TOTAL ANTIOXIDANT CAPACITY MAY NOT BE AN ACCURATE WAY TO PREDICT DENTAL CARIES.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Salivary biomarkers of oxidative stress in children with dental caries: Systematic review and meta-analysis doi:10.1016/j.archoralbio.2022.105432. SOURCE OF FUNDING: CAPES (Coordination for the improvement of higher education, National Council of Technological and Scientific Development), Finace code 001. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Validation of an instrument to determine oral health knowledge, attitudes, and practices during pregnancy.

BACKGROUND: Oral health of the mother-infant dyad is important to preserve general health. However, there are few instruments in Spanish for the evaluation of knowledge, attitudes and practices that determine this construct. Therefore, this research aimed to develop and evaluate the psychometric properties of the Maternal Oral Health Knowledge, Attitudes and Practices Questionnaire (CAPSOM in Spanish). METHODS: In this instrument development study that carried out in 2018-2019, involving pregnant women between the ages of 18 and 45 in the city of Leon, Guanajuato, Mexico. The sample size was calculated based on 10 women per questionnaire item (n = 10 k). The study used Cronbach's alpha, the modified Lawshe test of validity criteria, factor analysis, and the level of difficulty and discrimination of the items. RESULTS: 207 women took part with their signed, informed consent (25 ± 6 years). The internal consistency of the instrument, both total and by dimension was α = 0.70, α = 0.66 knowledge, α = 0.74 attitudes, and α = 0.66 practices. Values of Content Validity Ratio' ≥ 0.60 were obtained for the final 10 items and Content Validity Index' = 0.90. The average difficulty index of items was 0.40, and there were significant differences (Kruskall-Wallis, p < 0.001) in the discrimination test. Factor analysis demonstrated three main components. CONCLUSIONS: A valid and reliable 10-item Spanish questionnaire was designed to measure pregnant women's oral health knowledge, attitudes, and practices.

Atraumatic restorative treatment-ART in early childhood caries in babies: 4 years of randomized clinical trial.

OBJECTIVE: To assess the effectiveness of atraumatic restorative treatment (ART) performed 4 years ago in babies suffering from early childhood caries (ECC), and to compare the clinical performance of ART atraumatic restorations performed with two different high-viscosity glass ionomer cements (GIC). MATERIALS AND METHODS: This was a longitudinal follow-up of a randomized, double-blind, split-mouth-type clinical trial. The initial sample was composed of 100 deciduous molars with occlusal lesions in 25 children with ages between 18 and 36 months who received ART with two different GICs: Ketac Molar Easymix® (3 M ESPE) and Vitro Molar® (DFL). The clinical assessments were performed by a trained, blind examiner gauged by the parameters assessed in 1, 2, and 4 years (ART and USPHS criteria). RESULTS: For the analysis of the clinical performance of ARTs between the different GICs, the chi-square and Mann-Whitney tests were applied (p < 0.05). In the 4 years of evaluation, the sample was composed by 76 ARTs and 19 children, with 94.7% of the treatments having inactivated the cavity process. The total success percentage of the ARTs was 94%, 87.5%, and 82.9%, in 1, 2, and 4 years of follow-up, respectively. Moreover, among the GICs studied, this difference was not statistically significant (p > 0.05) ( ClinicalTrials.gov NCT03756025). CONCLUSION: ART was effective in handling ECC, with an excellent clinical performance of ART restorations, for both GICs, during the 4 years of follow-up. CLINICAL RELEVANCE: ART, with both GIC studied, is an alternative therapy for ECC.

Asthma and oral changes in children: Associated factors in a community of southern Brazil.

BACKGROUND: Asthma is a chronic disease that involves several healthcare services that need attention in relation to its treatment and prevention. AIM: The objective of this study was to evaluate caries, erosion, and enamel defects in children with and without asthma. DESIGN: Cross-sectional study, with a sample of 228 children ages 6-12 years, stratified as asthmatic (n = 112) and non-asthmatic (n = 116), at two Primary Health Units of the Community Health Service, Brazil. The evaluation consisted of an oral examination and a structured interview with parents/guardians, in addition to data from medical records. Data were analysed by Poisson regression with a robust error variance, all of them at a level of significance of P < 0.05. RESULTS: Of 112 asthmatic children, 63 (51.2%) had dental caries and 25 (53.2%) enamel defects. In the adjusted analysis, dental caries and use of salbutamol were associated (PR = 1.32, 95% CI = 1.01-1.72). In addition, children who performed oral hygiene more than three times a day showed a greater prevalence (PR = 2.36, 95% CI = 1.02-4.85) of dental erosion compared with children who performed it only once a day. CONCLUSIONS: There is no evidence for an association between asthma, caries, erosion, and enamel defect in children aged from 6 to 12 years. There was, however, an association between dental caries and use of salbutamol.

Motivational Interviewing in Preventing Early Childhood Caries in Primary Healthcare: A Community-based Randomized Cluster Trial.

OBJECTIVE: To assess the effectiveness of motivational interviewing in preventing early childhood caries compared with conventional oral health education. STUDY DESIGN: Twelve health care units in southern Brazil were randomly allocated in 2 groups of 6 and professionals in 1 group were trained in motivational interviewing. The mothers/children and external examiners were blinded to the intervention. The data were collected by calibrated examiners using questionnaires and a clinical examination based on modified International Caries Detection and Assessment System criteria. Of the 674 children born in the catchment area in the year 2013, 469 received the intervention (224 in the conventional oral health education group, 245 in the motivational interviewing group), and 320 were examined by the end of the study (145 in the conventional oral health education group, 175 in the motivational interviewing group), with mean age of 30 months. The final follow-up was 68%, after 3 years. RESULTS: Mean of decayed, missing, and filled surfaces at the end of the study period for the whole sample was 1.34 (95% CI 0.97-1.71). The caries rate per 100 surface-year in the conventional oral health education group was 1.74 (95% CI 1.14-2.34) and in the motivational interviewing group, it was 0.92 (95% CI 0.63-1.20). To correct for clustering effect and unbalanced factors, multilevel Poisson regression was fitted and the effect of motivational interviewing on the incidence rate ratio was 0.40 (95% CI 0.21-0.79). CONCLUSIONS: An intervention based on the principles of motivational interviewing style was more effective in reducing the number of surfaces affected by early childhood caries compared with conventional oral health education intervention. TRIAL REGISTRATION: ClinicalTrials.govNCT02578966, Brazilian Registry of Clinical Trials RBR-8fvwxq.

Motivational interviewing for preventing oral morbidities in adults: Systematic review and meta-analysis.

OBJECTIVE: This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) effectively prevents oral morbidities in adults. METHODS: Studies considered were randomized controlled trials, cluster-randomized controlled trials and community-based randomized trials assessing interventions based on MI or indicating that a counselling technique based on the principles developed by Miller and Rollnick was used. Controls were any type of oral health education or negative controls. Participants were 18-60 years old. The main outcome was any oral morbidity. From 602 studies identified in MEDLINE, Scopus, Web of Science and LILACS databases, seven studies were included in the synthesis. RESULTS: Studies included only evaluated periodontal outcomes, no studies were found for other oral morbidities. Patients' mean age was 43.7 years, and the follow-up time after MI or MI-based intervention varied between 1 month and 1 year. The total study population was 272 people with moderate-to-severe periodontitis; other groups analysed were pregnant women (n = 112) and patients with mental disorders and alcohol problems (n = 60). Meta-analysis for the plaque index (four studies, n = 267), bleeding on probing (two studies, n = 177) and gingival index (two studies, n = 166) were carried out. The summary effects for the random-effects model were estimated respectively as -3.59 percentage points (CI: [-11.44; 4.25] for plaque index, -6.41 percentage points (CI: [-12.18, -0.65]) for bleeding on probing and -0.70 (CI: [-1.87; 0.48]) for gingival index, marginally favouring the MI group. The reduced number of studies, the non-disclosure of some aspects of the data and the heterogeneity among them undermine the precision of the estimates. CONCLUSION: The current evidence available is limited to periodontal outcomes, and it is not possible to determine whether MI effectively prevents oral morbidities in adults.

Trends in Breastfeeding and Associated Factors in a Primary Healthcare Service in the South of Brazil: 2004 to 2015.

The aim was to monitor the frequency of Breastfeeding (BF) and Exclusive Breastfeeding (EBF) in a Primary Healthcare Service, between the years of 2004 to 2015. This is a historical series is composed of eight cross-sectional surveys that were carried out during the annual vaccination campaigns. A total of 6027 children were evaluated, with a mean age of 6.2 months. There was a significant increase in the rates of BF (7.2%) and EBF (9.5%) in children less than four months old. In infants from four to five months old, a substantial decline was observed in the EBF rate between 2010 and 2015 (6.3%). The frequency of BF had a 10.1% increase in infants from six to nine months old and remained stable in children from 10 to 11 months of age. Among children less than six months old, monitoring by the health service had a positive impact on the frequency of BF (p < 0.001) and EBF (p < 0.001). The better BF and EBF rates seen in this study in infants followed up by the primary healthcare centers reinforce the evidence on the importance of expanding and qualifying primary healthcare as support for mother and child healthcare.

Effectiveness of motivational interviewing in smoking groups in primary healthcare: a community-based randomized cluster trial.

Smoking is the main cause of avoidable death and a major public health problem worldwide, with primary healthcare being a strategic setting for treating this problem. Aims: to evaluate the effectiveness of motivational interviewing associated with the cognitive behavioral therapy (CBT) in smoking groups in primary healthcare. A community-based cluster randomized clinical trial was conducted in Brazil, starting in July 2016. Professionals in the test group were trained in motivational interviewing for eight hours to associate it with the CBT. The usual treatment for smoking cessation in groups consists of four structured weekly sessions of 90 minutes each using a CBT. Taylor's linearization was used to correct the p-values; the chi-square test with Pearson correlation was used for categorical variables, and analysis of variance as well as the Student t-test were used for continuous variables. In total, 44 smoking groups were conducted, totaling 329 patients (178 in the motivational interviewing group and 151 in the control group). The smoking cessation rate with motivational interviewing was 61.8%, with RR = 1.25 (95%CI: 1.01-1.54, p = 0.043), and 47.7% in the control group, in the fourth weekly group treatment session. Mean session attendance was 3.1 (95%CI: 2.9-3.3) in the motivational interviewing group and 2.9 (95%CI: 2.5-3.4) in the control group. The completion rate for the motivational interviewing group was 65.2% and for the control group, 57.6%. Motivational interviewing associated with the CBT was shown to be effective and superior to only CBT to smoking cessation in groups in the fourth weekly session and for the population profile of the study (women with an average age of 50.6 years).

Factors Associated with Tobacco Cessation in Primary Health Care.

Introduction Cigarettes are the main cause of preventable death in the world, and primary health care services can contribute to the management of this habit. Objective To describe and analyze the factors associated with tobacco cessation in groups of smokers in primary health care. Methods The present is a cross-sectional study conducted in 12 primary health care units from July 2016 to May 2017. We investigated sociodemographic and health variables, as well as smoking characteristics and different interventions for tobacco cessation, with the outcome being studied and analyzed after the fourth group care session. Results We evaluated 329 smokers, of which 182 quit smoking after the fourth interview. Most of the individuals who quit smoking were women ( n = 121, 66.5%), with a monthly income of 2 to 5 minimum wages ( n = 88, 77.9%). After the multivariable analysis, we observed that tobacco cessation was significantly associated with depression (prevalence ratio [PR] = 1.11; 95% confidence interval [95%CI] = 1.02 to 1.22), as well as with belonging to the groups which used as approaches motivational interviewing (PR = 1.21; 95%CI = 1.13 to 2.01), patches (PR = 1.36; 95%CI = 1.24 to 1.48), and bupropion (PR = 1.16; 95%CI = 1.03 to 1.31). Conclusion Primary health care is the ideal site for the reduction of smoking rates, given that different technologies may be applicable and useful for tobacco cessation. The comprehensiveness and longitudinal care offered in primary care may provide opportunities for health professionals to understand which is the best technology for each health system user, thus contributing to personalized care.

Factors associated with the initiation of breastfeeding in a maternity hospital in Lima, Peru. / Fatores associados ao início da prática do aleitamento em uma maternidade de Lima, Peru.

PURPOSE: To verify the anatomophysiological, psychological, and sociocultural factors of the mother-newborn binomial, as well as their association with the initiation of breastfeeding. METHODS: Cross-sectional study conducted in a maternity hospital in Lima, Peru. The sample consisted of 304 healthy neonates and their mothers. Breastfeeding performance was estimated by clinical assessment using the Clinical Evaluation of Breastfeeding Efficacy scale and maternal self-perception by the Breastfeeding Self-Efficacy Scale. Multivariate Prevalence Ratios (PR) were estimated by Poisson Regression with Robust Variance and 95% confidence intervals (CI). RESULTS: The prevalence of clinical low breastfeeding performance was 27.6%. Primiparous women were associated with higher prevalence of low performance when they did not trust to succeed [PR:2.02(95%CI:1.18-3.44)] and lower prevalence in having a good latch [PR:0.52(95%CI:0.29-0.95)], as well as in coping successfully [PR:0.59(95%CI:0.37-0.91)]. Multiparous women showed higher prevalence when they were not confident in staying motivated [PR:3.47(95%CI:1.67-7.22)] and in calming the neonate [PR:4.07(95%CI:1.83-9.95)]. There was lower prevalence in keeping the neonate awake [PR:0.32(95%CI:0.14-0.75)] and when they did not feel confident in the presence of their family [PR:0.29(95%CI:0.13-0.64)]. CONCLUSION: It is important that health professionals be aware of emotional, social, and cultural issues to promote quality breastfeeding.

OBJETIVO: Verificar os fatores anatomofisiológicos, psicológicos, socioculturais do binômio mãe neonato e sua associação com o início da prática do aleitamento materno. MÉTODO: Estudo transversal realizado em uma Maternidade de Lima Peru. A amostra foi de 304 neonatos sadios e suas respectivas mães. O desempenho na amamentação foi estimado por avaliação clínica utilizando-se a escala de Avaliação Clínica da Eficácia da Amamentação e a autopercepção materna pela Escala de Autoeficácia da Amamentação. Razões de Prevalência (RP) multivariadas foram estimadas pela Regressão de Poisson com Variância Robusta e intervalos de confiança (IC) de 95%. RESULTADOS: A prevalência de baixo desempenho clínico na amamentação foi de 27,6%. Primíparas associarem-se a maior prevalência de baixo desempenho quando não confiavam em ter sucesso [RP:2,02(IC95%:1,18-3,44)] e menor prevalência em ter boa pega [RP:0,52(IC95%:0,29-0,95)], assim como em enfrentar com êxito [RP:0,59(IC95%:0,37-0,91)]. As multíparas, apresentaram maior prevalência quando não confiavam em manter-se motivadas [RP:3,47(IC95%:1,67-7,22)] e em acalmar o neonato [RP:4,07(IC95%:1,83-9,95)]. Houve menor prevalência em manter o neonato acordado [RP:0,32(IC95%:0,14-0,75)] e quando não se sentiam confiantes na presença de seus familiares [RP:0,29(IC95%:0,13-0,64)]. CONCLUSÃO: É importante que profissionais da saúde estejam atentos às questões emocionais, sociais e culturais para a promoção de um aleitamento materno com qualidade.

Motivational interviewing for preventing early childhood caries: A systematic review and meta-analysis.

OBJECTIVES: This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity. METHODS: Interventions based on motivational interviewing were considered eligible. The main outcome was new caries lesions (some studies included white-spot lesions in total count), and secondary outcomes included caregivers' oral health knowledge, home-care behaviours, plaque index, gingival index and fluoride varnish applications. Controls were any type of oral health education or negative controls without any specific intervention. RESULTS: From a total of 1498 studies identified in the databases search, 1078 were assessed for eligibility by reading titles and abstracts, after removal of duplicates. Full-text screening was performed in 61 articles, with 18 reporting on 14 different studies included in the qualitative synthesis and 8 in the quantitative synthesis (four studies included new white-spot lesions in total count). Subgroup analysis was performed by the control group dmft/dmfs and the test for subgroup differences suggests that there is a subgroup effect (P = .06), so population caries experience modifies the effect of MI-based intervention. In populations with high caries experience, the MI-based approach proved preventing an average of 3.15 (95% CI: -6.14, -0.17) dmfs in young children. In samples with low caries experience, differences were smaller, since the caries levels were already lower (-0.31; 95% CI: -0.63, 0.00). CONCLUSION: Motivational interviewing has the potential to modify knowledge and behaviours and reduce ECC with a more significant impact on children with high caries experience.

Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil.

PURPOSE: to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. METHODS: a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. RESULTS: out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). CONCLUSION: the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.

Dietary intake quality and associated factors in one year-old children seen by primary healthcare services. / Qualidade do consumo alimentar e fatores associados em crianças de um ano de vida na Atenção Primária à Saúde.

The purpose of this paper was to analyze the food intake quality in one year-old children seen by a primary healthcare (PHC) service. This is a cross-sectional studied nested within a child oral health cohort study which collected data regarding children born in 2013 and monitored in Porto Alegre for two years. We applied a questionnaire on maternal variables and frequency of pediatric appointments, weight and height measurements, and children's food intake. To that end, a score was generated based on the points assigned according to SISVAN (meaning 'food and nutrition monitoring system,' run by the Brazilian Ministry of Health). A multivariate model was calculated using Poisson regression with robust variance. The sample comprised 249 children. We found 30.5% (76) of poor/regular dietary quality, which in the multivariate model was associated to the guardian's educational background, considering up to incomplete high school (PR = 2.14, CI95% = 1.03-4.44) and complete high school (PR = 1.70, CI95% = 0.81-3.54), as well as their failure to see a dentist (PR = 2.54, CI95% = 1.33-4.84) or having seen one before the age of four months (PR = 1.94, CI95% = 1.01-3.72). It is our conclusion that failing to see a dentist within the first year of life and lower maternal schooling negatively impact on children's dietary quality.

O objetivo foi analisar a qualidade do consumo alimentar de crianças com um ano de idade acompanhadas por um serviço de Atenção Primária à Saúde (APS). Trata-se de estudo transversal aninhado a uma coorte de saúde bucal infantil em que foram coletados dados de crianças nascidas em 2013 e acompanhadas por 2 anos, em Porto Alegre. Foi aplicado um questionário sobre variáveis maternas e frequência de consultas de puericultura, medidas antropométricas e consumo alimentar da criança. Para tal, foi gerado um escore a partir da pontuação criada conforme o SISVAN (Sistema de Vigilância Alimentar e Nutricional). Foi calculado um modelo multivariado, por meio da Regressão de Poisson com variância robusta. A amostra consistiu de 249 crianças. Encontrou-se 30,5% (76) de qualidade ruim/regular da alimentação, que no modelo multivariado esteve associada com nível educacional do responsável, sendo até ensino médio incompleto (RP = 2,14, IC95% = 1,03-4,44) e ensino médio completo (RP = 1,70, IC95% = 0,81-3,54), assim como não ter consultado com dentista (RP = 2,54, IC95% = 1,33-4,84) ou ter consultado até o quarto mês de idade (RP = 1,94, IC95% = 1,01-3,72). Conclui-se que não consultar com dentista no primeiro ano de vida e menor escolaridade materna repercutem negativamente na qualidade alimentar infantil.

Effectiveness of Motivational Interviewing Training for Primary Care Dentists and Dental Health Technicians: Results from a Community Clinical Trial.

Motivational interviewing (MI) is an approach that uses dialogue about behavioral change to encourage a constructive relationship between professionals and patients. The aim of this study was to evaluate the maintenance of basic MI skills in the daily practice of dentists and oral health technicians (OHTs) after a training course and for two years of follow-up in the context of primary health care (PHC). A randomized community trial, from September 2012 to September 2014, was conducted at the Community Health Service of Conceição Hospital Group in Porto Alegre, RS, Brazil. The experimental group consisted of all 41 dentists and OHTs who received an intensive eight-hour training course in basic MI principles; the control group consisted of 31 dentists and OHTs who did not receive MI training. The follow-up assessments were at one and two years using three instruments validated for MI. In the one- and two-year follow-ups, improvement was maintained in responses with a statistically significant difference for use of open questioning, reflective listening, and total percentage of correct answers (p<0.001), with a large effect size (ES=1.12). On the Helpful Responses Questionnaire, the participants continued using open questioning and reflective listening (p<0.001), maintaining an increase in the percentage of responses compatible with MI (p<0.001). Likewise, the effect size remained large (ES=1.33) over time. These results suggest that the training course with dentists and OHTs of the PHC oral health staff was effective over the two-year follow-up in enabling them to act in the spirit and techniques of MI.

Motivational interviewing effects on caries prevention in children differ by income: A randomized cluster trial.

OBJECTIVES: This study aimed to investigate the differential preventive effect of motivational interviewing (MI) on early childhood caries (ECC) according to socioeconomic variables, using a community-based trial in a public healthcare setting. METHODS: A cluster-randomized, double-blind study with two parallel groups in healthcare clinical settings (HCCs) comparing conventional oral health education (CE) and MI aimed at mothers of children born in 2013 and 2014. The oral health team of 6 of the 12 HCCs were trained in MI. This training was intensive for active learning of the basic MI principles, conducted by a psychologist who is a PhD in psychiatry and has extensive experience in conducting MI training workshops. It was held in an experiential format divided into two 4-hour shifts, with a 1-week interval. Children who attended at least one dental visit in the first year of life at their HCC were clinically evaluated by trained examiners and parents responded to a questionnaire. The effect of MI on the caries outcome compared with CE was evaluated in different subgroups: family income, mother's education and skin colour. RESULTS: One hundred and eighty-six were included in the CE group and 228 in the MI group. The caries rate per 100 surface-year was 1.29 (95%CI: 0.92-1.80) in the CE group and 0.46 (95%CI: 0.29-0.73) in the MI group. The effect of MI was statistically significant in the lower-income category (P = .03); MI prevented 57% of carious lesions (IRR = 0.43, 95% CI 0.22-0.83) and reduced the occurrence of the disease on more than one surface per 100 followed surface-year in this same category in the equivalent income subgroup (IRD = -1.37, P = .04). CONCLUSIONS: Motivational interviewing had a greater preventive effect against caries in children whose families are of lower income.

Access to oral health in early childhood in the city of Porto Alegre, Brazil. / Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil.

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.

O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.

¿La Entrevista Motivacional puede ser utilizada en la prevención de las caries en preescolares? Una revisión integradora / A Entrevista Motivacional pode ser utilizada na prevenção da cárie em pré-escolares? Uma revisão integrativa / Can Motivational Interviewing be used in caries prevention in preschoolers? An integrative review

El objetivo fue realizar una revisión a partir de una duda clínica: "¿La práctica de la entrevista motivacional (EM) puede ser utilizada en la prevención de las caries en preescolares?" Materiales y métodos: se realizó una revisión integradora de la literatura en abril de 2021 utilizándose una adaptación del "Sistema 6S". Se evaluó la calidad de las revisiones sistemáticas (RS). Fueron realizadas búsquedas en las revistas periódicas Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice y en el sitio del Centro de Odontología Basada en Evidencias de American Dental Associaton, Biblioteca Cochrane y PubMed/Medline. Las palabras para la búsqueda fueron "motivational interviewing" y "dental caries". Resultados: Se hallaron 2 RS sobre el tema. Una RS de 2020 mostró reducción de caries a través del meta-análisis, pero sin diferencia estadísticamente significativa; los autores destacan que las evidencias limitadas se deben a la presencia de estudios heterogéneos basados en diferentes metodologías. Otra RS de 2021 concluyó que la EM posee el potencial de modificar el comportamiento y reducir significativamente lesiones cariosas principalmente en niños con elevada experiencia de caries. Fue también evaluada la calidad metodológica de las RS incluidas en esta revisión a través de los protocolos PRISMA y AMSTAR-2. Ambas presentaron bajo riesgo de sesgo y alta calidad. Conclusión: la práctica de la EM contribuyó en la prevención de la caries en preescolares, principalmente en los niños de alto riesgo. Sin embargo, las evidencias son moderadas, obtenidas a partir de meta-análisis poco robustos y de un número limitado de estudios aleatorios de buena calidad metodológica

Objetivou-se realizar uma revisão integrativa a partir de uma dúvida clínica: "A prática da entrevista motivacional (EM) pode ser utilizada na prevenção da cárie dentária em pré-escolares?". Materiais e métodos: foi realizada uma revisão integrativa da literatura em abril de 2021 utilizando-se uma adaptação do "Sistema 6S". Avaliou-se a qualidade das revisões sistemáticas (RS) encontradas através de duas ferramentas para avaliação metodológica. Foram realizadas buscas nos periódicos Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice e no site do Centro de Odontologia Baseada em Evidências da American Dental Associaton. Buscou-se RS nas bases da Biblioteca Cochrane e PubMed/Medline. As palavras selecionas para as buscas foram "motivational interviewing" e "dental caries". Resultados: a busca final resultou em 2 RS sobre o tema. Uma RS de 2020 mostrou redução de cárie através da meta-análise, porém sem diferença estatisticamente significativa; os autores destacam que as evidências limitadas se devem a presença de estudos heterogêneos baseados em diferentes metodologias. Outra RS de 2021 concluiu que a EM possui o potencial de modificar o comportamento e reduzir significativamente lesões cariosas principalmente em crianças com elevada experiência de cárie. Foi ainda avaliada a qualidade metodológica das RS incluídas nesta revisão através dos protocolos PRISMA e AMSTAR-2. Ambas apresentaram baixo risco de viés e alta qualidade. Conclusão: a prática da EM contribui na prevenção da cárie em pré-escolares, principalmente nas crianças de alto risco. Entretanto, as evidências são moderadas, obtidas a partir de meta-análises pouco robustas e de um número limitado de estudos randomizados de boa qualidade metodológica

Aim: to perform an integrative review based on a clinical question: "Can motivational interviewing (MI) be used to prevent dental caries in preschool children?". Materials and methods: an integrative literature review was conducted in April 2021 using an adaptation of the "6S System". We also evaluated the quality of the systematic reviews (SR) found through two tools for methodological assessment. Evidence-Based Dentistry, Journal of Evidence-Based Dental Practice and on the website of the Center for Evidence-Based Dentistry of the American Dental Association. SRs were searched in the Cochrane Library and PubMed/Medline databases were searched. The selected search words were "motivational interviewing" and "dental caries". Results: the final search resulted in 2 SR on the topic. One SR from 2020 showed a reduction in dental caries through meta-analysis, but with no statistically significant difference; the authors point out that the limited evidence is due to the presence of heterogeneous studies based on different methodologies. Another SR from 2021 concluded that MI has the potential to modify behavior and significantly reduce carious lesions, mainly in children with high caries experience. The methodological quality of the SR included in this review was also assessed using the PRISMA and AMSTAR-2 protocols. Both showed high quality and low risk of bias. Conclusion: the practice of MI contributes to the prevention of dental caries in preschoolers, especially in high-risk children. However, the evidence is moderate, obtained from poor meta-analyses and a limited number of randomized studies of good methodological quality.

Aplausos às diretrizes para a prática clínica odontológica na atenção primária à saúde / Applause to the guidelines for clinical dental practice in primary health care

In recent important days, social media have been communication tools for the new Guidelines for the Dental Clinic that are being used and disseminated by the Ministry of Health (MS) through the Secretariat of Primary Health Care (APS). This year, more precisely in May, the Guideline for clinical dental practice in Primary Health Care: treatment in pregnant women was published. The document was previously made available, still in 2021, in public consultation, and various sectors of society and the community were aware of their considerations and suggestions. This is a relevant strategy for validating the material, as it provides opportunities for the professional health teams to look at the use of the future Guideline. For those who are unaware, the General Coordination of Oral Health of the Ministry of Health, in partnership with the GODeC (Global Observatory for Dental Care) initiative of the Federal University of Pelotas, will make available in the year 2022, 22 clinical guidelines for the qualification of the caregiver. in health oral supply in Primary Health Care by the Unified Health System (SUS)

Oral Health in the Children's Preventive Health Care Initiative: indicators and goals in a Primary Health Care Service. / Saúde Bucal na Ação Programática da Criança: indicadores e metas de um Serviço de Atenção Primária à Saúde.

The objective of this study is to assess fulfillment of the oral health goals of the Children's Preventive Health Care Initiative in 12 Health Units (HU) of a Primary Health Care Service, in Porto Alegre, in the state of Rio Grande do Sul, through a cross-sectional analytical study on the annual dental visit coverage in early childhood. The study was comprised of 660 children born in 2010. In relation to the coverage of dental visits for each year of life of children, the health units did not achieve the set targets (100%). However, a considerable number of children (35%) had their first dental visit during the first year of life. In relation to the total number of visits, 22% of the children had never gone to the dentist and only 8% did the recommended four visits. There was a positive correlation between the ratio of the total population and children from ages 0 to 4 years in the area enrolled in the initiative, on the one hand, and the number of dental professionals and coverage in the first year of life in each health unit, on the other. Although few children had adequate follow-up visits in relation to the set targets, the percentage of coverage was higher than that found in the literature.

Grupos de cessação de tabaco: série histórica de um serviço de atenção primária à saúde no sul do Brasil / Tobacco cessation groups: historical series of a primary health care at the south of Brazil

Resumo Introdução O tabagismo é uma das principais causas evitáveis de doenças e um grande desafio para a saúde pública, sendo a Atenção Primária à Saúde (APS) o nível de atenção à saúde com maior potencial de manejo da cessação de uso de tabaco. Objetivo O objetivo foi descrever os resultados de cessação de tabaco em grupos inseridos em um programa público de tratamento do tabagismo ao longo de 11 anos. Método Estudo retrospectivo do tipo série histórica dos grupos de tabagismo desenvolvido no período de 2006 a 2016 nas 12 unidades de saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição (GHC), Porto Alegre-RS. Os dados foram coletados nos Relatórios Anuais de Indicadores de Saúde e no Sistema de Informações do GHC. Análises descritivas foram realizadas por meio de frequências absolutas e relativas. Resultados Dos 2.691 tabagistas acompanhados, 1.273 (47%) deixaram de fumar até a quarta sessão do grupo. Discussão A cessação de tabaco em grupos contribuiu para que mais da metade dos participantes conseguisse parar de fumar ao longo do período de 4 semanas de tratamento em grupo. Esta é uma importante estratégia terapêutica acessível e eficiente para auxiliar e oportunizar um atendimento integral aos usuários tabagistas no contexto da APS.

Abstract Background Smoking is one of the main preventable causes of diseases and a major challenge for public health. Primary Health Care (PHC) is the level of health care with the greatest potential for managing tobacco cessation. Objective The objective was to describe the results of smoking cessation in groups included in a public smoking treatment program over 11 years. Methods Retrospective study of the historical series type of smoking groups developed between 2006 and 2016 in the 12 health units of the Community Health Service of Grupo Hospitalar Conceição (GHC), Porto Alegre-RS. Data were collected in the Annual Health Indicator Reports and the GHC Information System. Descriptive analyzes were performed using absolute and relative frequencies. Results Of the 2,691 smokers monitored, 1,273 (47%) quit smoking until the fourth session of the group. Discussion Smoking cessation in groups contributed to more than half of the participants being able to quit smoking over 4 weeks of treatment groups. This is an important accessible and efficient therapeutic strategy to assist and provide comprehensive care to smokers in the context of PHC.