Income- and education-based inequalities of edentulism and dental services utilization in Brazil.

OBJECTIVE: Tooth loss is a worldwide public health problem affecting mainly socioeconomically disadvantaged groups. Dental services utilization may increase access to preventive actions and conservative treatment, reducing the prevalence of tooth loss. This study evaluated the income- and education-based inequalities in edentulism according to the utilization of dental services among adults and older adults in Brazil. METHODS: Data from the National Oral Health Survey (SB Brazil, 2010) of adults (ages 35-44 years, n = 9779) and older adults (ages 65-74 years, n = 7619) were analysed. Socioeconomic indicators (SES) included education and income. The magnitude of inequality in edentulism by education and income levels was estimated by the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The changes in the RII and SII according to the utilization of dental services were estimated. Regression models estimated the association between SES and edentulism and whether dental services utilization modified this association. RESULTS: Higher edentulism prevalence was observed among those with lower education and income levels. The utilization of dental services changed the education-based inequality index in edentulism for adults, with percentage changes of 17.4% (RII) and 56.8% (SII). For adults with low education (0-4 years of study), the odds of edentulism were 80% (OR 0.2; 95% CI 0.1-0.6) and 90% (OR 0.1; 95% CI 0.01-0.2) lower for those who had used dental services within the preceding year and within 1-2 years compared with those who had used such services within the preceding 3 or more years, respectively. CONCLUSION: There was a social gradient in the prevalence of edentulism in adults and older adults, and the education-based inequalities in edentulism were lower among adults reporting utilization of dental services in the preceding year.

Mapping the trends and impact of research collaboration between countries in oral implantology publications: A bibliometric analysis from 1999 to 2019.

STATEMENT OF PROBLEM: Scientific collaboration provides a suitable strategy for enhancing the exchange of knowledge and technological development. However, the impact of collaboration in oral implantology research between countries and how it has been influenced by the income status of the country has not been previously evaluated. PURPOSE: The purpose of this bibliometric analysis was to evaluate how collaboration between countries affected oral implant publications and whether patterns of collaboration differ depending on the country's income. MATERIAL AND METHODS: Articles were retrieved from 7 well-established journals whose scope included oral implantology at 5 time points (1999, 2004, 2009, 2014, and 2019). Data were extracted, and descriptive, bivariate, and multivariate logistic regression analyses were performed (α=.05). RESULTS: A total of 1944 articles were included; of which, 27.5% presented collaboration between countries. In 2009, 2014, and 2019, collaboration between countries was more likely to occur than at previous time points (P≤.005). Corresponding authors with a higher h-index (P<.05) and authors from Europe and North America (P<.001) were more likely to establish international connections. The possibility of collaboration between countries was higher for animal studies (P<.001) and for articles published by Clinical Oral Implants Research (P=.026). Collaborations between high-income and upper-middle- or lower-middle-income countries were more likely to happen in 2014 and 2019 (P<.05), as well as when the number of authors was higher (P=.015), compared with collaboration between high-income countries. With regard to the continent, European articles were less likely to have collaborations with upper-middle- or lower-middle-income countries (P<.001). CONCLUSIONS: The findings revealed that some parameters related to the study, authors, countries, and journals were statistically associated with the presence of collaboration between countries. However, the bibliometric parameters showed different trends when countries of different incomes established collaboration.

Association between industry support and the reporting of study outcomes in randomized clinical trials of dental implant research from the past 20 years.

BACKGROUND: Industry support is a significant funding source in implant dentistry research, not only to provide regulatory processes, but also to validate and promote products through randomized clinical trials (RCTs). However, industry funding should not affect scientific outcomes. PURPOSE: The aim of this study was to investigate whether there is an association between industry support for RCTs in implant dentistry and a greater chance of the reporting of positive outcomes, and whether there are other funding tendencies. MATERIALS AND METHODS: Randomized clinical trials from five implant dentistry journals were reviewed. Data were extracted, and descriptive and inferential statistical analyses (α = 0.05), including bivariate and multivariable logistic regression, and Spearman's correlation were performed. RESULTS: Two hundred eleven RCTs were included. Industry-funded and -unfunded studies presented similar outcomes, in terms of positive and negative results (p ≥ 0.05). North American and European countries received more industry funding, as did high-income countries, which showed well-established collaboration with each other. Clinical Oral Implants Research and Clinical Implant Dentistry and Related Research published 83.6% of industry-funded articles. Industry-funded studies from middle-income countries established more international collaborations with high-income countries than did unfunded studies. Citation numbers were similar for funded and unfunded studies. The chance of RCTs being industry-funded was higher for high-income (odds ratio [OR] = 3.00; 95% confidence interval [CI], 0.99-9.32; p = 0.05) and North American articles (OR = 3.40; 95% CI, 1.37-8.42; p = 0.008) than in lower-middle-income and other continents, respectively. Higher industry funding was associated with specific topics such as "surgical procedures," "prosthodontics topics," and "implant macrodesign" (OR = 4.7; 95% CI, 1.45-15.20; p = 0.010) and with the increase in numbers of institutions (OR = 1.52; 95% CI, 1.16-2.0; p = 0.002). CONCLUSION: The available evidence suggests no association between industry funding and greater chances of the reporting of positive outcomes in implant dentistry RCTs. A strong association was identified in industry trends concerning geographic origins, higher numbers of institutions, and specific research topics.

[Use of public dental services by elderly Brazilians: a multilevel analysis]. / Uso de serviços odontológicos públicos entre idosos brasileiros: uma análise multinível.

This study evaluated whether the use of dental services of the Unified Health System (SUS) by elderly Brazilians is equitable. Individual data collected by qualified professionals during the national oral health survey (2010) and contextual data from DATASUS and IBGE were used. The dependent variable was the type of service used: SUS and others. Multilevel analyses were conducted using logistic regression (α=5%) (OR/CI 95%) using SPSS 24.0. A total of 6,303 elderly people were included and the prevalence of dental service use in SUS was 30%. Associated contextual factors were: access to bathroom and running water (1.54/1.19-2.00) and the dental care index (1.41/1.10-1.81); the individual factors were: age (0.77/0.66-0.90), years of schooling (1.83/1.53-2.20), family income (2.57/2.20-3.01), reason for last dental visit (0.75/0.60-0.93), decayed teeth total (1.26/1.08-1.48), plugged teeth total (0.63/0.54-0.74), dental prosthesis use (2.23/1.91-2.59), dental pain (1.36/1.11-1.67), self-perception of the need for dental treatment (1.20/1.12-1.51) and need for dental prosthesis (1.38/1.20-1.59). Dental service from SUS has been equitable, however it is necessary to organize the working process, enabling its use in a regular and preventive manner, thereby seeking universality and comprehensiveness.

Avaliou-se, entre idosos brasileiros, se o uso dos serviços odontológicos provenientes do Sistema Único de Saúde (SUS) é equânime. Utilizaram-se dados individuais de exames conduzidos por profissionais calibrados do levantamento nacional de saúde bucal (2010) e dados contextuais originários do DATASUS e do IBGE. A variável dependente foi o tipo de serviço utilizado: SUS e Outros. Foram conduzidas análises multiníveis através de regressão logística (α = 5%) (OR/IC 95%), através do SPSS 24.0. Participaram 6.303 idosos, a prevalência do uso no SUS foi de 30%, os fatores contextuais associados foram o acesso a banheiro e a água encanada (1,54/1,19-2,00) e o índice de cuidados odontológicos (1,41/1,10-1,81); já os individuais: idade (0,77/0,66-0,90), anos de estudo (1,83/1,53-2,20), renda familiar (2,57/2,20-3,01), motivo da última consulta (0,75/0,60-0,93), no de dentes cariados (1,26/1,08-1,48), no de dentes obturados (0,63/0,54-0,74), uso de próteses (2,23/1,91-2,59), dor de dente (1,36/1.11-1,67), autopercepção da necessidade de tratamento odontológico (1,20/1,12-1,51) e da necessidade de próteses (1,38/1,20-159). O uso no SUS tem sido equânime, porém é preciso organizar o processo de trabalho, viabilizando tal uso de forma regular e preventiva buscando a universalidade e a integralidade.

Is reduced dentition with and without dental prosthesis associate with oral health-related quality of life? A cross-sectional study.

BACKGROUND: Oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research and should contribute to professional judgment about restorative treatments and prosthetic replacement in patients who had reduced dentitions. The aim was to compare the OHRQoL among adults (35-44 years) categorized according to different definitions of reduced dentition and considering the use (or non-use) of dental prosthesis. METHODS: This study used data from a probabilistic sample of adults in Sao Paulo, Brazil, 2015. OHRQoL was based on none items of Oral Impacts on Daily Performance (OIDP) index, as prevalence (at least one impact) and extent (the number of items with non-zero score). We used different criteria to assess dentition status: (1) Shortened Dental Arch (SDA): having 3-5 natural occlusal units (OUs) in posterior teeth and intact anterior region; (2) hierarchical functional classification system: a five-level stepwise classification of dentition; and (3) presence of ≥21 teeth. The use or nonuse of dental prosthesis was recorded. Negative binomial regression models involved the adjustment for social determinants of health. RESULTS: Nearly half (53.1%) of the 5753 participating adults had at least one oral health issue impacting OHRQoL. OIDP prevalence in adults with SDA did not differ from those with more OUs (PR = 1.02; 95%CI 0.91-1.13). Individuals with non-functional dentition had worse OHRQoL regardless of their use of a dental prosthesis. Adults with fewer than 21 remaining teeth, ranked significantly higher in OIDP extent, regardless of dental prosthesis use (PR = 1.38; 95%CI 1.16-1.63 with prosthesis; PR = 1.62; 95%CI 1.19-2.20 without dental prosthesis). CONCLUSIONS: Individuals with more missing teeth reported worse OHRQoL regardless of using a dental prosthesis. Preserving a functional dentition, even with missing teeth, is compatible with OHRQoL.

[Access to dental services and related factors: a home-based population study]. / Acesso aos serviços odontológicos e fatores associados: estudo populacional domiciliar.

The scope of this study was to identify factors associated with lack of access to dental services. It involved a cross-sectional study and a probabilistic complex sample by conglomerates in two stages with 857 participants over 18 years of age in a large city. Multiple analyses by means of logistic and multivariate regression in decision trees were made. The lack of access to dental services was considered a dependent variable. It was identified that 10.3% did not have access. In the multiple and multivariate analyses an association with age was verified and in the logistic regression a greater possibility of lack of access was found for each year of increased age, among those with the lowest per capita income and those who ranked appearance of teeth and gums as "fair/poor/very poor." The lack of access to dental services was greater among the most socially vulnerable. There is a pressing need to increase the allocation of public resources to promote health education and provide knowledge about how to access services when they are needed, focusing on dental care as a human right and ensuring that lack of access does not occur as users get older or among those with low income and also those dissatisfied with their oral appearance.

Objetivou-se identificar fatores associados à falta de acesso aos serviços odontológicos. Estudo transversal, amostra complexa probabilística por conglomerados em dois estágios de 857 participantes, com mais de 18 anos em um município de grande porte populacional. Foram feitas análises múltiplas através da regressão logística e multivariada em árvores de decisão. Considerou-se como variável dependente o acesso aos serviços odontológicos. Identificou-se que 10,3% não obtiveram acesso. Nas análises múltipla e multivariada constataram-se associação com a idade, na regressão logística constatou-se maior chance de falta de acesso a cada ano de idade incrementado, entre aqueles com menor renda per capita e entre os que classificaram a aparência dos dentes e gengivas como "regular/ruim/péssima". A falta de acesso aos serviços odontológicos é maior entre os mais vulneráveis socialmente. Há necessidade de incremento na alocação de recursos públicos que promovam educação em saúde e gere conhecimento sobre como acessar os serviços quando necessitar, tendo em foco os cuidados odontológicos como um direito humano e que possibilitem que não ocorra a falta de acesso à medida que os usuários envelhecem ou entre os com baixa renda e também os insatisfeitos com a aparência bucal.

Acesso aos serviços odontológicos e fatores associados: estudo populacional domiciliar / Access to dental services and related factors: a home-based population study

Resumo Objetivou-se identificar fatores associados à falta de acesso aos serviços odontológicos. Estudo transversal, amostra complexa probabilística por conglomerados em dois estágios de 857 participantes, com mais de 18 anos em um município de grande porte populacional. Foram feitas análises múltiplas através da regressão logística e multivariada em árvores de decisão. Considerou-se como variável dependente o acesso aos serviços odontológicos. Identificou-se que 10,3% não obtiveram acesso. Nas análises múltipla e multivariada constataram-se associação com a idade, na regressão logística constatou-se maior chance de falta de acesso a cada ano de idade incrementado, entre aqueles com menor renda per capita e entre os que classificaram a aparência dos dentes e gengivas como "regular/ruim/péssima". A falta de acesso aos serviços odontológicos é maior entre os mais vulneráveis socialmente. Há necessidade de incremento na alocação de recursos públicos que promovam educação em saúde e gere conhecimento sobre como acessar os serviços quando necessitar, tendo em foco os cuidados odontológicos como um direito humano e que possibilitem que não ocorra a falta de acesso à medida que os usuários envelhecem ou entre os com baixa renda e também os insatisfeitos com a aparência bucal.

Abstract The scope of this study was to identify factors associated with lack of access to dental services. It involved a cross-sectional study and a probabilistic complex sample by conglomerates in two stages with 857 participants over 18 years of age in a large city. Multiple analyses by means of logistic and multivariate regression in decision trees were made. The lack of access to dental services was considered a dependent variable. It was identified that 10.3% did not have access. In the multiple and multivariate analyses an association with age was verified and in the logistic regression a greater possibility of lack of access was found for each year of increased age, among those with the lowest per capita income and those who ranked appearance of teeth and gums as "fair/poor/very poor." The lack of access to dental services was greater among the most socially vulnerable. There is a pressing need to increase the allocation of public resources to promote health education and provide knowledge about how to access services when they are needed, focusing on dental care as a human right and ensuring that lack of access does not occur as users get older or among those with low income and also those dissatisfied with their oral appearance.

Socioeconomic inequalities in the use of dental care services during early childhood: an epidemiological survey.

BACKGROUND: The use of dental care services contributes to the improvement of children's healthy behaviors, reducing the prevalence of future dental problems. In this way, the purpose of this study was to describe the use of dental care service during early childhood and the possible socioeconomic inequalities in this use. DESIGN: Data from the Brazilian Oral Health Survey (SB Brasil, 2010) were used. Interviews with the children's parents and clinical examinations with the children were conducted in a 5-year-old representative sample. Descriptive, bivariate and multiple hierarchical statistical analyses were applied. RESULTS: Of the 7241 children included, 3812 (53.2%) had used dental care services at least once in their lifetimes, and 1872 (48.8%) had used services for check-up/prevention. The use of dental services was greater among children with a higher family income (P < 0.05). The use of check-ups was lower among children with non-White skin color (Black and Browns) and among those who did not live in state capitals (P < 0.05). Clinical conditions and self-perception were also associated with the use (P < 0.05). CONCLUSION: Socioeconomic differences in the general use of dental care and in its use for check-ups were identified during early childhood, indicating the presence of inequalities.

[The use of dental services on a regular basis in the population of Montes Claros in the State of Minas Gerais, Brazil]. / Uso de serviços odontológicos de forma regular na população de Montes Claros, MG, Brasil.

The use of dental services on a regular basis by residents of Montes Claros (MG) was assessed, as well as related aspects. Cross-sectional study was conducted with a complex probabilistic sample by conglomerates. Logistic regression was used (OR/CI95%) with a significance level of 5. Of the 2582 study participants, 761 required and obtained access to the services for less than a year. Of these, 262 (35.8%) used the services in a regular/routine manner. The use of dental services on a regular basis was greatest among individuals in the age group "≥ 18 ≤ 37"; with schooling "equal to or greater than 9 years"; who classified their oral health, general health and appearance of teeth and gums as "excellent/good"; who reported no pain" on teeth and gums over the last six months; They reported that the "assistance provider had adequate skills"; that they "always/often" received information about oral hygiene and diet/nutrition. In addition, this use was lower among those who rated the time to ask questions about the dental problem or treatment as "regular/bad/terrible." The conclusion drawn is that the use of dental services on a regular basis was relatively low, being associated with personal traits, subjective health conditions and characteristics related to the services.

Avaliou-se o uso de serviços odontológicos de forma regular entre os residentes de Montes Claros (MG), assim como os aspectos relacionados a esse uso. Estudo transversal realizado com amostra complexa probabilística por conglomerados. Utilizou-se a análise de regressão logística (OR/IC95%). Dos 2582 participantes do estudo, 761 necessitaram de serviços odontológicos e obtiveram acesso a eles há menos de um ano. Destes, 262 (35,8%) fizeram uso dos serviços de forma regular. Esse uso foi maior entre os indivíduos na faixa etária "≥ 18 ≤ 37"; com escolaridade "igual ou maior a 9 anos"; que classificaram sua saúde bucal, saúde geral e a aparência dos dentes e gengivas como "ótima/boa"; que não relataram dor nos dentes e gengivas nos últimos seis meses; que relataram que o "prestador da assistência possuía habilidades adequadas"; que "sempre/frequentemente" receberam informações sobre higiene bucal e sobre dieta/alimentação. Em adição, esse uso foi menor entre os que classificaram o tempo para fazer perguntas sobre o problema bucal ou tratamento como "regular/ruim/péssimo". Conclui-se que o uso de serviços odontológicos de forma regular foi relativamente baixo, sendo associado a características pessoais, condições subjetivas de saúde e características relacionadas aos serviços.

Uso de serviços odontológicos de forma regular na população de Montes Claros, MG, Brasil / The use of dental services on a regular basis in the population of Montes Claros in the State of Minas Gerais, Brazil

Resumo Avaliou-se o uso de serviços odontológicos de forma regular entre os residentes de Montes Claros (MG), assim como os aspectos relacionados a esse uso. Estudo transversal realizado com amostra complexa probabilística por conglomerados. Utilizou-se a análise de regressão logística (OR/IC95%). Dos 2582 participantes do estudo, 761 necessitaram de serviços odontológicos e obtiveram acesso a eles há menos de um ano. Destes, 262 (35,8%) fizeram uso dos serviços de forma regular. Esse uso foi maior entre os indivíduos na faixa etária "≥ 18 ≤ 37"; com escolaridade "igual ou maior a 9 anos"; que classificaram sua saúde bucal, saúde geral e a aparência dos dentes e gengivas como "ótima/boa"; que não relataram dor nos dentes e gengivas nos últimos seis meses; que relataram que o "prestador da assistência possuía habilidades adequadas"; que "sempre/frequentemente" receberam informações sobre higiene bucal e sobre dieta/alimentação. Em adição, esse uso foi menor entre os que classificaram o tempo para fazer perguntas sobre o problema bucal ou tratamento como "regular/ruim/péssimo". Conclui-se que o uso de serviços odontológicos de forma regular foi relativamente baixo, sendo associado a características pessoais, condições subjetivas de saúde e características relacionadas aos serviços.

Abstract The use of dental services on a regular basis by residents of Montes Claros (MG) was assessed, as well as related aspects. Cross-sectional study was conducted with a complex probabilistic sample by conglomerates. Logistic regression was used (OR/CI95%) with a significance level of 5. Of the 2582 study participants, 761 required and obtained access to the services for less than a year. Of these, 262 (35.8%) used the services in a regular/routine manner. The use of dental services on a regular basis was greatest among individuals in the age group "≥ 18 ≤ 37"; with schooling "equal to or greater than 9 years"; who classified their oral health, general health and appearance of teeth and gums as "excellent/good"; who reported no pain" on teeth and gums over the last six months; They reported that the "assistance provider had adequate skills"; that they "always/often" received information about oral hygiene and diet/nutrition. In addition, this use was lower among those who rated the time to ask questions about the dental problem or treatment as "regular/bad/terrible." The conclusion drawn is that the use of dental services on a regular basis was relatively low, being associated with personal traits, subjective health conditions and characteristics related to the services.

Contextual and individual determinants of oral health-related quality of life in older Brazilians.

PURPOSE: This cross-sectional, population-based study evaluated contextual and individual determinants on the oral health-related quality of life in older Brazilians. MATERIALS AND METHODS: Data from the National Survey of Oral Health were used. The sample was selected by multi-stage probability cluster sampling, with probability proportional to size. The Oral Impacts on Daily Performance (OIDP) was used to evaluate oral health-related quality of life (OHRQoL). Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate and multilevel analyses were conducted. RESULTS: Of the sample of 7619 older Brazilians, 45.7% was impacted by at least one of the OIDP items. The item impact average was 1.2 (95% CI 1.04-1.37). The impact on OHRQoL was lower in older Brazilians residents in municipalities with the highest value of the GINI index (contextual variable) (p = 0.007), among edentulous people (p = 0.001) and dental prosthesis users (p < 0.001). This impact was greater among older people of nonwhite skin color (p = 0.024), lower family income (p = 0.024) and dissatisfied with the oral health (p < 0.001). CONCLUSION: A high prevalence of oral problems impacting OHRQoL in older Brazilians was identified. Furthermore, the impact prevalence was related to a positive situation in contextual determinants and a negative situation for the individual, showing a social inequalities profile in relation to individual determinants.

Equity inthe use of dental services provided by the Brazilian Unified Health System (SUS) among the elderly: a population-based study. / Equidade no uso de serviços odontológicos provenientes do SUS entre idosos: estudo de base populacional.

The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

Equidade no uso de serviços odontológicos provenientes do SUS entre idosos: estudo de base populacional / Equity inthe use of dental services provided by the Brazilian Unified Health System (SUS) among the elderly: a population-based study

Resumo Propõe-se caracterizar os idosos usuários de serviços odontológicos ofertados pelo Sistema Único de Saúde, considerando o princípio da equidade. Trata-se de um estudo transversal analítico com modelagem hierarquizada, conduzido a partir de uma amostra probabilística, complexa, por conglomerados de idosos (65-74 anos) residentes em um município brasileiro de grande porte populacional. Foram incluídas variáveis independentes referentes a: características sociodemográficas, acesso a informações em saúde, comportamentos/sistema de atenção à saúde e desfechos em saúde. Realizou-se análises descritivas, bivariadas e múltiplas hierarquizadas. Dos 480 idosos incluídos, 138 (31,2%) utilizaram serviços odontológicos provenientes do SUS. O uso desses serviços foi maior à medida que diminuíam a renda per capita e a escolaridade dos idosos, menor entre os que não haviam realizado o autoexame da boca e maior entre os que usavam os serviços odontológicos para procedimentos que não fossem rotina. Além disso, verificou-se que utilizaram mais o SUS pessoas que tiveram o relacionamento afetado pela saúde bucal e uma autopercepção negativa da sua aparência. Conclui-se que o uso dos serviços odontológicos no SUS foi predominante entre os idosos que vivem sob condições de vulnerabilidade.

Abstract The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

Profile and scientific production of Brazilian researchers in dentistry / Perfil e produção científica dos pesquisadores brasileiros em Odontologia

Aim: The present study seeks to investigate the profile and scientific production of Brazilian researchers in dentistry from the National Council for Scientific and Technological Development (CNPq). Methods: An observational study was conducted. The sample consisted of productivity researchers from CNPq with fellowships awarded in February 2013. Data were collected from Lattes Curriculum. Analyzed parameters corresponded to the years 2011 and 2012. Results: The sample consisted of 209 researchers. Most of the researchers were male, who received a category 2 fellowship, distributed in 12 Brazilian States. Regarding the area of expertise, most of the researchers worked in dentistry clinics, oral pathology, and periodontics. A predominance of publications was found in Qualis B journals and in the supervision of scientific initiation. Conclusion: The results of this study reveal both a significant contribution from dentistry researchers towards the consolidation of national scientific production as well as the updating of information regarding dentistry production.(AU)

Objetivo: investigar o perfil e a produção científica dos pesquisadores brasileiros em Odontologia bolsistas de produtividade do Conselho Nacional de desenvolvimento científico e tecnológico (CNPq). Material e Métodos: Foi realizado um estudo observacional. A amostra consistiu de pesquisadores de produtividade do CNPq, com bolsas de estudo ativas em fevereiro de 2013. Os dados foram coletados do Currículo Lattes. Parâmetros analisados correspondem para os anos 2011 e 2012. Resultados: A amostra consistiu de 209 investigadores. A maioria dos pesquisadores era do sexo masculino, categoria 2 de bolsa e distribuídos em 12 Estados brasileiros. Sobre a área de especialização, a maioria dos pesquisadores atuava em Clínica Odontológica, Patologia Bucal e Periodontia. Há uma predominância de publicações em revistas Qualis B e supervisão de iniciação científica. Conclusão: Os resultados deste estudo mostram uma contribuição significativa de pesquisadores de Odontologia para a consolidação da produção científica nacional, além de atualizar informações sobre produção de odontologia.(AU)

Consumption profile and factors associated with the ingestion of beer and distilled beverages among elderly Brazilians: Gender differences.

AIM: To estimate the prevalence of the consumption of beer and distilled beverages and associated factors among Brazilian older adults residing in a highly populated city in Brazil, highlighting the factors associated with frequent consumption and differences in consumption between men and women. METHODS: It was a cross-sectional, analytic study carried out by means of probability samples of conglomerates of older adults (aged 65-74 years). Descriptive analysis, univariate analysis and estimates of multivariate models through logistic regression (OR, 95% CI) were realized. RESULTS: 500 of the 736 evaluated seniors were included in the present analysis. 128 (27.3%), 103 (21.3%) and 167 (34.9%) of the seniors indicate past or current use of beer, distilled beverages and frequent use of alcohol, respectively. The consumption of beer was associated with use of tobacco between women; and with marital status and schooling between men. The consumption of distilled beverages was associated with schooling and use of tobacco between women; and age and use of tobacco in men. Daily or weekly use was associated with schooling and use of tobacco between women; age and the use of tobacco between men. CONCLUSION: In the elderly population studied, a noteworthy prevalence of the consumption of beer and distilled beverages was identified, and this use was associated with personal and behavioral determinants. Similar associations related to frequent (daily or weekly) consumption were also identified. Significant differences in the profile of consumption were identified between men and women, with more abusive use among men. Geriatr Gerontol Int 2016; 16: 810-820.

Access to information on how to avoid oral health problems among elderly persons registered with the Family Health Strategy / Acesso a informações sobre como evitar problemas bucais entre idosos cadastrados na Estratégia de Saúde da Família

Objectives : To identify the level of access to information regarding how to prevent oral health problems among the elderly, and verify if such levels were higher among members of households registered with the Family Health Strategy Program. Methods : An analytic cross-sectional study was conducted of a probabilistic complex sample of elderly (65-74 years old) members of the population of a large city. The level of access was estimated with adjustment for the design effect, as well as the magnitudes of association. Descriptive, bivariate and logistic regression (OR/CI95%) analysis was performed. Variables related to personal determinants, health services, health-related behavior and health outcomes were considered. Results : Of the 490 participants, 53.4% reported they had access to information about how to prevent oral health problems. This access was higher among elderly persons living in a household registered with the Family Health Strategy Program (2.04/1.14-3.67), and who had at least five years of schooling (2.53/1.67-3.83), regularly used dental services (1.84/1.07-3.17), did not smoke either now or in the past (1.79/1.13-2.82), did not suffer from chronic diseases (2.14/1.34-3.42) and had not suffered social impacts because of their oral health conditions (1.77/1.08-2.91). Conclusion : Most of the elderly persons had access to information about how to prevent oral health problems, with such access being greater among those registered with the Family Health Strategy Program.

Objetivos: Identificar a prevalência do acesso a informações sobre como evitar problemas bucais entre idosos e verificar se esse acesso foi maior entre os residentes em domicílios cadastrados na Estratégia de Saúde da Família (ESF). Método: Estudo transversal analítico conduzido a partir de amostra probabilística complexa por conglomerado de idosos (65-74 anos) de um município de grande porte populacional. Foi estimada a prevalência do acesso com correções pelo efeito de desenho, além das magnitudes das associações, sendo conduzidas análises descritivas, bivariadas e regressão logística (OR/IC95%). Considerou-se variáveis referentes aos determinantes pessoais, serviços de saúde, comportamentos relacionados à saúde e desfechos de saúde. Resultados: Dentre os 490 participantes, 53,4% relataram o acesso a informações sobre como evitar problemas bucais. Esse acesso foi maior entre os idosos que residiam em domicílio cadastrado na ESF (2,04/1,14-3,67), tinham maior escolaridade (2,53/1,67-3,83), utilizaram os serviços odontológicos por rotina (1,84/1,07-3,17), não relataram hábito tabagista atual ou passado (1,79/1,13-2,82), não possuíam doença crônica (2,14/1,34-3,42) e não tiveram impacto social das suas condições de saúde bucal (1,77/1,08-2,91). Conclusão: Conclui-se que a maioria dos idosos teve acesso a informações sobre como evitar problemas bucais, sendo o acesso maior entre aqueles cadastrados na Estratégia de Saúde da Família.

Users' dissatisfaction with dental care: a population-based household study.

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users' dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users' dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units.

Need for orthodontic treatment among Brazilian adolescents: evaluation based on public health / Necessidade de tratamento ortodôntico em adolescentes brasileiros: avaliação com base na saúde pública

OBJECTIVE: To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents. METHODS: This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003). Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable need orthodontic treatment was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated. RESULTS: The majority of the adolescents needed orthodontic treatment (53.2%). In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad. CONCLUSIONS: There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system.

OBJETIVO: Identificar a prevalência e a gravidade das más oclusões e fatores associados com a necessidade de tratamento ortodôntico dos adolescentes brasileiros. MÉTODOS: Estudo transversal feito com base nos dados da pesquisa epidemiológica nacional em saúde bucal no Brasil (2002-2003). Condições sociodemográficas, autopercepção, existência e nível de gravidade da má oclusão, com o uso do Índice de Estética Dentária, foram avaliados em 16.833 adolescentes brasileiros selecionados por amostra probabilística por conglomerados. A variável dependente necessidade de tratamento ortodôntico foi estimada a partir da gravidade da má oclusão. A magnitude e a direção das associações nas análises bivariada e multivariada foram estimadas pela regressão de Poisson. RESULTADOS: A maioria dos adolescentes apresentou necessidade de tratamento ortodôntico (53,2%). Na análise multivariada, a prevalência da necessidade de tratamento ortodôntico foi maior entre as mulheres, os não brancos, aqueles que autopercebiam a necessidade de tratamento e aqueles que autopercebiam sua aparência como normal, ruim ou muito ruim. A necessidade de tratamento ortodôntico foi menor entre aqueles que viviam nas regiões Nordeste e Centro-Oeste em comparação com aqueles da Sudeste e também menor entre aqueles que autopercebiam sua mastigação como normal e sua saúde bucal como ruim ou muito ruim. CONCLUSÕES: O estudo identificou uma prevalência elevada da necessidade de tratamento ortodôntico em adolescentes no Brasil, associada com questões demográficas e subjetivas de saúde bucal. A alta prevalência de necessidades ortodônticas entre adolescentes é um desafio para o Sistema Único de Saúde (SUS) do Brasil.

[Need for orthodontic treatment among Brazilian adolescents: evaluation based on public health]. / Necessidade de tratamento ortodôntico em adolescentes brasileiros: avaliação com base na saúde pública.

OBJECTIVE: To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents. METHODS: This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003). Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable - need orthodontic treatment - was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated. RESULTS: The majority of the adolescents needed orthodontic treatment (53.2%). In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad. CONCLUSIONS: There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system.

Users' dissatisfaction with dental care: a population-based household study / Insatisfação dos usuários com a assistência odontológica: estudo domiciliar populacional

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users' dissatisfaction with such are.METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users' dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals.RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms.CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units.

OBJETIVO Analisar se condições demográficas, socioeconômicas, subjetividade da saúde bucal e caracterização da assistência odontológica estão associadas à insatisfação dos usuários com a assistência odontológica.MÉTODOS Estudo transversal com 781 pessoas que necessitavam de assistência odontológica, em 2012, em Montes Claros, MG, município de médio porte populacional. Foram realizadas entrevistas domiciliares e aplicado questionário que avaliou a insatisfação dos usuários com a assistência odontológica (variável dependente), condições demográficas, socioeconômicas, subjetividade da saúde bucal e caracterização da assistência odontológica (variáveis Independentes). Utilizou-se cálculo amostral para população finita, com estimativa para proporções de insatisfação em 50,0% da população, erro de 5,0%, taxa de não resposta de 5,0% e efeito de desenho de 2,0. Utilizou-se regressão logística e calculou-se odds ratio, com nível de significância de 5% e intervalos de 95% de confiança.RESULTADOS Estavam insatisfeitos com a assistência 9,0% dos entrevistados (7,9%, considerando correção pelo efeito de desenho). Constatou-se associação da insatisfação com menor escolaridade, autoavaliação negativa de saúde bucal, percepção da inabilidade do prestador de assistência odontológica, avaliação negativa da forma como foi tratado, da limpeza das salas do local de exame, incluindo banheiros, e quantidade de espaço na sala de espera e sala onde foi realizado a consulta.CONCLUSÕES A taxa de insatisfação com a assistência odontológica foi baixa. Estiveram associadas à insatisfação variáveis referentes a condições socioeconômicas, subjetividade da saúde bucal, habilidade profissional, ao relacionamento profissional-paciente e à infraestrutura do local de atendimento. Sugere-se que há necessidade de intervenções educativas que visem a melhoria da qualidade da assistência entre os profissionais, por órgãos competentes, assim como a necessidade de melhoria da infraestrutura dos locais de atendimento.