{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:29:36Z","timestamp":1786537776581,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dent. J.","Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: Oral diseases are a major public health challenge and share behavioral and socioeconomic determinants with other noncommunicable diseases. Although physical activity has been proposed as one of these shared determinants, evidence at the population level remains limited. This study investigated the association between physical activity and oral health indicators using nationwide Brazilian surveillance data. Methods: An ecological study was conducted using aggregated data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) and the Brazilian National Oral Health Survey (SB Brasil) (2022\u20132023). Physical activity participation and weekly volume were evaluated against untreated dental caries, toothache, pain intensity, tooth loss, and the Decayed, Missing, and Filled Teeth (DMFT) index. Weighted multivariable linear regression models with heteroskedasticity-consistent standard errors were applied. Results: The analysis included 28,707 VIGITEL participants and 14,753 SB Brasil observations. After adjustment, physical activity participation was inversely associated with untreated dental caries, whereas weekly physical activity volume showed no association with any oral health outcome. No significant associations were observed for tooth loss, dental pain, pain intensity, or the DMFT index. Conclusions: Higher population-level participation in physical activity was associated with a lower prevalence of untreated dental caries but not with other oral health indicators. These findings may suggest that physical activity and oral health share common behavioral and social determinants, supporting integrated public health strategies targeting upstream risk factors.<\/jats:p>","DOI":"10.3390\/dj14080514","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:02:11Z","timestamp":1786532531000},"page":"514","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical Activity and Untreated Dental Caries in Brazil: Implications for Population-Based Caries Risk Assessment"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1751-6177","authenticated-orcid":false,"given":"Maria Clara dos","family":"Reis","sequence":"first","affiliation":[{"name":"Research Group on Technology Applied to Exercise Physiology\u2014GTAFE, Health Sciences Postgraduate Program, S\u00e3o Francisco University, Bragan\u00e7a Paulista 12916-900, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Paulo Menezes","family":"Scariot","sequence":"additional","affiliation":[{"name":"Research Group on Technology Applied to Exercise Physiology\u2014GTAFE, Health Sciences Postgraduate Program, S\u00e3o Francisco University, Bragan\u00e7a Paulista 12916-900, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8324-8866","authenticated-orcid":false,"given":"Leonardo Henrique Dalcheco","family":"Messias","sequence":"additional","affiliation":[{"name":"Research Group on Technology Applied to Exercise Physiology\u2014GTAFE, Health Sciences Postgraduate Program, S\u00e3o Francisco University, Bragan\u00e7a Paulista 12916-900, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Oral Disorders Collaborators (2025). Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: A systematic analysis for the Global Burden of Disease Study 2021. Lancet, 405, 897\u2013910."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"GBD 2017 Oral Disorders Collaborators, Bernabe, E., Marcenes, W., Hernandez, C.R., Bailey, J., Abreu, L.G., Alipour, V., Amini, S., Arabloo, J., and Arefi, Z. (2020). Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study. J. Dent. Res., 99, 362\u2013373.","DOI":"10.1177\/0022034520908533"},{"key":"ref_3","unstructured":"Minist\u00e9rio da Sa\u00fade (2026). SB Brasil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106625","DOI":"10.1016\/j.jdent.2026.106625","article-title":"Are the inequalities in dental caries decreasing over time in Brazil? A comparison between the urban population in two National Oral Health Surveys","volume":"169","author":"Chisini","year":"2026","journal-title":"J. Dent."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1590\/S0034-8910.2013047004226","article-title":"Tooth loss in Brazil: Analysis of the 2010 Brazilian Oral Health Survey","volume":"47","author":"Peres","year":"2013","journal-title":"Rev. Sa\u00fade P\u00fablica"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e00162324","DOI":"10.1590\/0102-311xen162324","article-title":"Evolution of socioeconomic inequalities in oral health and use of dental services in adult population of Brazil between 2013 and 2019","volume":"41","author":"Teixeira","year":"2025","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/odi.12428","article-title":"Global burden of oral diseases: Emerging concepts, management and interplay with systemic health","volume":"22","author":"Jin","year":"2016","journal-title":"Oral Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Jin, W., Tang, L., Yang, J., Hu, X., Guo, W., Ai, H., Zuo, Y., and Jin, Z. (2026). The oral\u2014X axis: From periodontal dysbiosis to systemic disease. Front. Immunol., 17.","DOI":"10.3389\/fimmu.2026.1806445"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1034\/j.1600-0528.2000.028006399.x","article-title":"The common risk factor approach: A rational basis for promoting oral health","volume":"28","author":"Sheiham","year":"2000","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e899","DOI":"10.1016\/S2468-2667(23)00205-0","article-title":"Redefining the non-communicable disease framework to a 6 x 6 approach: Incorporating oral diseases and sugars","volume":"8","author":"Benzian","year":"2023","journal-title":"Lancet Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/s41415-020-1306-3","article-title":"Associations between self-reported physical activity and oral health: A cross-sectional analysis in 17,777 Spanish adults","volume":"228","author":"Sanchez","year":"2020","journal-title":"Br. Dent. J."},{"key":"ref_12","first-page":"490","article-title":"Association of Physical Activity, Physical Fitness, Dental Caries, and Erosive Tooth Wear in Northern Finland Birth Cohort 1966","volume":"59","author":"Blomster","year":"2025","journal-title":"Caries Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/jcpe.13669","article-title":"The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011\u20132012","volume":"49","author":"Almohamad","year":"2022","journal-title":"J. Clin. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/jcpe.13766","article-title":"Leisure-time and occupational physical activity demonstrate divergent associations with periodontitis: A population-based study","volume":"50","author":"Marruganti","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29086","DOI":"10.1038\/s41598-024-73690-4","article-title":"The relationship between periodontal status, physical activity, dietary practices, and dental caries","volume":"14","author":"Sen","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/prd.12398","article-title":"Oral health\u2019s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions","volume":"87","author":"Kapila","year":"2021","journal-title":"Periodontol. 2000"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1111\/cdoe.12771","article-title":"Income- and education-based inequalities of edentulism and dental services utilization in Brazil","volume":"51","author":"Ferreira","year":"2023","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Galvao, M.H.R., Medeiros, A.A., and Roncalli, A.G. (2021). Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254310"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Galvao, M.H.R., and Roncalli, A.G. (2021). Does the implementation of a national oral health policy reduce inequalities in oral health services utilization? The Brazilian experience. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10586-2"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Alosaimi, N., Sherar, L.B., Griffiths, P., and Pearson, N. (2023). Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: A systematic review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16372-6"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bjornerud Korslund, S., Hansen, B.H., and Bjorkkjaer, T. (2023). Association between sociodemographic determinants and health behaviors, and clustering of health risk behaviors among 28,047 adults: A cross-sectional study among adults from the general Norwegian population. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-15435-y"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/cdoe.12354","article-title":"Clustering patterns of oral and general health-risk behaviours in Brazilian adolescents: Findings from a national survey","volume":"46","author":"Jordao","year":"2018","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_23","unstructured":"Minist\u00e9rio da Sa\u00fade (2026). Vigitel Brasil 2023\u2014Vigil\u00e2ncia de Fatores de Risco e Prote\u00e7\u00e3o para Doen\u00e7as Cr\u00f4nicas por Inqu\u00e9rito Telef\u00f4nico."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.zefq.2016.07.010","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"115\u2013116","author":"Benchimol","year":"2016","journal-title":"Z. Evid. Fortbild. Qual. Gesundheitswesen"},{"key":"ref_25","unstructured":"Minist\u00e9rio da Sa\u00fade (2023). Pesquisa Nacional de Sa\u00fade Bucal: Relat\u00f3rio Final."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chen, J., Chen, X., Wang, C., Zhao, D., and Zhang, Y. (2025). Relationship between behavioral-related variables and dental caries prevalence among university students: A cross-sectional study. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1683170"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: A global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/jcpe.70075","article-title":"Network Analysis of Health Behaviours Associated with Periodontitis in Chinese Adults","volume":"53","author":"Fu","year":"2026","journal-title":"J. Clin. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s00421-018-3847-6","article-title":"Exercise intensity and its impact on relationships between salivary immunoglobulin A, saliva flow rate and plasma cortisol concentration","volume":"118","author":"Leicht","year":"2018","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ntovas, P., Loumprinis, N., Maniatakos, P., Margaritidi, L., and Rahiotis, C. (2022). The Effects of Physical Exercise on Saliva Composition: A Comprehensive Review. Dent. J., 10.","DOI":"10.3390\/dj10010007"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1007\/s00421-024-05467-6","article-title":"Effects of different exercise intensities or durations on salivary IgA secretion","volume":"124","author":"Uchino","year":"2024","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/ije\/18.1.269","article-title":"Ecological bias, confounding, and effect modification","volume":"18","author":"Greenland","year":"1989","journal-title":"Int. J. Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1146\/annurev.pu.16.050195.000425","article-title":"Ecologic studies in epidemiology: Concepts, principles, and methods","volume":"16","author":"Morgenstern","year":"1995","journal-title":"Annu. Rev. Public Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1146\/annurev.publhealth.29.020907.090821","article-title":"Ecologic studies revisited","volume":"29","author":"Wakefield","year":"2008","journal-title":"Annu. Rev. Public Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/cdoe.12826","article-title":"Inequities and oral health: A behavioural sciences perspective","volume":"51","author":"Goodwin","year":"2023","journal-title":"Community Dent. Oral Epidemiol."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/8\/514\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:35:47Z","timestamp":1786534547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/8\/514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["dj14080514"],"URL":"https:\/\/doi.org\/10.3390\/dj14080514","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]}}}