Aim To examine the evidence on the influence of oral health status on school performance and school attendance in children and adolescents. Design A systematic review was performed in accordance with PRISMA included epidemiological studies that assessed concomitantly oral health measures, participants’ school performance and/or school attendance. Electronic search was conducted on MEDLINE, SCOPUS, Web of Science, ScienceDirect, and LILACS. Studies published up to May 2018 in any language were eligible. The risk of bias was assessed using the Newcastle‐Ottawa Scale. Meta‐analysis was used to obtain pooled estimates between oral health measures and school performance and school attendance. Results Eighteen studies were included. Of them, fifteen studies were used for the meta‐analyses. Most studies were assessed as moderate quality. Children with one or more decayed teeth had higher probability of poor school performance (OR = 1.44 95%CI: 1.24‐1.64) and poor school attendance (OR = 1.57 95%CI: 1.08‐2.05) than caries‐free children. Poor parent's perception of child's oral health increased the odds of worse school performance (OR = 1.51 95%CI: 1.10‐1.92) and poor school attendance (OR = 1.35 95%CI: 1.14‐1.57). Conclusions Children and adolescents with dental caries and those reporting worse oral health experience poor school performance and poor school attendance.

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Objectives To examine the association of contextual and individual determinants with non‐utilization of dental services among Brazilian adults. Methods Data were from adults aged 35‐44 years (N = 7,265) from the 2010 Brazilian Oral Health Survey (SB Brasil Project). Non‐utilization of dental services was assessed whether the individual has never had a dental visit over the whole life time. Independent variables were selected according to Andersen's behavioral model. Contextual variables included Human Development Index‐longevity (HDI‐Longevity) (predisposing demographic), HDI‐Education and Gini index (predisposing social), integration of oral health teams into Primary Care (enabling health policy), and HDI‐Income (enabling financing). Individual data were age and sex (predisposing demographic), ethnicity and schooling (predisposing social), family monthly income (predisposing enabling), perceived dental treatment (perceived need), and decayed teeth (evaluated need). The relationship of contextual and individual variables with non‐utilization of dental services was assessed through multilevel logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). Results The prevalence of non‐utilization of dental services was 4.7 percent. Adults living in cities with high HDI‐Income were less likely to never have a dental visit. The odds of non‐utilization of dental services were lower for adults living in cities with high HDI‐Longevity. Sex, skin color, dental treatment needs, poor socioeconomic characteristics, perceived dental treatment needs, and decayed teeth were also associated with non‐utilization of dental services. Conclusions The results suggest that contextual enabling and predisposing factors, individual sociodemographic, and needs‐related characteristics influence non‐utilization of dental services by Brazilian adults.

Short title: periodontitis, quality of life and hypertension Conflict of InterestThe authors declare that there are no conflicts of interest in this study.A one-sentence summary describing the key finding(s) Periodontal disease predicted poor OHRQoL and mediated the link between smoking, socioeconomic status and OHRQoL in people with systemic arterial hypertension.

In the light of the scarcity of epidemiological studies on the oral health of the general population within the context of the Amazon region, this study aimed to estimate the prevalence of dental caries and gingivitis, as well as to evaluate the need for restorative treatment, among school students aged 15 to 19 years in the city of Manaus, AM, Brazil. A cross-sectional study was carried out on a sample of 889 students from within city limits who were enrolled in 26 public and private schools. Dental examinations were performed to obtain the DMFT index (decayed, missing and filled teeth) as well as to determine the treatments needed. The gingival index (Lõe & Silness) was used to classify gingivitis. The intra-examiner diagnostic concordance was 94% and the Kappa statistic was 0.91. The DMFT index found was 4.65 (+/- 0.12), without significant difference between the sexes or skin color groups. The prevalence of dental caries was 87.4%. Restoration of a dental surface was the greatest need (59.3%). Slight gingival inflammation was present in 78.5% and gingival bleeding following probing occurred in 53.3%. Although the DMFT index was lower than that observed for the northern region of Brazil, restorative dental services are lacking for this population. Additional studies are suggested to better understand the differences found.