Health literacy on oral health practice and condition in an adult and elderly population.

The objective of this study was to investigate the impact of health literacy (HL) on health practices and oral health outcomes in an adult and elderly population in Brazil. A cross-sectional study nested in a cohort study was followed up over a period of four years (2011 and 2015) and assessed individuals between 23 and 69 years old from Piracicaba, São Paulo, Brazil. Data were collected by means of oral examinations (coronal caries, periodontal disease and visible biofilm) and interviews (socioeconomic, demographic, oral health-related quality of life, health practices and HL). The 14-item Health Literacy Scale (HLS) was used for HL data, which was the main explanatory variable. The result of the sum of the HLS-14 questionnaire for each participant was dichotomized into the median (46 points): 'high' and 'low' HL. Binary/multinomial logistic regressions were performed on health practice and oral health outcomes, controlled by age and sex (Model 1) and age, sex and socioeconomic status (Model 2; p < 0.05). The final sample consisted of 137 subjects and 43.8% (n = 60) presented low HL (LHL). LHL was associated with health practices, such as use of public dental services in Model 1 (odds ratio [OR] = 0.34, 95% CI: 0.14-0.87) and use of dental services for emergency in Model 1 (OR = 2.69, 95% CI: 1.29-5.51) and Model 2 (OR = 2.93, 95% CI: 1.17-7.30). Based on age and sex, LHL was associated with use of public dental service and use of emergency dental visits. Based on age, sex and socioeconomic status, LHL was associated with use of emergency dental visits.

Factors related to occupational stress among private sector dentists in the first year of the COVID-19 pandemic. / Fatores associados ao estresse ocupacional entre cirurgiões-dentistas do setor privado no primeiro ano da pandemia de COVID-19.

This cross-sectional study examined factors associated with occupational stress among 384 dentists working in the private sector in the first year of the COVID-19 pandemic in Brazil. Data were collected from August to October 2020 through an online form. Two outcomes - (1) anxiety and worry and (2) preparation and safety for work during the pandemic - constituted a proxy for occupational stress. The independent variables were grouped according to the explanatory theoretical model into individual, organisational and extra-organisational factors. Associations were tested by bivariate and multivariate logistic regression. Although prepared and confident, dentists felt anxious and worried about providing clinical care. Women, younger respondents and those who received no guidance on safety measures were more likely to report insecurity and unpreparedness. Younger professionals, those who did not participate in decision-making and who only sometimes had an assistant for four-hand work, were more likely to feel anxious and worried. In addition to individual factors, work organisation factors were associated with occupational stress among dentists in the first year of the pandemic.

O objetivo deste estudo transversal foi analisar os fatores associados ao estresse ocupacional entre cirurgiões-dentistas atuantes no setor privado no primeiro ano da pandemia de COVID-19 no Brasil. Incluiu 384 profissionais do estado do Paraná, cujos dados foram obtidos entre agosto e outubro de 2020 por meio de formulário online. Dois desfechos compuseram proxy de estresse ocupacional: (1) ansiedade e preocupação e (2) preparo e segurança para o trabalho durante a pandemia. As variáveis independentes foram agrupadas segundo modelo teórico explicativo em fatores individuais, organizacionais e extraorganizacionais. As associações foram testadas por regressão logística bi e multivariada. Apesar de preparados e seguros, os profissionais se sentiam ansiosos e preocupados para o atendimento clínico. Mulheres, mais jovens e que não receberam orientações sobre as medidas de segurança apresentaram maiores chances de relatar insegurança e despreparo. Profissionais mais jovens, que não participavam da tomada de decisões e que às vezes dispunham de auxiliar para o trabalho a quatro mãos, tiveram maiores chances de se sentirem ansiosos e preocupados. Além dos fatores individuais, fatores organizacionais do trabalho estão associados ao estresse ocupacional entre cirurgiões-dentistas no primeiro ano da pandemia.

Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil.

The aim of this study was two-fold: (1) to describe the surveillance and biosafety measures adopted by dentists, dental hygienists, and dental assistants who worked in the Southern Region of Brazil and (2) to evaluate access to information in the context of the COVID-19 pandemic. This was a multicenter and cross-sectional design, using a self-applied and validated online questionnaire. The availability of health-care-related supplies and the adoption of biosafety measures recommended by the Technical Note of the National Health Surveillance Agency No. 04/2020 were analyzed. A total of 2560 Brazilian workers participated (75.8% dentists, 15.7% dental assistants and 8.5% dental hygienists), 52.7% from the public and 37.7% from the private sector. Approximately 70% of the individuals reported being away from work during the pandemic. The surveillance measures adopted with higher mean scores were the investigation of respiratory infection symptoms when scheduling appointments and the adoption of distancing in the waiting room. Of the biosafety measures to avoid aerosols, the procedures with lower compliance were those related to the use of intraoral radiographs and rubber dams. Moreover, the correct use of personal protective equipment at work seems to be related to self-perceived stress and anxiety. Worryingly, high access to information through non-governmental documents was observed. Permanent health education policies should reinforce safe practices and encourage workers to implement biosafety and surveillance measures in health services.

Effectiveness of iodoform-based filling materials in root canal treatment of deciduous teeth: a systematic review and meta-analysis.

Introduction: The objective was to review the effectiveness of iodoform-based compared to noniodoform-based filling materials in the root canal treatment of deciduous teeth. Methods: This systematic review and meta-analysis used randomized clinical trials with six months or more follow-up. The risk of bias of individual studies and the certainty of the evidence were evaluated (Cochrane risk of bias tool and GRADE, respectively). Results: The initial search resulted in 5,127 studies after removal of duplicates. After screening by title and abstract, 34 full-text studies were eligible and 21 remained in the qualitative synthesis and 19 in the meta-analysis. Iodoform-based filling materials resulted in fewer clinical failures when compared to noniodoform-based filling materials at the 6 months (OR = 0.43, 95%CI: 0.19-0.97, p = .04) and 9-12 months (OR = 0.46, 95%CI: 0.23-0.93, p = .03), but not at the 18-30 months follow-up (OR = 1.08, 95%CI: 0.58-2.03, p = .81). When considering radiographic failures, there was no statistical difference between iodoform-based and noniodoform-based filling materials at the 6 months (OR = 0.72, 95%CI: 0.39-1.32, p = .29) and 18-30 months follow-ups (OR = 1.06, 95%CI: 0.51-2.21, p = .87), but fewer radiographic failures were detected at the 9-12 months follow-up (OR = 0.49, 95%CI: 0.29-0.80, p = .005). Conclusion: Iodoform-based filling materials showed better clinical and radiographic performance when compared to non-iodoform-based filling materials in the short term, and similar performance in the long term. However, most of the studies exhibited unclear or high risk of bias and the overall certainty of the evidence ranged from low to very low. Therefore, new randomized clinical trials must be accomplished to corroborate this conclusion.

The role of health literacy as a factor associated with tooth loss.

OBJECTIVE: The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS: The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS: The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS: tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.

Reducing social inequalities in the oral health of an adult population.

The objective of this study was to evaluate the association between social inequality indicators and oral health conditions in an adult population. This prospective cohort study assessed a probabilistic sampling of adults (aged 20-64 years) living in Piracicaba, São Paulo, Brazil. Oral examinations were performed in 2011 and 2015, conducted at home, and used the decay-missing-filled (DMFT) index of permanent teeth, the Community Periodontal Index (CPI), and the visible biofilm criterion. A questionnaire was administered to determine demographic and socioeconomic aspects and dental services used, and collect oral health-related quality of life (OHRQoL) data. Social inequality indicators were evaluated according to social class (high, middle or low) and type of dental service used (public, health insurance or private), and compared with oral health conditions (visible biofilm, DMFT and incidence of tooth loss, periodontal pockets and bleeding, and OHRQoL), evaluated between 2011 and 2015. Analysis using chi-squared or Fisher tests (p < 0.05) and Cochran's Q test was conducted separately for each category analyzed between 2011 and 2015 (p < 0.05). A total of 143 adults who participated in an earlier study were examined after four years of follow-up. Although the occurrence of oral disease did not decrease over the study period (4 years), there was a reduction in inequality among lower social classes in regard to presence of tooth decay and oral health impact on self-perceived quality of life between 2011 and 2015 (p < 0.05). These results suggest that the Brazilian National Oral Health Policy has achieved its principles, especially that of greater equity.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population.

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Prospective cohort of adult oral health in Piracicaba, SP, Brazil.

OBJECTIVE: To describe the methodological aspects of a Prospective Cohort Study of adult oral health in Piracicaba, Brazil. RESULTS: This Prospective Cohort Study evaluated adults (20-64 years old) between the years of 2011 and 2015, in Piracicaba, São Paulo, Brazil. The main objective was to evaluate the risk factors for tooth loss in adults. Data were collected at households and selected via probabilistic sampling, through clinical examination of caries, considering as variables the decayed, missing and filled permanent teeth index, need for caries treatment, periodontal disease (Community Periodontal Index and Periodontal Attachment Loss), use and need for dental prosthesis, and presence of visible biofilm. A questionnaire about demographic, socioeconomic and health habits, use of dental services, self-perceived quality of life (Oral Health Impact Profile-14) and health literacy (14-item Health Literacy Scale) was also employed. In 2011, 248 adults participated, and in 2015, 143 (follow-up rate = 57.7%). Despite the follow-up sample loss, most sociodemographic characteristics remained in the participant sample: for example, women (72.0%) (p = 0.534), family income between R$545,00 and R$1090,00 (63.9%) (p = 0.920), above 11 years of education (53.1%) (p = 0.200) and belonging to middle class (67.1%) (p = 0.909).

Tooth loss in adults: factors associated with the position and number of lost teeth.

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.

Correction: Risk factors for tooth loss in adults: A population-based prospective cohort study.

[This corrects the article DOI: 10.1371/journal.pone.0219240.].

Risk factors for tooth loss in adults: A population-based prospective cohort study.

The aim of this study was to identify the risk factors for tooth loss in an extended age group of adults over 4 years. The prospective cohort study assessed adults (20-64 years old) in 2011 and 2015, from Piracicaba, São Paulo, Brazil. The sample selection was planned based on the adult population in the city. The inclusion criteria were randomly selected residences per census tract unit (one adult per household). The exclusion criteria comprised of a physical or psychological state that prevented the achievement of clinical procedures or understanding of the questionnaire. The home oral examination was performed using the index of decayed, missing, and filled teeth (DMFT), the Community Periodontal Index according to the World Health Organization, and visible biofilm. Demographic and socio-economic data, information on health habits, and the use of dental services were obtained by questionnaire. The outcome was a presence incidence of tooth loss, assessed by the difference between Missing teeth (M>0) from DMFT in 2011 and that in 2015. The conceptual theoretical model 'Ethnicity, aging and oral health outcomes' was adapted for tooth loss and used in a Hierarchical multivariate Poisson Regression analysis (p<0.20). The reference category for the Poisson regression were individuals who had no missing teeth (M) due to caries or periodontal disease (p<0.05). There were a total of 143 (follow-up rate = 57.7%) participants in the four-year study, and there was incidence of tooth loss in 51 (35.7%) adults over this period. The risk factors for tooth loss were reason for seeking dental services by pain (RR = 2.72; 95.0% CI: 1.04-7.37), previous tooth loss (RR = 3.01; 95.0% CI: 1.18-7.73) and decayed teeth (RR = 2.87; 95.0% CI: 1.22-6.73). The risk factors for tooth loss were: reason for seeking dental services by pain, previous tooth loss and dental caries.

Fatores contextuais do desempenho do atendimento odontológico para gestantes na Atenção Básica entre municípios baianos / Contextual factors of the performance of dental care for pregnant women in Primary Care among municipalities in Bahia

RESUMO Este estudo objetivou analisar os fatores contextuais do desempenho do atendimento odontológico para gestantes na Atenção Básica entre municípios baianos. A série temporal utilizou dados secundários dos 417 municípios, entre 2018 e 2022. O desfecho foi a meta do indicador de proporção de gestantes com atendimento odontológico por município: insuficiente (<60,0%) ou suficiente (≥60,0%). As variáveis contextuais foram: fatores sociodemográficos (Porte Populacional, Índice de Desenvolvimento Humano Municipal, Produto Interno Bruto municipal per capita - PIB, Índice de Gini da renda domiciliar per capita, Índice de Vulnerabilidade Social e Núcleos Regionais de Saúde) e serviço de saúde (Cobertura de Estratégia Saúde da Família - ESF e de Saúde Bucal). Realizou-se regressão de Poisson uni e multivariada (p<0,05). No último quadrimestre de cada ano: 2,9% (2018), 2,4% (2019), 5,3% (2020), 37,2% (2021) e 71,2% (2022) dos municípios atingiram a meta. No terceiro quadrimestre de 2021, os municípios com menor PIB, e em 2021 e 2022, com maior cobertura de ESF, apresentaram maior chance de atingir a meta. Conclui-se que houve aumento da proporção de atendimento odontológico para gestante ao longo dos anos entre os municípios baianos e atingir a meta foi associado a fatores sociodemográficos e de serviço de saúde.

ABSTRACT This study aimed to analyze the contextual factors of the performance of dental care for pregnant women in Primary Care among municipalities in Bahia. The time series used secondary data from 417 municipalities between 2018-2022. The outcome was the target indicator for the proportion of pregnant women with dental care per municipality: insufficient (<60.0%) or sufficient (≥60.0%). The contextual variables were: sociodemographic factors (Population Size, Municipal Human Development Index, municipal Gross Domestic Product per capita - GDP, Gini Index of household income per capita, Social Vulnerability Index and Regional Health Centers) and health service (Coverage of Family Health Strategy - ESF and Oral Health). Poisson regression was performed (p<0.05). In the last four months of each year: 2.9% (2018), 2.4% (2019), 5.3% (2020), 37.2% (2021) and 71.2% (2022) of the municipalities reached the goal. In the third four months of 2021, municipalities with lower GDP, and in 2021 and 2022, with greater ESF coverage, had a greater chance of reaching the target. It is concluded that there was an increase in the proportion of dental care for pregnant women over the years among the municipalities in Bahia, and achieving the goal was associated with sociodemographic and health service factors.

Use of Sealants in Permanent Molars by Brazilian Dentist: A Comparative Study of Public versus Private

Abstract Objective: To compare the use of sealants in permanent molars between public and private dentists in Brazil. Material and Methods: This was a cross-sectional and analytical web survey study. The convenience sample consisted of dentists in Brazil who answered a pre-tested online form released via social media between July and October 2021. Descriptive analysis was performed using absolute and relative frequencies (%) and associations using the Chi-square test (p<0.05). Results: Brazilian professionals participated in the study (n=2,244). Comparing the professionals from the public service with those from the private service, the former had a higher positive perception of the use of sealants as a preventive (92.4% vs. 81.1%, p<0.00l) and therapeutic procedure (90.7% vs. 82.4%, p=0.00l), higher percentage of non-invasive (91.7% vs. 83.8%, p<0.00l) and invasive (22.8% vs. 12.0%, p< 0.001) techniques. Professionals from the private service reported more frequently that they did not use sealants than those from the public service (14.0% vs. 4.8%, p<0.00l). Resin sealant (97.7% vs. 94.9%, p=0.0l5) and Flow resin (62.0% vs. 54.3%, p=0.013) were the most used by professionals in the private service. The use of glass ionomer cement was not associated with the type of service (75.1% vs. 77.2%, p=0.172), nor was the use of adhesives (0.6% vs. 1.4%, p=0.195) or resin with Giomer technology (1.9% vs. 2.2%, p=0.856) (p>0.05). Conclusion: The percentage of use of sealants among dentists in Brazil is high, especially among professionals in the public service, and the most used materials were resinous sealants and glass ionomer cement.

Fatores associados ao estresse ocupacional entre cirurgiões-dentistas do setor privado no primeiro ano da pandemia de COVID-19 / Factors related to occupational stress among private sector dentists in the first year of the COVID-19 pandemic

Resumo O objetivo deste estudo transversal foi analisar os fatores associados ao estresse ocupacional entre cirurgiões-dentistas atuantes no setor privado no primeiro ano da pandemia de COVID-19 no Brasil. Incluiu 384 profissionais do estado do Paraná, cujos dados foram obtidos entre agosto e outubro de 2020 por meio de formulário online. Dois desfechos compuseram proxy de estresse ocupacional: (1) ansiedade e preocupação e (2) preparo e segurança para o trabalho durante a pandemia. As variáveis independentes foram agrupadas segundo modelo teórico explicativo em fatores individuais, organizacionais e extraorganizacionais. As associações foram testadas por regressão logística bi e multivariada. Apesar de preparados e seguros, os profissionais se sentiam ansiosos e preocupados para o atendimento clínico. Mulheres, mais jovens e que não receberam orientações sobre as medidas de segurança apresentaram maiores chances de relatar insegurança e despreparo. Profissionais mais jovens, que não participavam da tomada de decisões e que às vezes dispunham de auxiliar para o trabalho a quatro mãos, tiveram maiores chances de se sentirem ansiosos e preocupados. Além dos fatores individuais, fatores organizacionais do trabalho estão associados ao estresse ocupacional entre cirurgiões-dentistas no primeiro ano da pandemia.

Abstract This cross-sectional study examined factors associated with occupational stress among 384 dentists working in the private sector in the first year of the COVID-19 pandemic in Brazil. Data were collected from August to October 2020 through an online form. Two outcomes - (1) anxiety and worry and (2) preparation and safety for work during the pandemic - constituted a proxy for occupational stress. The independent variables were grouped according to the explanatory theoretical model into individual, organisational and extra-organisational factors. Associations were tested by bivariate and multivariate logistic regression. Although prepared and confident, dentists felt anxious and worried about providing clinical care. Women, younger respondents and those who received no guidance on safety measures were more likely to report insecurity and unpreparedness. Younger professionals, those who did not participate in decision-making and who only sometimes had an assistant for four-hand work, were more likely to feel anxious and worried. In addition to individual factors, work organisation factors were associated with occupational stress among dentists in the first year of the pandemic.

Percepção de adultos e idosos sobre os seus comportamentos e sua condição de saúde bucal segundo o seu nível de literacia em saúde / Perception of adults and elderly on your behaviors and your oral health condition according their level of health literacy

Resumo Introdução O nível da literacia em saúde pode ser um fator que influencia os comportamentos e a saúde dos indivíduos. Objetivo Analisar a percepção de adultos e idosos sobre os seus comportamentos e sua condição de saúde bucal segundo o seu nível de literacia em saúde (LS). Método O presente estudo qualitativo foi realizado com adultos e idosos que que participaram da 'Coorte de Saúde Bucal de Adultos de Piracicaba', sendo classificados conforme os três perfis de perda dentária seguintes: 1) nunca ter perdido dentes; 2) incidência de perda dentária ≥ 4 dentes; 3) edêntulo total e com nível de literacia em saúde alta e baixa de acordo com a variável LS dicotomizada a partir da mediana. Para a coleta dos dados, foi feita uma nova entrevista domiciliar gravada com uso de roteiro-guia e após a transcrição foi realizada a análise de conteúdo. Resultados Independente do nível de LS, os indivíduos identificaram fatores de risco e proteção determinantes para o processo saúde-doença bucal. No entanto, os entrevistados com baixa LS apresentaram uma maior propensão aos comportamentos de risco. Os fatores individuais foram preponderantes para o entendimento de sua condição bucal, seja pelo sentimento de descuido ou de responsabilidade pela falta de acesso aos serviços odontológicos, seja pelo aspecto socioeconômico ou geográfico. Conclusão Os indivíduos com alta LS apresentaram uma capacidade argumentativa e um entendimento maiores sobre os comportamentos saudáveis, como higiene bucal e uso regular do serviço odontológico, independente do tipo de serviço utilizado.

Abstract Background The level of health literacy can be a factor that influences the behaviors and health of individuals. Objective To analyze the perception of adults and the elderly on their behaviors and their oral health conditions according to their level of health literacy (HL). Method The qualitative study was carried out with adults and the elderly who participated in the "Piracicaba Adult Oral Health Cohort" and had been classified into three tooth loss profiles: 1) never having lost teeth; 2) incidence of tooth loss ≥ 4 teeth; 3) total toothlessness and the level of health literacy dichotomized in the median at high and low HL. There was a new home interview recorded using a script, and after transcription, content analysis was performed. Results The individuals, regardless of the HL level, identified risk and protective factors that were decisive in the oral health-disease process. However, individuals with low HL were more adept at risky behavior. The individual factors were preponderant for the understanding of his oral condition, either by the feeling of carelessness or by the feeling of responsibility for the lack of access to dental services, either by the socioeconomic or geographical aspect. Conclusion Individuals with high HL showed greater argumentative capacity and understanding of healthy behaviors, such as oral hygiene and regular use of dental services, regardless of the type of service used.

Amalgam x Composite Resin: supplies and restorative procedures more performed among Oral Health Teams in Brazil

Abstract This study aimed to compare the availability of supplies and amalgam and composite resin restorations among Oral Health Teams (OHT) in Brazilian regions. Secondary data were extracted from Modules I and II of the 1st (2012) and V and VI of the 2nd (2014) and 3rd cycle (2017) of the external evaluation of the National Program for Access and Quality in Primary Care2. The proportions between regions and cycles were compared using the Chi-square test with the z-test adjusted by the Bonferroni method (p<0.05). Among 2012, 2014, and 2017 there was a significant reduction in the proportion of OHT that performed amalgam restorations (87.5%, 89.2%, and 80.2%; p<0.001) and an increase in resin composite (92.5 %, 97.7%, and 99.0%; p<0.001), with the same trend in Brazilian regions (p<0.001). Amalgamator availability decreased among 2012 (99.0%), 2014 (98.4%) and 2017 (85.6%) (p<0.001). Amalgam availability was lower in 2017 (80.1%), compared to 2012 (87.5%) and 2014 (97.5%) (p<0.001). The availability of light curing decreased between 2012 (99.0%), 2014 (98.4%) and 2017 (85.6%) (p<0.001), being less available in the North (95.7%) (p<0.001). The light-curing resin increased between 2012 (94.1%), 2014 (96.6%) and 2017 (97.0%) (p<0.001), with no increase only in the North (p=0.134). While there was a reduction in supplies and amalgam restoration, there was an increase in supplies and resin composite restorations in the period evaluated in all Brazilian regions. However, regional disparities are still evident, with fewer supplies of restorative services in the North region.

Resumo Este estudo objetivou comparar a disponibilidade de fornecimentos e restaurações de amálgama e resina composta entre as Equipas de Saúde Oral (OHT) por regiões brasileiras. Os dados secundários foram extraídos dos módulos I e II do 1º (2012) e V e VI do 2º (2014) e 3º ciclo (2017) da avaliação externa do Programa Nacional de Acesso e Qualidade em Cuidados Primários. As proporções entre regiões e ciclos foram comparadas utilizando o teste Qui-quadrado com o teste z ajustado pelo método de Bonferroni (p<0,05). Entre 2012, 2014, e 2017 houve uma redução significativa na proporção de OHT que realizou restaurações de amálgama (87,5%, 89,2%, e 80,2%; p<0,001) e um aumento na resina composta (92,5%, 97,7%, e 99,0%; p<0,001), com a mesma tendência nas regiões brasileiras (p<0,001). A disponibilidade de amalgamadores diminuiu entre 2012 (99,0%), 2014 (98,4%) e 2017 (85,6%) (p<0,001). A disponibilidade de amálgama foi menor em 2017 (80,1%), em comparação com 2012 (87,5%) e 2014 (97,5%) (p<0,001). A disponibilidade de polimerização por luz diminuiu entre 2012 (99,0%), 2014 (98,4%) e 2017 (85,6%) (p<0,001), estando menos disponível no Norte (95,7%) (p<0,001). A resina fotopolimerizadora aumentou entre 2012 (94,1%), 2014 (96,6%) e 2017 (97,0%) (p<0,001), sem aumento apenas no Norte (p=0,134). Embora tenha havido uma redução nos fornecimentos e restauração de amálgamas, houve um aumento nos fornecimentos e restaurações de resina composta no período avaliado em todas as regiões brasileiras. Contudo, as disparidades regionais são ainda evidentes, com menos oferta de serviços de restauração na região Norte.

Factors associated with oral health literacy among users of primary health care: a cross-sectional study

Aim To analyze associations between sociodemographic factors, self-perception, self-care practices in health with Oral Health Literacy (OHL) levels among users of Primary Health Care (PHC). Methods A cross-sectional and analytical study was performed in Piracicaba (São Paulo), Brazil, in 2018, with a convenience sample of users of PHC that were aged over 18 years. Data were collected with a questionnaire by a trained dentist in two Family Health Units. The outcome variable was OHL, measured by the OHLA-B instrument, which was dichotomized by median into low (≤8 point) and high (>8 point). The independent variables were sociodemographic conditions (age, sex, self-declared skin color, and education), self-perceived oral health and self-care practices in health (tooth brushing frequency, smoking habits, reason for the last visit to the dentist, and source of health information search). Unadjusted and adjusted analyses were performed between OHL and independent variables for multiple logistic regression model (p≤0.05). Results The sample consisted of 450 adults. A total of 54.7% had a low OHL. After adjusting for sex and age, OHL was associated with skin color (OR=0.57; 95%CI=0.37-085), educational level (OR=4.92; 95%CI=3.16-7.79), health information from health professionals (OR=2.40; 95%CI=1.42-4.16) and internet (OR=2.88; 95%CI=1.59-5.32), toothbrushing >1 time a day (OR=3.23; 95%CI=1.27-9.92) and smokers (OR=0.42; 95%CI=0.23-0.73). After adjusting for sex, age and income, OHL was associated with (OR=0.63; 95%CI=0.41-096), educational level (OR=4.06; 95%CI=2.57-6.51) and smokers (OR=0.48; 95%CI=0.26-0.84). Conclusions Low OHL was associated with socioeconomic factors, source of information and smoking. This fact highlights the importance of health professionals to promote OHL.

Retorno das atividades presenciais nos cursos de Odontologia brasileiros na pandemia de COVID-19: comparação entre instituições públicas e privadas / Retorno de las actividades presenciales en los cursos de Odontología brasileños durante la pandemia de COVID-19: comparación entre instituciones públicas y privadas / Return of on-site activities in Brazilian Dentistry courses during the COVID-19 pandemic: comparison between public and private institutions

Trata-se de estudo quanti-qualitativo que analisa o retorno das atividades presenciais nos cursos de Odontologia brasileiros, durante a pandemia de COVID-19, e as dificuldades enfrentadas, comparando instituições públicas e privadas. Um formulário on-line com questões abertas e fechadas foi encaminhado por e-mail aos representantes dos cursos de Odontologia, de março a junho de 2021. Foram incluídos os cursos cadastrados no sitee-MEC iniciados até 2017. A análise quantitativa utilizou os testes qui-quadrado, exato de Fisher e t de Student(p<0,05); uma questão aberta foi submetida à análise temática de conteúdo. Dos 329 cursos elegíveis, foram respondidos 83 formulários (21 públicos e 62 privados). Os cursos de instituições públicas apresentaram menor frequência de retorno das atividades presenciais até a data da coleta (p=0,038), inclusive com maior proporção de suspensão das atividades clínicas e laboratoriais (p≤0,001), mas sem diferença para aulas teóricas remotas (p>0,05). Os cursos privados demonstraram ter maior disponibilidade de recursos para o retorno presencial, tais como: estrutura, funcionários e docentes (p<0,001). Apesar das normas de biossegurança constituírem um desafio comum, as principais dificuldades relatadas nas instituições privadas diante do retorno das atividades presenciais foram a modulação ou escalonamento das turmas e ambientes de aula, controle do fluxo de pessoas e implantação de protocolos. Nas públicas, destacam-se dificuldades relacionadas à adequação da estrutura e aquisição de materiais. Conclui-se que a maioria dos cursos de Odontologia havia retomado às aulas no início de 2021, mas as instituições privadas apresentaram maior proporção de retorno às atividades laboratoriais e clínicas presenciais (AU).

Se trata de un estudio cuantitativo y cualitativo que analiza el retorno de las actividades presenciales en las carreras de Odontología brasileñas, durante la pandemia de COVID-19, y las dificultades enfrentadas, comparando instituciones públicas y privadas. Se envió por correo electrónico un formulario en línea con preguntas abiertas y cerradas a los representantes de los cursos de Odontología, de marzo a junio de 2021. Se incluyeron los cursos registrados en el sitio web de e-MEC que iniciaron hasta el año 2017. El análisis cuantitativo utilizó las pruebas chi-cuadrado, Fisher exacta y t de Student (p<0,05); se sometió una pregunta abierta al análisis de contenido temático. De los 329 cursos elegibles, se completaron 83 formularios (21 públicos y 62 privados). Los cursos de instituciones públicas mostraron una menor frecuencia de retorno a actividades presenciales hasta la fecha de cobro (p=0,038), incluyendo una mayor proporción de suspensión de actividades clínicas y de laboratorio (p≤0,001), pero sin diferencia para clases teóricas remotas (p >0.05). Los cursos privados demostraron mayor disponibilidad de recursos para el retorno presencial, tales como: estructura, personal y docentes (p<0,001). Si bien los estándares de bioseguridad constituyen un desafío común, las principales dificultades reportadas en las instituciones privadas ante el regreso de las actividades presenciales fueron modular o escalonar clases y ambientes de aula, controlar el flujo de personas e implementar protocolos. En las públicas destacan dificultades relacionadas con la adecuación de la estructura y adquisición de materiales. Se concluye que la mayoría de las carreras de Odontología habían retomado clases a inicios de 2021, pero las instituciones privadas tuvieron una mayor proporción de retorno a las actividades presenciales de laboratorio y clínicas (AU).

This is a quantitative-qualitative study analyzing the return of on-site activities in Brazilian dentistry undergraduate courses during the COVID-19 pandemic and the difficulties faced, comparing public and private institutions. An online form with open and multiple-choice questions was sent via e-mail to the representatives of dentistry courses from March to June 2021. The courses included were those registered on the e-MEC webpage that had started up to 2017. The quantitative analysis employed the chi-square, the Fisher exact, and the T student tests (p<0.05); the open question was subjected to thematic content analysis. Out of the 329 eligible courses, 83 forms were answered and returned (21 public and 62 private). Public institution courses showed lower frequency of return to on-site activities up tothe data collection (p=0.038), and presented higher proportion of suspension of clinical and laboratory activities (p≤0.001), but no difference regarding remote theoretical lessons (p>0.05). Private courses showed higher availability of resources supporting the return to on-site activities, namely, structure, workers, and professors (p<0.001). Although biosafety norms presented a common challenge, the main difficulties reported in private institutions related to the return to on-site activities were the modulation and schedule of the classes and lesson environments, controlling the flow of people, and the implementation of protocols. Public institutions highlighted difficulties related to adjustment of the structure and material acquisition. The results showed that most dentistry courses had returned to on-site lessons in the early 2021, but private institutions reported higher proportion of return to on-site laboratory and clinical activities (AU).

Dental care of hospitalized pediatric patient with tetralogy of Fallot: a case report / Atendimento odontológico hospitalar de paciente pediátrico com tetralogia de Fallot: relato de caso

ABSTRACT Tetralogy of Fallot is the most prevalent cyanotic congenital heart disease and it has a high mortality rate. The aim of this article was to provide a clinical case, describing the dental treatment of an infant patient with tetralogy of Fallot done at a hospital. The patient was a 7-year-old male, lived in a rural area with no previous diagnosis of this cardiopathy when he was attended to by a multidisciplinary team at University Hospital Ana Bezerra, at Santa Cruz, Northern Rio Grande, Brazil. After his medical appointment, the patient received a visit from the dental resident in Mother-Infant Health in his hospital room. During the dental exam, multiple carious lesions were found and there was an urgent need to reduce the risk of dental infection before the patient underwent heart surgery. The treatment started with a preventive approach, including oral hygiene instruction and behavior management. The treatment was completed using the atraumatic restorative technique, and a root tip was extracted. Antibiotic prophylaxis was administered before the extraction to minimize the risk of infectious endocarditis. After the dental treatment, the multidisciplinary team referred the patient for surgery to address the tetralogy of Fallot. The integration between the multidisciplinary residency and the medical team was important to reduce the risks of infectious endocarditis during the dental treatment, aiming to provide integral care to this patient.

RESUMO A tetralogia de Fallot é a cardiopatia cianótica congênita mais prevalente, e apresenta alta mortalidade. O objetivo do presente artigo foi descrever um caso clínico de atendimento odontológico de paciente infantil com tetralogia de Fallot em ambiente hospitalar. O paciente de 7 anos de idade, sexo masculino, morador da zona rural, não possuía o diagnóstico da cardiopatia quando buscou o serviço e foi atendido pela equipe multidisciplinar do Hospital Universitário Ana Bezerra, em Santa Cruz, Rio Grande do Norte, Brasil. O paciente, após atendimento médico, recebeu no leito da enfermaria do hospital a visita do cirurgião-dentista residente na Residência Multiprofissional em Saúde Materno-Infantil. Após avaliação bucal, verificou-se múltiplas lesões de cárie, e necessidade de tratamento odontológico urgente para redução de risco do foco infeccioso, previamente ao procedimento cirúrgico da cardiopatia. O tratamento iniciou pela abordagem preventiva, com orientações de higiene oral e condicionamento psicológico, e em seguida foi feito tratamento restaurador, pela técnica restauradora atraumática e extração de um fragmento radicular. A profilaxia antibiótica foi realizada antes da extração, para minimizar o risco de endocardite bacteriana. Após o atendimento odontológico, o paciente foi encaminhado pela equipe multidisciplinar para a abordagem cirúrgica da tetralogia de Fallot. A integração da residência multiprofissional com a equipe médica foi importante para a redução de riscos de endocardite bacteriana durante os procedimentos odontológicos, visando uma atenção integral ao paciente.

Incidence of Tooth Loss in Adults: A 4-Year Population-Based Prospective Cohort Study.

OBJECTIVE: To verify the incidence of tooth loss in extended age group of adults in 4 years. MATERIALS AND METHODS: The prospective cohort study assessed adults (20-64 years old) between 2011 and 2015, from Piracicaba, São Paulo, Brazil. The dependent variable was cumulative incidence of tooth loss, assessed by difference between missing teeth (M) of decayed, missing, and filled tooth index (DMFT) in 2011 and 2015. Participants were stratified into young (20-44 years old) and older (45-64 years old) adults. Mann-Whitney U test (p < 0.05) was used to compare the means of incidence of tooth loss between age groups. RESULTS: After four years, 57.7% (n = 143) of adults were followed up and the mean incidence of tooth loss was 0.91 (SD = 1.65); among these, 51 adults (35.7%) who lost their teeth showed mean tooth loss of 2.55 (SD = 1.86). In older adults, incidence of tooth loss was higher (p = 0.008), but no difference between age groups was found when only adults with incidence of tooth loss were assessed (p = 0.844). CONCLUSION: There was higher incidence of tooth loss in older adults after four years, however, without difference between age groups when only those who lost teeth were evaluated.