Oral health studies in the 1982 Pelotas (Brazil) birth cohort: Methodology and principal results at 15 and 24 years of age

Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública (Impact Factor: 0.98). 08/2011; 27(8):1569-80. DOI: 10.1590/S0102-311X2011000800012
Source: PubMed


The aim of this study was to describe the methodology and results of oral health studies nested in a birth cohort in Pelotas, Southern Brazil. For the oral health studies a sub-sample (n = 900) was selected from the cohort and dental examinations and interviews were performed at ages 15 (n = 888) and 24 years (n = 720; 81.1%). Data collection included dental outcomes, dental care, oral health behaviors, and use of dental services. Mean DMF-T varied from 5.1 (SD = 3.8) to 5.6 (SD = 4.1) in the study period. The proportion of individuals with at least one filled tooth increased from 51.9% to more than 70%. Individuals who had always been poor used dental services less and had fewer healthy teeth on average than those who had never been poor. Individuals with decreasing or increasing family income trajectories showed intermediate values. An increase was seen in the number of healthy teeth from age 15 to 24 only among those who had never been poor. A history of at least one experience with poverty had a negative impact on oral health in adulthood.

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Available from: Flavio Fernando Demarco, Jun 06, 2014
    • "A group-based trajectory analysis was performed to estimate family income trajectory groups with the PROCTRAJ macro in SAS version 9.1 (SAS Institute Inc., Cary, NC, USA). The combination of this classification resulted in four different family income trajectories from birth to 23 years of age: (a) those who were always poor; (b) those who were never poor; (c) those who were poor at birth and nonpoor later on (upwardly mobile) and (d) those who were non-poor at birth and then became poor (downwardly mobile) (Peres et al. 2011a, 2011b). At age 15, the patients were asked if they received oral health instructions from a dentist. "
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    ABSTRACT: To investigate the association of direct posterior restorations with gingival bleeding and dental calculus in young adults from a birth cohort. A representative sample (n = 720) of 5,914 infants born live in Pelotas, Brazil, in 1982, were prospectively investigated, and posterior restorations and periodontal health outcomes assessed when they were 24 years of age. Tooth-level exploratory variables included the presence and number of restoration's surfaces. Demographic and socio-economic characteristics, oral health instructions, dental floss usage, dental caries presence and smoking were also considered whilst gingival bleeding and dental calculus were the outcomes. Multilevel logistic regression was carried out. Class I cavities were found in 15.2% (95%CI 14.5 - 15.9) of the teeth and class II in 3.6% (3.3 - 4.0). Percentage of teeth with gingival bleeding was 6.1% (5.6 - 6.6) and that with dental calculus 22% (21.2 - 22.8). Even after all the individual variables were controlled for, the presence of a class I [OR1.51 (1.14-2.00)] and class II [OR 1.76 (1.04-2.97)] cavities was positively associated with gingival bleeding. Class I [OR1.36 (1.13-1.65)] and Class II [OR1.80 (1.28-2.53)] cavities were associated with dental calculus also. Posterior restoration and higher number of restored surfaces was associated with a higher prevalence of gingival bleeding and dental calculus around the restoration. This article is protected by copyright. All rights reserved.
    Journal Of Clinical Periodontology 09/2013; 40(12). DOI:10.1111/jcpe.12168 · 4.01 Impact Factor
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    • "Diagnostic inter-examiner reproducibility was measured, and the lowest Kappa was 0.60 for gingival bleeding but most of the values were close to 1.00. More details were reported elsewhere (Peres et al. 2011). The phases of the study were approved by the Ethical Review Board of the Faculty of Medicine of the Federal University of Pelotas, and written informed consent was obtained from participating subjects. "
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    ABSTRACT: To evaluate the association between obesity and periodontal disease and the mediating effect of oral hygiene, systemic inflammation and carbohydrate intake. Subjects born in 1982 in Pelotas, Brazil (n = 5,914), have been followed for several times. Oral health was assessed in a representative sample of 720 individuals at 24 years. Obesity, waist circumference and number of episodes with obesity between 15 and 23 years of age were the main exposures. Mediating effect of oral hygiene, C-reactive protein level and carbohydrate consumption was also assessed. Obese individuals were more likely to have ≥ 2 teeth with gingival bleeding. However, after adjusting for confounders, the association was not statistically significant [OR (obese × 2 or more teeth) 1.72 (95% CI: 0.95, 3.11)] and adjustment for potential mediators decreased the OR (OR = 1.38). The risk of presenting calculus in obese subjects was 10% higher [PR 1.10 (95% CI: 1.02, 1.18)]. The number of episodes of obesity between 15 and 23 years was associated with dental calculus. Periodontal pockets were not associated with obesity. Systemic inflammation and oral hygiene may be mediating the association between obesity and gingivitis. Obesity was not associated with periodontal pockets in young adults in this cohort.
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    ABSTRACT: This study aimed to investigate the patient and tooth factors associated with selection of restorative material in direct posterior restorations in young adults from a population-based birth cohort. A representative sample (n=720) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated, and posterior restorations were assessed in 2006, when the patients were 24 years old. Tooth-related variables (individual level) included restorative material (amalgam or composite), type of tooth, size of cavity, and estimated time in mouth. Data regarding demographic and socio-economic characteristics, oral health, and service utilization patterns during the life course were also assessed (contextual level). Logistic Regression Multilevel models showed that individuals who have accessed dental services by private insurance by age 15 [odds ratio (OR)=1.66 (0.93-2.95)] and who had a higher dental caries index at age 15 (high DMFT tertile) [OR 2.89 (1.59-5.27)] presented more amalgam restorations in the posterior teeth. From tooth-level variables, the frequency of amalgams decreases with increasing number of surfaces enrolled in the cavity preparation (p<0.001) and was almost 5 times greater in molars than in premolars. The present findings suggest that variables related to type of dental service, dental caries (higher DMFT index), and cavity characteristics (tooth type, size) determine the choice of dentists for restorative materials. Other individual characteristics such as demographic and socioeconomic status have not influenced this choice. This is the first population-based study that assesses the determinant factors for the choice of dentists for composite or amalgam in posterior direct restorations, showing that, independently of socioeconomic and demographic characteristics, type of payment of dental services and clinical factors are associated with this choice.
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