[Tooth loss and associated socioeconomic, demographic, and dental-care factors in Brazilian adults: an analysis of the Brazilian Oral Health Survey, 2002-2003]. / Perdas dentárias e fatores sociais, demográficos e de serviços associados em adultos brasileiros: uma análise dos dados do Estudo Epidemiológico Nacional (Projeto SB Brasil 2002-2003).

The aim of this study was to estimate the prevalence of tooth loss among Brazilian adults aged 35 to 44 years. The study also tested the association between tooth loss and demographic, socioeconomic, and dental-care utilization variables. Data were analyzed from 13,431 individuals submitted to dental examination and interviewed in the National Oral Health Survey in 2002-2003. The number of lost teeth ( 12) was the outcome. Exploratory variables included geographic area, gender, skin color, age, per capita income, schooling, time since last dental appointment, and type of dental service used. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. The prevalence of edentulism was 9%, while median tooth loss was 11. Tooth loss was strongly associated with living in rural areas, female gender, poor socioeconomic status, low schooling, and older age. Individuals who attended public dental care services and those with more time elapsed since their last dental appointment showed a higher prevalence of tooth loss than their counterparts after controlling for demographic and socioeconomic factors.

Contextual socioeconomic determinants of tooth loss in adults and elderly: a systematic review.

OBJECTIVE: To perform a systematic review regarding studies that investigated the association between contextual socioeconomic factors and tooth loss. METHODS: MEDLINE, Embase, and LILACS databases were searched and no language or date restrictions were applied for this research. The search was also carried out at the Brazilian Library of Theses and Dissertations (BDTD), with the objective of seeking unpublished studies. We evaluated the bibliographical and methodological characteristics of the studies, as well as the findings. RESULTS: We found 348 articles, out of which only 6 were included in this study after revision by 2 independent researchers. We also identified an unpublished thesis. In general, these results show that the socioeconomic context interferes in tooth loss. We found an association between the highest number of missing teeth with less favorable contextual variables, despite the weak evidence, due to the fact that all selected studies had a cross-sectional design. CONCLUSION: We suggest the standardization of outcome formats and exposures in order to favor the comparison between studies and their quantitative analysis.

Desafios da docência: reflexões a partir da vivência em um curso de graduação em medicina / Teaching challenges: reflections from the experience in a medicine course

RESUMO: Introdução:Os novos cursos de medicina demandam inovações pedagógicas e curriculares que intensificam os desafios da prática docente. Objetivo: O trabalho objetiva apresentar os desafios da docência em um curso de graduação em medicina, viabilizado pelo Programa Mais Médicos, a partir da narrativa de três professores. Metodologia: Trata-se de um relato de experiência construído a partir de narrativas reflexivas redigidas livremente por cada um dos docentes, em momentoúnico, no primeiro semestre de 2019. Elas foram sistematizadas e organizadas por um dos autores. Resultados: Dois dos docentes são graduados em odontologia, com pós-graduação na área de saúde coletiva, participando dos oito ComponentesCurriculares Regulares (CCR) ligados à essa área. A terceira docente é farmacêutica, com pós-graduação em Ciências Biológicas e compõe os componentes de Processos Biológicos III e IV e Temas Emergentes na Formação Médica 3. As narrativas revelam o quanto o cenário da educação médica é singular e gerador de desafios próprios. O modelo contra-hegemônicodo referido curso de medicina gera insegurança para os atores envolvidos, sobretudo pela ausência de referencial comparativo. Além disso, a construção do curso demanda energia extra, visto que se parte do zero para organização de todas as demandas. O uso de metodologias ativas de aprendizagem constitui outro desafio, uma vez que os docentes foram formados sob a ótica do modelo tradicional. Outro aspecto apontado como desafiador pelos três docentes ­ chamando atenção para o fato de nenhum deles ser médico ­ é apresentar formação de graduação em outros cursos da área da saúde e o quanto isso causa incompreensões e resistências, manifestada por estudantes e colegas docentes. Por fim, no contexto atual de exercício da docência, o uso intenso de dispositivos tecnológicos foi apontado pelos docentes como um desafio, talvez o mais com plexo deles já que seu uso é massivo e é complexo "competir" e organizar uma aula que seja atrativa a ponto de fazer com os estudantes se "desconectem" para se concentrar no que está sendo trabalhado. Conclusão: Conclui-se que a docência em cursos de medicina, em especial naqueles orientados pelas novas DCN, apresenta desafios variados que precisam ser compreendidos e contornados para propiciar uma prática exitosa. (AU)

ABSTRACT: Introduction: The new medical courses demand pedagogical and curricular innovations that intensify the challenges of the teaching practice. Objective: This work presents the challenges of teaching in an undergraduate medical course, made possible by the Mais Médicos Program, based on the narrative of three professors. Methodology: it is an experience report from reflective narratives written by each professional in the first term of 2019. They were systematized and organizedby one of the authors. Results: Two of the professors are graduated in dentistry, with postgraduate studies in the area of collective health, participating in eight regular curriculum component components linked to this area. The third professor is a pharmacist, with a postgraduate degree in Biological Sciences and composes the components of Biological Processes III and IV and Emerging Themes in Medical Education 3. The narratives reveal how the current scenario is unique and what the current problem is. The counter-hegemonic model of the medical course generates insecurity for the actors involved, mainly due to the lack of comparative reference. Also, the construction of the course requires extra energy since it starts from zero to organize the demands. The use of active learning methodologies is another challenge since the documents were formed from the perspective of the traditional model. Another aspect pointed out as challenging by the three professors - calling attention to the fact that none of them are doctors - is the graduation training in other courses in the health area and the extent to which this causes misunderstandings and resistance, revealed by students and doctors. Finally, in the current con-text of teaching, the intensive use of technological devices has been addressed by professors as a challenge, perhaps the most complex of them since its use is massive and it is hard to "compete" with it and organize the lessons to be attractive to make students "disconnect" from it to focus on what is being done. Conclusion:It was concluded that teaching in medical courses, especially in those guided by DCN, presents varied challenges that require understanding and circumvented to provide a successful practice. (AU)

Contextual and individual indicators associated with the presence of teeth in adults.

OBJECTIVE The objective of this study was to analyze whether socioeconomic conditions and the period of availability of fluoridated water are associated with the number of teeth present. METHODS This cross-sectional study analyzed data from 1,720 adults between 20 and 59 years of age who resided in Florianópolis, SC, Southern Brazil, in 2009. The outcome investigated was the self-reported number of teeth present. The individual independent variables included gender, age range, skin color, number of years of schooling, and per capita household income. The duration of residence was used as a control variable. The contextual exposures included the period of availability of fluoridated water to the households and the socioeconomic variable for the census tracts, which was created from factor analysis of the tract's mean income, education level, and percentage of households with treated water. Multilevel logistic regression was performed and inter-level interactions were tested. RESULTS Residents in intermediate and poorer areas and those with fluoridated water available for less time exhibited the presence of fewer teeth compared with those in better socioeconomic conditions and who had fluoridated water available for a longer period (OR = 1.02; 95%CI 1.01;1.02). There was an association between the period of availability of fluoridated water, per capita household income and number of years of education. The proportion of individuals in the poorer and less-educated stratum, which had fewer teeth present, was higher in regions where fluoridated water had been available for less time. CONCLUSIONS Poor socioeconomic conditions and a shorter period of availability of fluoridated water were associated with the probability of having fewer teeth in adulthood. Public policies aimed at reducing socioeconomic inequalities and increasing access to health services such as fluoridation of the water supply may help to reduce tooth loss in the future.

[Tooth loss in Brazil: analysis of the 2010 Brazilian Oral Health Survey]. / Perdas dentárias no Brasil: análise da Pesquisa Nacional de Saúde Bucal 2010.

OBJECTIVE: To estimate the mean number of missing teeth, lack of functional dentition and total tooth loss (edentulism) among adolescents, adults and the elderly in Brazil, comparing the results with those of 2003. METHODS: Data from 5,445 adolescents aged 15-19, 9,779 adults aged 35-44 and 7,619 elderly individuals aged 65-74, participants in the Brazilian Oral Health Survey (SBBrasil) 2010, were analyzed. The mean missing teeth, proportion of lack of functional dentition (< 21 natural teeth) and proportion of edentulism (total tooth loss) were estimated for each age group, each state Capital and each macro region. Multivariable logistic regression (tooth loss) and Poisson (absence of functional dentition and edentulism) analyses were performed in order to identify socioeconomic factors and demographic characteristics associated with each outcome. RESULTS: The prevalence of tooth loss among adolescents was 17.4% (38.9% in 2002-03) ranging from 8.1% among those earning higher income to almost 30% among those with less schooling. Among adolescents, females, those with black or brown skin and those with the lowest levels of income and schooling had a higher prevalence of tooth loss. Lack of functional dentition affected nearly » of adults, it was higher among women, among those with black and brown skin and among those with the lowest levels of income and schooling. Mean missing teeth in adults decreased from 13.5 in 2002-03 to 7.4 in 2010. More than half of elderly is edentulous (similar to the 2002-03 findings); higher prevalence of edentulism was found among women and those with the lowest levels of income and schooling. Among adolescents the mean missing teeth ranged from 0.1 (in Curitiba, South Brazil and Vitória, Southeast Brazil) to 1.2 (in the North countryside). Among adults the lowest mean missing teeth was found in Vitória (4.2) and the highest in Rio Branco, North Brazil (13.6). CONCLUSIONS: A remarkable reduction in tooth loss among adolescents and adults was identified between 2010 and 2003. Among the elderly, tooth loss figure remained the same. In spite of important achievements in tooth loss figures, social and regional inequalities persist.

Contextual socioeconomic determinants of tooth loss in adults and elderly: a systematic review / Determinantes socioeconômicos contextuais das perdas dentárias em adultos e idosos: uma revisão sistemática da literatura

To perform a systematic review regarding studies that investigated the association between contextual socioeconomic factors and tooth loss.

Realizar revisão sistemática de estudos que investigaram a associação entre os determinantes socioeconômicos contextuais e as perdas dentárias.

Contextual and individual indicators associated with the presence of teeth in adults / Indicadores contextuais e individuais associados à presença de dentes em adultos

OBJETIVO Analisar se condições socioeconômicas contextuais e tempo de disponibilidade de água fluoretada estão associados ao número de dentes presentes. MÉTODOS Neste estudo transversal, foram analisados dados de 1.720 adultos entre 20 e 59 anos residentes em Florianópolis, SC, em 2009. O desfecho investigado foi o autorrelato do número de dentes presentes. As variáveis independentes individuais incluíram sexo, faixa etária, cor da pele, anos de estudo e renda per capita familiar. Como variável de controle, utilizou-se o tempo de residência. As exposições contextuais foram o tempo de disponibilidade da água fluoretada nos domicílios e a variável socioeconômica para os setores censitários, elaborada a partir da análise fatorial da renda média do setor, escolaridade média e percentual de domicílios com água tratada. Foi realizada regressão logística multinível e foram testadas interações interníveis. RESULTADOS Residentes nas áreas intermediárias e mais pobres e aqueles com menos tempo de disponibilidade de água fluoretada apresentaram menos dentes presentes comparados àqueles em melhor posição socioeconômica e com disponibilidade de água fluoretada por maior período (OR = 1,02; IC95% 1,01;1,02). Houve interação entre o tempo de disponibilidade de água fluoretada, renda per capita familiar e anos de estudo. A proporção de indivíduos do estrato mais pobre e menos escolarizado, que apresentou menos dentes presentes, foi maior nas regiões com menor tempo de disponibilidade de flúor na água. CONCLUSÕES As piores condições socioeconômicas contextuais associaram-se à chance de ter menos dentes presentes na idade adulta, da mesma forma que o menor tempo de fluoretação da água. Políticas públicas que visem a reduzir desigualdades socioeconômicas e ampliem o acesso à saúde, como a fluoretação da água de abastecimento podem, futuramente, contribuir para reduzir as perdas dentárias.(AU)

OBJECTIVE The objective of this study was to analyze whether socioeconomic conditions and the period of availability of fluoridated water are associated with the number of teeth present. METHODS This cross-sectional study analyzed data from 1,720 adults between 20 and 59 years of age who resided in Florianópolis, SC, Southern Brazil, in 2009. The outcome investigated was the self-reported number of teeth present. The individual independent variables included gender, age range, skin color, number of years of schooling, and per capita household income. The duration of residence was used as a control variable. The contextual exposures included the period of availability of fluoridated water to the households and the socioeconomic variable for the census tracts, which was created from factor analysis of the tract's mean income, education level, and percentage of households with treated water. Multilevel logistic regression was performed and inter-level interactions were tested. RESULTS Residents in intermediate and poorer areas and those with fluoridated water available for less time exhibited the presence of fewer teeth compared with those in better socioeconomic conditions and who had fluoridated water available for a longer period (OR = 1.02; 95%CI 1.01;1.02). There was an association between the period of availability of fluoridated water, per capita household income and number of years of education. The proportion of individuals in the poorer and less-educated stratum, which had fewer teeth present, was higher in regions where fluoridated water had been available for less time. CONCLUSIONS Poor socioeconomic conditions and a shorter period of availability of fluoridated water were associated with the probability of having fewer teeth in adulthood. Public policies aimed at reducing socioeconomic inequalities and increasing access to health services such as fluoridation of the water supply may help to reduce tooth loss in the future.(AU)

Tooth loss and associated factors in adolescents: a Brazilian population-based oral health survey.

OBJECTIVE: To estimate tooth loss among adolescents and its factors associated. METHODS: Data from 16,833 participants of the Brazilian Oral Health Survey 2002-2003 were analyzed. The outcome studied was tooth loss of at least one tooth. Independent variables included geographical localization, gender, skin color, per capita income, education gap, dental service utilization and fluoridated water supply at the local level. Crude and adjusted prevalence ratios were estimated using Poisson regression for each Brazilian macroregion and nationwide. RESULTS: The prevalence of at least one tooth loss was 38.9% (95% CI 38.2%;39.7%). Adolescents living in localities with non-fluoridated water supply were 40% more likely to have tooth loss compared with those living in areas with fluoridated water supply. There was seen a strong association (p<0.01) between non-fluoridated water supply and tooth loss prevalence in the Northeast. In other Brazilian regions this association was confounded for distal variables, mainly socioeconomic variables, reinforcing regional inequalities. CONCLUSIONS: High prevalence of tooth loss among Brazilian adolescents shows a need for targeted dental actions including prevention at earlier ages, treatment of affected teeth and universal access to fluoridated water.

Perdas dentarias no Brasil: analise da Pesquisa Nacional de Saude Bucal 2010 / Perdidas dentarias en Brasil: analisis de la Investigacion Nacional de Salud Bucal 2010 / Tooth loss in Brazil: analysis of the 2010 Brazilian Oral Health Survey

OBJETIVO: Analisar a perda dentária com base em estimativas do número médio de dentes perdidos, prevalência de ausência de dentição funcional e edentulismo em adolescentes, adultos e idosos brasileiros, comparando-a com resultados de 2003. MÉTODOS: Os dados referem-se à Pesquisa Nacional de Saúde Bucal (SBBrasil 2010): adolescentes de 15 a 19 anos (n = 5.445), adultos entre 35 e 44 anos (n = 9.779) e idosos entre 65 e 74 anos (n = 7.619). O número de dentes perdidos, a prevalência de indivíduos sem dentição funcional (< 21 dentes naturais) e de edentulismo (perda total dos dentes) foram estimados para cada grupo etário, capitais e macrorregiões brasileiras. Foram realizadas análises de regressão logística (perdas dentárias) e de Poisson (ausência de dentição funcional e edentulismo) multivariáveis para identificar fatores socioeconômicos e demográficos associados a cada desfecho. RESULTADOS: A prevalência de perdas dentárias entre adolescentes foi de 17,4% (38,9% em 2002-3), variando de 8,1% entre os estratos de maior renda a quase 30% entre os menos escolarizados. Entre adolescentes, as mulheres, pardos e pretos, os de menor renda e escolaridade apresentaram maiores prevalências de perdas. Ausência de dentição funcional ocorreu em aproximadamente » dos adultos, sendo superior nas mulheres, nos pretos e pardos, nos de menor renda e escolaridade. A média de dentes perdidos em adultos declinou de 13,5 em 2002-3 para 7,4 em 2010. Mais da metade da população idosa é edêntula (similar em 2002-3); maiores prevalências de edentulismo em idosos foram observadas em mulheres, nos de menores renda e escolaridade. A média de dentes perdidos em adolescentes variou de 0,1 (Curitiba e Vitória) a 1,2 (interior da região Norte). Entre ...

OBJETIVO: Analizar la pérdida dentaria con base en estimaciones del número promedio de dientes perdidos, prevalencia de ausencia de dentición funcional y edentulismo en adolescentes, adultos y ancianos brasileños, comparándola con resultados de 2003. MÉTODOS: Los datos se refieren a la Investigación Nacional de Salud Bucal (SBBrasil): adolescentes de 15 a 19 años (n=5.445), adultos entre 35 y 44 años (n=9.779) y ancianos entre 65 y 74 años (n=7.619). El número de dientes perdidos, la prevalencia de individuos sin dentición funcional (< 21 dientes naturales) y de edentulismo (pérdida total de los dientes), fueron estimados para cada grupo etario, capitales y macro regiones brasileñas. Se realizaron análisis de regresión logística (pérdidas dentarias) y de Poisson (ausencia de dentición funcional y edentulismo) multivariables para identificar factores socioeconómicos y demográficos asociados a cada aspecto. RESULTADOS: La prevalencia de pérdidas dentarias entre adolescentes fue de 17,4% (38,9% en 2002-3) variando de 8,1% entre los estratos de mayor renta a casi 30% entre los menos escolarizados. Entre adolescentes, las mujeres, pardos y negros, los de menor renta y escolaridad presentaron mayores prevalencias de pérdidas. La ausencia de dentición funcional ocurrió en aproximadamente » de los adultos, siendo superior en las mujeres, en los negros y pardos, en los de menor renta y escolaridad. El promedio de dientes perdidos en adultos declinó de 13,5 en 2002-3 a 7,4 en 2010. Más de la mitad de la población anciana es edéntula (similar en 2002-3); mayores prevalencias de edentulismo en ancianos fueron observadas en mujeres, en los de menor renta y escolaridad. El promedio de dientes perdidos en adolescentes varió de 0,1 (Curitiba y Vitória) a 1,2 (interior de la región ...

OBJECTIVE: To estimate the mean number of missing teeth, lack of functional dentition and total tooth loss (edentulism) among adolescents, adults and the elderly in Brazil, comparing the results with those of 2003. METHODS: Data from 5,445 adolescents aged 15-19, 9,779 adults aged 35-44 and 7,619 elderly individuals aged 65-74, participants in the Brazilian Oral Health Survey (SBBrasil) 2010, were analyzed. The mean missing teeth, proportion of lack of functional dentition (< 21 natural teeth) and proportion of edentulism (total tooth loss) were estimated for each age group, each state Capital and each macro region. Multivariable logistic regression (tooth loss) and Poisson (absence of functional dentition and edentulism) analyses were performed in order to identify socioeconomic factors and demographic characteristics associated with each outcome. RESULTS: The prevalence of tooth loss among adolescents was 17.4% (38.9% in 2002-03) ranging from 8.1% among those earning higher income to almost 30% among those with less schooling. Among adolescents, females, those with black or brown skin and those with the lowest levels of income and schooling had a higher prevalence of tooth loss. Lack of functional dentition affected nearly » of adults, it was higher among women, among those with black and brown skin and among those with the lowest levels of income and schooling. Mean missing teeth in adults decreased from 13.5 in 2002-03 to 7.4 in 2010. More than half of elderly is edentulous (similar to the 2002-03 findings); higher prevalence of edentulism was found among women and those with the lowest levels of income and schooling. Among adolescents the mean missing teeth ranged from 0.1 (in Curitiba, South Brazil and Vitória, Southeast Brazil) to 1.2 (in the North countryside). Among adults the lowest mean missing teeth was found in Vitória (4.2) and the highest in Rio Branco, North Brazil (13.6). CONCLUSIONS: A remarkable ...

Perdas dentárias em adolescentes brasileiros e fatores associados: estudo de base populacional / Perdidas dentarias en adolescentes brasileros y factores asociados: estudio de base poblacional / Tooth loss and associated factors in adolescents: a Brazilian population-based oral health survey

OBJETIVO: Estimar a prevalência das perdas dentárias em adolescentes brasileiros e os fatores a elas associados. MÉTODOS: Foram analisados dados de 16.833 participantes do estudo epidemiológico nacional de saúde bucal, realizado em 2002/2003. O desfecho investigado foi a ocorrência de perda de pelo menos um dente. As variáveis independentes incluíram localização geográfica de residência, sexo, cor de pele, idade, renda per capita, atraso escolar, tipo de serviço e residência em município com fluoretação das águas de abastecimento. Foram estimadas razões de prevalência brutas e ajustadas por meio da regressão de Poisson para cada macrorregião e para o País como um todo. RESULTADOS: A prevalência de pelo menos uma perda dentária foi de 38,9 por cento (IC 95 por cento: 38,2 por cento; 39,7 por cento). Os adolescentes residentes em locais não servidos por água fluoretada apresentaram prevalência de perdas dentárias 40 por cento maior do que os residentes em áreas com disponibilidade dessa medida. Houve forte associação (p<0,01) entre a ausência da fluoretação das águas de abastecimento e as perdas dentárias para a região Nordeste. Para as demais regiões a associação das perdas com fluoretação de águas foi confundida pelas variáveis mais distais, notadamente as socioeconômicas, reforçando as características de desigualdades regionais. CONCLUSÕES: A alta prevalência de perdas dentárias em adolescentes confirma a necessidade de haver prioridade para atendimento desse grupo pelos serviços odontológicos, considerando medidas preventivas em idades mais precoces, de recuperação dos danos instalados e acesso universal à água fluoretada.

OBJECTIVE: To estimate tooth loss among adolescents and its factors associated. METHODS: Data from 16,833 participants of the Brazilian Oral Health Survey 2002-2003 were analyzed. The outcome studied was tooth loss of at least one tooth. Independent variables included geographical localization, gender, skin color, per capita income, education gap, dental service utilization and fluoridated water supply at the local level. Crude and adjusted prevalence ratios were estimated using Poisson regression for each Brazilian macroregion and nationwide. RESULTS: The prevalence of at least one tooth loss was 38.9 percent (95 percent CI 38.2 percent;39.7 percent). Adolescents living in localities with non-fluoridated water supply were 40 percent more likely to have tooth loss compared with those living in areas with fluoridated water supply. There was seen a strong association (p<0.01) between non-fluoridated water supply and tooth loss prevalence in the Northeast. In other Brazilian regions this association was confounded for distal variables, mainly socioeconomic variables, reinforcing regional inequalities. CONCLUSIONS: High prevalence of tooth loss among Brazilian adolescents shows a need for targeted dental actions including prevention at earlier ages, treatment of affected teeth and universal access to fluoridated water.

OBJETIVO: Estimar la prevalencia de las perdidas dentarias en adolescentes brasileros y los factores asociados a ellas. MÉTODOS: Fueron analizados datos de 16.833 participantes del estudio epidemiológico nacional de salud bucal, realizado en 2002/2003. El hecho investigado fue la ocurrencia de pérdida de por lo menos un diente. Las variables independientes incluyeron localización geográfica de residencia, sexo, color de piel, edad, renta per capita, atraso escolar, tipo de servicio y residencia en municipio con fluorificación de las aguas de abastecimiento. Fueron estimadas las tasas de prevalencia brutas y ajustadas por medio de la regresión de Poisson para cada macro región y para Brasil como un todo. RESULTADOS: La prevalencia de por lo menos una pérdida dentaria fue de 38,9 por ciento (IC 95 por ciento: 38,2 por ciento; 39,7 por ciento). Los adolescentes residentes en locales no servidos por agua fluorificada presentaron prevalencia de pérdida dentaria 40 por ciento mayor que los residentes en áreas con disponibilidad de esa medida. Hubo fuerte asociación (p<0,01) entre la ausencia de fluorificación de las aguas de abastecimiento y las pérdidas dentarias para la región Noroeste. Para las demás regiones la asociación de las pérdidas con fluorificación de aguas fue confundida por las variables más distantes, notoriamente las socioeconómicas, reforzando las características de desigualdades regionales. CONCLUSIONES: Las altas prevalencias de pérdidas dentarias en adolescentes confirma la necesidad de existir prioridad para atención de ese grupo por los servicios odontológicos, considerando medidas preventivas en edades más precoces, de recuperación de los daños instalados y acceso universal al agua fluorificada.

Perdas dentárias e fatores sociais, demográficos e de serviços associados em adultos brasileiros: uma análise dos dados do Estudo Epidemiológico Nacional (Projeto SB Brasil 2002-2003) / Tooth loss and associated socioeconomic, demographic, and dental-care factors in Brazilian adults: an analysis of the Brazilian Oral Health Survey, 2002-2003

O objetivo deste estudo foi estimar a prevalência de perdas dentárias em adultos de 35 a 44 anos de idade. Além disso, foram testadas associações entre as perdas dentárias e condições demográficas, sócio-econômicas e com utilização de serviços odontológicos. Foram analisados os dados de 13.431 participantes do estudo epidemiológico nacional de saúde bucal realizado em 2002-2003. O número de perdas dentárias (£ 12 e > 12) foi o desfecho investigado. As variáveis independentes incluíram localização geográfica, gênero, cor da pele, idade, renda per capita, escolaridade, tempo decorrido desde a última consulta odontológica e tipo de serviço utilizado. Foram estimadas as razões de prevalência bruta e ajustada através de regressão de Poisson. Edentulismo atingiu 9 por cento da amostra; a mediana de dentes perdidos foi igual a 11. Perdas dentárias foram fortemente associadas com indivíduos residentes em zona rural, com as mulheres, com os mais pobres, com os de menor escolaridade e com aqueles de idade mais avançada. Usuários do serviço público e aqueles que consultaram dentista há mais tempo também apresentaram maior prevalência do agravo mesmo após o ajuste por variáveis sócio-econômicas e demográficas.

The aim of this study was to estimate the prevalence of tooth loss among Brazilian adults aged 35 to 44 years. The study also tested the association between tooth loss and demographic, socioeconomic, and dental-care utilization variables. Data were analyzed from 13,431 individuals submitted to dental examination and interviewed in the National Oral Health Survey in 2002-2003. The number of lost teeth (£ 12 and > 12) was the outcome. Exploratory variables included geographic area, gender, skin color, age, per capita income, schooling, time since last dental appointment, and type of dental service used. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. The prevalence of edentulism was 9 percent, while median tooth loss was 11. Tooth loss was strongly associated with living in rural areas, female gender, poor socioeconomic status, low schooling, and older age. Individuals who attended public dental care services and those with more time elapsed since their last dental appointment showed a higher prevalence of tooth loss than their counterparts after controlling for demographic and socioeconomic factors.