{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:47:36Z","timestamp":1790012856759,"version":"4.0.1"},"reference-count":39,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T00:00:00Z","timestamp":1516147200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["403315\/2012-3"],"award-info":[{"award-number":["403315\/2012-3"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003758","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa e ao Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico do Maranh\u00e3o","doi-asserted-by":"publisher","award":["PRONEM 2012"],"award-info":[{"award-number":["PRONEM 2012"]}],"id":[{"id":"10.13039\/501100003758","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>Chronic oral diseases are rarely studied together, especially with an emphasis on their common risk factors. This study examined the association of added sugar consumption on \u201cchronic oral disease burden\u201d among adolescents, with consideration of obesity and systemic inflammation pathways through structural equation modeling. A cross-sectional study was conducted of a complex random sample of adolescent students enrolled at public schools in S\u00e3o Lu\u00eds, Brazil ( n = 405). The outcome was chronic oral disease burden, a latent variable based on the presence of probing depth \u22654 mm, bleeding on probing, caries, and clinical consequences of untreated caries. The following hypotheses were tested: 1) caries and periodontal diseases among adolescents are correlated with each other; 2) added sugar consumption and obesity are associated with chronic oral disease burden; and 3) chronic oral disease burden is linked to systemic inflammation. Models were adjusted for socioeconomic status, added sugar consumption, oral hygiene behaviors, obesity, and serum levels of interleukin 6 (IL-6). All estimators of the latent variable chronic oral disease burden involved factor loadings \u22650.5 and P values &lt;0.001, indicating good fit. Added sugar consumption (standardized coefficient [SC] = 0.212, P = 0.005), high IL-6 levels (SC = 0.130, P = 0.036), and low socioeconomic status (SC = \u22120.279, P = 0.001) were associated with increased chronic oral disease burden values. Obesity was associated with high IL-6 levels (SC = 0.232, P = 0.001). Visible plaque index was correlated with chronic oral disease burden (SC = 0.381, P &lt; 0.001). Our finding that caries and periodontal diseases are associated with each other and with added sugar consumption, obesity, and systemic inflammation reinforces the guidance of the World Health Organization that any approach intended to prevent noncommunicable diseases should be directed toward common risk factors.<\/jats:p>","DOI":"10.1177\/0022034517745326","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T00:24:54Z","timestamp":1516321494000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["Added Sugar Consumption and Chronic Oral Disease Burden among Adolescents in Brazil"],"prefix":"10.1177","volume":"97","author":[{"given":"C.D.S.","family":"Carmo","sequence":"first","affiliation":[{"name":"Postgraduate Program of Dentistry, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.R.C.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Medicine III, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.X.P","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Public Health, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.M.C.","family":"Alves","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Dentistry, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.M.","family":"Franco","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Dentistry, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.K.T.C.","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Public Health, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.B.","family":"Benatti","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Dentistry, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cunha-Cruz","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.C.C.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Postgraduate Program of Dentistry, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"},{"name":"Postgraduate Program of Public Health, Federal University of Maranh\u00e3o, S\u00e3o Lu\u00eds, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,1,17]]},"reference":[{"key":"bibr1-0022034517745326","unstructured":"ABEP. 2012. Criterion of economic classification Brazil. S\u00e3o Paulo (Brazil): ABEP; [accessed 2014 May 2]. http:\/\/www.abep.org\/criterio-brasil."},{"key":"bibr2-0022034517745326","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.013540"},{"issue":"4","key":"bibr3-0022034517745326","first-page":"229","volume":"25","author":"Ainamo J","year":"1975","journal-title":"Int Dent J"},{"key":"bibr4-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.112.4.545"},{"key":"bibr5-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2007.09.004"},{"key":"bibr6-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002214"},{"key":"bibr7-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2009.080376"},{"key":"bibr8-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1902\/annals.2002.7.1.79"},{"key":"bibr9-0022034517745326","volume":"50","author":"Bloch KV","year":"2016","journal-title":"Rev Saude Publica"},{"key":"bibr10-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12685"},{"key":"bibr11-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-016-1988-8"},{"key":"bibr12-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1159\/000016428"},{"key":"bibr13-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1111\/idj.12078"},{"key":"bibr14-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311x00165415"},{"key":"bibr15-0022034517745326","unstructured":"Fisberg RM, Marchioni DML. 2012. Manual of evaluation of food consumption in population studies: the experience of the health survey in S\u00e3o Paulo (ISA). S\u00e3o Paulo (Brazil): Faculdade de Sa\u00fade P\u00fablica da USP; [accessed 2017 November 8]. http:\/\/www.gac-usp.com.br\/resources\/manual%20isa%20biblioteca%20usp.pdf."},{"key":"bibr16-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1177\/0022034509337700"},{"issue":"4","key":"bibr17-0022034517745326","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/ajcn\/86.4.899","volume":"86","author":"Johnson RJ","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"bibr18-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-016-1725-3"},{"key":"bibr19-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.140589"},{"key":"bibr20-0022034517745326","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2016.16699"},{"key":"bibr21-0022034517745326","volume-title":"Principles and practice of structural equation modeling","author":"Kline RB.","year":"2011","edition":"3"},{"key":"bibr22-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2891-10-27"},{"key":"bibr23-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1990.tb01059.x"},{"key":"bibr24-0022034517745326","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.089656"},{"key":"bibr25-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00477-5"},{"key":"bibr26-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1099\/mic.0.26082-0"},{"key":"bibr27-0022034517745326","unstructured":"Ministry of Health. 2008. Protocols of the food and nutrition surveillance system\u2014in health care. Bras\u00edlia (Brazil):\u2009Ministry of Health. http:\/\/bvsms.saude.gov.br\/bvs\/publicacoes\/protocolo_sistema_vigilancia_alimnetar.pdf"},{"key":"bibr28-0022034517745326","unstructured":"Ministry of Health. 2012. SB Brazil 2010: National research on oral health: main results. Bras\u00edlia (Brazil):\u2009Ministry of Health. http:\/\/bvsms.saude.gov.br\/bvs\/publicacoes\/pesquisa_nacional_saude_bucal.pdf"},{"key":"bibr29-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2009.00514.x"},{"key":"bibr30-0022034517745326","volume-title":"Mplus: statistical analysis with latent variables: user\u2019s guide (1998\u20132010)","author":"Muth\u00e9n LK","year":"2010","edition":"6"},{"key":"bibr31-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1590\/1807-3107BOR-2015.vol29.0098"},{"key":"bibr32-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1177\/0022034515625907"},{"issue":"20","key":"bibr33-0022034517745326","first-page":"4313","volume":"20","author":"Shi FY","year":"2016","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"bibr34-0022034517745326","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2016.09.007"},{"key":"#cr-split#-bibr35-0022034517745326.1","unstructured":"World Health Organization. 2012. Oral health. Fact sheet No. 318. Geneva (Switzerland): World Health Organization"},{"key":"#cr-split#-bibr35-0022034517745326.2","unstructured":"[accessed 2017 November 8]. http:\/\/www.who.int\/mediacentre\/factsheets\/fs318\/en\/index.html"},{"key":"bibr36-0022034517745326","unstructured":"World Health Organization. 2013. Oral health surveys: basic methods. 5th ed. Geneva (Switzerland): WHO Library Cataloguing; [accessed 2017 November 8]. http:\/\/www.who.int\/oral_health\/publications\/9789241548649\/en\/."},{"key":"bibr37-0022034517745326","unstructured":"World Health Organization. 2015. Guideline: sugars intake for adults and children. Geneva, Switzerland: WHO Library Cataloguing; [accessed 2017 November 8]. http:\/\/www.who.int\/nutrition\/publications\/guidelines\/sugars_intake\/en\/."},{"key":"bibr38-0022034517745326","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497"}],"container-title":["Journal of Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0022034517745326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0022034517745326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0022034517745326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:07:31Z","timestamp":1777496851000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0022034517745326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,17]]},"references-count":39,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1177\/0022034517745326"],"URL":"https:\/\/doi.org\/10.1177\/0022034517745326","relation":{},"ISSN":["0022-0345","1544-0591"],"issn-type":[{"value":"0022-0345","type":"print"},{"value":"1544-0591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,17]]}}}