Physical violence in children and adolescents: a retrospective study of injuries to the head and neck region

Aim: This study aimed to investigate the prevalence of physical violence and head and neck injuries among children and adolescents who suffered physical aggression, firearm aggression, and white gun aggression referred to the Legal Medical Department in a southern city in Brazil. Methods: This study was performed at Legal Medical Department in the city of Pelotas, RS, Brazil, from January 2011 to December of 2015. Data were collected from medical reports of children and adolescents (0-19 years old). Demographic information such as sex, age, and skin color was collected. Data were submitted to Chi-square test and multivariate Poisson regression analysis. Results: In this study, 2,716 physical examination reports were analyzed, with a total of 2,171 exams resulting from violence; lesions that had physical aggression as their etiology (1,951) had a higher prevalence. The analysis of the exams revealed that the majority were adolescents (90,05%), white (84.09%), and female (50.21%). The head and neck regions were affected in most cases of violence (57.90%). In the adjusted model, the occurrence of injuries in the head and neck region was higher in males (PR 1.16, CI 95% 1.08 - 1.25), among adolescents (PR 1.28, CI 95% 1.10 - 1.48) and in victims of physical aggression compared to victims of the firearm (2.81, CI 95% 1.79 - 4.40). Conclusion: The results revealed a high prevalence of head and face injuries in victims of violence and that there was a greater prevalence of physical violence among adolescents compared to children and males

Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

Abstract: This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.

How common is dry mouth? systematic review and meta-regression analysis of prevalence estimates

Abstract The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

Resumo O objetivo do estudo é revisar sistematicamente a literatura afim de estimar a prevalência global de xerostomia/hiposalivação em estudos epidemiológicos. Uma busca eletrônica foi conduzida até Fevereiro de 2018 sem restrições de linguagem. Um total de 5760 títulos foram inicialmente identificados e somente vinte e nove artigos foram incluídos na revisão e meta-análise após dois revisores independentes aplicarem os critérios de seleção. Os artigos foram extraídos das bases de dados PubMed/Medline e Web of Science. Os critérios de elegibilidade incluíram investigações originais de estudos observacionais de base populacional os quais reportaram a prevalência de xerostomia ou dados que permitissem o cálculo da prevalência de xerostomia e/ou hiposalivação. Estudos realizados em populações com condições de saúde específicas, revisões de literatura, relato de casos e estudos antropológicos, assim como, conferências ou comentários foram excluídos. Tamanho amostral, localização geográfica aonde foi realizado o estudo, desenho do estudo, idade da população estudada, métodos de diagnóstico e o critério de avaliação para determiner xerostomia e/ou hiposalivação foram extraídos para a meta-análise e metaregressão. Análise de meta-regressão multípla foi realizada para explorar a heterogeneidade entre os estudos. A prevalência global estimada de boca seca foi de 22.0% (95%IC 17.0-26.0%). Uma maior prevalência de xerostomia foi observada em estudos realizados exclusivamente em populações idosas. Apesar de diferentes abordagens utilizadas para mensurar as condições de interesse, cerca de uma em quatro pessoas é acometida por xerostomia, com taxas mais elevadas sendo observadas na população idosa. Além disso, os métodos de mensuração podem ter super- ou subestimado os valores de xerostomia. Os achados do presente estudo salientam a necessidade de mais estudos acerca das existentes e novas formas de avaliação clínica, os quais serão úteis para determinar qual é a mais confiável para as perspectivas clínicas e epidemiológicas.

Tooth Erosion Association with Obesity: Findings from a Brazilian Survey in Schoolchildren

Objective: To evaluate a possible association between tooth erosion and weight status in Brazilian schoolchildren. Material and Methods: 1211 children aged 8-12-year-old from public and private schools in Southern Brazil were selected by a two-stage cluster method. Oral conditions were assessed by six trained and calibrated examiners. Tooth erosion assessment was determined by using the O´Sullivan index. Anthropometric measures were taken in order to obtain the body mass index. Socio-demographic and behavioral data were collected using questionnaires in children and parents. Multivariate Poisson regression model considering the cluster sample was used for data analysis (Prevalence ratio - PR; 95% Confidence Interval - CI). Results: Tooth erosion was observed in 25.1% of the children. Obesity and overweight prevalence was 34.6%. In the multivariate adjusted model, tooth erosion was associated with children from private schools (PR 1.68; 95%CI 1.05-2.68) and higher frequency of physical activity weekly (PR 1.48; 95%CI 1.04-2.09), whereas dental crowding in both arches was considered a protective effect (PR 0.55; 95%CI 0.34-0.89). In the stratified analysis regarding the type of school, children from private schools presented a positive association between tooth erosion and obesity (PR 3.26; 95%CI 1.38-7.69). Conclusion: Tooth erosion was not associated with obesity in the total sample. Socioeconomic differences seem to influence the relationship tooth erosion and obesity.

Exploratory and confirmatory factorial analysis of the OHIP-Edent instrument

Abstract Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients' wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach's alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated "Physical Impact", "Psychological Impact" and "Social Impact". In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the "Physical Impact", "Psychological Impact", and "Social Impact" of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

How has dental pulp stem cells isolation been conducted? A scoping review

Abstract: The objective of this study was to realize a scoping review the literature in order to identify the profile of DPSCs isolation and analyze the possible risk factors that could change the native behavior of these cells. An initial search was conducted using the following MeSH terms: "(dental pulp stem cell [MeSH])"; "(dental pulp [MeSH])" AND "(stem cell [MeSH])"; "("dental pulp stem cell" [MeSH]")". The electronic search was done without date restriction up to and including April 2014, in PubMed, Scopus, Scielo and ISI Web of Knowledge databases. Studies were submitted to inclusion and exclusion criteria and 222 articles were included. Data showed that over the past 15 years many studies have been conducted using DPSCs. However this is the first systematic review regarding the isolation of stem cell, and more specifically of dental pulp stem cells. The isolation of dental pulp stem cells showed great variability, hampering the development of standard protocols to achieve in vitro dental pulp stem cells with similar characteristics. This scoping review combined, for the first time, the methodologies used for dental pulp stem isolation, highlighting the most frequently used.

Short-term quality of life change perceived by patients after transition to mandibular overdentures

Abstract The aim of this longitudinal observational study was to evaluate the oral health-related quality of life (OHRQoL) following patient rehabilitation with implant-retained mandibular overdentures (IMO) and to identify the contribution of the different domains to OHRQoL. The Oral Health Impact Profile (OHIP-EDENT), Dental Impact on Daily Living (DIDL), and Geriatric Oral Health Assessment Index (GOHAI) questionnaires were completed twice by 25 patients: after 3 months of rehabilitation with complete dentures (CD) and after 3 months of IMO loading using stud abutments. The evaluation after IMO rehabilitation showed significant improvement in three DIDL domains: appearance (p = 0.011), eating and chewing (p = 0.003), and general performance (p = 0.003). The GOHAI results showed significant differences in two domains: psychosocial (p = 0.005) and pain and discomfort (p = 0.0004). The OHIP-EDENT outcomes showed significant improvements in five domains: functional limitation (p = 0.0001), physical pain (p = 0.0002), physical disability (p = 0.0010), and psychological disability and handicap (p = 0.032). The largest observed effect sizes were close to one standard deviation and were observed in the eating and chewing domain (0.93) of the DIDL; the pain and discomfort domain (0.83) of the GOHAI, and the functional limitation (0.89), physical pain (1.02), physical disability (0.84) domains of the OHIP-EDENT. The percentage of satisfied patients increased in all domains. Self-reported OHRQoL of CD wearers was significantly improved after 3 months of treatment with IMO, especially concerning the functional and pain-related aspects.

Edentulism, Severe Tooth Loss and Lack of Functional Dentition in Elders: A Study in Southern Brazil

Abstract The aim of this study was to estimate self-reported prevalence of edentulism, severe tooth loss and lack of functional dentition in elders, and to identify potential associated factors. A population based cross-sectional study was carried out with 1,451 elders (≥60 years), in Pelotas, RS, Brazil. Crude and adjusted prevalence ratios were estimated using Poisson regressions. The prevalence of edentulism, severe tooth loss and lack of functional dentition was 39.3%, 60.9% and 82.7%, respectively. The factors positively associated with tooth loss in the three-degree severity were sex (females), older individuals, low familial income, low level of schooling and having the last dental visit longer than 24 months ago. The high prevalence of tooth loss in its different degrees of severity and the association with preventable factors highlight the need of programs focused on elders, emphasizing the prevention of tooth loss and need for prosthetic rehabilitation.

Resumo O objetivo deste estudo foi estimar as prevalências autorreferidas de edentulismo, perda dentária severa e ausência de dentição funcional em idosos, assim como identificar potenciais fatores associados. Um estudo transversal de base populacional foi realizado com 1.451 idosos (≥60 anos), em Pelotas, RS, Brasil. Razões de prevalência brutas e ajustadas foram estimadas por meio de regressões de Poisson. As prevalências verificadas foram 39,3% para edentulismo, 60,9% para perda dentária severa e 82,7% para ausência de dentição funcional. Os fatores associados positivamente à perda dentária nos seus três diferentes graus de severidade foram sexo feminino, idade avançada, baixa renda familiar, baixa escolaridade e última consulta odontológica há mais de 24 meses. As altas prevalências de perda dentária nos seus diferentes graus de severidade e a constatação de fatores associados passíveis de intervenção alertam para necessidade de medidas e programas que priorizem a faixa etária idosa com ênfase na prevenção da perda dentária e na reabilitação protética.

Use of motorcycle in Brazil: users profile, prevalence of use and traffic accidents occurrence - a population-based study / Uso de motocicletas no Brasil: perfil dos usuários, prevalência de uso e ocorrência de acidentes de trânsito - estudo de base populacional

Abstract This study aimed to describe the profile of motorcycle users and determine the prevalence of use. Also, to evaluate the reason for using a motorcycle, users' perceived risk of traffic accident, pattern of helmet wearing and number of accidents related to motorcycle use in the last 12 months. This cross-sectional study was conducted in the city of Pelotas, Southern Brazil. Sampling process was carried out in two stages, with the primary unit being the census track and the secondary the house. The study included 3,004 individuals aged 10 to 59 years, which answered a structured questionnaire. The outcome of the study was the use of motorcycle. The prevalence of motorcycle use was 25%. The majority of the riders were composed by males (79%). Individuals aged from 18 to 35-years-old comprised 42% of the total number of users, mainly as riders (24%). Forty percent of the users were not using properly the helmet strap. The major part of the users (76%) had a perception of high risk for accidents. The prevalence of accidents was 8%; it was higher among males and among those individuals aged from 18 to 35 years. The use of motorcycle was widespread in the population. Users were aware of the risk of accident, even though they reported to not wear correctly the helmet.

Resumo Este estudo buscou descrever o perfil dos usuários de motocicleta e determinar a prevalência de uso desta. Além disso, avaliar a razão para o uso da motocicleta, o risco percebido de acidente de trânsito, o padrão de uso do capacete e o número de acidentes com injúrias ocorridos nos últimos 12 meses. Estudo transversal realizado na cidade de Pelotas com processo de amostragem conduzido em dois estágios. A primeira unidade foi o setor censitário e a segunda a casa dos indivíduos. Foram incluídos 3.004 indivíduos com idades entre 10 e 59 anos, que responderam um questionário estruturado. O desfecho do estudo foi o uso de motocicleta. A prevalência do uso de motocicleta foi de 25,1%. A maioria dos motociclistas foi composta por homens (79%). Indivíduos com idade entre 18 e 35 anos representaram 42% do total de usuários, especialmente como motoristas (24%), e 40% reportaram não usar adequadamente o capacete. A maior parte dos usuários (76%) considerou estar em alto risco para acidentes. A prevalência de acidentes foi de 8%, sendo mais alto entre os homens e entre os indivíduos com idade entre 18 a 35 anos. A motocicleta é amplamente usada nesta população. Usuários estão cientes do risco de acidentes, embora tenham reportado não usar o capacete de forma adequada.

Use of Fusidic Acid for Desquamative Gingivitis Treatment: 1-Year Follow-Up

This study evaluated retrospectively the effect of fusidic acid on the management of desquamative gingivitis (DG). The study population consisted of 15 patients with DG. Patients were requested to make topical application of 2% fusidic acid ointment 4 times a day for 6 weeks. Clinical assessments were recorded at baseline, at 6 weeks and 12 months after beginning the therapy. Patients' examination involved lesion size area, pain score and impact on daily activities. All patients presented lesions in maxilla; in 9 patients (60.0%) lesions were predominately at the anterior region and 6 (40.0%) at the posterior region of maxilla. Treatment significantly (p<0.05) reduced the pain intensity (from 5.4±1.12 to 1.16±0.97) and its periodicity (from 53.33% with pain>3 x/week to 13.33%), and the lesion size in 72.47% (±4.12) immediately after 6 weeks of treatment. Improvements were sustained for 12 months compared to baseline (p<0.001). It also reduced the impact of disease in daily activities (eating and oral hygiene performance), and improved the emotional condition of patients, who reported better social relationships and habits. Topical application of fusidic acid may be a possible alternative local palliative therapy for desquamative gingivitis treatment.

Este estudo avaliou retrospectivamente o efeito do ácido fusídico sobre o manejo da gengivite descamativa (DG). A população do estudo consistiu de 15 pacientes com DG. Os pacientes foram solicitados a fazer aplicação tópica de pomada de ácido fusídico 2% 4 vezes ao dia, durante 6 semanas. As avaliações clínicas foram registradas no início do estudo, em 6 semanas e 12 meses após o início da terapia. O exame dos pacientes envolveu tamanho da área da lesão, intensidade da dor e impacto nas atividades diárias. Todos os pacientes apresentaram lesões na maxila; em 9 pacientes (60,0%) as lesões foram predominantemente na região anterior e em 6 (40,0%) na região posterior da maxila. O tratamento significantemente (p<0,05) reduziu a intensidade da dor (de 5,4±1,12 para 1,16±0,97) e a sua periodicidade (de 53,33% com dor>3x/semana para 13,33%), e o tamanho da lesão em 72,47% (±4,12) imediatamente após 6 semanas de tratamento. As melhorias foram sustentadas por 12 meses, quando comparado aos valores iniciais (p<0,001). Também reduziu o impacto da doença nas atividades diárias (alimentação e desempenho de higiene oral), e melhorou a condição emocional dos pacientes, que relataram melhores relações e hábitos sociais. A aplicação tópica de ácido fusídico pode ser uma alternativa para terapia local paliativa no tratamento de gengivite descamativa.

Obesidade e saúde bucal: impacto da obesidade sobre condições bucais / Obesity and oral health: impact of obesity on oral conditions

Objetivo: o objetivo deste estudo foi observar a existência de uma possível relação entre a obesidade e as seguintes doenças bucais: cárie, doenças periodontais e traumatismo dental. Revisão de literatura: a obesidade é considerada uma doença crônica de causa multifatorial, sendo uma complexa associação de fatores genéticos, ambientais, socioeconômicos, biológicos e comportamentais. Sua prevalência vem crescendo entre pessoas de todas as idades, tanto em países de alta renda, quanto em países de baixa e média renda, elencando essa doença como um dos maiores problemas de saúde pública mundial. Além disso, essa condição tem sido apontada como um importante fator de risco a outras doenças como diabetes tipo II, hipertensão, doenças cardiovasculares, câncer, além de problemas psicossociais que afetam diretamente a vida do indivíduo. As doenças bucais também se destacam pela sua etiologia multifatorial e pelo seu desenvolvimento crônico. Essas doenças têm sido apontadas como significantes marcadores biológicos e sociais, e parecem estar ligadas a outras doenças sistêmicas, entre essas, a obesidade. Estudos apontam uma possível associação entre o estado nutricional e a cárie dentária, as doenças periodontais e o traumatismo dentário. Considerações finais: os resultados, entretanto, são controversos entre os diferentes estudos, destacando a ainda existente falta de evidências que suportem essa associação.

Blood clot stabilization on root dentin conditioned by the combination of tetracycline and EDTA

AIM: To assess the combined use of tetracycline (TTC) and ethylenediaminetetraacetic acid (EDTA) on clot formation, considering that EDTA may neutralize TTC acidity. METHODS: Planed human tooth roots were treated with saline solution, EDTA, TTC and their combination (EDTA followed by TTC and TTC before EDTA). Fresh human blood was applied on the conditioned surfaces to check clot adhesion and stabilization. A previously calibrated (kappa = 0.93) and blinded examiner scored scanning electron micrographs of the samples. Statistical analyses were performed using one-way ANOVA and Tukey's test. RESULTS: Application of TTC before EDTA presented the best results with the highest number of cells adhered to the root surface (p=0.046). Use of EDTA alone and EDTA before TTC disturbed clot stabilization when compared to control group (p<0.01). CONCLUSIONS: The use of TTC before EDTA seems to be able to keep blood cells viable to establish an organized clot and could be used by clinicians together with the conventional mechanical root scaling and planing...

Do Clinical Experience Time and Postgraduate Training Influence the Choice of Materials for Posterior Restorations? Results of a Survey with Brazilian General Dentists

The aims of this study were to evaluate the materials available for posterior restorations and to assess whether clinical experience time and post-graduate training influence dentists' choices. A cross-sectional study was conducted using a questionnaire with closed questions applied to dentists (n=276) of a mid-sized city of the southern Brazil. Information was collected regarding sociodemographic variables, level of specialization, time since graduation and working place. In addition, options regarding posterior restorations including the first choice of material, type of composite resin (if used) and use of rubber dam were also collected data. Data were submitted to descriptive analysis and the associations were evaluated using chi-square and Fisher's exact tests (α=0.05). The response rate was 68% (187). Direct composite resin was broadly indicated (73.2%) as the first-choice for posterior restorations. Most professionals used microhybrid composite (74.5%) and 42.6% of the participants used rubber dam for placement of posterior composite restorations. Dentists with more time of clinical practice used less composite (p=0.014). Specialists used more frequently rubber dam to restore posterior teeth than did non-specialists (p=0.006). The results of this survey revealed that direct composite was the first choice of dentists for posterior restorations; microhybrid was the preferred type of composite and the use of rubber dam for composite resin placement in posterior teeth was not frequent; time since graduation and level of specialization affected dentists' choices.

O objetivo deste estudo foi avaliar as possíveis opções restauradoras para dentes posteriores. Além disso, foi avaliada a possível relação entre tempo de formação e grau de formação profissional com suas escolhas. Este estudo transversal foi realizado a partir de questionários respondidos por cirurgiões-dentistas da cidade de Pelotas/RS. Foram avaliadas variáveis sociodemográficas, nível de especialização e ano de graduação. Além disso, foram obtidas informações sobre a primeira opção restauradora para dentes posteriores, tipo de resina composta e uso de isolamento absoluto. Dados foram submetidos à análise descritiva, e as associações foram testadas por meio do teste de Chi-quadrado ou do teste exato de Fisher, quando apropriado. A taxa de resposta foi de 68%. Os cirurgiões-dentistas, em sua maioria, escolheram o uso de resina composta como a primeira opção restauradora para dentes posteriores. Em relação ao tipo de resina usada, a maioria dos profissionais escolheu a resina microhíbrida; e apenas 42.6% utilizou isolamento absoluto para a realização da restauração posterior. Cirurgiões-dentistas com mais tempo de graduação utilizaram menos resina composta para dentes posteriores (p=0.014). Cirurgiões-dentistas que frequentaram cursos de pós-graduação usaram mais isolamento absoluto (p=0.006). Restauração direta de resina composta foi a primeira opção de tratamento restaurador para dentes posteriores; resina composta microhíbrida foi o tipo de resina preferido pelos cirurgiões-dentistas e o uso de isolamento absoluto para realização de restaurações posteriores não foi frequente. Tempo desde a graduação e grau de especialização influenciaram a escolha dos cirurgiões-dentistas.

Non-white people have a greater risk for maxillofacial trauma: findings from a 24-month retrospective study in Brazil

AIM: To identify the predominant causes and types of maxillofacial trauma in Brazil. METHODS: Reports of corporal trauma (7,536) between 2009-2010 in the Brazilian Institute of Forensic Medicine were analyzed as to the presence of maxillofacial traumas. Victims' demographic and trauma characteristics were recorded. RESULTS: Data were submitted to chi-square test and to multivariate Poisson regression. 778 reports referred maxillofacial trauma. Most victims were men (50.8%) around 27.6 years. Main causes were physical aggression (88.1%) and traffic accidents (6.7%). The most affected extraoral area was the middle third (60.7%). Risk for trauma in the middle third was significantly higher among patients aged 61-75 (RR 1.32), and non-white patients (black-skinned RR 1.21; brown-skinned RR 1.18); while falls were associated with trauma in the lower third (RR1.79). CONCLUSIONS: Violence was the main cause of maxillofacial trauma. Prevention of interpersonal violence may be a key element to prevent maxillofacial trauma.

Iniquidades em saúde bucal: escolares beneficiários do Bolsa Família são mais vulneráveis? / Inequalities in oral health: are schoolchildren receiving the Bolsa Família more vulnerable? / Inequidades en salud bucal: escolares beneficiarios de la Beca Familia son más vulnerables?

OBJECTIVE: To evaluate the association between being a recipient of the Bolsa Família program and oral health conditions in Brazilian schoolchildren.METHODS: A cross-sectional study was conducted with 1,107 schoolchildren aged between eight and 12 years from 20 public and private schools in Pelotas, RS, Southern Brazil. A list of all children receiving the Bolsa Família program was provided by the participant schools. Demographic, socioeconomic and oral hygiene information were assessed using a questionnaire completed by the schoolchildren and their parents. Dental exams were performed to assess the presence of dental plaque and prevalence of dental caries. Data were analyzed by Chi-square test, Chi-square test for linear trend and multivariate Poisson Regression (prevalence ratio; 95% confidence interval).RESULTS: Schoolchildren from non-nuclear families, with a DMFT ≥ 1 and who had never visited a dentist were associated with receiving the Bolsa Família. Final model showed that caries prevalence was twice as high (PR 2.00; 95%CI 1.47;2.69) in schoolchildren benefiting from the Bolsa Família . It was also showed that schoolchildren benefiting from the program presented greater severity of dental caries compared to school children from private schools (RR 1.53; 95%CI 1.18;2.00). After final adjustments, the prevalence of schoolchildren who have never visited a dentist was six times higher in children who received the government benefit (PR 6.18; 95%CI 3.07;12.45) compared to those from private schools.CONCLUSIONS: Schoolchildren benefiting from the Bolsa Família program experienced more caries lesions and have less frequently accessed dental care services, which suggest the need to include oral health in the program.

OBJETIVO: Analisar a associação entre ser beneficiário do Programa Bolsa Família e condições de saúde bucal entre escolares.MÉTODOS: Estudo transversal com 1.107 escolares entre oito e 12 anos de idade, provenientes de 20 escolas públicas e particulares da cidade de Pelotas, RS, em 2010. Os beneficiários do Programa Bolsa Família foram verificados por meio de lista fornecida pelas escolas participantes do estudo. Informações demográficas, socioeconômicas, de uso de serviço odontológico e de higiene bucal foram obtidas por meio de questionários respondidos pelos escolares e por seus pais. O exame clínico avaliou a presença de placa dental e experiência de cárie. Os dados foram analisados por meio dos testes do Qui-quadrado e Qui-quadrado de tendência linear e por regressão de Poisson (razão de prevalência; intervalo de confiança de 95%).RESULTADOS: Crianças de família não nuclear, que apresentavam CPOD ≥ 1 e que nunca haviam feito uso de serviço odontológico na vida estiveram associadas ao recebimento do Programa Bolsa Família. O modelo final mostrou que a prevalência de cárie foi duas vezes maior (RP 2,00; IC95% 1,47;2,69) em alunos beneficiários do Programa que também apresentaram maior severidade da doença, quando comparados aos alunos de escolas particulares (RM 1,53; IC95% 1,18;2,00). A prevalência de escolares que nunca haviam ido ao dentista foi mais de seis vezes maior em beneficiários do Programa Bolsa Família (RP 6,18; IC95% 3,07;12,45), em comparação com aqueles das escolas privadas, após ajustes.CONCLUSÕES: Escolares beneficiários do Programa Bolsa Família possuem maior carga de cárie e são os que menos acessam os serviços odontológicos. Esses achados sugerem a necessidade de incorporação da saúde bucal nas condicionalidades do Programa Bolsa Família.

OBJETIVO: Analizar la asociación entre ser beneficiario del Programa Beca Familia y condiciones de salud bucal entre escolares.MÉTODOS: Estudio transversal con 1.107 escolares entre ocho y 12 años de edad, provenientes de 20 escuelas públicas y privadas de la ciudad de Pelotas, RS, Brasil, en 2010. El beneficiario del Programa Beca Familia fue verificado por medio de lista suministrada por las escuelas participantes del estudio. Informaciones demográficas, socioeconómicas, de uso de servicio odontológico y de higiene bucal fueron obtenidas por medio de cuestionarios respondidos por los escolares y por sus padres. El examen clínico evaluó la presencia de placa dental y experiencia de caries. Los datos fueron analizados por medio de las pruebas de Chi-cuadrado y Chi-cuadrado de tendencia linear y por regresión de Poisson (cociente de prevalencia; intervalo de confianza de 95%).RESULTADOS: Niños de familia no nuclear, que presentaban COPD ≥1 y que nunca habían hecho uso de servicio odontológico en la vida estuvieron asociados al recibimiento en el Programa Beca Familia. El modelo final mostró que la prevalencia de caries fue dos veces mayor (RP 2,00; IC95% 1,47;2,69) en alumnos beneficiarios del Programa que también presentaron mayor severidad de la enfermedad, al ser comparados con los alumnos de escuelas privadas (RR 1,53; IC95% 1,18;2,00). La prevalencia de escolares que nunca habían ido al dentista fue más de seis veces mayor en beneficiarios del Programa Beca Familia (RP 6,18; IC95% 3,07;12,45), en comparación con aquellos de escuelas privadas, posterior a los ajustes.CONCLUSIONES: Escolares beneficiarios del Programa Beca Familia poseen mayor carga de caries y son los que menos tienen hacen uso de los servicios odontológicos. Estos resultados sugieren la necesidad de incorporar salud bucal en las condiciones del Programa Beca Familia.

Perfil de utilização dos serviços odontológicos na Atenção Primária à Saúde: experiência de duas unidades de saúde do município de Porto Alegre – Rio Grande do Sul / Oral health care in primary care attention: experience from two facilities of Porto Alegre – Rio Grande do Sul

Objetivo: estabelecer o perfil de utilização dos serviços odontológicosnas Unidades de Saúde SE SC e NSA do Grupo Hospitalar Conceição. Materiais e métodos: analisou-se o relatório do Sistema de Informação - SIS dasconsultas odontológicas (meses junho aagosto/2011). As variáveis foram: características sócio-demográficas(idade, gênero e microárea), motivo da consulta (CID-10) e tipo de consulta ambulatorial: consulta programada ou consulta não programada. Resultados: na US NSA prevaleceu os usuários do gênero feminino, faixa etária 35-44 anos, proveniente da microárea NSA3; o acesso aos serviços odontológicos foi por consultas programadas, e o códigoCID-10 de cárie dentária foi o mais freqüente. Na US SESC destaca-se de diferente a faixa etária de 0-11 anos e maior utilização do código CID-10 de primeira consulta odontológica programada. Conclusão: Os achados demonstram que é possível utilizar os dados do SIS para conhecer o perfil de utilização e a partir destes organizaro acesso em SB, baseado nos princípios APS.

Aim: Describe the dental service utilization profile from US NSA andUS SESC–Grupo Hospitalar Conceição.Materials and methods: The study evaluated a Sistema de Informações– SIS’ report obtained from dental appointments (June and August 2011. The variables were: demographic (age, gender and territory), aim of appointment (ICD-10) and type of it (booked or urgent). Results : Mostpatients from US NSA were women, age 35-44 years, coming from the area NSA3; seeking for booked appointments for treating dental caries. At US SESC, most patients were women, age 0-11 years, from the area SESC2, with a greater rate of booked appointments and utilization for complete dental exam/dental appointment to children 0-3 years. Conclusion: The results show that increasing the use of SIS data forDentistry can support the upgrading of resource distribution and management of oral health care in accor dance with the principles of Primary Care Attention.