Cost-effectiveness and cost-benefit analyses of fluoride varnish for caries prevention in Guangxi, China.

OBJECTIVES: The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. METHODS: This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6-8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. RESULTS: After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost-benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. CONCLUSIONS: Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health.

A proposal for an oral health educational programme for the first 1000 days of life: from pregnancy to childhood.

AIM: The aim of this paper is to highlight the need to consider oral health during the first 1000 days of a child's life with a view to developing appropriate educational programmes. CONTEXT: The first 1000 days of life represent a window of opportunity for prevention in children. This concept is built on a consideration of the overall health of mother and child, taking into account social inequalities in health. It is now established that the oral health of the mother determines the oral health of her child. Furthermore, parents' knowledge and behaviour have a direct influence on their child's health. CONCLUSION: The majority of the population does not have the necessary skills to adopt behaviours that promote oral health. The need for oral health education begins in the first 1000 days of life. Following the model of family health education, these programmes would involve providing pregnant women and, therefore, families with the skills they need to manage their own oral health and that of their future child as early as possible.

Satisfaction of Oral Health Education among Parents and Caregivers Regarding Children with Special Healthcare Needs in Riyadh, Saudi Arabia.

AIM AND OBJECTIVE: The aim of the study was to evaluate the satisfaction of an oral health promotion program among parents and caregivers of children with special healthcare needs (CSHCN) in Riyadh, Saudi Arabia. MATERIALS AND METHODS: A digital survey using Google forms was used during an event to commemorate the World Disability Day. Stalls for oral health education and training were set up at Disabled Children Society, Riyadh, Saudi Arabia. Oral health education was carried out using written pamphlets, brochures, and videos. Live demonstration on dental models was used for tooth-brushing training using a powered toothbrush. Parents and caregivers were asked to complete a survey about oral health education during the event. An overall 189 parents and caregivers of CSHCN including 62 males and 127 females completed the survey. The responses were entered digitally prior to being evaluated. RESULTS: The respondents were parents and/or caregivers of children mostly having cerebral palsy followed by autism. Females consisted of 67% of the respondents. Eight-one percent of respondents rated it as highly satisfied. Ninety-one percent of the respondents perceived that the information provided was new for them regarding oral healthcare for CSHCN. Ninety-eight percent of respondents were likely to attend a similar event in the future. CONCLUSION: Majority of parents and caregivers of CSHCN were highly satisfied by the oral health education during the event. They felt that they can take better care of the oral health of their CSHCN after the oral health education and training. CLINICAL SIGNIFICANCE: Oral health among CSHCN is neglected when compared to children among the general population. CSHCN exhibit many barriers to oral health care. Oral health promotion among CSHCN is important as they have a high unmet oral health need.

Educação em saúde bucal em uma pré-escola: planejamento estratégico para o desenvolvimento de atividades lúdicas / Oral health education in pre-school: strategic planning for the development of ludic activities

Trata-se de um relato de experiência, que descreve, sob estratégia narrativo-argumentativa, as significâncias político-pedagógicas atreladas ao planejamento estratégico de ações de educação em saúde bucal vivenciadas em um ambiente escolar e experimentadas por acadêmicos estagiários de um curso de Odontologia. Após análise detalhada, algumas inferências se destacaram: o reconhecimento do ambiente escolar como território fértil para o desenvolvimento de ações promotoras de saúde; a efetividade do instrumento "TPC" (Teorizar-Praticar-Criticar) no direcionamento dos acadêmicos estagiários no planejamento estratégico de atividades de educação em saúde bucal; a importância de se disseminar, em espaços científicos, os aprendizados advindos de experimentações práticas de estágios.

This is a report on an experience that describes, under a narrative-argumentative strategy, the political-pedagogical significance linked to the strategic planning of oral health education actions experienced in a school environment and experienced by university trainees from a Dentistry course. After a detailed analysis, some inferences were observed: the recognition of the school environment as a fertile territory for the development of health-promoting actions; the effectiveness of the "TPC" (Theorize-Practice-Criticize) instrument in directing university trainees in the strategic planning of oral health education activities; the importance of disseminating, in scientific spaces, the learning from practical experimentation during internships.

Assessment of Oral Health Education with the Simplified Oral Hygiene Index in Military Students - A Comparative Study.

PURPOSE: To assess the impact of participation in a group oral health education course on oral hygiene in Romanian military students compared to a non-participant control group. MATERIALS AND METHODS: A sample of 318 participants was enrolled from 805 recruited students. Baseline and 6-month post-intervention Simplified Oral Hygiene Index (OHI-S) scores were compared between an oral health education intervention (OHE) group (N = 159) and a control group (N = 159) using Student's t-test. All participants received individualised instruction; only those in the OHE group participated in interactive group oral-health training. RESULTS: Post-intervention OHI-S scores improved statistically significantly (p< 0.05) in both groups compared to baseline scores. The OHE group's post-intervention OHI-S scores were statistically significantly better (p< 0.05) than the control group's intervention scores. Women had better OHI-S scores than men at both time points. CONCLUSIONS: An interactive educational module produced favorable oral health results. It would be appropriate to provide an oral health course to military students aimed at supporting the maintenance of good oral health.

Importancia de la adherencia al tratamiento periodontal en pacientes diabéticos y el impacto del desapego / Importance of adherence to periodontal treatment in diabetic patients and the impact of detachment

La diabetes mellitus es una de las enfermedades sistémicas con mayor prevalencia en la población mundial. Este padecimiento representa uno de los factores de riesgo más importantes asociados con la enfermedad periodontal. El paciente con enfermedades crónicas como la diabetes necesita una disciplina convencida diaria y prolongada a través del tiempo (años) como única manera de reducir el impacto sistémico que deteriora la calidad de vida. Cuando se adhiere al tratamiento es posible observarlo en su condición estomatológica; sin embargo, cuando no se logra, se genera un deterioro en las condiciones bucales, principalmente enfermedad periodontal. En este artículo se presentan dos casos clínicos en los cuales se puede observar la mejoría de las condiciones bucales una vez que el paciente decide adherirse a su tratamiento. En el primero se aprecian las manifestaciones de manera notoria de un desapego en años posteriores. Se debe tener en cuenta que la adhesión al tratamiento no sólo depende de factores concernientes al paciente, también intervienen factores asociados al medio ambiente, situación económica, interacción médico-paciente, entre otros, por lo que resulta importante incentivar continuamente y acompañar al paciente en su tratamiento, así como conocer y entender la problemática de una enfermedad sistémica (AU)

Diabetes mellitus is one of the most prevalent systemic diseases in the world population. This condition represents one of the most important risk factors associated with periodontal disease. The patient with chronic diseases such as diabetes needs a daily and prolonged convinced discipline over time (years), as the only way to reduce the systemic impact, which deteriorates the quality of his life: when he has adherence to treatment it is possible to observe it in his stomatological condition, however when it is not achieved, a deterioration in the oral conditions is generated, mainly periodontal disease. This article presents two clinical cases where the improvement of oral conditions can be observed once the patient decides to adhere to their treatment. In the first one, the manifestations of a detachment in later years are noticeable. It should be taken into account that adherence to treatment does not only depend on factors concerning the patient. Also involved are factors associated with the environment, economic situation, doctorpatient interaction, among others, so it is important to continually encourage and accompany the patient in their treatment, as well as to know and understand the problem of a systemic disease (AU)

Necesidades educativas sobre salud bucodental en el grado prescolar / Educational needs related to oral health in the preschool grade

Introducción: La caries dental y la enfermedad periodontal son las enfermedades bucodentales más prevalentes, con una tendencia al aumento de las maloclusiones. Se considera la promoción de salud como un proceso educativo a través del cual la comunidad logra ejercer control de su salud. Objetivo: Identificar las necesidades educativas sobre salud bucodental en el grado prescolar, en Sagua la Grande, Villa Clara, durante el curso escolar 2017-2018. Método: Investigación descriptiva transversal en Sagua la Grande, durante el curso 2017-2018. La población quedó constituida por 326 niños, 24 docentes y 326 familias. La variable estudiada fue necesidades educativas sobre salud bucodental en el grado preescolar. Resultados: Se evidenció que no se realizan acciones educativas sobre salud bucodental. No existen proyectos ni un programa de capacitación sobre salud bucodental para los docentes que la sustente. No es concebida la salud bucal dentro del sistema de trabajo metodológico del sector. No se analizan contenidos de salud bucodental en consejos de dirección y preparaciones metodológicas Los docentes realizan escasas acciones educativas sobre salud bucodental. El nivel de conocimientos sobre salud bucodental fue evaluado de mal en los niños (74,23 por ciento), en docentes (41,67 por ciento) y familias (47,24 por ciento). Conclusiones: Se evidenció que no se realizan acciones educativas sobre salud bucodental y predominó el nivel de conocimientos sobre salud bucodental evaluado de mal en niños, docentes y familias(AU)

Introduction: Dental caries and periodontal disease are the most prevalent oral conditions, with a tendency to an increase in malocclusions. Health promotion is considered to be an educational process by which the community gains control of their health. Objective: Identify the educational needs related to oral health in the preschool grade. Method: A descriptive cross-sectional study was conducted in Sagua la Grande during the school year 2017-2018. The study population was 326 children, 24 teachers and 326 families. The variable analyzed was educational needs related to oral health in the preschool grade. Results: It was found that educational actions related to oral health are not performed, nor is there an oral health training program for teachers or projects supporting it. Oral health is not included in the system of methodological work for the sector. Oral health contents are not discussed in management meetings or methodological preparation sessions. Teachers conduct a scant number of oral health educational actions. Knowledge about oral health was evaluated as poor in 74.23 percent of the children, 41.67 percent of the teachers and 47.24 percent of the families. Conclusions: It was found that oral health educational actions are not performed and knowledge about oral health is poor among children, teachers and families(AU)

Relationship Between Socio-Demographic Profile, Parity and Dental Caries Among a Group of Nursing Mothers in South East, Nigeria

ABSTRACT Objective: To determine the prevalence and risk indicators of caries among nursing mothers in a tertiary hospital. Material and Methods: This was a cross-sectional study of 408 nursing mothers aged 15 to 52 years who brought their children for immunization in a tertiary hospital in Enugu, Nigeria. Data on socio-demographic profile, parity, dental visits were collected. The presence of dental caries was recorded using the World Health Organization criteria. Results: The prevalence of dental caries was 11.0%, and the mean DMFT was 0.18. There was a statistically significant association between level of education (p<0.001), past dental visit (p<0.001) and the occurrence of dental caries. Caries was more prevalent in the mandibular teeth than the maxillary teeth. The left mandibular first and second permanent molars had the highest occurrence of dental caries. Missing (M) component of the DMFT index was highest and the care index was low. The significant predictors of caries among nursing mothers were fair oral hygiene and having below tertiary education. Conclusion: The prevalence of caries and the care index were both low in this study population. The significant predictors of dental caries were a tertiary level of education and poor oral hygiene. Incorporating oral health education during postnatal care can help reduce dental caries' occurrence and complications among nursing mothers in the study population.

Ortodontia em saúde coletiva: epidemiologia das oclusopatias e da necessidade de tratamento ortodôntico em adolescentes / Orthodontics in public health: epidemiology of malocclusions and the need for orthodontic treatment in adolescents

A Epidemiologia tornou-se um ramo da ciência muito utilizado para a verificação das necessidades da população, o planejamento de ações e a organização dos serviços em saúde. Para isso, primeiramente, é fundamental realizar o diagnóstico situacional, a partir de dados específicos, em busca da compreensão e atuação sobre os problemas de saúde encontrados em coletividade. As oclusopatias têm sido uma das condições bucais mais prevalentes e, em consequência, houve o crescimento da demanda por tratamento ortodôntico. Nesta perspectiva, índices oclusais foram elaborados para medir a ocorrência das oclusopatias tendo em vista a priorização da necessidade de tratamento. O conhecimento da temática em escala global permitiu uma visão ampliada do problema e das estratégias desenvolvidas em saúde bucal. Neste contexto, a presente pesquisa teve os seguintes objetivos: 1) realizar uma revisão sistemática das evidências científicas existentes sobre a prevalência da necessidade de tratamento ortodôntico em adolescentes na faixa etária de 12 à 15 anos de idade; 2) investigar a prevalência das oclusopatias e a necessidade normativa de tratamento ortodôntico em adolescentes de 12 anos de idade. Na revisão sistemática foram incluídos trabalhos nacionais e internacionais publicados nas bases de dados Cochrane, Embase, Portal Regional da Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Electronic Library Online (Scielo), Scopus e Web of Science (WOS). A busca inicial não se limitou a nenhum filtro disponível nas bases de dados e utilizou os seguintes descritores: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child e adolescent. Termos utilizados na literatura científica também foram empregados: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index e DAI index. Foram incluídas publicações que avaliaram a prevalência da necessidade de tratamento ortodôntico em adolescentes entre 12 à 15 anos de idade utilizando o Índice de Estética Dentária (DAI) e/ou Índice de Necessidade de Tratamento Ortodôntico (IOTN) em estudos epidemiológicos transversais, sem restrições de ano do periódico e idioma. Do total de artigos encontrados (n=2255), 525 estudos permaneceram após a remoção por duplicidade. Os títulos e resumos destas publicações foram avaliados e aplicando os critérios de exclusão, selecionou-se 38 artigos. Para elegibilidade, os critérios de inclusão foram empregados e 11 estudos foram eleitos. Os textos completos destas publicações foram obtidos para leitura e análise da qualidade metodológica. Com relação aos achados da necessidade de tratamento ortodôntico global, houve variabilidade nos resultados, mas observou-se que a prevalência foi considerada alta. Quanto às ações desenvolvidas, foram sugeridas a educação em saúde bucal para os adolescentes e pais com foco na prevenção e no tratamento interceptativo precoce das oclusopatias, bem como, inserção da ortodontia nos programas de saúde com a implantação de mais centros especializados. A segunda etapa desta pesquisa consistiu em um estudo observacional e transversal, realizado com 461 adolescentes de 12 anos de idade, matriculados em escolas públicas de um município de médio porte do Estado de São Paulo. A oclusão e a necessidade de tratamento ortodôntico foram avaliadas por meio da Classificação de Angle e do DAI. Os dados foram analisados utilizando estatística descritiva e as distribuições absolutas e percentuais das variáveis categóricas foram tabuladas. A verificação da associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle e o DAI foi realizada por meio do teste G, adotando-se um nível de significância de 5%. O processamento e a análise dos dados foram realizados com auxílio do Programa Epi-InfoTM versão 7.2. (Center for Disease Control and Prevention). O diagnóstico da oclusão, segundo a Classificação de Angle, mostrou que 8,89% apresentavam oclusão normal, 56,83% oclusopatia em Classe I, 24,08% em Classe II e 10,20% em Classe III. A prevalência da necessidade de tratamento ortodôntico, segundo o DAI, foi de 52,69% dos adolescentes considerando tratamento eletivo à obrigatório. Houve associação entre os resultados dos exames clínicos para diagnóstico de oclusopatias utilizando a Classificação de Angle com o DAI (p <0,0001). A prevalência das oclusopatias e da necessidade normativa de tratamento ortodôntico foi elevada, sendo 18,44% dos adolescentes com necessidade de tratamento obrigatório. Os índices foram eficazes para a identificação das oclusopatias, entretanto por avaliarem aspectos clínicos distintos, poderiam ser utilizados concomitantemente para aprimorar o diagnóstico das oclusopatias(AU)

Epidemiology has become a branch of science widely used to define the needs of the population, plan actions and organize health services. For this, first, it is essential to perform the situational diagnosis, based on specific data, in search of understanding and acting on the health problems found in the community. Malocclusion has been one of the most prevalent oral conditions and, as a result, there has been an increase in demand for orthodontic treatment. In this perspective, occlusal indexes were developed to measure the occurrence of malocclusions in order to prioritize the need for treatment. The knowledge of the theme on a global scale allowed an expanded view of the problem and the strategies developed in oral health. In this context, the present research had the following objectives: 1) to carry out a systematic review of the existing scientific evidence on the prevalence of the need for orthodontic treatment in adolescents aged 12 to 15 years old; 2) to investigate the prevalence of malocclusions and the normative need for orthodontic treatment in 12-year-old adolescents.The systematic review included national and international works published in the Cochrane, Embase, Regional Portal of the Virtual Health Library (VHL Regional Portal), PubMed, Scientific Electronic Library Online (Scielo), Scopus and Web of Science (WOS) databases. The initial search was not limited to any filter available in the databases and used the following descriptors: prevalence, epidemiology, malocclusion, index orthodontic treatment need, child and adolescent. In addition, terms used in the scientific literature were also used: orthodontic treatment need, index for need of orthodontic treatment, index of orthodontic treatment needs, IOTN index, dental aesthetic index and DAI index. Were included publications that evaluated the prevalence of the need for orthodontic treatment in adolescents between 12 and 15 years of age using the Dental Aesthetic Index (DAI) and / or Orthodontic Treatment Needs Index (IOTN) in cross-sectional epidemiological studies, without restrictions on year of the journal and language. Of the total articles found (n = 2255), 525 studies remained after removal due to duplication. The titles and abstracts of these publications were evaluated and applying the exclusion criteria, 38 articles were selected. For eligibility, the inclusion criteria were used and 11 studies were elected. The complete texts of these publications were obtained for reading and analysis of methodological quality. As for the actions developed, oral health education recommendations were suggested for adolescents and parents with a focus on prevention and early interceptive treatment of malocclusions, as well as insertion of orthodontics in health programs with the implementation and development of specialized centers. The second stage of this research consisted of an observational, crosssectional, survey-type study conducted with 461 12-year-old adolescents enrolled in public schools in the medium-sized municipality of the State of São Paulo. Occlusion and the need for orthodontic treatment were assessed using the Angle Classification and the DAI. The data were analyzed using descriptive statistics and the absolute and percentage distributions of categorical variables were tabulated. The verification of the association between the results of clinical exams for the diagnosis of malocclusions using the Angle Classification and the DAI was performed using the G test, adopting a significance level of 5%. Data processing and analysis were performed using the Epi-InfoTM version 7.2 program. (Center for Disease Control and Prevention). The diagnosis of occlusion, according to the Angle Classification, showed that 8.89% had normal occlusion, 56.83% occlusion Class I, 24.08% Class II and 10.20% Class III. The prevalence of the need for orthodontic treatment, according to the DAI, was 52.69% of adolescents considering elective treatment to mandatory treatment. There was an association between the results of clinical examinations for the diagnosis of malocclusions using the Angle Classification with the DAI (p <0.0001). The prevalence of malocclusions and the normative need for orthodontic treatment was high, with approximately 18,44% of adolescents in need of mandatory treatment. The indices were effective for the identification of malocclusions, however, by evaluating different clinical aspects, they could be used concomitantly to improve the diagnosis of malocclusions(AU)

Prevalência de consulta odontológica e fatores associados à sua realização durante o pré-natal: estudo transversal com puérperas em hospitais do Sistema Único de Saúde, Santa Catarina, 2019 / Consulta odontológica y factores asociados durante la atención prenatal: estudio transversal con puérperas en hospitales del Sistema Único de Salud, Santa Catarina, Brasil, 2019 / Prevalence of dental visits and its associated factors during prenatal care: a cross-sectional study with puerperal women in hospitals covered by the Brazilian National Health System, Santa Catarina State, Brazil, 2019

Objetivo: Analisar a prevalência de consulta odontológica e fatores associados a sua realização durante o pré-natal. Métodos: Estudo transversal, baseado em entrevistas com puérperas em 31 hospitais do Sistema Único de Saúde (SUS) de Santa Catarina, Brasil, 2019. Foram coletados dados sociodemográficos, econômicos e relacionados ao pré-natal. Foram realizadas análises multivariadas, mediante regressão logística, para calcular razões de chances (odds ratio, OR). Resultados: Foram incluídas 3.580 puérperas e 41,4% (intervalo de confiança de 95% [IC95%] 39,7;43,0%) realizaram consulta odontológica durante o pré-natal. Maior chance de consulta odontológica foi observada com maior escolaridade (OR=1,35 - IC95% 1,06;1,71) e maior número de consultas médicas/de enfermagem (OR=1,97 - IC95% 1,47;2,65); diminuiu essa chance não ter trabalho remunerado (OR=0,82 - IC95% 0,70;0,96) e não participar de atividade educativa no SUS (OR=0,63 - IC95% 0,52;0,77). Conclusão: Fatores relacionados a escolaridade, emprego, consultas de pré-natal e atividades educativas aumentaram a chance da consulta odontológica na gravidez em Santa Catarina.

Objetivo: Analizar la prevalencia y los factores asociados a la consulta odontológica durante la atención prenatal. Métodos: Estudio transversal a partir de entrevistas a puérperas de 31 hospitales del Sistema Único de Salud (SUS) de Santa Catarina, Brasil, 2019. Se recolectaron datos sociodemográficos, económicos y prenatales. Se realizaron análisis multivariados mediante regresión logística para calcular las razones de probabilidades (OR, razón de probabilidades). Resultados: Se incluyeron 3.580 puérperas y el 41,4% (intervalo de confianza del 95% [IC95%] 39,7;43,0%) se sometió a consultas dentales durante la atención prenatal. Se observó una mayor probabilidad de consulta a mayor escolaridad (OR=1,35 - IC95% 1,06;1,71) y un mayor número de consultas médicas/de enfermería (OR=1,97 - IC95% 1,47;2,65); disminuyó la probabilidad el no tener trabajo remunerado (OR=0,82 - IC95% 0,70;0,96) y no participar en una actividad educativa en el SUS (OR=0,63 - IC95% 0,52;0,77). Conclusión: Los factores relacionados con la educación, el empleo, las consultas prenatales y las actividades educativas aumentaron la posibilidad de consultas dentales durante el embarazo en Santa Catarina.

Objective: To assess the prevalence of dental visits and its associated factors during prenatal care. Methods: This was a cross-sectional study based on interviews conducted with puerperal women in 31 hospitals covered by the Brazilian National Health System (SUS) in Santa Catarina, Brazil, 2019. Sociodemographic, economic and prenatal-related data were collected. Multivariate analyses were performed using logistic regression to calculate odds ratios (OR). Results: 3,580 puerperal women and 41.4% (95% confidence interval [95%CI] 39.7;43%) underwent dental visits during prenatal care. Higher chance of dental visits was associated with higher education level (OR=1.35 - 95%CI 1.06;1.71) and a higher number of medical/nursing consultations (OR= 1.97 - 95%CI 1.47;2.65); this chance decreased when the puerperal women did not have paid work (OR=0.82 - 95%CI 0.70;0.96) and did not take part in education activities offered by the SUS (OR=0.63 - 95%CI 0.52;0.77). Conclusion: Factors related to schooling, employment, prenatal care and education activities increased the chance of dental visits during pregnancy in Santa Catarina State.

Um olhar sobre a saúde bucal de pacientes acamados domiciliados cadastrados em unidades da Estratégia Saúde da Família no município de Teresópolis/RJ / A perspective on the oral health of home care bedridden patients registered in ESF units in the city of Teresópolis/RJ

Resumo Saúde bucal deficiente pode interferir na saúde geral do indivíduo acamado, prolongando o tempo de recuperação ou agravando a enfermidade. Nesse contexto, esse estudo teve o objetivo de identificar os problemas de saúde bucal percebidos por cuidadores e pacientes acamados domiciliados cadastrados em unidades da ESF no município de Teresópolis, região serrana do Estado do Rio de janeiro. Realizou-se um estudo exploratório baseado em entrevistas. Os principais problemas de saúde bucal referidos foram a dor de dente, a cárie dental, os dentes permanentes perdidos, as lesões na mucosa e a doença periodontal. Esses resultados ajudam a compreender a real demanda de serviços odontológicos possibilitando oferecer um atendimento que respeite as prioridades dos indivíduos. Tais achados apontam para a necessidade de um maior suporte por parte da equipe de saúde para essas famílias. Existe a necessidade de atividades de educação em saúde bucal para o paciente e seu cuidador, orientação quanto a higiene oral, identificação de lesões orais e tratamento clínico.

Abstract Poor oral health may interfere with the general health of the bedridden subject, prolonging recovery time or aggravating the disease. In this context, this study aimed to identify oral health problems perceived by caregivers and home care bedridden patients registered in ESF units in the city of Teresópolis, located in the mountainous region of the state of Rio de Janeiro. An exploratory study based on interviews was conducted. The main referred oral health problems were toothache, dental caries, lost permanent teeth, mucosal lesions and periodontal disease. These results help to understand the demand for dental services, making it possible to provide a service that respects the individual's priorities. These findings point to the need for greater support from the health team for these families. There is a need for oral health education activities for the patient and their caregiver, guidance on oral hygiene, identification of oral lesions and clinical treatment.

Comunidades ribeirinhas do Amazonas têm conhecimento sobre cárie dentária: resultado da educação em saúde bucal / Knowledge about dental caries among ribeirinhos: result of oral health education / Comunidades ribereñas del Amazonas tienen conocimiento sobre la caries dental: resultado de la educación en salud bucal

O Amazonas é o maior estado brasileiro em extensão territorial, com uma parcela significativa da população vivendo em torno dos rios, as chamadas comunidades ribeirinhas. O acesso aos serviços de saúde por essas comunidades é limitado, levando à criação de projetos de saúde pública para prevenção e tratamento de doenças, assim como ações de educação em saúde. Diversas organizações não governamentais (ONG) e equipes de saúde atuam nessas comunidades com projetos de educação em saúde. Neste artigo, verificou-se a percepção dos pais sobre a saúde bucal de seus filhos e a importância dos cuidados da dentição decídua para prevenção da cárie dentária. Para isso, foram entrevistados trezentos pais ou responsáveis por crianças de zero a sete anos em comunidades ribeirinhas localizadas em três municípios do Amazonas (Parintins, Nhamundá e Barreirinha ­ N = 300, cem em cada município). A partir das entrevistas, pode-se concluir que as mães foram as principais respondentes (80%), cuja renda familiar é de até um salário mínimo (91%). Além disso, a maioria tinha conhecimentos sobre cárie dentária (56%), bem como já recebeu alguma orientação sobre como escovar os dentes (41%). Todas as crianças possuem escova de dentes e 94% delas utilizam dentifrício na escovação. Por fim, os pais foram considerados os principais responsáveis pela escovação dentária supervisionada de seus filhos (87%), embora apenas 44% deles a realize. Portanto, neste artigo, demonstra-se a efetividade das ações e dos projetos aplicados em comunidades ribeirinhas em relação à cárie dentária, ainda que exista a necessidade da continuidade dessas ações para mudanças efetivas de hábitos, impactando positivamente a saúde bucal das crianças ribeirinhas do Amazonas.

Amazonas is the largest Brazilian state in land area, with a significant portion of its population living near rivers, the so-called ribeirinhos. Since access to health care services by these communities is limited, specific public health actions and projects for health prevention, treatment and education are created. Several non-governmental organizations (NGOs) and health care teams work on health education projects on these communities. Given this context, this study investigated how parents perceived their children's oral health and the importance of deciduous dentition care for preventing dental caries. Data was collected by a questionnaire applied to 300 parents or guardians of children aged 0 to 7 years from three municipalities of Amazonas (Parintins, Nhamundá and Barreirinhas ­ 100 each). Mothers (80%) and homes living with a family income of up to 1 minimum wage (91%) comprised most of the sample. Most parents had knowledge about dental caries (56%) and had received some guidance on how to brush their children's teeth (41%). All children have a toothbrush and 94% of them use toothpaste. Finally, parents consider themselves the main responsible for supervised brushing (87%), although only 44% of them perform it. In conclusion, these findings attest to the effectiveness of actions and projects carried out in ribeirinho communities regarding dental caries, although continued actions are needed to change habits and positively impact the oral health of ribeirinho children living in Amazonas.

Amazonas es el estado brasileño más grande en extensión territorial, con una porción significativa de la población que vive alrededor de los ríos, las llamadas comunidades ribereñas. El acceso a los servicios de salud por parte de estas comunidades es limitado, lo que lleva a la creación de acciones y proyectos de salud pública para la prevención y el tratamiento de enfermedades, así como acciones de la educación en salud. Son varias las ONG que trabajan en estas comunidades con proyectos de educación en salud. En este artículo se evaluó la percepción de los padres sobre la salud bucal de sus hijos y la importancia de cuidar la dentición primaria en la prevención de la caries dental. Para ello, se entrevistaron a los padres o tutores de niños de 0 a 7 años, en las comunidades ribereñas de tres municipios de Amazonas (Parintins, Nhamundá y Barreirinhas ­N = 300, cien en cada municipio). Los resultados muestran que la madre fue la principal respondiente de la entrevista (80%), con un ingreso familiar de hasta 1 salario mínimo brasileño (91%). La mayoría tiene conocimiento sobre la caries dental (56%) y ya había recibido alguna orientación sobre cómo cepillarse los dientes (41%). Todos los niños tienen un cepillo de dientes, y el 94% de ellos usa pasta de dientes. Los padres se consideran los principales responsables del cepillado supervisado de sus hijos (87%), aunque solo el 44% de ellos lo realizan en sus hijos. Este artículo demuestra la efectividad de las acciones y proyectos llevados a cabo en comunidades ribereñas con respecto a la caries dental, pero es necesario continuar con estas acciones para que tengamos cambios en los hábitos e impactos positivos en la salud bucal de los niños que viven en las comunidades ribereñas del Amazonas.

Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries.

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand. The National Institute of Dental and Craniofacial Research (NIDCR) and Fogarty International Center (FIC), joined efforts on creating research capacity in oral health in South East Asia through the Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand (2006-2016). The University of Washington (USA), Thammasat University (Thailand) and Khon Kaen University (Thailand) partnered to conduct short-, medium- and long-term training programs to build regional oral health research capabilities. Investing in research has not only impacted trainees' career development but enhanced advancement of oral health research of South East Asia. The success of partnership calls for expanding oral health research training in other low-income countries.

Developing leadership in dentists and schoolteachers to improve oral health inequalities.

With oral diseases affecting people of all ages in every country of the world, new approaches are necessary to remove inequalities in oral health and increase access to oral health education. With over 1 billion children attending school, developing dental leadership skills not only in dental professionals but also in schoolteachers will help to spread oral health prevention messages effectively, implement healthy habits at a young age and impact a greater proportion of the global population to improve their oral health.

Systematic review of the tools of oral and dental health literacy: assessment of conceptual dimensions and psychometric properties.

BACKGROUND: This article aims to provide a description of conceptual dimensions and psychometric properties of the tools of oral and dental health literacy. METHODS: Two authors in this study conducted electronic searches in the Medline (via PubMed), and Embase databases to find relevant articles from 1990 to present day. Evaluation of the tools was carried out in two parts; general evaluation of the tools using skills introduced by Sørensen et al., and qualitative assessment of psychometric properties using COSMIN checklist. RESULTS: After reviewing 1839 articles on oral and dental health literacy and evaluating 33 full text articles for eligibility, 21 articles entered the study. The sample size varied from 20 to 1405 subjects and the items of each tool ranged from 11 to 99 items. Of the 21 tools examined, 16 tools were evaluated for word recognition. For the studies examined, the evaluation of COSMIN scores was often fair or good. Of the 21 tools examined, 9 tools at least in one dimension were in the category of "poor", 19 tools were in the category of "fair", 20 tools were in the category of "good", and 4 tools were in the category of "excellent" in at least one dimension. CONCLUSION: The findings of this study showed that some aspects of oral and dental health literacy are being ignored in the existing tools. Therefore, the authors of present study emphasize on the necessity to design and develop a comprehensive tool and take into account two characteristics of simplicity and briefness for international use.

Social story-based oral health promotion for preschool children with special healthcare needs: A 24-month randomized controlled trial.

OBJECTIVES: This study aimed to investigate the efficacy of the social story-based intervention in promoting the oral health status among preschool children with special healthcare needs. METHODS: The 24-month randomized controlled trial recruited 306 children from centres that provided educational training for 2- to 6-year-old children who had special healthcare needs. The participants received standardized toothbrushing training and oral health education materials. The education materials for children in the test group were validated social stories, while materials for children in the control group were standard leaflets. Those materials were introduced in each training session and used at home by parents. Children's oral health status and oral health-related behaviours were assessed before and after interventions. Data were analysed via generalized estimating equations, negative binomial regression and binary logistic regression. RESULTS: There was no significant difference in caries experience among children in both groups after 24 months. However, children in the test group showed better oral hygiene status and better toothbrushing performance, and they were more likely to visit a dentist (OR = 2.00, 95% CI:1.15,3.49) than their peers in the control group. Caries progression was more likely to be observed among children who had low social skills or whose parents were not working full-time. Children from high-income families showed better oral hygiene status than their peers (Estimate = -0.11, 95%CI: -0.20,-0.01). CONCLUSION: Social stories could be used to improve oral health-related behaviours among young children with SHCN. The efficacy of the intervention might be associated with children's adaptive skills and family socio-demographic status.

Benefits of Oral Health Education at Women, Infant, and Children (WIC) Clinic Visits: Assessments of Parent's Oral Health Beliefs, Behaviors and Dental Access in O'ahu, Hawai'i.

Improving oral health outcomes in Hawai'i for children and families remains a high priority. Children in the state are leading the nation with the highest caries rates, while women before, during, and after pregnancy are failing to receive regular and necessary dental care resulting in poor health outcomes. To answer for this need, an educational intervention was conducted among families enrolled in the Kapi'olani Medical Center for Women and Children's Women, Infant, and Children program (WIC) in O'ahu. The project included the following activities: (1) identification the oral health beliefs and behaviors of families, (2) providing oral health education to families, and (3) reassessing beliefs and behaviors in 3-6 months to document the impact of theeducation session. Participants consisted of 81 families resulting in the data on 176 children and 4 pregnant women. Of the 81 families, 40 representing84 children completed the follow-up oral health questionnaire. Results of the assessment and education demonstrated a positive impact on the family's oral health behaviors. Parents were 6.61 times as likely to report using fluoride toothpaste in the follow-up visit compared to their initial visit (95% confidence interval [CI] = 3.12-14.00). Additionally, statistically significant changes were noted in the frequency of children's daily tooth brushing (odds ratio [OR] = 2.15, 95% CI = 1.33-3.46), as well as in the incidence of children receiving fluoride varnish application over time (OR = 2.66, 95% CI = 1.50-4.73). These results provide further evidence that initiating a simple educational intervention can have a positive impact on oral health behaviors in groups that are at highest risk for developing dental disease in Hawai'i.

Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study.

BACKGROUND: The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE. METHODS: Children aged 3-5 years old (N = 1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and caregivers' oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses. RESULTS: The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits (P < 0.05, chi-square tests). Complete breastfeeding within 6 months of birth primarily contributed to the high ECC risk of the 3-year-old group (OR: 3.39, 95% CI: 1.41-8.17), while high frequency bedtime sweet consumption mainly contributed to that of the 5-year-old group (OR: 3.22, 95% CI: 1.03-10.06; logistic regression analysis). Tooth brushing was not associated with ECC in this study, and some positive knowledge and attitude variables were positively correlated with a high risk of ECC. CONCLUSION: These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. We should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage preventive dental visit and supplemental training for oral health practices.

Regular dental care in preschoolers in rural Southern Brazil.

OBJECTIVE: To evaluate if factors related to the mother's previous guidance on her children's dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS: A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children's care in daycare centers or schools and maternal guidance on the child's dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS: The prevalence of regular use was 11.4% (95%CI 7.5-15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38-4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77-9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION: When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.