google Scholar. Only observational epidemiological studies published in either English or Portuguese prior to June 2018 were included in our study. The bibliographic and methodological characteristics of the selected studies were evaluated. The Review Manager 5.3 software was used in the meta-analysis. RESULTS: We identified 343 articles, 24 of which met all the eligibility criteria and were included in the review. Unfavourable demographic and socioeconomic conditions were associated with the highest proportion of edentulous individuals. Age, level of education, and socioeconomic status were the main factors that were found to influence edentulism among elderly individuals. The meta-analysis results showed a lower risk of edentulism in men (OR = 0.93; 95% CI = 0.90-0.96) and no significant differences in the risk of developing edentulism among different races/ethnicities or skin colours (OR = 0.68; 95% CI = 0.45-1.01). CONCLUSION: Better socioeconomic conditions and male sex were identified as protective factors against edentulism among older individuals. Thus, public policies aimed at helping the most vulnerable populations must be implemented.

Contextual and Individual Determinants of Root Caries in Older People.

The aim of this study was to identify the association of the presence of root caries in older people with contextual and individual determinants using a multilevel model. Data from the National Survey of Oral Health collected in Brazil were used. A sample of older Brazilians (aged 65-74 years) was included and selected through multistage probability cluster sampling, using probability proportional to size. Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate, and multilevel analyses were conducted. Of the 3,926 older people included in the study, 934 (21.8%) had at least 1 tooth with root caries. There seemed to be no pattern of involvement between the anterior and posterior teeth in the dental arches. Multilevel analysis showed a higher presence of root caries among older people resident in municipalities that were noncapital cities (OR = 1.50), who were over 70 years of age (odds ratio, OR = 1.22), had nonwhite skin color (OR 1.35), had coronal caries (OR = 5.58), were dissatisfied with their teeth and mouth (OR = 1.47), and had self-perceived dental treatment needs (OR = 1.33). Contextual and individual determinants were associated with the occurrence of root caries in older people. Lesion presence demonstrated a profile of social inequality.