RESUMEN
The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.
O objetivo foi analisar a distribuição espacial da má oclusão (MO) em adolescentes, estimar a prevalência e avaliar os fatores associados. Estudo com dados de 5.558 adolescentes entre 15 e 19 anos de idade do inquérito - SB São Paulo 2015. O desfecho foi a MO. As variáveis independentes foram os aspectos sociodemográficos, acesso aos serviços odontológicos, cárie e perdas dentárias. Foram incluídos 162 municípios do estado de São Paulo e aplicadas técnicas de estatística espacial. Foram realizados modelos de regressão logística hierarquizada. A prevalência de MO foi de 29,3%. Houve um padrão de espalhamento entre os tipos de MO e correlação espacial positiva (p<0,05). Adolescentes não brancos (OR=1,32, IC95%: 1,24-1,42), com menor tempo de estudo (OR=1,30, IC95%: 1,22-1,42) e com dentes extraídos por cárie (OR=1,40, IC95%: 1,03-1,88) tiveram mais chances de apresentarem MO. O acesso dos adolescentes à consulta odontológica não contribuiu para reduzir a chance de apresentar a MO, independentemente de a consulta ao dentista ter ocorrido há menos (OR=2,02, IC95%: 1,65-2,47) ou há mais de um ano (OR=1,63, IC95%: 1,31-2,03). Assim, a ocorrência de MO é desigualmente distribuída no estado de São Paulo, e associada a condições sociodemográficas de acesso à consulta e perda dentária por cárie.
Asunto(s)
Caries Dental , Maloclusión , Pérdida de Diente , Humanos , Adolescente , Caries Dental/epidemiología , Brasil/epidemiología , Estudios Transversales , Maloclusión/epidemiología , PrevalenciaRESUMEN
Resumo O objetivo foi analisar a distribuição espacial da má oclusão (MO) em adolescentes, estimar a prevalência e avaliar os fatores associados. Estudo com dados de 5.558 adolescentes entre 15 e 19 anos de idade do inquérito - SB São Paulo 2015. O desfecho foi a MO. As variáveis independentes foram os aspectos sociodemográficos, acesso aos serviços odontológicos, cárie e perdas dentárias. Foram incluídos 162 municípios do estado de São Paulo e aplicadas técnicas de estatística espacial. Foram realizados modelos de regressão logística hierarquizada. A prevalência de MO foi de 29,3%. Houve um padrão de espalhamento entre os tipos de MO e correlação espacial positiva (p<0,05). Adolescentes não brancos (OR=1,32, IC95%: 1,24-1,42), com menor tempo de estudo (OR=1,30, IC95%: 1,22-1,42) e com dentes extraídos por cárie (OR=1,40, IC95%: 1,03-1,88) tiveram mais chances de apresentarem MO. O acesso dos adolescentes à consulta odontológica não contribuiu para reduzir a chance de apresentar a MO, independentemente de a consulta ao dentista ter ocorrido há menos (OR=2,02, IC95%: 1,65-2,47) ou há mais de um ano (OR=1,63, IC95%: 1,31-2,03). Assim, a ocorrência de MO é desigualmente distribuída no estado de São Paulo, e associada a condições sociodemográficas de acesso à consulta e perda dentária por cárie.
Abstract The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.
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Aim To analyze associations between sociodemographic factors, self-perception, self-care practices in health with Oral Health Literacy (OHL) levels among users of Primary Health Care (PHC). Methods A cross-sectional and analytical study was performed in Piracicaba (São Paulo), Brazil, in 2018, with a convenience sample of users of PHC that were aged over 18 years. Data were collected with a questionnaire by a trained dentist in two Family Health Units. The outcome variable was OHL, measured by the OHLA-B instrument, which was dichotomized by median into low (≤8 point) and high (>8 point). The independent variables were sociodemographic conditions (age, sex, self-declared skin color, and education), self-perceived oral health and self-care practices in health (tooth brushing frequency, smoking habits, reason for the last visit to the dentist, and source of health information search). Unadjusted and adjusted analyses were performed between OHL and independent variables for multiple logistic regression model (p≤0.05). Results The sample consisted of 450 adults. A total of 54.7% had a low OHL. After adjusting for sex and age, OHL was associated with skin color (OR=0.57; 95%CI=0.37-085), educational level (OR=4.92; 95%CI=3.16-7.79), health information from health professionals (OR=2.40; 95%CI=1.42-4.16) and internet (OR=2.88; 95%CI=1.59-5.32), toothbrushing >1 time a day (OR=3.23; 95%CI=1.27-9.92) and smokers (OR=0.42; 95%CI=0.23-0.73). After adjusting for sex, age and income, OHL was associated with (OR=0.63; 95%CI=0.41-096), educational level (OR=4.06; 95%CI=2.57-6.51) and smokers (OR=0.48; 95%CI=0.26-0.84). Conclusions Low OHL was associated with socioeconomic factors, source of information and smoking. This fact highlights the importance of health professionals to promote OHL.
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Humanos , Masculino , Femenino , Adulto , Higiene Bucal , Atención Primaria de Salud , Autoimagen , Salud Bucal , Alfabetización en Salud , Factores SociodemográficosRESUMEN
Resumo Introdução A Autopercepção da Saúde Bucal (ASB) é uma importante variável subjetiva associada à procura por serviços odontológicos e determinada por diversos fatores. Objetivo O objetivo deste trabalho foi investigar associações entre a ASB, o Letramento em Saúde Bucal (LSB) e covariáveis, em usuários da Atenção Básica. Método A amostra foi composta por 366 adultos e idosos, moradores em territórios adscritos a uma unidade de equipe de Saúde da Família (eSF) do município de Piracicaba, que procuraram por tratamento odontológico no ano de 2019 e que aceitaram participar da pesquisa. Aplicou-se o instrumento Health Literacy in Dentistry (HeLD-14) para avaliação do LSB, bem como um questionário para investigar características sociodemográficas e da ASB. Ademais, exames intrabucais foram realizados. Realizaram-se análises de regressões logísticas simples e múltipla, para se avaliar o nível de associação entre a variável ASB e as variáveis preditoras. Resultados Pacientes com menor escore de LSB, pior Autopercepção da Saúde Geral e com mais de um dente perdido tiveram, respectivamente, 2,73 (IC95%: 1,62-4,61), 14,24 (IC95%: 7,41-27,38) e 2,93 (IC95%: 1,76-4,89) vezes mais chance de apresentar pior ASB (p<0,05). Conclusão A ASB é um constructo associado a diversas variáveis não clínicas, incluindo o LSB.
Abstract Background The Self-Rated Oral Health (SROH) is an important subjective variable associated with the demand for dental services and determined by several factors. Objective The objective of this work was to investigate associations between SROH, Oral Health Literacy (OHL) and covariates in Primary Care users. Method The sample consisted of 366 adults and elderly living in territories assigned to a Family Health team unit in the municipality of Piracicaba who sought dental treatment in 2019 and who agreed to participate in the research. The Health Literacy in Dentistry instrument (HeLD-14) was applied to assess OHL, as well as a questionnaire to investigate sociodemographic and SROH characteristics. In addition, clinical dental examinations were performed. Simple and multiple logistic regression analyzes were performed to assess the level of association between the SROH variable and the predictor variables. Results Patients with lower OHL score, worse Self-Rated Health and with more than one missing tooth had, respectively, 2.73 (95% CI: 1.62-4.61), 14.24 (95% CI: 7.41-27.38) and 2.93 (95% CI: 1.76-4.89) times more likely to have worse SROH (p <0.05). Conclusion The SROH is a construct associated with several non-clinical variables, including OHL.
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This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes "tooth loss" and "reason for the last dental appointment" were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.
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Caries Dental , Alfabetización en Salud , Adulto , Brasil/epidemiología , Estudios Transversales , Caries Dental/epidemiología , Humanos , Salud Bucal , Atención Primaria de Salud , Factores SociodemográficosRESUMEN
Objetivo: avaliar associações entre fatores sociodemográficos, sociais e bucais e reprovação escolar entre adolescentes. Métodos: Trata-se de um estudo transversal e analítico realizado com 251 adolescentes, entre 14 e 18 anos, provenientes de cinco escolas estaduais do município de Piracicaba, São Paulo, Brasil. A variável desfecho avaliada foi a reprovação escolar e as variáveis independentes incluíram fatores sociodemográficos e bucais. Para se avaliar a associação entre as variáveis, realizou-se regressão logística simples e múltipla, permanecendo no modelo final as variáveis com p≤0,05, após o ajuste para as demais variáveis. Resultados: A maioria dos participantes era do sexo feminino (61,8%), com idade até 16 anos (58,6%), tinham mais que um irmão (60,2%) e o grau de instrução dos chefes das famílias era acima de oito anos (71,3%). A reprovação escolar foi relatada por 12,7% dos adolescentes. No modelo ajustado final, verificou-se que a reprovação escolar permaneceu associada aos adolescentes que apresentavam mais de um irmão (OR = 3,79: IC 95%: 1,34-10,73), que foram ao dentista na última vez por motivo de dor (OR = 3,00: IC 95%: 1,26-7,15) e com autoavaliação negativa da saúde bucal (OR = 5,50: IC9 5%: 2,10-14,36). Conclusão: Fatores sociodemográficos e bucais estiveram associados com a reprovação escolar em adolescentes. Nesse contexto, recomenda-se a continuidade das ações e políticas públicas intersetoriais entre os setores de educação e saúde para a melhoria da saúde bucal dos escolares, a qual apresenta associações com o rendimento acadêmico.
Aim: to evaluate the association between sociodemographic, social and oral factors, and school failure among adolescents. Methods: This is a cross-sectional and analytical study carried out with 251 adolescents, between 14 and 18 years of age, from five state schools in the city of Piracicaba, São Paulo, Brazil. This work evaluated the outcome variable of school failure, and the independent variables included sociodemographic, social, and oral factors. To assess the association between the variables, simple and multiple logistic regressions were performed, with the variables presenting p≤0.05 remaining in the final model after adjustments for the other variables. Results: Most participants were female (61.8%), up to 16 years of age (58.6%), who had more than one sibling (60.2%), and whose level of education of the heads of the household was over eight years (71.3%). School failure was reported by 12.7% of the adolescents. In the final adjusted model, school failure remained associated with adolescents who had more than one sibling (OR = 3.79: 95% CI: 1.34-10.73), who went to the dentist the last time due to pain (OR = 3.00: 95% CI: 1.26-7.15) and a negative oral health self-assessment (OR = 5.50: 95% CI: 2.10-14.36). Conclusion: Sociodemographic and oral factors were associated with school failure in adolescents. In this context, it is recommended to continue intersectoral actions and public policies between education and health to improve the oral health of schoolchildren and, consequently, their academic performance.
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Rendimiento Escolar Bajo , Salud Bucal , Adolescente , Educación , Fracaso EscolarRESUMEN
Objetivo: Testar as associações da má oclusão (MO) com as variáveis clínicas odontológicas e socioeconômicas em adolescentes brasileiros de 15 a 19 anos. Métodos: Trata-se de um estudo observacional transversal analítico que utilizou os dados do relatório final da Pesquisa Estadual de Saúde Bucal do ano de 2015. Resultados:Adolescentes não brancos, com baixa escolaridade, com menor frequência de consultas ao dentista e com dentes extraídos por cárie tiveram, respectivamente, 1,32, 1,32, 2,02 e 1,63, e 1,40 vezes mais chance de apresentar MO. Conclusão: A MO é um problema de saúde pública e sofre influência dos determinantes socioeconômicos, deste modo, deve-se garantir o acesso ao tratamento ortodôntico para aqueles que apresentem maior vulnerabilidade social e, consequentemente, maior susceptibilidade aos agravos em saúde bucal.
Aim: To test the associations of malocclusion with clinical and socioeconomic variables in Brazilian adolescents aged 15 to 19 years. Methods: This is an analytical cross-sectional observational study, which used data from the final report of the 2015 State Oral Health Survey. Results: Non-white adolescents, low educational level, with fewer visits to the dentist, and teeth extracted due to caries, had, respectively, 1.32, 1.32, 2.02 and 1.63, and 1.40-fold greater chances of presenting malocclusion. Conclusion:Malocclusion is a public health problem and is influenced by socioeconomic determinants. Therefore, conditions for orthodontic treatment must be guaranteed for those who are more socially vulnerable and, consequently are more likely to suffer from oral health problems.
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Ortodoncia , Encuestas Epidemiológicas , Vulnerabilidad Social , MaloclusiónRESUMEN
Abstract This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes "tooth loss" and "reason for the last dental appointment" were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.
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OBJECTIVE: To evaluate the repercussions of the COVID-19 pandemic on procedures performed by a public urgent dental care service (PUDS). METHODS: This was a cross-sectional study, using data from the PUDS in Piracicaba, SP, Brazil, prior to the pandemic (February-March 2020) and during the pandemic (March-April 2020). Differences in the care profile between the pre-COVID-19 period and the COVID-19 period, according to sex, age and dental procedures were analyzed using Pearson's Chi-square test. Effect size was also measured using Cramer's V. RESULTS: There was a 51% reduction in the number of visits between the pre-COVID-19 period (n=824) and the COVID-19 period (n=404). The percentage of extractions reduced from 14.7% to 8.9%, while the percentage of temporary cavity fillings increased from 22.9% to 33.2%, between the two periods. CONCLUSION: The COVID-19 pandemic had repercussions on the amount and pattern of procedures performed at the city's urgent dental care service.
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COVID-19 , Brasil/epidemiología , Estudios Transversales , Atención Odontológica , Humanos , Pandemias , SARS-CoV-2RESUMEN
ABSTRACT Objective: To test possible associations between Oral Health Literacy (OHL) level and socioeconomic covariates among users of Centers for Dental Specialties (CEOs). Material and Methods: The Health Literacy in Dentistry (HeLD-14) instrument was applied to 130 adult users of CEOs located in 13 municipalities in the state of São Paulo - Brazil, as well as socioeconomic issues. The researcher applied instruments in a specific room after randomly selecting individuals in the waiting room and invitation acceptance. Each item was ranked on a 5-point scale, ranging from 0 to 4, in which high scores indicate minimal difficulties in performing functions (high OHL) and low scores indicate very limited abilities to perform functions (low OHL). Statistical analysis using the Levene test was used to verify the possibility of using the one-way ANOVA test, and in case results show positive values (p>0.05), the Kruskal Wallis test was used. Results: The average age of participants was 45 years, with more than half being female (68.7%) with 9-11 years of schooling (48.4%). When considering the total value of HeLD-14 questions, OHL was associated with covariates schooling, marital status and family income. Conclusion: OHL levels were associated with socioeconomic variables, contributing to evidence in this field of specialized care.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Clase Social , Salud Bucal , Educación del Paciente como Asunto , Clínicas Odontológicas , Alfabetización en Salud , Atención Secundaria de Salud , Brasil/epidemiología , Estudios Transversales/métodos , Encuestas y Cuestionarios , Análisis de Varianza , Estadísticas no ParamétricasRESUMEN
Objetivo: Avaliar as repercussões da pandemia de COVID-19 nos procedimentos realizados por um serviço público odontológico de urgência (SPOU). Métodos: Estudo transversal, utilizando-se dados do SPOU de Piracicaba, SP, Brasil, relativos a dois períodos, anterior (fevereiro e março de 2020) e durante a pandemia (março e abril de 2020). Diferenças no perfil de atendimentos, entre os períodos pré-COVID-19 e COVID-19 selecionados, de acordo com sexo, idade e procedimentos odontológicos, foram analisadas pelo teste qui-quadrado de Pearson. Também foi calculado o tamanho do efeito Cramer's V. Resultados: Houve redução de 51% no número de atendimentos, entre o período anterior (n=824) e o período da pandemia de COVID-19 observado (n=404). O percentual de exodontias reduziu-se, de 14,7 para 8,9%, enquanto o de selamento provisório de cavidades aumentou de 22,9 para 33,2%, entre ambos períodos. Conclusão: A pandemia de COVID-19 repercutiu na quantidade e no padrão de procedimentos realizados pelo serviço odontológico de urgência do município.
Objetivo: Evaluar el impacto de la pandemia COVID-19 en los procedimientos realizados por un servicio de odontología pública de emergencia (SOPE). Métodos: Estudio transversal, utilizando datos del SOPE de Piracicaba, SP, Brasil, para los períodos anteriores (febrero y marzo 2020) y durante la pandemia (marzo y abril 2020). Las diferencias en el perfil de atención entre los períodos Pre-COVID-19 y COVID-19, según sexo, edad y procedimientos dentales, se analizaron mediante la prueba Chi-cuadrado de Pearson. También se calculó el tamaño del efecto de Cramer V. Resultados: Hubo una reducción del 51% en el número de visitas entre el período anterior (n=824) y el período de la pandemia de COVID-19 (n=404). El porcentaje de extracciones se redujo del 14,7% al 8,9%, mientras que el porcentaje de sellado provisional de cavidades aumentó del 22,9% al 33,2%, entre estos períodos. Conclusión: La pandemia de COVID-19 afectó la cantidad y patrón de procedimientos realizados en el servicio de odontología de emergencia de la ciudad.
Objective: To evaluate the repercussions of the COVID-19 pandemic on procedures performed by a public urgent dental care service (PUDS). Methods: This was a cross-sectional study, using data from the PUDS in Piracicaba, SP, Brazil, prior to the pandemic (February-March 2020) and during the pandemic (March-April 2020). Differences in the care profile between the pre-COVID-19 period and the COVID-19 period, according to sex, age and dental procedures were analyzed using Pearson's Chi-square test. Effect size was also measured using Cramer's V. Results: There was a 51% reduction in the number of visits between the pre-COVID-19 period (n=824) and the COVID-19 period (n=404). The percentage of extractions reduced from 14.7% to 8.9%, while the percentage of temporary cavity fillings increased from 22.9% to 33.2%, between the two periods. Conclusion: The COVID-19 pandemic had repercussions on the amount and pattern of procedures performed at the city's urgent dental care service.