Atenção básica em saúde bucal: a experiência no curso de graduação / Primary dental care: the experience in the undergraduate courses

INTRODUÇÃO: A participação do cirurgião-dentista na atenção básica fomenta a importância da formação do profissional de clínica geral como generalista, bem como a necessidade do perfil de um profissional de saúde, com olhar holístico sobre o paciente. RELATO DE EXPERIÊNCIA: O presente artigo tem como objetivo relatar a experiência vivenciada na implantação da Clínica de Atenção Básica no curso de Odontologia (CAB). A análise reflexiva da experiência vivida se deu por meio do relato dos discentes participantes do projeto. CONCLUSÃO: A nova proposta de atendimento, uniu a teoria com as práticas técnicas tão importantes para o discente, permitindo que os discentes ampliassem os seus conhecimentos quando expostos à situações e processo de trabalho compatíveis com a realidade da comunidade e do serviço.

INTRODUCTION: The activities developed promote the importance of professional training general practitioners, generalist, as well as the need for access to a health professional with a comprehensive view. EXPERIENCE REPORT: This study aims to report an experience about implementation of the Primary Care at the dental clinic. The reflective analysis of this experiencewas through the story of students. CONCLUSION: This new proposal united theory with practical techniques as important to the student, allowing students broaden their knowledge when exposed to situations and work process compatible with the reality of community and service.

Dental caries and gingivitis among 15 to 19 year-old students in Manaus, AM, Brazil.

In the light of the scarcity of epidemiological studies on the oral health of the general population within the context of the Amazon region, this study aimed to estimate the prevalence of dental caries and gingivitis, as well as to evaluate the need for restorative treatment, among school students aged 15 to 19 years in the city of Manaus, AM, Brazil. A cross-sectional study was carried out on a sample of 889 students from within city limits who were enrolled in 26 public and private schools. Dental examinations were performed to obtain the DMFT index (decayed, missing and filled teeth) as well as to determine the treatments needed. The gingival index (Lõe & Silness) was used to classify gingivitis. The intra-examiner diagnostic concordance was 94% and the Kappa statistic was 0.91. The DMFT index found was 4.65 (+/- 0.12), without significant difference between the sexes or skin color groups. The prevalence of dental caries was 87.4%. Restoration of a dental surface was the greatest need (59.3%). Slight gingival inflammation was present in 78.5% and gingival bleeding following probing occurred in 53.3%. Although the DMFT index was lower than that observed for the northern region of Brazil, restorative dental services are lacking for this population. Additional studies are suggested to better understand the differences found.

Necessidade de tratamento decorrente da cárie dentária em estudantes de 15 a 19 anos de idade, em Manaus-AM, Brasil e fatores associados / Need for dental treatment due to caries in 15-19-year-old students of Manaus, AM, Brazil, and associated factors

Objetivo: verificar se há diferença entre as necessidades de tratamento nos dentes anteriores e posteriores dos adolescentes, e fatores associados. Método: foi realizado um estudo transversal em uma amostra composta de 889 estudantes de 15 a 19 anos, matriculados em escolas da área urbana da cidade de Manaus ? AM. Foram realizados exames odontológicos para registrar as necessidades de tratamento e índice CPO-D. A análise estatística foi realizada utilizando-se o programa Stata11. O teste estatístico utilizado foi a Regressão de Poisson Multivariada com nível de significância 95%. Resultados: observou-se que a necessidade de tratamento nos dentes posteriores foi 30,71% maior que nos dentes anteriores, e que não houve diferença significativa entre as necessidades de tratamento e o gênero. A maioria dos adolescentes apresentou necessidade de tratamento nos dentes posteriores, no entanto adolescentes que não apresentaram necessidade de tratamento nos dentes posteriores também não necessitavam de tratamento nos dentes anteriores. Mães com menos anos de estudo e o fato do adolescente nunca ter ido ao dentista estiveram associados à necessidade de tratamento nos dentes posteriores, conforme análise de regressão multivariada (p menor que 0,05). A necessidade de tratamento dos dentes anteriores também apresentou relação significativa com a escolaridade da mãe e com a autopercepção de tratamento dentário (p menor que 0,05). Conclusão: a necessidade de tratamento dos dentes posteriores foi maior que dos dentes anteriores, o que reforça a importância do cirurgião-dentista oferecer orientações precisas para higiene oral destes dentes ao paciente adolescente. Variáveis como escolaridade da mãe e CPO-D parecem estar associadas à necessidade de tratamento tanto dos elementos posteriores como anteriores.

Objective: To determine whether differences exist between the treatment needs for anterior and posterior teeth of adolescents, relating them to associated risk factors. Method: A cross-sectional study was conducted in a sample of 889 students aged 15 to 19 years enrolled in schools in the urban area of Manaus, AM, Brazil. Dental examinations were conducted for treatment needs and DMFT index. Statistical analysis was performed by Multivariate Poisson Regression using the Stata11 software. Results: The need for treatment in posterior teeth was 30.71% higher than in anterior teeth, and there was no significant difference between treatment needs and gender. Most adolescents needed treatment in posterior teeth, but those who did not need treatment in posterior teeth also did not require treatment in anterior teeth. Mothers with fewer years of schooling and the fact the adolescent had never been to the dentist was significant compared with the need for treatment in posterior teeth, as demonstrated by multivariate regression analysis (p less than 0.05). The need for treatment in anterior teeth also showed a significant correlation with mother's low educational background and self-perception of dental treatment (p less than 0.05). Conclusion: The need for treatment of posterior teeth was greater than that of anterior teeth, which reinforces the importance of the dentist providing to adolescent patients precise instructions on how to properly clean these teeth. Variables such as maternal education and DMFT appear to be associated with the need for treatment of both anterior and posterior teeth.

Estudo longitudinal do desgaste dentário em adolescentes / Longitudinal study of tooth wear in adolescents

Com o controle da cárie dentária em muitos países e a permanência por mais tempo do elemento dentário na cavidade bucal, o desgaste dentário começou a despertar atenção da comunidade científica. Considerando os poucos estudos que abordam a incidência e progressão do desgaste em adolescentes, o objetivo deste estudo foi investigar a prevalência, incidência e a progressão do desgaste dentário em adolescentes de 15 anos de idade, estudantes de Rio Grande da Serra - São Paulo. A progressão do desgaste também foi estudada, associada com as variáveis independentes: gênero, fatores socioeconômicos (renda familiar e escolaridade da mãe) e ausência de elemento dentário na cavidade bucal. O primeiro exame foi realizado com 203 adolescentes entre os meses de outubro e novembro de 2011, e o reexame realizado após um ano e meio contando com 121 adolescentes. O desgaste dentário foi avaliado pelo índice de desgaste dentário (de Carvalho Sales-Peres). Uma cirurgiã-dentista previamente calibrada com o padrão ouro mostrou concordância de 80% e resultado do teste Kappa0,78 (+ 0,03). O resultado intra examinador obtido foi de 93% de concordância e teste Kappa 0,90 (+ 0,08)

Nos dois exames, o desgaste dentário acometendo apenas o esmalte foi o mais comum, no entanto o desgaste em dentina foi observado em 2,1% das superfícies no primeiro exame passando para 8,6% no segundo exame e, 55,4% das superfícies não sofreram modificações entre os dois exames. A progressão do desgaste dentário acometendo a dentina foi de 6,6% das superfícies. Estudantes com renda familiar inferior a três salários mínimos e com mães que estudaram até o ensino fundamental apresentaram maior progressão do desgaste para dentina. Esta progressão não foi relacionada ao gênero e nem a ausência de elemento dentário. A prevalência de desgaste das superfícies dentárias destes estudantes foi elevada, porém com baixa severidade

With the control of the dental caries in many countries and the permanence for more time of the dental elements in the oral cavity, the tooth wear started to attract the attention of the scientific community. Considering the few studies that have approached the wear incidence and progression in adolescents, the objective of this study was to investigate the prevalence, incidence and the progression of the tooth wear in 15-year-old adolescents who study in Rio Grande da Serra - São Paulo. The wear progression was also studied and associated with the independent variables: gender, socioeconomic factors (family income and the mother's education level) and the absence of the dental element in the oral cavity. The first examination was conducted with 203 adolescents between October and November of 2011, and the re-examination was conducted one year and a half later counting with 121 adolescents. The tooth wear was evaluated through the dental wear index (de Carvalho Sales-Peres). A dental surgeon previously calibrated with the gold standard showed a concordance of 80% and the result of the Kappa test of 0.78 (+ 0.03). The intra examiners result obtained was of 93% of concordance and the Kappa test 0.90 (+ 0.08)

In both exams, the tooth wear affecting only the enamel was the most common one, however the dentin wear observed in 2.1% of the surfaces in the first exam went to 8.6% in the second exam and, 55.4% of the surfaces did not undergo modifications between both exams. The progression of the tooth wear affecting the dentin was of 6.6% of the surfaces. Students with family income lower than three minimum wages and with mothers who studied until the elementary school presented higher levels of dentin wear progression. This progression was not related to the gender neither to the absence of the dental element. Tooth wear prevalence of the dental surfaces of these students was high, however with low severity

Dental caries and gingivitis among 15 to 19 year-old students in Manaus, AM, Brazil

In the light of the scarcity of epidemiological studies on the oral health of the general population within the context of the Amazon region, this study aimed to estimate the prevalence of dental caries and gingivitis, as well as to evaluate the need for restorative treatment, among school students aged 15 to 19 years in the city of Manaus, AM, Brazil. A cross-sectional study was carried out on a sample of 889 students from within city limits who were enrolled in 26 public and private schools. Dental examinations were performed to obtain the DMFT index (decayed, missing and filled teeth) as well as to determine the treatments needed. The gingival index (Lõe & Silness) was used to classify gingivitis. The intra-examiner diagnostic concordance was 94 percent and the Kappa statistic was 0.91. The DMFT index found was 4.65 (± 0.12), without significant difference between the sexes or skin color groups. The prevalence of dental caries was 87.4 percent. Restoration of a dental surface was the greatest need (59.3 percent). Slight gingival inflammation was present in 78.5 percent and gingival bleeding following probing occurred in 53.3 percent. Although the DMFT index was lower than that observed for the northern region of Brazil, restorative dental services are lacking for this population. Additional studies are suggested to better understand the differences found.

Caries experience in adolescents from a metropolitan region of the Brazilian Amazon / Experiência de cárie em adolescentes de uma região metropolitana da Amazônia brasileira

Purpose: To estimate the prevalence of dental caries among adolescents from a poor metropolitan region of the Brazilian Amazon, and to identify the independent socioeconomic variables of access to dental services, oral hygiene habits, and self-perception of oral health. Method: The sample comprised 178 adolescents aged from 15 to 19 year-old, enrolled in schools in the Eastern zone of the city of Manaus, AM, Brazil. Primary data were collected using a standardized questionnaire and clinical examination. Result: The prevalence of dental caries was 92.7%, and the mean DMF-T index was 5.16 (SD: 0.28). The average number of decayed, missing, and filled teeth was 4.4, 0.87, and 0.75, respectively. No statistically significant differences were found between DMF-T index and per capita household income. Most adolescents declared that they had had an appointment with a dentist at least once in their lifetime, had sought the public service, and that pain was the predominant reason for consultation. The perception of oral health of the majority was good/excellent. Conclusion: The data suggest lack of restorative dental treatment and high prevalence of dental caries in this socially disadvantaged sample, which evidences the need to implement strategies to improve delivery of oral health care.

Objetivo: Estimar a prevalência de cárie em adolescentes, escolares de uma região metropolitana de Manaus, Brasil, identificando variáveis independentes socioeconômicas, de acesso a serviço odontológico, hábitos de higiene oral e autopercepção da saúde bucal. Metodologia: Foram investigados 178 escolares de 15 a 19 anos, matriculados nas escolas da zona leste da cidade de Manaus, AM, Brasil. Foram coletados dados primários por meio de questionário e exame clínico. Resultado: A prevalência de cárie foi 92,7% e a média do índice CPO-D foi de 5,16 (desvio-padrão: 0,28). A média de dentes cariados, perdidos e obturados foi de 4,4; 0,87 e 0,75, respectivamente. Não foram encontradas diferenças estatisticamente significantes entre CPO-D e renda domiciliar per capita. A maioria dos adolescentes declarou já ter ido ao dentista pelo menos uma vez na vida e ter procurado o serviço público, sendo a dor o motivo predominante para a consulta. A percepção da saúde bucal da maioria foi boa/ótima. Conclusão: Os dados obtidos sugerem carência de tratamento odontológico restaurador e prevalência preocupante sobre dentes perdidos por cárie dentária, evidenciando necessidade de implantação de estratégias de atenção à saúde bucal, considerando a realidade desta população em desvantagem socioeconômica.