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Given the high prevalence of obesity in children and adolescents, the investigation of early markers is of clinical importance to better manage this condition. Thus, the aim was to evaluate the cross-sectional relationship between salivary microbiota, gingival health status, and excess weight in adolescents. A total of 248 students (14-17 y; 119 girls) were included, free of caries lesions and periodontal pockets. Physical examination included measures of height, weight, and body fat percentage (%BF). Oral examination was performed to gather information on dental (DMFT index) and gingival health status. Unstimulated saliva was submitted to qPCR reactions to quantify Streptococcus mutans, Porphyromonas gingivalis, Bifidobacteria, and Streptococcus pneumoniae percentages and the NFKappaB expression. Two-way ANOVA was applied considering group (normal-weight/overweight/obesity) and sex factors, in addition to cluster analysis. Group effect was significant for %S. mutans (partial eta2 = 0.20; p < 0.001) and %Bifidobacteria (partial eta2 = 0.19; p < 0.001), with overweight and obesity groups showing the highest levels compared to normal-weight ones, with no significant sex effect. There was no difference in the frequency of gingivitis, P. gingivalis, and S. pneumoniae percentages or NFKappaB expression between groups. Cluster analysis generated three clusters according to body fat accumulation: "Higher %BF," "Moderate %BF," and "Lower %BF." "Higher %BF" cluster was characterized by higher body fat percentage and higher salivary %Bifidobacteria, while cluster "Lower %BF" was characterized by lower body fat percentage and lower frequency of gingivitis ("Moderate %BF" cluster was the contrast). According to nutritional status, a difference in salivary S. mutans and Bifidobacteria percentages was found, with overweight or obesity adolescents showing the highest percentages than normal-weight ones. Besides, a positive relationship between body fat accumulation and Bifidobacteria count was observed, indicating a possible interaction between oral bacteria communities and weight gain.

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The current study aimed at the determination of the impact of obesity on the salivary microbiome in adolescents. Sixty subjects ranging 14-17 years old were enrolled (obese: n = 30-50% females, and normal weight: n = 30-50% females). Stimulated saliva was collected for denaturing gradient gel electrophoresis (DGGE) band patterns and massive 16S rRNA gene sequencing using the Ion Torrent platform. Overall, data analysis revealed that male subjects harbored a higher diverse salivary microbiome, defined by a significant higher richness (32.48 versus 26.74) and diversity (3.36 versus 3.20), higher Simpson values (0.96 versus 0.95) and distinct bacterial community structure considering either sex or condition (p < 0.05). Bacterial community fingerprinting analysis in human saliva showed a positive correlation with increased body mass index (BMI) in adolescents. Veillonella, Haemophilus and Prevotella occurrence was found to be affected by BMI, whereas Neisseria and Rothia occurrence was significantly impacted by sex in obese subjects. Our findings suggest that male and female adolescents may harbor a naturally distinct salivary microbiota and that obesity may specifically have an impact on their oral bacterial community. The potential dysbiotic oral microbiome in obese adolescents raises new insights on the etiology and prevention of future conditions in these populations.

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As saliva showed to be a noninvasive source of markers useful to monitor clinical status, the hypothesis tested was that saliva may provide reliable markers able to predict the body fat accumulation in young subjects. The salivary characteristics of 248 adolescent scholars (119 girls; 14-17 years) of flow rate, pH, phosphorus, urea, and calcium concentrations were assessed in stimulated saliva (colorimetric automated technique). The concentrations of cholesterol, 7-ketocholesterol, 25-hydroxyvitamin D2 and D3, and uric acid (UA) were measured with high-performance liquid chromatography in saliva collected at home (12-hour fast). Physical examination included height, weight, and body fat percentage (%BF) measured using bioelectric impedance to classify groups in below/above the %BF cutoff. Data were evaluated using 2-way analysis of variance and multiple linear regression. No significant difference was found in the levels of 25-hydroxyvitamin D2 and D3, cholesterol, 7-ketocholesterol, phosphorus, calcium, and urea between groups above and below %BF cutoff, and the variation in salivary flow was small. Significant sex and group effects were observed for salivary UA, which was increased in adolecents with higher %BF and in males (compared to females), without sex group interaction (power = 99.8%). Sex showed a significant effect on salivary urea, with lower levels in females. A predictive model was obtained, with salivary UA and sex explaining the variation of %BF (P < .001; power = 84%). Salivary UA showed to be an important marker of body fat accumulation in adolescents, demonstrating the clinical relevance of saliva to detect early changes and to monitor the nutritional status using a noninvasive and accurate method.

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The evaluation of mastication is important to understand the masticatory behavior and diagnose feeding difficulties. The objective of this preliminary study was to verify if there is agreement between objective and subjective validated methods of chewing evaluation in a convenience sample which consisted of 32 adolescents (mean 15.5years), complete permanent dentition and free of tooth decay. The Quality of Masticatory Function Questionnaire with the Food-Mastication, Habits, Meat, Fruit and Vegetables domains was used in the subjective evaluation. The objective aspects consisted of maximum bite force (BF) and masticatory performance (MP) by mastication of cubes of test-material and sieving to determine the median particle size (X50) and distribution in the sieves ("b"), and by the colorimetric method using colorchangeable chewing gum. Data were submitted to exploratory analysis, normality test and correlation tests (Pearson/Spearman). The correlation between BF and X50 (r=-0.43; p=0.02) and between BF and MP chewing gum (r=0.53; p=0.002) was significant with large effect size. The MP evaluated by chewing gum correlated with X50 (r=-0.34; p=0.055), but not with "b" (r=-0.06; p=0.73), while "b" correlated only with X50 (r=0.52, p=0.002). No significant correlation was observed between the objective measures and the total score of the subjective evaluation; only a negative correlation was observed between "b" and Meat domain (r=-0.40; p=0.023). The objective methods showed moderate correlation with each other and no agreement between the objective and subjective methods was observed in this sample of healthy adolescents, emphasizing the importance of both aspects in the evaluation of masticatory function.

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Physiological and behavioral aspects of masticatory function may have an impact on nutritional status, which has been little studied. The aim was to perform a comprehensive evaluation of objective, subjective and behavioral aspects of masticatory function in 231 adolescents, aged 14-17 years and compare these parameters between normal-weight (n = 115) and adolescents with overweight/obesity (n = 116). Objective aspects were examined by the Oro-facial Myofunctional Evaluation-expanded protocol (OMES-e), determining the masticatory type, chewing time/frequency, abnormal movements, and other; masticatory performance (color changeable chewing gum) and bite force were also explored. The subjective and behavioral evaluations were assessed using the Quality of Mastication Function Questionnaire, which explores the masticatory behavior and frequency/intensity of difficulty in chewing different types of foods. Results were submitted to normality tests, Chi-square, unpaired t-test and Mann-Whitney. A multiple linear regression model was used to evaluate which of the variables under study contributed to the variation in Percent Body Fat (α = 0.05). The results showed that OMES-e total score differed significantly between groups, that is, individuals with overweight showed more changes in oro-facial myofunctional aspects than normal-weight ones. Unilateral mastication was more frequent among females with overweight/obesity. They also showed greater difficulty on Habits and Fruit domains, reporting the need of adding sauce to the meal to facilitate swallowing and peeling and cutting fruit (apples) in small pieces in order to better chew them. OMES-e total score also showed a significant relationship with Percent Body Fat. Masticatory performance evaluated by chewing gum and bite force did not differ between groups. This study showed that adolescents with excess weight presented changes in masticatory behavior and greater difficulty in performing the masticatory function comparing to normal-weight ones.

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OBJECTIVE: The objective of this study is to better understand salivary and masticatory characteristics, this study evaluated the relationship among salivary parameters, bite force (BF), masticatory performance (MP) and gustatory sensitivity in healthy children. The secondary outcome was to evaluate possible gender differences. MATERIALS AND METHODS: One hundred and sixteen eutrophic subjects aged 7-11 years old were evaluated, caries-free and with no definite need of orthodontic treatment. Salivary flow rate and pH, total protein (TP), alpha-amylase (AMY), calcium (CA) and phosphate (PHO) concentrations were determined in stimulated (SS) and unstimulated saliva (US). BF and MP were evaluated using digital gnathodynamometer and fractional sieving method, respectively. Gustatory sensitivity was determined by detecting the four primary tastes (sweet, salty, sour and bitter) in three different concentrations. Data were evaluated using descriptive statistics, Mann-Whitney/t-test, Spearman correlation and multiple regression analysis, considering α = 0.05. RESULTS: Significant positive correlation between taste and age was observed. CA and PHO concentrations correlated negatively with salivary flow and pH; sweet taste scores correlated with AMY concentrations and bitter taste sensitivity correlated with US flow rate (p < 0.05). No significant difference between genders in salivary, masticatory characteristics and gustatory sensitivity was observed. The regression analysis showed a weak relationship between the distribution of chewed particles among the different sieves and BF. CONCLUSIONS: The concentration of some analytes was influenced by salivary flow and pH. Age, saliva flow and AMY concentrations influenced gustatory sensitivity. In addition, salivary, masticatory and taste characteristics did not differ between genders, and only a weak relation between MP and BF was observed.

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Chewing behavior may show sex differences; thus, the present study aimed to compare the masticatory aspects and the prediction of masticatory performance between male and female adolescents. Ninety-one healthy subjects (47 girls, 44 boys), caries-free and aged 14-17years, were included. Masticatory performance and maximal bite force were evaluated using a color-changeable chewing gum and digital gnathodynamometer, respectively. Masticatory behavior was assessed by the subjective aspect of the quality of the masticatory function (validated questionnaire) and the Orofacial Myofunctional Evaluation with Scores expanded (OMES-e) was used to determine chewing time, frequency of chewing cycles and other aspects. Salivary flow rate was also assessed. The physical examination involved measurements of facial morphometry, body weight, height, skeletal muscle mass, and dental/occlusal evaluations. It was observed that boys showed larger facial dimensions, higher bite force and chewing frequency and better masticatory performance than girls. They also showed shorter chewing time, fewer chewing cycles and lower score for OMES-e (that is, more changes in orofacial myofunctional aspects). Bite force showed a weak correlation with skeletal muscle mass only in boys (r=0.3035; p=0.0451). The masticatory performance was dependent on the bite force in boys (Adj R(2)=19.2%; Power=84.1%); among girls, masticatory performance was dependent on the frequency of chewing cycles and masticatory behavior (subjective aspect) (Adj R(2)=34.1%; Power=96.1%). The findings support the existence of sex differences in many masticatory aspects of function and behavior, hence the importance of considering sex differences when evaluating masticatory function and myofunctional therapy outcomes among young subjects.

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OBJECTIVES: Mastication is an essential function that prepares the food for swallowing and digestion and may be related to nutritional status. Thus, the aims of this study were to evaluate the masticatory parameters in overweight and obese children and the relation between bite force and anthropometric evaluation, food consistency, breast/bottle-feeding, and occlusion. MATERIALS AND METHODS: The sample consisted of 204 children of both genders, age range 8-10 years, divided into normal weight, overweight, and obese. Unilateral bite force was measured using a digital gnatodynamometer with 10mm force fork. Anthropometric and nutritional evaluation involved the measurements of body mass index and skeletal muscle mass using bioelectric impedance analysis. Occlusion was evaluated as regards orthodontic treatment need and food consistency was analysed using a structured questionnaire. In addition, the time of breast- and bottle-feeding was investigated. The results were submitted to chi-square and correlation tests, analysis of variance, and multiple linear regression to determine the relation between bite force and the independent variables under study (α = 0.05). RESULTS: Statistical analysis showed that the time of breast- and bottle-feeding and food consistency did not differ among groups. The regression model showed that body mass index, orthodontic treatment need, and body skeletal muscle mass contributed significantly to the variation in bite force. CONCLUSIONS: Breast- and bottle-feeding behaviour and food consistency did not differ in normal-weight, overweight, and obese children. However, bite force was dependent on body skeletal muscle mass, body mass index, and orthodontic treatment need.

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