Maternal periodontitis as a risk factor for prematurity.

BACKGROUND: The aim of this study was to investigate maternal periodontitis associated with prematurity. METHODS: We carried out a case-control study including 718 puerperae who experienced a spontaneous delivery: 360 cases (premature) and 358 controls (full-term). Sociodemographic, obstetric, prenatal, perinatal and periodontal data were obtained within 48 h after delivery. Periodontitis was defined as probing depth ≥ 4 mm and attachment loss ≥ 3 mm at same site, for ≥ 4 teeth. RESULTS: Periodontitis was associated with prematurity (odds ratio 6.95; confidence interval 3.69-13.09). Prematurity was associated with maternal age < 20 years, family income < one minimum salary, maternal schooling < 8 years, premature birth history, premature membrane rupture, ruptured membranes > 24 h, smoking, urinary tract infection, leukorrhea, pre-eclampsia, prenatal consultations < 3 and precarious housing. After multivariate confounder adjustments, periodontitis remained independently associated with prematurity (odds ratio 6.05; confidence interval 3.01-12.16). CONCLUSIONS: Periodontitis is strongly associated with prematurity, indicating necessity for regular periodontal investigation and treatment during pregnancy.

Nutritional status and prevalence of dental caries among 12-year-old children at public schools: a case-control study.

PURPOSE: The aim of the present study was to investigate the possibility that malnutrition and overweight/obesity might act as factors associated with dental caries among 12-year-old children. METHODS: This was a cross-sectional study that was carried out on 689 12-year-olds at public schools in the municipality of Caruaru, State of Pernambuco, Brazil, to determine the prevalence of dental caries and malnutrition. A case-control study nested within the cross-sectional study was carried out to determine the association between malnutrition and dental caries. To assess the nutritional status, weight for age, height for age and body mass index were determined. The occurrence of dental caries was determined using the decayed, missing and filled teeth (DMFT) index. RESULTS: The prevalence of caries was 71.8%, with a mean DMFT index of 2.9. The prevalence of height deficit was 9.9%, and the prevalence of risk of overweight and overweight/obesity was 9.3% and 3.2%, respectively. No statistically significant association was found between these nutritional indices and the occurrence of dental caries. CONCLUSION: The results suggest that malnutrition did not act as a risk factor for dental caries in this population.

Non-surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient.

Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient's doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.

Oral health care for children and adolescents with cerebral palsy: perceptions of parents and caregivers. / Cuidados em saúde bucal a crianças e adolescentes com paralisia cerebral: percepção de pais e cuidadores.

The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Factors associated with the utilization of dental health services by the pediatric population: an integrative review. / Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa.

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Utilization of oral health services network among children and adolescents with leukemia.

AIM: To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers. METHODS AND RESULTS: An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%). CONCLUSIONS: The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed.

Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study.

The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

Social Conditions and High Levels of Dental Caries in Five-year-old Children in Brazil.

PURPOSE: To identify factors associated with dental caries experience in at least four primary teeth in five-year-old Brazilian children. METHODS: This was a case-control study, part of a prior investigation of the prevalence of dental caries in the primary dentition of five-year-old children conducted in 2006 in public health services in Recife, Brazil. Study patients had a decayed, missing, and filled teeth [dmft] score ≥ 4 and controls had a dmft score ≤ 3. The cutoff point was based on the dmft scores mean value of the study population. Categories of independent variables were sociodemographic, family structure, oral health behavior, and use of oral health services. Crude odds ratios and 95% CI were calculated. Variables associated with dmft greater than or equal to four at a significance level of P≤.20 in univariate analyses were included in multivariate logistic regression models using a backward stepwise variable selection method and permanence criterion in the final model of P≤.10. RESULTS: The study included 479 children (171 study patients and 308 controls). After controlling for confounding variables, factors associated with a dmft score ≥ 4 were children living in households with at least six people, residence in a poor area, caregiver's low educational level, consumption of sweets between meals, and the reason for and location of oral health care seeking. CONCLUSION: Most factors associated with high levels of dental caries in five-year-old children were related to the social conditions in which they lived.

Cuidados em saúde bucal a crianças e adolescentes com paralisia cerebral: percepção de pais e cuidadores / Oral health care for children and adolescents with cerebral palsy: perceptions of parents and caregivers

Resumo Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Abstract The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Fatores associados à utilização dos serviços de saúde bucal pela população pediátrica: uma revisão integrativa / Factors associated with the utilization of dental health services by the pediatric population: an integrative review

Resumo O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: ("dental care/utilization" OR "dental health services/utilization") AND (child OR "child, preschool") AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Abstract This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study

Abstract The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

Periodontitis-associated risk factors in pregnant women.

OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ≥ 4 mm and an attachment loss ≥ 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.

Periodontitis as a risk factor for preeclampsia.

BACKGROUND: Periodontitis is an inflammatory process caused by a specific group of microorganisms, resulting in the destruction of the tooth-supporting tissue and the resorption of the alveolar bone. Therefore, periodontitis has been considered a risk factor for preeclampsia because infection is one of the factors involved in the etiology and pathogenesis of preeclampsia. The aim of the present study is to determine whether periodontitis is a risk factor for preeclampsia and to identify other possible risk factors. METHODS: A case-control study was performed with 574 puerperae under care at the university hospital at the Universidade Federal de Pernambuco in the city of Recife, Brazil. Data collection was preceded by a training exercise and a pilot study. Biologic and socioeconomic data were collected along with medical and dental records. A periodontal examination was performed on all dental elements to determine probing depth and gingival recession. The association between periodontitis and preeclampsia was first adjusted for the variables within each block, and adjusted for the variables of all blocks in the final multivariate model. RESULTS: The multivariate logistic regression analysis showed that, after adjustment for other risk factors, periodontitis remained an independent risk factor for preeclampsia (adjusted odds ratio [OR] = 8.60, confidence interval [CI] = 3.92 to 18.88, P < 0.001 and adjusted OR = 2.03, 95% CI = 1.43 to 2.90, P < 0.001, when using the Centers for Disease Control and Prevention/American Academy of Periodontology definition). CONCLUSION: The results suggest that within the population studied, periodontitis was a risk factor for preeclampsia.

Access to Dental Care among Adolescents with Heart Disease

Objective: To evaluate the access of adolescents aged 15 to 19 years with heart disease to oral health services at a reference hospital in the city of Recife, Brazil. Material and Methods: A cross-sectional study was conducted at the Cardiology Clinic of Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) from April to September 2015 using a convenience sample of 83 adolescents with heart disease. A questionnaire was administered in interview form to adolescents and/or parents/guardians to collect information on socio-demographic characteristics, the use of dental services and oral health habits. Data analysis was performed using descriptive statistics and association tests (chi-square test and Fisher's exact test), with the significance level set to 5% to identify possible associated factors. Results: Fifty-two adolescents (62.7%) had never been denied dental care due to their condition. Public services accounted for 66.3% of the care offered. Checkup/prevention was the main reason for seeking care (39.8%). Many of the adolescents exhibited inadequate oral hygiene habits. Forty-four (53%) did not brush their teeth regularly at night and 66 (79.5%) did not floss. No statistically significant association was found between access to dental care and social class (p=0.148), with whom the adolescent resided (p=0.607), birth order (p=0.598), race (p=0.068), education level of the head of the household (p=0.828) or scholastic failure on the part of the adolescent (p=0.196). Conclusion: Most adolescents with heart disease obtained dental care, although most did not have adequate hygiene habits. Moreover, socio-demographic, psychosocial and behavioral factors exerted no influence on access to oral health services. Further studies on this issue are needed.

Desenvolvimento da fala e alimentação infantil: possíveis implicações / Speech development and infant feeding: possible implications

RESUMO Objetivo: identificar a associação entre hábito alimentar e desenvolvimento da fala em crianças pré-escolares. Métodos: estudo do tipo caso-controle, com amostra constituída por 273 crianças matriculadas nos Centros Municipais de Educação Infantil da cidade do Recife. Foi pesquisada a associação do desfecho com variáveis referentes a características socioeconômicas, hábitos de sucção nutritiva e não nutritiva e desenvolvimento do sistema estomatognático. Foram utilizados os softwares STATA/SE 9.0 e Excel 2007 para calcular a medida de risco, OddsRatio, o intervalo de confiança de 95% e o valor de p≤0,05. Para verificar a existência de associação, aplicou-se o teste qui-quadrado para variáveis categóricas. Resultados: no que se refere às alterações de fala, verificou-se associação significante no sexo masculino. Já os hábitos de sucção não se associaram significantemente com o desfecho estudado. Com relação ao sistema estomatognático, registra-se associação significante às alterações de fala, principalmente no que concerne à postura habitual de lábios e língua, assim como com a presença de oclusopatias. Não houve associação significante entre a variável de consistência alimentar e o evento estudado. Conclusão: a consistência alimentar demonstrou associação significante com variáveis que impactam na fisiologia adequada do sistema estomatognático, em termos de órgãos fonoarticulatórios e desempenho de funções, podendo-se inferir que padrão alimentar e fala constituem ponto de convergência na saúde infantil.

ABSTRACT Purpose: to identify the association between dietary habits and speech development in preschool children. Methods: case-control study, with sample constituted of 273 children enrolled in Municipal Daycare Centers in Recife. It was researched the association of outcome with the variables related to socioeconomic characteristics, nutritive and not nutritious sucking habits and development of the stomatognathic system. We used the software STATA/SE 9.0 and Excel 2007 to calculate the risk measure, Odds Ratio with a confidence interval of 95%, plus the value of p≤0.05. To verify the existence of association, it was adopted the chi-square test for categorical variables. Results: concerning the speech disorders, it was verified significant association in males. Yet, sucking habits were not significantly associated with the outcome studied. Regarding the stomatognathic system, it was registered significant association on speech disorders, especially regarding the habitual posture of the lips and tongue, as well as the presence of malocclusion. There was no significant association between food consistency and the variable studied event. Conclusion: the food consistency demonstrated a significant association with variables that impact on the proper physiology of the stomatognathic system, in terms of phono-articulatory organs and function performance, can be inferred that eating patterns and speech constitute a convergence point in child health.

[Oral health and perceptions regarding dental care in patients with mental disorders living in therapeutic residences]. / Saúde bucal e percepção sobre o atendimento odontológico em pacientes com transtorno psíquico moradores de residências terapêuticas.

Patients with mental disorders have considerable difficulty in access to dental care, including the refusal of oral health professionals to offer care to this clientele and the inadequate professional training of oral health professionals regarding this issue. The present study was carried out in therapeutic residences in order to assess the oral health conditions of the residents as well as their perceptions regarding the dental care they have received. Thirty-eight individuals participated in the study. Data were collected through clinical examinations and a semi-structured interview. Data analysis revealed a high number of caries and the need for dentures, with 42.5% of the individuals needing complete dentures and 30.3% needing partial dentures. Regarding periodontal conditions, 28.5% of the dental elements exhibited losses of over 4 mm of periodontal insertion. Data from the interviews were submitted to content analysis, which enabled the establishment of two categories: the association of pain with the presence of teeth and mutilating dental care. Oral health was associated to dental extraction, which was considered the only solution to oral health disturbances, indicating that, for this population, oral health signifies not having teeth.

Persistência de hábitos de sucção não nutritiva: prevalência e fatores associados / Non-nutritive sucking habits persistence: prevalence and associated factors

Identificar a prevalência de hábitos de sucção não nutritiva em pré-escolares e verificar fatores associados a sua persistência. MÉTODOS: estudo transversal e analítico realizado por meio de questionário com responsáveis de 524 crianças em 17 centros educacionais públicos de Recife/PE. Variáveis dependentes (sucção digital e de chupeta) e independentes, relacionadas à criança (sexo, idade, aleitamento materno, uso de mamadeira, enurese noturna, turnos na unidade educacional, cuidador, ordem de nascimento, visita ao dentista) e a sua mãe (escolaridade, idade, renda familiar, trabalho fora do domicilio, turnos de trabalho, coabitação, orientação sobre hábitos), foram associadas, usando os testes estatísticos qui-quadrado de Pearson, Exato de Fisher e regressão Poisson. RESULTADOS: prevalência de hábitos de sucção não nutritiva de 57 por cento: 47,5 por cento apenas sucção de chupeta. Após análise multivariada, as variáveis: tempo de aleitamento materno e uso de mamadeira continuaram associadas ao uso de chupeta, enquanto que as variáveis: escolaridade materna, uso de mamadeira, idade e sexo da criança encontraram-se fortemente associadas à sucção digital. CONCLUSÕES: alta prevalência de hábitos de sucção não nutritiva, sendo a chupeta mais frequente. Aspectos associados ao padrão de aleitamento foram apontados como principais fatores explicativos à persistência destes hábitos em pré-escolares e os aspectos psicossociais tiveram poder de associação relevante...

To identify the prevalence of nonnutritive sucking habits in preschoolers and verify factors associated with persistent habit. METHODS: a cross-sectional analytical study conducted in 17 public educational units of Recife/PE through questionnaire with 524 preschooler guardians. Dependent (digital and pacifier sucking) and independent variables, related to the children (sex, age, breastfeeding, bottle feeding, nocturnal enuresis, school period, caregiver, birth order, dentist visit) and to their mothers (schooling, age, familiar income, outside work, work shift, cohabitation, habits guidance), were associated by Pearson´s chi-square test, Fisher´s Exact test and Poisson´s regression. RESULTS: prevalence of nonnutritive sucking habits was 57 percent; 47,5 percentpacifier sucking, 5,7 percent digital sucking and 3,8 percent of both habits. After odds ratio adjustment, in a multivariate analysis, variables: breastfeeding and bottle feeding duration remained associated with pacifier sucking, while others variables as mother education, bottle feeding, and children´s age and sex were statistically significant with digital sucking. CONCLUSIONS: nonnutritive sucking habits showed high prevalence, being pacifier sucking most prevalent. Factors related to breastfeeding pattern (bottle feeding and breastfeeding duration) were explanatory factors to the habits persistence and psychosocial factors had relevant association...

Cuidado dos avós com a saúde bucal de seus netos em um programa de atenção odontológica precoce / Grandparents' attention to their grandchildren's oral health in an early dental care program

Objetivos: identificar significados atribuídos pelos avós no cuidado com a saúde bucal dos netos e a condição dental destes por meio de exame clínico em um Programa de Atenção Odontológica Precoce. Métodos: estudo descritivo, exploratório e qualitativo com nove crianças acompanhadas pelos avós no ambulatório do Hospital Geral de Areias, participantes do programa "Crescendo sem Cárie". Realizou-se entrevista e exame clínico para detecção de lesões de cárie, presença de placa visível e manchas brancas por meio dos índices de cárie ceo-d e ceo-d modificado. Utilizou-se análise de conteúdo das entrevistas na modalidade temática. Resultados: os avós pertenciam à faixa etária de 38 a 77 anos. Os netos tinham idade entre 21 a 36 meses. Dois não apresentaram lesões de cárie, porém tinham manchas brancas, e sete apresentaram um índice de cárie elevado. Quatro temáticas emergiram das falas: 1. O significado do cuidado em relação à saúde bucal, 2. Avós: mães com açúcar, 3. A experiência da perda dentária no passado e 4. O conflito intergeracional interferindo na saúde bucal. Conclusões: como cuidadores dos netos no âmbito familiar, torna-se importante questionar as atitudes e os comportamentos no controle e na prevenção da cárie infantil. Atenta-se para o consumo de açúcar como transferência de amor e carinho dos avós aos netos, embora seja prejudicial à saúde bucal, conforme se comprove mediante o exame clínico.

Aim: Identify meanings attributed by grandparents' attention to their grandchildren's dental health care through clinical examination in an Early Dental Care Program. Methods: descriptive, exploratory and qualitative study with nine children accompanied by their grandparents at the Areias General Hospital participated in the "Growing up without caries" Program. It was held interviews and clinical examinations to detect caries lesions and presence of visible plaque and white spots, through caries indices ceo-d and ceo-d modified. We used content analysis of the interviews, in thematic. Results: grandparents belonged to the age group 38-77 years. The grandchildren were aged between 21 and 36 months. Two of them showed no carious lesions, however, they had white spots and seven of them showed a high caries index. Four themes emerged from the speech: 1. The meaning of care in relation to oral health, 2. Grandparents: mothers with sugar, 3. The experience of tooth loss in the past and 4. The intergenerational conflict interfering with oral health. Conclusions: as caregivers of their grandchildren in the family becomes important to question the attitudes and behaviors in the control and prevention of childhood caries. Attentive to the fact that the consumption of sugar as a transfer of love and care from grandparents to grandchildren, although detrimental to oral health, as evidenced by clinical examination.

[Oral health among adolescents: aspects relating to hygiene, dental cavities and periodontal disease in the cities of Recife and Feira de Santana, Brazil]. / A saúde bucal de adolescentes: aspectos de higiene, de cárie dentária e doença periodontal nas cidades de Recife, Pernambuco e Feira de Santana, Bahia.

OBJECTIVE: To characterize the oral health in adolescents in the cities of Recife and Feira de Santana, Northeast Brazil by assessment of personal hygiene and dental cavities and periodontal disease. METHOD: Forty adolescents between ten and eighteen years old were assessed through an exploratory study run in Recife in 2005. In Feira de Santana, 971 adolescents (twelve years old) were examined through a cross section study in 2002. It was assessed cavity status through the number of cavitied, missing and filled teeth, visible dental plaque, bleeding gums and periodontal status. The analysis was based on Chi-Square, Kruskall-Wallis and Fisher tests, with a confidence interval of 95%. RESULTS: The most of adolescents followed oral hygiene practices three times a day. The DMTF values presented a median of 1.5 in Recife and averages of 1.89 in state schools, 2.17 in municipal schools and 2.39 in private schools in Feira de Santana. The bleeding gum in Recife presented a median of 27%, and in Feira de Santana the healthy sextant averages of 4.36, 4.08 and 5.16 in state, municipal and private schools respectively. CONCLUSION: The frequency of the dental cavities was low, with most of the adolescents reporting good habits of oral hygiene and favorable periodontal conditions.

Periodontitis-associated risk factors in pregnant women

OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth > 4 mm and an attachment loss > 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11 percent. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.