RESUMO
BACKGROUND AND OBJECTIVE: Lead is known to have significant effects on bone metabolism and the immune system. This study tested the hypothesis that lead exposure affects periodontitis in adults. MATERIAL AND METHODS: This study used the data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94). It analyzed data from 2500 men and 2399 women, 20-56 yr old, who received complete periodontal examination. Periodontitis was defined as the presence of > 20% of mesial sites with >or= 4 mm of attachment loss. Lead exposure was grouped into three categories: < 3; 3-7; and > 7 microg/dL. Covariates were cotinine levels, poverty ratio, race/ethnicity, education, bone mineral density, diabetes, calcium intake, dental visit, and menopause (for women). All analyses were performed separately for men and women and considering the effect design. Univariate, bivariate, and stratified analysis was followed by multivariable analysis by estimating prevalence ratios through poisson regression. RESULTS: After adjustment for confounders, the prevalence ratios, comparing those with a lead blood level of > 7 microg/dL to those with a lead blood level of < 3 microg/dL was 1.70 (95% confidence interval (CI): 1.02, 2.85) for men and 3.80 (95% CI: 1.66, 8.73) for women. CONCLUSION: The lead blood level was positively and statistically associated with periodontitis for both men and women. Considering the public health importance of periodontitis and lead exposure, further studies are necessary to confirm this association.
Assuntos
Exposição Ambiental/estatística & dados numéricos , Chumbo/sangue , Periodontite/epidemiologia , Adulto , Densidade Óssea , Cálcio da Dieta/administração & dosagem , Fatores de Confusão Epidemiológicos , Cotinina/sangue , Assistência Odontológica/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Escolaridade , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Menopausa , Pessoa de Meia-Idade , Perda da Inserção Periodontal/epidemiologia , Pobreza/estatística & dados numéricos , Fatores Sexuais , Estados Unidos/epidemiologiaRESUMO
Data for caries in the permanent and primary dentitions of children in Mexico, the United States, and Canada are reviewed from the years around 1982 to the present time. Sources are national, state, and provincial surveys, together with a number of smaller, local surveys. Data from minority populations are also reviewed. Conclusions are that caries prevalence and severity in the permanent dentition are continuing to decline in the general populations of Canada and the United States, but that caries experience in the primary dentition may have stabilised since around 1986-87. There is nothing in the limited data available from Mexico to suggest a decline in that country, caries levels remaining high. There are considerable geographic variations in caries experience in the general populations of the United States and Canada; the highest prevalence and severity is found in Quebec. Caries is more prevalent and severe in the indigenous populations of Canada and the United States than in the general population, but there are indications of a decline in the permanent dentitions of those indigenous groups. Caries will probably decline further in the general populations of Canada and the United States before it reaches an irreducible minimum, but that point may not be far away because caries experience is already very low in many localities. It is anticipated that the recent introduction of salt fluoridation in Mexico will help to bring down the high caries levels in that country.
Assuntos
Cárie Dentária/epidemiologia , Adolescente , Adulto , Canadá/epidemiologia , Criança , Pré-Escolar , Índice CPO , Cárie Dentária/etnologia , Inquéritos de Saúde Bucal , Etnicidade/estatística & dados numéricos , Fluoretos/administração & dosagem , Fluoretos/uso terapêutico , Humanos , Indígenas Norte-Americanos/estatística & dados numéricos , Inuíte/estatística & dados numéricos , México/epidemiologia , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Prevalência , Quebeque/epidemiologia , Cloreto de Sódio na Dieta , Dente Decíduo , Estados Unidos/epidemiologiaRESUMO
Analysis of Southwestern HHANES data showed that the prevalence of dental caries among Mexican-American children is similar to that of children of the same age examined during the NIDR survey (1979-1980), despite a lower level of restorative treatment. Approximately 50% of Mexican-American children 17 years of age, however, had five or more teeth that were either decayed or filled. Occlusal surfaces of molars were the most susceptible teeth to decay; few anterior teeth were affected. This distribution of dental caries strongly supports the use of fissure sealants on molar teeth. Children from low-income families had two times more decayed teeth than children from high-income families. Mild gingivitis and poor oral hygiene were more prevalent in the Mexican-American children than in the child population for the region examined during NHANES I in 1971-1974. Children from high-income families had better periodontal health than those from low-income families.
Assuntos
Cárie Dentária/epidemiologia , Hispânico ou Latino , Doenças Periodontais/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Índice CPO , Métodos Epidemiológicos , Feminino , Gengivite/epidemiologia , Humanos , Masculino , México/etnologia , Distribuição Aleatória , Fatores Sexuais , Fatores Socioeconômicos , Estados UnidosRESUMO
This paper describes the estimated prevalence of dental caries and periodontal disease in 2,550 children, 5 through 17 years of age, who resided in five southwestern states of the United States and were examined in the Hispanic Health and Nutrition Examination Survey (HHANES) of 1982-84 of the National Center for Health Statistics. Dental caries in the Mexican American children was predominantly a disease of occlusal surfaces of molars; few smooth surfaces of posterior and anterior teeth were affected by caries. This intra-oral distribution of dental caries strongly supports the use of fissure sealants as a preventive procedure. Filled tooth surfaces contributed about 66 per cent of the total DMFS (decayed, missing, filled surfaces) scores. The analysis also shows that about 50 per cent of the 17 year old Mexican Americans had five or more filled or decayed teeth. Mild gingivitis was prevalent (76.9 per cent) in the Mexican American children.
Assuntos
Cárie Dentária/epidemiologia , Hispânico ou Latino , Doenças Periodontais/epidemiologia , Adolescente , Criança , Pré-Escolar , Inquéritos de Saúde Bucal , Humanos , Renda , México/etnologia , Estados UnidosRESUMO
The Southwestern portion of the Hispanic Health and Nutrition Examination Survey (HHANES) was conducted by the National Center for Health Statistics (NCHS) in 1982 and 1983. The survey population was Mexican-Americans residing in five Southwestern states. This report presents data on the prevalence of total tooth loss, dental caries, and periodontal diseases in 3860 Mexican-American adults aged from 18 to 74. Results show that 4.3% of this group was edentulous. Among the dentate, Mexican-Americans had lower overall DMF scores but higher numbers of untreated decayed teeth than did residents of the same region seen in the NHANES I survey in 1971-1974. Caries of the smooth surfaces in both posterior and anterior teeth was more pronounced in the older than in the younger age groups. Mexican-Americans had more gingivitis but fewer periodontal pockets than did the general population in the Western states during NHANES I. The caries pattern in the Mexican-Americans suggests that caries among adults may remain a problem in the future, with the possibility of increased involvement with the aging, although modest, of smooth tooth surfaces.
Assuntos
Cárie Dentária/epidemiologia , Hispânico ou Latino , Arcada Edêntula/epidemiologia , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Idoso , Índice CPO , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Índice de Higiene Oral , Pobreza , Estados UnidosRESUMO
The purpose of this study was to describe the distribution of advanced periodontal destruction (pocket depth equal to or deeper than six mm) in continuous residents, aged 27 to 74 years, of Lordsburg and Deming, New Mexico. The distance from the free gingival margin to the base of the gingival crevice or pocket was measured on the facial and mesiofacial sides of six index teeth. The presence of supragingival calculus, subgingival calculus, and plaque, as well as gingival bleeding around the index teeth, also were evaluated. Of the 372 examinees, only 46 individuals (12.4 percent) had at least one deep pocket equal to or deeper than six mm on at least one site on the six index teeth. Age was significantly associated with prevalence of deep pockets, although about 80 percent of those aged 47 to 74 years did not have deep pockets. Of those with deep pockets, 89.1 percent had fewer than four tooth sites (out of 12) affected. The only significant risk factor of the presence of deep pockets, other than age, was the number of teeth with plaque accumulations. Age and the number of teeth with plaque explained only 10.5 percent of the variability in the prevalence of deep pocketing, suggesting that risk factors other than those included in this study may be important. The results of this study indicate that destructive periodontal disease occurs at selected sites within the mouth, and that about 87 percent of the adults over age 27, in this population, do not have deep pockets in the six index teeth examined.