Implementation of a digital tool for population management in Primary Health Care.

OBJECTIVE: Describe the implementation of a digital diagnostic and territorial monitoring tool in primary healthcare. METHODS: Quantitative and qualitative study, developed in 14 basic healthcare units in São Paulo, with community health workers, coordinators, nurses, and physicians. Data collection occurred in four phases: analysis of the instruments used by the team for territory management; development of the digital tool; training and implementation; and evaluation after 90 days using focus groups. Descriptive analyses were conducted by calculating absolute and relative frequencies to treat quantitative data. Qualitative data were subjected to content analysis. RESULTS: Three hundred thirty-four professionals participated in the study. In the first step, territory management's main challenges were filling out various instruments, system failures, data inconsistency, internet infrastructure/network, and lack of time. Therefore, a digital tool was developed consisting of 1) a spreadsheet recording the number of family members and markers of health conditions, date of visit, and number of return visits; 2) a spreadsheet with a summary of families visited, not visited, and refusals; and 3) a panel with a summary of the data generated instantly. In the evaluation, after the initial use of the tool, the themes that emerged were integration of the tool into daily work, evaluation of the digital tool implementation process, and improvement and opportunities for improvement. CONCLUSIONS: Faced with the challenges faced by family healthcare teams when filling out systems and managing the territory, the tool developed provided greater reliability and agility in data visualization, reduced the volume of instruments, and optimized the work process.

Contextual and individual determinants of oral health-related quality of life among adolescents.

The aim of this study was to assess the factors associated with oral health-related quality of life in adolescents (OHRQoL). Individual data on adolescents were collected from a secondary database. OHRQoL was measured using the oral impact on daily performance (OIDP) scale. Individual- and city-level variables were selected to represent the structural and intermediate determinants of health. The individual covariates analyzed were sex, age, skin color, maternal education, household income, number of people per room in the housing unit, dental attendance, self-perception of dental needs, untreated dental caries, and gingival bleeding. The contextual variables included the allocation factor, the Human Development Index (HDI), Gini coefficient, illiteracy, unemployment, income, average number of emergency dental visits per inhabitant, access to a sanitary sewer system, garbage collection, primary health care coverage, oral health team coverage, and number of tooth extractions between selected dental procedures and supervised toothbrushing. Unadjusted and adjusted multilevel Poisson regression analyses were used to evaluate the relationship between contextual and individual variables with overall OIDP scores (STATA version 16.0) - rate ratio (RR) and 95%CI. The mean OIDP score was 0.72 and the prevalence was 31.8%. There was an association between supervised toothbrushing average and the outcome (RR 0.95; 95%CI 0.91­0.99). Moreover, adolescents who lived in municipalities with the highest average number of emergency dental visits per inhabitant showed a higher OIDP. Sex, maternal education, untreated dental caries, and gingival bleeding were associated with OIDP. In addition, intersectoral public policies focusing on the reduction of social inequalities should be on the agenda of policymakers and stakeholders.

Contextual and individual determinants of oral health-related quality of life among adolescents

Abstract The aim of this study was to assess the factors associated with oral health-related quality of life in adolescents (OHRQoL). Individual data on adolescents were collected from a secondary database. OHRQoL was measured using the oral impact on daily performance (OIDP) scale. Individual- and city-level variables were selected to represent the structural and intermediate determinants of health. The individual covariates analyzed were sex, age, skin color, maternal education, household income, number of people per room in the housing unit, dental attendance, self-perception of dental needs, untreated dental caries, and gingival bleeding. The contextual variables included the allocation factor, the Human Development Index (HDI), Gini coefficient, illiteracy, unemployment, income, average number of emergency dental visits per inhabitant, access to a sanitary sewer system, garbage collection, primary health care coverage, oral health team coverage, and number of tooth extractions between selected dental procedures and supervised toothbrushing. Unadjusted and adjusted multilevel Poisson regression analyses were used to evaluate the relationship between contextual and individual variables with overall OIDP scores (STATA version 16.0) - rate ratio (RR) and 95%CI. The mean OIDP score was 0.72 and the prevalence was 31.8%. There was an association between supervised toothbrushing average and the outcome (RR 0.95; 95%CI 0.91-0.99). Moreover, adolescents who lived in municipalities with the highest average number of emergency dental visits per inhabitant showed a higher OIDP. Sex, maternal education, untreated dental caries, and gingival bleeding were associated with OIDP. In addition, intersectoral public policies focusing on the reduction of social inequalities should be on the agenda of policymakers and stakeholders.

Oral health in Brazil: What were the dental procedures performed in Primary Health Care?

This cross-sectional study aims to describe the primary dental care procedures performed by Oral Health Teams (OHTs), adhering to the third cycle of the "National Program for Improving Access and Quality of Primary Care" (PMAQ-AB) in Brazil. A descriptive analysis was performed through 26 dental procedures, including spontaneous, preventive, restorative/prosthetic and surgical procedures, and actions of cancer monitoring. Each conducted procedure assigned a score to the OHT, the final score being the sum of the number of procedures performed by the OHTs. These scores were then compared among the geographic regions of the country. Most OHTs perform basic dental procedures, such as supragingival scaling, root planning and coronal polishing (98.1%), composite filling (99.0%), and permanent tooth extraction (98.6%). The frequency related to dental prosthesis and monitoring of oral cancer decreased. Only 12.9% of the OHTs carries out biopsies, 30.9% monitor patients undergoing biopsy, 15.1% carry out impression for prostheses, and 13.6% carry out prostheses' installation. The scores reveal that OHT's performed, on average, 19.45 (±3.16) dental procedures. The OHTs in the South, Southeast, and Northeast had a higher number of primary dental procedures, while the teams in the North and Midwest performed, on average, fewer procedures. The Brazilian regions with the highest dental need have the lowest number of dental procedures. It is necessary to increase the range of procedures offered by OHT and reduce regional inequalities, adapting to the needs of the population in order to achieve comprehensive oral health.

Factors associated with toothache in 12-year-old adolescents in a southeastern state of Brazil

Abstract: This cross-sectional study evaluated factors associated with toothache in 12-year-old adolescents from the state of Minas Gerais in Brazil. Secondary data were collected from the SB Minas Gerais 2012 epidemiological survey. The dependent variable was toothache in the past 6 months. The independent variables were grouped into two levels: individual (sex, ethnic group, family income, periodontal condition, dental caries, dental treatment needs, and type of service used) and contextual (allocation factor, Human Development Index, Gini coefficient, gross domestic product, unemployment, illiteracy, basic sanitation, garbage collection, family income, half or a quarter of a minimum wage, primary healthcare coverage, primary oral healthcare team coverage, oral health technician, access to individual dental care, and supervised tooth brushing). A multilevel analysis was performed using the Hierarchical Linear and Nonlinear Modeling Software Program to assess the association of individual and contextual variables with toothache in the last 6 months. The prevalence of toothache in the last six months among the adolescents of this study was 19.1%. An association was found with family income (p <0.001), dental caries (p <0.001), primary oral healthcare team coverage (p = 0.015) and oral health technician (p = 0.008). Socioeconomic conditions and the most prevalent oral diseases, such as dental caries, as well as the use of public services, were related to toothache in adolescents aged 12 years. These findings reinforce the need to develop and implement public policies to address the oral health problems of this population.

Perspectives on Social and Environmental Determinants of Oral Health.

Most oral conditions have a multifactorial etiology; that is, they are modulated by biological, social, economic, cultural, and environmental factors. A consistent body of evidence has demonstrated the great burden of dental caries and periodontal disease in individuals from low socioeconomic strata. Oral health habits and access to care are influenced by the social determinants of health. Hence, the delivery of health promotion strategies at the population level has shown a great impact on reducing the prevalence of oral diseases. More recently, a growing discussion about the relationship between the environment, climate change, and oral health has been set in place. Certainly, outlining plans to address oral health inequities is not an easy task. It will demand political will, comprehensive funding of health services, and initiatives to reduce inequalities. This paper sought to give a perspective about the role of social and physical environmental factors on oral health conditions while discussing how the manuscripts published in this Special Issue could increase our knowledge of the topic.

The Influence of Dentists' Profile and Health Work Management in the Performance of Brazilian Dental Teams.

To evaluate the association between dentists' profile and health work management with the performance of primary care dental teams in the Brazilian National Health System, both nationally and regionally. Secondary data analysis from a Brazilian National Programme that evaluated 18,114 Brazilian dental teams, working in the public sector, between 2013 and 2014. Twenty-four independent variables taken from dentists' profile and dental team management characteristics were analysed to assess their influence on reported "dental team performance." An estimated score was generated from their performance on 20 dental procedures by an item response theory model. Multiple linear regression models were performed for each Brazilian geographical region, separately and for the whole of Brazil. p values ≤ 0.05 were considered significant. Two variables related to dentists' profile, "having graduate studies" (ß = 0.151) and "undertaking continuing professional development training" (ß = 0.101), were associated with enhanced dental team performance in all five Brazilian geographical regions and nationally. The dental team management variables of "having a flexible dental appointment list" (ß = 0.218) and "monitoring oral health indicators" (ß = 0.132) also contributed to improve team performance in each of the regions and nationally. Dentists' profile influenced the performance of dental teams from south region more than the other regions. The findings suggest that continuing professional development, including postgraduate education, and strategic management characteristics are important for primary dental care performance and should be reflected in health policy initiatives in support of quality care. Regional factors could be considered for health care management.

Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil

Abstract The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

Análise das exodontias realizadas na atenção primária da Região Metropolitana de Belo Horizonte / Analysis of tooth extractions performed in the primary health care of the Belo Horizonte metropolitan region

Objetivo: Analisar as exodontias de dentes permanentes (exodontia de dente permanente e múltipla com alveoloplastia por sextante) realizadas na atenção primária da Região Metropolitana de Belo Horizonte (RMBH). Métodos:Para a coleta de dados, foi utilizado o banco de dados da produtividade da atenção primária, da RMBH, ano de 2017, disponibilizado pelo Departamento de Informática do Sistema Único de Saúde (SUS). A variável dependente foi o indicador nº 21 do SUS, que corresponde ao percentual de exodontias realizadas dentre os procedimentos da atenção primária, cujo parâmetro deve ser ≤ 8% (≤ 8% e > 8%). As variáveis independentes foram: dados sociodemográficos (localização, população, Índice de Desenvolvimento Humano ­ IDH e Índice de Gini) e de saúde (cobertura de Estratégia de Saúde da Família ­ ESF e Equipes de Saúde Bucal ­ ESB e presença de Centro de Especialidades Odontológicas ­ CEO). Associações foram avaliadas por meio dos testes do Qui-Quadrado de Pearson e Exato de Fisher (p < 0,05), utilizando o programa SPSS 22.0. Resultados:Foram analisados 49 municípios, sendo 67,3% do núcleo metropolitano. A mediana populacional foi de 25.537 habitantes, com IDH médio de 0,707 e Índice de Gini mediano de 0,464. As medianas de cobertura da ESF e ESB foram, respectivamente, 96,7% e 52,7%. Apenas 32,7% dos municípios apresentaram CEO. O indicador nº 21 do SUS apresentou uma mediana de 6,7%. Não houve associação entre o indicador nº 21 do SUS e as variáveis sociodemográficas e de saúde (p > 0,05). Conclusão:A RMBH apresentou valores satisfatórios em relação ao percentual de exodontias realizadas, provavelmente devido aos bons indicadores socioeconômicos e de saúde bucal apresentados.

Aim: To analyze the extractions of permanent teeth (extraction of permanent teeth and extraction of multiple teeth with alveoloplasty per sextant), performed in a primary health care unit of the Metropolitan Region of Belo Horizonte (MRBH). Methods:For data collection, the primary care productivity database of 2017 from MRBH, provided by the Department of Information Technology of the Brazilian Unified Health System (SUS in Portuguese), was used. The dependent variable was the SUS indicator number 21, which corresponds to the percentage of extractions performed among primary dental care procedures, whose parameter must be ≤ 8% ( ≤ 8% and > 8%). The independent variables were: sociodemographic data (location, population, Human Development Index (HDI), and Gini Index) and health (coverage of Family Health Strategy (FHS) and Oral Health Teams (OHT), as well as the presence of Dental Specialty Centers (DCS). Associations were evaluated using the Pearson's Chi-square and Fisher's Exact tests (p < 0.05), using the SPSS 22.0 program. Results: This study analyzed 49 municipalities, 67.3% of which were metropolitan areas. The median population was 25,537 inhabitants, with a mean HDI of 0.707 and a median Gini index of 0.464. The median coverage of ESF and ESB were 96.7% and 52.7%, respectively. Only 32.7% of the municipalities presented CEO. The SUS indicator number 21 presented a median of 6.7%. No association was found between the SUS indicator number 21 and the sociodemographic and health variables (p > 0.05). Conclusion: The MRBH presented satisfactory values in relation to the percentage of tooth extractions, most likely due to the good socioeconomic and oral health indicators presented.

Características de Autocuidado em Saúde Oral, Hábitos e Acesso a Serviço Odontológico por Idosos Rurais e Urbanos / Characteristics of oral health self-care, habits and access to dental service by rural and urban elderly / Características del autocuidado en salud bucal, hábitos y acceso al servicio odontológico por ancianos rurales y urbanos

O artigo buscou investigar as diferenças no estado de saúde oral entre idosos rurais e urbanos, incluindo características de autocuidado, hábitos e acesso a serviços odontológicos, através daPesquisa Nacional de Saúde de2013.Foram encontrados perfis diferentes depacientes,de acordo com a zonageográfica.Idosos urbanosmostraram melhores indicadores de saúde oral, agendamento com maior uso de tecnologiase menor busca de tratamentospor patologia oral que os idosos rurais.

We have investigated the differences related to oral health status between urban and rural elderly, including oral health self-care, habits and access to dental service characteristics. Data was obtained from Brazilian National Health Survey (2013). According to geographic area we have found different profiles. Urbans demonstrated better indicators of oral health status, more use of technology to appoint a dentistry consultation and less looking for treatment because oral pathology than rural elderly.

El artículo buscó investigar las diferencias en el estado de salud bucal entre ancianos rurales y urbanos, incluyendo características de autocuidado, hábitos y acceso a servicios dentales, a través de la Encuesta Nacional de Salud de 2013. Se encontraron diferentes perfiles de pacientes, segúnel área geográfica.Los ancianos urbanos mostraron mejores indicadores de salud bucal, programación con mayor uso de tecnologías y menor búsqueda de tratamientos para patología oral que los ancianos rurales.

What we know about management and organisation of primary dental care in Brazil.

This cross-sectional study evaluated the management and organisation of primary dental care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care (PMAQ-AB) were used. Dentists from 18,114 Oral Health Teams (OHTs) answered a structured questionnaire in 2014. The data were analyzed descriptively and by cluster analysis. Half the Brazilian OHTs (51.0%) undertake planning and programming of activities. The majority of OHTs (66.4%) conducted monitoring and analysis of indicators and oral health information. The majority of OHTs had performed some self-evaluation process in the last 6 months (67.5%) and utilised self-evaluation results for planning and programming actions (71.4%). The OHTs grouped in Cluster 1 demonstrated better management organisation, followed by the teams grouped in Cluster 2. In the Brazilian macro-regions, the more OHTs were grouped in Cluster 1 in the Southeast (87.5%), Northeast (85.4%) and South (82.7%) regions. The majority of OHTs have satisfactory management and organisation. However, some need improvement, mainly in planning and programming actions based on health indicators and self-evaluation. All Brazilian OHTs need to participate in PMAQ-AB and it is important to continue evaluating the data to improve oral health care.

Assessment on hereditary angioedema burden of illness in Brazil: A patient perspective.

Background: Hereditary angioedema (HAE) is an autosomal dominant disorder that affects ∼1 in 50,000 individuals. The disorder is characterized by spontaneous and gradual episodes of edema in subcutaneous tissues or mucosal membrane that may endanger the patient's life. Previous studies that concern HAE treatment and burden of illness in the United States and Europe suggest an improvement in the control of HAE. However, no similar data are available in South American patients. The purpose of the present study was to evaluate the burden of disease and compliance to therapy of patients with HAE in Brazil. Methods: We developed a structured questionnaire to assess the variables that influence the diagnosis and treatment of Brazilian patients with HAE. The questionnaire was evaluated by allergists with expertise in HAE and was reformatted before applying it. The consent form was included before survey access; approval from the ethic committee of Faculdade de Medicina do ABC (Santo André, São Paulo, Brazil) was ensured. The Brazilian association of patients with HAE distributed the survey by e-mail to associated patients all over the country, and responses were accepted within a period of 3 months after signing a consent form. Results: Ninety patients (67 women, 23 men; average age, 36.5 years) responded; the main findings were the following: 53 of 90 (64%) had no need of visiting emergency departments in the past 6 months; 71 of 90 (79%) reported life-threatening fear due to their diagnosis; 73 of 90 (83%) had other family members affected, but 54 of 73 of these affected relatives did not look for specific HAE treatment; and 26 of 90 (29%) reported death due to asphyxia or throat swelling in family members. Conclusion: Patients with HAE report understanding how severe their diagnosis represent, but they did not ponder how important their commitment to treatment may decrease the constant fear brought by the disease in its possible swelling crisis. Family data supported this conclusion.

Diferenças no perfil socioeconômico e de saúde de idosos do meio rural e urbano: pesquisa nacional de saúde, 2013 / Differences in the socioeconomic and health profiles of older adults in rural and urban environments: 2013 national health survey

OBJETIVO: Compreender as possíveis diferenças sociodemográficas, econômicas e de saúde entre idosos brasileiros rurais e urbanos participantes da Pesquisa Nacional de Saúde (PNS) de 2013. MÉTODOS: Estudo transversal, com análise secundária de dados de 11.177 idosos da PNS. A variável dependente foi o local do domicílio (meio rural ou meio urbano), e as demais variáveis (independentes) foram as características sociodemográficas: faixa etária (60 a 79 e 80 anos ou mais), sexo, raça, estado conjugal e escolaridade, cidade e condição socioeconômica; e clínicas: planos de saúde, cadastro na Estratégia Saúde da Família (ESF) e autopercepção de saúde. Tabelas de distribuição da variável dependente e das independentes tiveram suas associações testadas pelo teste χ2, considerando significativo p < 5%. RESULTADOS: Exceto a faixa etária, todas as outras características sociodemográficas e clínicas foram significativamente associadas com o meio onde moram (p < 0,0001). Residentes no meio rural eram, em maior frequência, do sexo masculino, pardos, casados, analfabetos, moradores de cidades interioranas, com maior cobertura pela ESF, nível socioeconômico baixo e menor frequência de plano de saúde. Idosos do meio urbano apresentavam com maior frequência autopercepção de saúde muito boa, boa e muito ruim (p < 0,0001). CONCLUSÕES: Observamos que idosos do meio rural apresentaram características sociodemográficas vulneráveis e clínicas desfavoráveis quando comparados aos idosos brasileiros do meio urbano, contrariando estudos internacionais. Os achados encontrados estimulam novas investigações para o melhor entendimento das lacunas da literatura sobre o idoso residente no meio rural

OBJECTIVE: To understand possible sociodemographic, economic and health differences between older rural and urban Brazilians participating in the 2013 National Health Survey (Pesquisa Nacional de Saúde). METHODS: A cross-sectional study was conducted with a secondary analysis of data from 11,177 elderly individuals. The dependent variable was place of residence (rural or urban), and the independent variables were sociodemographic characteristics (age group [age 60 to 79 or 80 years and older], gender, race, municipality and socioeconomic condition) and clinical characteristics: private health plan, enrollment in the Family Health Strategy program (Estratégia Saúde da Família) and self-perceived health. Associations between dependent and independent variables were assessed using the χ2 test, with p < 5% considered significant. RESULTS: Except for age group, all other sociodemographic and clinical characteristics were significantly associated with place of residence (p < 0.0001). Rural participants were more frequently: male, mixed race, married, illiterate, non-capital residents, with a lower socioeconomic level, better Family Health Strategy coverage, were less likely to have private health insurance. The self perceived health of urban elderly was more frequently very good, good or very poor (p <0.0001). CONCLUSIONS: Older individuals in rural areas had less favorable sociodemographic and clinical characteristics than those in urban areas, which contradicts international studies. These findings should stimulate further research to fill gaps in the literature regarding the rural elderly

Dental Procedures in Primary Health Care of the Brazilian National Health System.

The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs) adhering to the second cycle of the 'National Programme for Improving Access and Quality of Primary Care' (PMAQ-AB) in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013-2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental needs deliver the lowest number of dental procedures. The need to expand the supply of prostheses and the early diagnosis of oral cancer in primary health care (PHC) is evident.

Assessment of the cytotoxicity of a mineral trioxide aggregate-based sealer with respect to macrophage activity.

AIM: To assess the influence of co-culture with mineral trioxide aggregate (MTA) and MTA Fillapex (FLPX) on the viability, adherence, and phagocytosis activity of peritoneal macrophages from two mouse strains. METHODOLOGY: Cellular viability, adherence, and phagocytosis of Saccharomyces boulardii were assayed in the presence of capillaries containing MTA and MTA Fillapex. The data were analyzed using parametric (Student's t) and non-parametric (Mann-Whitney) tests. RESULTS: FLPX was severely cytotoxic and decreased cell viability, adherence, and phagocytic activity of both macrophage subtypes. Cells that were treated with MTA Fillapex remained viable (>80%) for only 4 h after stimulation. Macrophages from C57BL/6 mice presented higher adherence and higher phagocytic activity compared with macrophages from BALB/c mice. CONCLUSION: Comparison of MTA and FLPX effects upon macrophages indicates that FLPX may impair macrophage activity and viability, while MTA seems to increase phagocytic activity.

Use and diversity of palm (Arecaceae) resources in Central Western Brazil.

Arecaceae Schultz-Sch. (Palmae Juss.), a member of the monocotyledon group, is considered one of the oldest extant angiosperm families on Earth. This family is highly valuable because of its species diversity, its occurrence in a wide range of habitats, and its status as an integral part of the culture and the family-based economy of many traditional and nontraditional communities. The main objectives of this study were to perform an ethnobotanical study involving these palms and a "Quilombola" (Maroon) community in the municipality of Cavalcante, GO, Brazil. The variables gender, age, and formal schooling had no influence on the number of species recognized and used by the Kalungas. Ethnobotanical studies based on traditional knowledge in addition to use and management of palms are fundamental aspects for planning and appliance of public policies directed to the use of natural resources and improvement of life quality.

A percepçäo de mäes pertencentes a diferentes níveis sócio-econômicos sobre a saúde bucal dos seus filhos bebês / The perception of mothers from diferent socioeconomic levels about their babies oral health

Para a realizaçäo de um trabalho bem sucedido de promoçäo de saúde bucal é fundamental conhecer as necessidades e limitaçöes da comunidade assistida. Além disso, quanto mais precocemente forem empregadas medidas educativas e preventivas, melhores resultados poderäo ser obtidos. Sendo assim, o objetivo deste estudo foi avaliar o nível de conhecimento das mäes de crianças de zero a três anos sobre a saúde bucal de seus filhos bebês. A técnica da entrevista dirigida com classificaçäo dos resultados foi aplicada em 68 mäes, sendo 34 correspondentes ao nível sócio-econômico alto(A), cujos filhos frequentavam escolas particulares, e 34 pertencentes ao nível sócio-econômico baixo(B), cujos filhos frequentavam creches públicas, em Belo Horizonte, MG. Observou-se que 67,7 por cento das mäes de nível sócio-econômico A conheciam adequadamente os cuidados para com a saúde bucal dos seus filhos, contra apenas 17,6 por cento do nível B. Na categoria A, 82,3 por cento das mäes já tinham recebido orientaçöes sobre a saúde bucal das crianças e na B apenas 14,7 por cento das mäes. O maior responsável por estas informaçöes foi o Cirurgiäo Dentista (70,6 por cento/A, 11,8 por cento/B). Das mäes de nível A, 94,1 por cento tinham conhecimento sobre a dieta mais adequada ao bebê, contra 35,3 por cento das de nível B. A frequência e momento adequados em relaçäo a higiene bucal das crianças foram maior em A (70,6 por cento), em comparaçäo com B (23,5 por cento). A totalidade das mäes A (100 por cento) sabiam a finalidade do uso de fluoretos, contra 58,8 por cento das mäes B. Tendo em vista os resultados, nota-se que as mäes de nível sócio-econômico A detiveram uma manancial de informaçöes sobre a saúde bucal de seus filhos, o que näo ocorreu com mäes de nível sócio-econômico B, indicando que o fator sócio-econômico interfere marcadamente no acesso à informaçäo