Changes in gingivitis and protective factors among adults: A 4-year prospective population-based study.

OBJECTIVES: There are limited longitudinal data regarding gingival inflammation in adults. This study aimed to assess changes in gingivitis over 4 years and to determine protective factors. METHODS: A representative sample of 1023 adults living in Porto Alegre, Brazil, was obtained in the Caries-Perio Collaboration Study. At follow-up, 402 individuals were re-examined. Gingivitis was assessed by the gingival bleeding index (GB) at both time points. Individuals were dichotomized into those showing reductions ≥ 15% and those showing reductions < 15% or increase in bleeding sites. Multivariable Poisson regression models were fitted with 11 possible risk factors, estimating relative risks (RR) and 95% confidence intervals (95% CI). RESULTS: Percentage of individuals with GB ≥ 10% reduced from 72.4% to 53.8%. Bleeding sites significantly reduced (25.9%-20.1%), and in a higher magnitude in buccal/palatal sites (34.1%-24.0%). 31.0% of individuals presented GB reduction ≥ 15% in all sites. Toothbrushing ≥ 3 times/d increased 72% the probability of ≥15% GB reduction compared with ≤1/d (RR = 1.72; 95% CI 1.01-3.16). For each 10 pack-years smoked, the probability of ≥15% GB reduction was 3% higher (RR = 1.03; 95% CI: 1.01-1.04). At buccal/palatal sites, normal weight individuals had 26% higher probability of reducing GB than overweight-obese individuals (RR = 1.26; 95% CI: 1.01-1.62). A 5% higher decrease in GB sites was observed in the absence than the presence of periodontitis. Younger individuals had higher reduction in GB sites. CONCLUSIONS: In the studied population, gingivitis reduced over time, with younger age, better oral hygiene, absence of periodontitis and normal weight being found to be protective factors. Smoking was associated with lower levels of gingivitis over time, probably due to its vasoconstrictive effect.

Incidence and progression of gingival recession over 4 years: A population-based longitudinal study.

AIM: To describe changes in gingival recession (GR) at buccal and palatal sites in adults over an average follow-up of 4 years. MATERIALS AND METHODS: Baseline data were obtained from a multistage probabilistic representative sample of 1023 individuals aged ≥35 years from Porto Alegre, Brazil. Buccal and palatal/lingual GR were analysed. RESULTS: 402 individuals (6,862 teeth) were followed. At baseline, 3,356 (48.9%) teeth did not have GR at the buccal site and 1206 developed the condition overtime (incidence =35.9%; 95% CI 32.6-38.9). Percentage of incident teeth was higher among individuals with (42.3%) than those without (29.5%) periodontitis stages III/IV. Also, 38.5% of teeth with proximal attachment loss at follow-up had incident GR compared to 7.6% of those without proximal attachment loss. Incidence of palatal GR was observed in 32.5% of teeth (95% CI 29.7-35.3). Mean buccal and palatal/lingual GR incidence was 2.11 mm and 2.33 mm, whereas buccal and palatal/lingual GR progression equalled 0.40 mm and 0.48 mm. The prevalence of GR ≥3 mm increased in individuals with (from 35.9% to 47.4%) and without (from 25.2 to 41.5%) periodontitis. CONCLUSION: Incidence and progression of GR are high in a general urban Brazilian population of adults.

Self-reported dentin hypersensitivity in south brazilian adolescents: occurrence and risk indicators / Hipersensibilidade dentinária autorreportada em adolescentes do sul do Brasil: ocorrência e indicadores de risco

ABSTRACT The aim of this study was to assess the occurrence of selfreported dentin hypersensitivity (DH) and its risk indicators in adolescents from a southern Brazilian city. 736 students (1519 years old) were randomly selected from 20 public and private schools in the city of Passo Fundo, Brazil. DH was assessed through the answers on a Likert scale to the question: "Do you have tooth sensitivity?".Participants underwent a clinical examination in which present teeth were counted, and answered an interview based on a structured questionnaire on sociode mographic information, history of dental bleaching, orthodontic treatment and oral health habits. The dependent variable (DH) was dichotomized at the point where hypersen sitivity occurs fairly often or always. Data were analyzed by multivariable logistic regression, including demographic, health history, socioeconomic and behavioral variables. Results: 556 (75.5%) subjects reported having sensitive teeth never, rarely or sometimes, while 180 (24.5%) reported having sensitive teeth fairly often or always. In the final model, number of present teeth, age, skin color, flossing, smoking, bleaching and orthodontic history were not associated with selfreported DH. Females showed significantly greater chance of having DH than males [odds ratio (OR)=1.91; 95% confidence interval (95%CI) 1.342.72]. The likelihood of DH in students at public schools was 63% higher than in those at private schools (OR=1.63 95%, CI 1.012.75). DH is a common perception among adolescents and is associated with female gender and studying at public schools.

RESUMO O objetivo deste estudo foi determinar a ocorrência de hipersensibilidade dentinária (HD) autorreportada e seus indicadores de risco de uma cidade do sul do Brasil. 736 estudantes (1519 anos) foram selecionados aleatoriamente em 20 escolas públicas e privadas da cidade de Passo Fundo, Brasil. HD foi aferida pela resposta em escala Likert à pergunta: "Você tem sensibilidade nos dentes?". O exame clínico incluía a contagem de dentes presentes e um questionário estruturado foi aplicado incluindo dados sociodemográficos, história de clareamento dental, tratamento ortodôntico e hábitos de saúde bucal.A variável de pendentes (HD) foi dicotomizada no ponto que a hipersensibilidade ocorria repetidamente ou sempre. Os dados foram analisados por meio de regressão logística multivariada, incluindo variáveis demográficas, histórico de saúde, dados socioeconômicos e comportamentais. Nos resultados 556 (75.5%) indivíduos reportaram experiência de sensibilidade dentinária, nunca raramente ou às vezes, enquanto 180 (24.5%) reportaram ter sensibilidade repetidamente ou sempre. No modelo final, número de dentes presentes, idade, raça, uso do fio dental, tabagismo, histórico de clareamento dental e tratamento ortodôntico não foram associados com HD autorreportada. Mulheres mostraram uma chance significativamente maior de ter HD comparado aos homens [odds ratio (OR)=1,90; 95% intervalo de confiança (95%CI) 1.332.71]. Frequentar escolas públicas aumentou a chance de HD em 63% comparado com escolas particulares (OR=1,63 95%IC 1.012.75). HD é uma percepção comum entre adolescentes e está associada com gênero feminino e estudar em escolas públicas.

Periodontitis and tooth loss have negative impact on dietary intake: A cross-sectional study with stable coronary artery disease patients.

BACKGROUND: Despite the association between cardiovascular diseases and periodontitis, there are scarce data on the impact of oral health in the dietary intake of patients with coronary artery disease (CAD). The aim of this study was to assess the association between dietary intake with periodontitis and present teeth in individuals with stable CAD. METHODS: This cross-sectional study included 115 patients with stable CAD (76 males, aged 61.0 ± 8.3 years) who were under cardiovascular care in an outpatient clinic for at least 3 months. Dietary intake was recorded applying a food frequency questionnaire previously validated. Periodontal examinations were performed by two calibrated examiners in six sites per tooth from all present teeth. Blood samples were collected to determine serum levels of lipids. Multivariable logistic and linear regression models were fitted to evaluate the association between dietary outcomes and oral health variables. RESULTS: Individuals with periodontitis had significantly higher percentage of total energy intake from fried foods, sweets, and beans, and also had lower consumption of fruits than those without periodontitis. Presence of periodontitis was associated with lower percentage of individuals who reached the nutritional recommendation of monounsaturated fatty acids and higher blood concentration of triglycerides. Having a greater number of present teeth (≥20 teeth) was associated with higher intake of fibers and total calories. CONCLUSION: In patients with stable CAD, the presence of periodontitis and tooth loss were associated with a poor dietary intake of nutrients and healthy foods, which are important for cardiovascular prevention.

Self reported dentin hypersensitivity in south brazilian adolescents: occurrence and risk indicators.

The aim of this study was to assess the occurrence of selfreported dentin hypersensitivity (DH) and its risk indicators in adolescents from a southern Brazilian city. 736 students (1519 years old) were randomly selected from 20 public and private schools in the city of Passo Fundo, Brazil. DH was assessed through the answers on a Likert scale to the question: "Do you have tooth sensitivity?".Participants underwent a clinical examination in which present teeth were counted, and answered an interview based on a structured questionnaire on sociode mographic information, history of dental bleaching, orthodontic treatment and oral health habits. The dependent variable (DH) was dichotomized at the point where hypersen sitivity occurs fairly often or always. Data were analyzed by multivariable logistic regression, including demographic, health history, socioeconomic and behavioral variables. Results: 556 (75.5%) subjects reported having sensitive teeth never, rarely or sometimes, while 180 (24.5%) reported having sensitive teeth fairly often or always. In the final model, number of present teeth, age, skin color, flossing, smoking, bleaching and orthodontic history were not associated with selfreported DH. Females showed significantly greater chance of having DH than males [odds ratio (OR)=1.91; 95% confidence interval (95%CI) 1.342.72]. The likelihood of DH in students at public schools was 63% higher than in those at private schools (OR=1.63 95%, CI 1.012.75). DH is a common perception among adolescents and is associated with female gender and studying at public schools.

O objetivo deste estudo foi determinar a ocorrência de hipersensibilidade dentinária (HD) autorreportada e seus indicadores de risco de uma cidade do sul do Brasil. 736 estudantes (1519 anos) foram selecionados aleatoriamente em 20 escolas públicas e privadas da cidade de Passo Fundo, Brasil. HD foi aferida pela resposta em escala Likert à pergunta: "Você tem sensibilidade nos dentes?". O exame clínico incluía a contagem de dentes presentes e um questionário estruturado foi aplicado incluindo dados sociodemográficos, história de clareamento dental, tratamento ortodôntico e hábitos de saúde bucal.A variável de pendentes (HD) foi dicotomizada no ponto que a hipersensibilidade ocorria repetidamente ou sempre. Os dados foram analisados por meio de regressão logística multivariada, incluindo variáveis demográficas, histórico de saúde, dados socioeconômicos e comportamentais. Nos resultados 556 (75.5%) indivíduos reportaram experiência de sensibilidade dentinária, nunca raramente ou às vezes, enquanto 180 (24.5%) reportaram ter sensibilidade repetidamente ou sempre. No modelo final, número de dentes presentes, idade, raça, uso do fio dental, tabagismo, histórico de clareamento dental e tratamento ortodôntico não foram associados com HD autorreportada. Mulheres mostraram uma chance significativamente maior de ter HD comparado aos homens [odds ratio (OR)=1,90; 95% intervalo de confiança (95%CI) 1.332.71]. Frequentar escolas públicas aumentou a chance de HD em 63% comparado com escolas particulares (OR=1,63 95%IC 1.012.75). HD é uma percepção comum entre adolescentes e está associada com gênero feminino e estudar em escolas públicas.

Gingival recession and oral health-related quality of life: a population-based cross-sectional study in Brazil.

OBJECTIVES: To assess the association between gingival recession (GR) and oral health-related quality of life (OHRQoL) in a Brazilian population of adults. METHODS: A representative sample from Porto Alegre city was drawn in 2011 using a multistage probability sampling strategy. For this study, 740 individuals, 35-59 years of age and with ≥6 teeth, were included. GR was assessed by two calibrated examiners at four sites in all present teeth. The Oral Health Impact Profile (OHIP-14) was used to assess OHRQoL. OHIP-14 was dichotomized using 'fairly often' as the cutoff point for a negative impact. Multiple logistic regression models were fitted to define which descriptors of GR were associated with the dichotomous outcome of OHIP-14, including dentine hypersensitivity in separate models, adjusting for age, gender, socioeconomic status, smoking, dental care, and missing teeth. RESULTS: Mean OHIP was significantly higher for individuals with ≥1 tooth with GR ≥2, ≥3, ≥4, and ≥5 mm. Individuals with ≥1 tooth with GR ≥2 mm had approximately two times higher chance of having a negative impact than individuals without GR of this threshold [odds ratio (OR) = 1.99, 95% confidence interval (CI) 1.05-3.78]. When buccal and proximal sites were analyzed separately, the presence of GR was significantly associated with worst quality of life only in anterior and not in posterior teeth. GR in the lower arch had no impact on OHRQoL. GR ≥2 mm affected only physical pain (OR = 2.61; 95% CI 1.06-6.42), whereas GR ≥4 mm affected functional limitation, physical pain, psychological discomfort, physical and psychological disabilities, with ORs ranging from 1.43 to 1.91. Dentine hypersensitivity alone was not associated with OHRQoL, but it modified the association between GR and OHIP when present concomitantly with GR, mainly in buccal sites. CONCLUSIONS: OHRQoL is poorer in this adult population in the presence of GR, mainly in upper and anterior teeth. Dentine hypersensitivity and esthetics were found to be factors linking GR to OHRQoL.