Oral health profile among community-dwellingelderly and its association with self-rated oral health. / Perfil de saúde bucal de idosos não institucionalizados e sua associaçãocom autoavaliação da saúde bucal.

INTRODUCTION: The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. OBJECTIVES: The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. METHODS: Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. RESULTS: The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. CONCLUSION: There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.

INTRODUÇÃO: O uso de prótese e a perda dentária em idosos estão associados a impactos significativos na saúde geral e na qualidade de vida. A avaliação contínua do perfil de saúde bucal dessa população é importante para o planejamento das ações e políticas da área. OBJETIVO: Foram objetivos deste trabalho avaliar a prevalência de perda dentária e uso de próteses entre idosos em diferentes períodos, verificar as características sociodemográficas associadas à dentição funcional (mais de 20 dentes) e avaliar o impacto do uso de prótese e da perda dentária na autoavaliação da saúde bucal. MÉTODOS: A amostra foi composta por pessoas de 60 anos ou mais, participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). A avaliação da prevalência de perda dental e uso de próteses foi feita a partir da comparação dos dados coletados nos anos de 2000, 2006 e 2010. As análises dos fatores associados à dentição funcional e autoavaliação de saúde bucal foram realizadas com base nos dados coletados no ano de 2010. A comparação do perfil de saúde bucal ao longo dos três períodos foi feita por meio de análises descritivas e comparação de intervalos de confiança. Realizou-se análise de regressão logística múltipla para avaliar os fatores associados à dentição funcional e à autoavaliação da saúde bucal. RESULTADOS: A prevalência de perda dental e uso de próteses se manteve constante ao longo dos três anos analisados. A dentição funcional foi significativamente associada à escolaridade, sexo e cor/gênero. Idosos com necessidade de próteses e bolsa periodontal apresentaram mais chances de autoavaliação ruim. CONCLUSÃO: Não houve redução da prevalência de perda dentária e uso de próteses ao longo de dez anos na população estudada. A dentição funcional está associada a desigualdades sociodemográficas. A autoavaliação de saúde bucal está associada à necessidade de próteses.

[Prospective study on tooth loss in a cohort of dentate elderly]. / Estudo prospectivo da perda dentária em uma coorte de idosos dentados.

The aim of this study was to assess factors associated with tooth loss in elderly 60 years or older during a four-year observation period. A representative cohort of dentate elderly from the city of São Paulo, Brazil, participated in the study. The outcome was teeth loss incidence from 2006 to 2010. Demographic and socioeconomic characteristics, health services access and use, behavior, reported diseases, cognitive status, functional status, state of dentition, and use of dental prosthesis were recorded as independent variables in 2006 and the outcome was measured in 2010. Negative binomial regression models were used. Participation included 440 dentate elderly. Increased likelihood of tooth loss was associated with use of two removable prostheses (RR = 1.57; 95%CI: 1.02-2.41), fair self-rated oral health (RR = 1.62; 95%CI: 1.11-2.36), bad/very bad self-rated oral health (RR = 1.87; 95%CI: 1.11-3.17), male gender (RR = 1.74; 95%CI: 1.28-2.37), and living alone (RR = 2.03; 95%CI: 1.11-3.72).

Factors associated with deterioration of self-rated chewing ability among adults aged 60 years and older over a 6-year period.

AIM: To assess factors associated with the deterioration of self-rated chewing ability among adults aged 60 years and older over a 6-year period. METHODS: We carried out a case-control study nested in a cohort involving 890 individuals living in the city of Sao Paulo from 2000 to 2006. The outcome was the reduction of self-rated chewing ability. Covariates on demographic, socioeconomic, behavior, cognitive, and functional and physical status variables were investigated. Simple and multiple analyses were carried out using unconditional logistic regression with hierarchical selection of variables. RESULTS: We analyzed 236 cases and 654 controls. In the unadjusted assessment, the reduction of self-rated chewing ability was associated with being aged older than 74 years, widowed, low schooling/income, not having a microwave oven or a car, physical inactivity, poor/regular self-rated health, to feel disgusted, poor/regular self-rated memory, one or more compromised daily life activities, dependence for daily life activities and to report less than half of teeth. Older adults aged older than 74 years and widowers had twice the odds of the outcome in the final model. Adjusted for demographic variables, individuals with lower income showed a similar increase of odds (OR 2.06 95% CI 1.31-3.23). To report poor/regular memory (OR 1.85 95% CI 1.28-2.67) and less than half remaining teeth (OR 1.76 95%CI 1.06-2.93) were significant factors in the adjusted model. CONCLUSION: Advanced age, low income, widowhood, poor/regular memory and less than half remaining teeth were important risk indicators for the reduction of self-rated chewing ability among individuals aged 60 years or older.

[Oral Health in the cohorts from the São Paulo Health, Well-Being, and Aging Study (SABE)]. / Saúde bucal nas Coortes do Estudo SABE (Saúde, Bem-Estar e Envelhecimento) em São Paulo.

The objective of this paper is to present the characteristics and methodological procedures used in the study SABE (Health, Well-Being, and Aging). This is a longitudinal study with multiple cohorts, carried out in the city of São Paulo, Brazil, since 2000. Follow-ups are conducted every five years when the new cohort is initiated. The SABE study employed a stratified, multistage sampling design to obtain a representative sample of community-dwelling individuals aged 60 years or more in the city of Sao Paulo. Data were collected by a structured questionnaire and clinical measurements taken by trained and calibrated examiners. The questionnaire included information on socioeconomic and demographic conditions, cognitive function, general health, medication, use and access to health services, oral health, nutrition, social support, functionality and well-being. The baseline study included self-reported oral health measurements, and clinical oral health measures were introduced in 2006.

Oral health and changes in weight and waist circumference among community-dwelling older adults in Brazil.

BACKGROUND: The authors conducted a study to evaluate the association between changes in weight and waist circumference (WC) and oral health status among older adults in Brazil. METHODS: The study sample consisted of community-dwelling people representing the population 60 years and older in the city of São Paulo who were enrolled in the Health, Well-being and Aging cohort study. Changes in weight and WC were classified as stable (within 5 percent of the second-wave weight and WC), loss (5 percent or more decrease since the second wave) and gain (5 percent or more increase since the second wave). The following baseline characteristics were the independent variables: sociodemographic variables (age, sex and education), general health data (number of self-reported chronic diseases, physical activity, weight, WC and smoking status) and oral health (edentulism, need for dental prostheses). RESULTS: The incidence of weight (33.2 percent) and WC (35.3 percent) gain was higher than that of loss (13.5 percent and 10.6 percent, respectively). Neither weight nor WC gains were associated with dental status. The risk of weight and WC loss was higher among edentulous participants than among dentate participants. CONCLUSION: The results of this study show that edentulism status was a significant predictor of weight and WC loss, independent of socioeconomic and general health status. PRACTICAL IMPLICATIONS: Edentulism has a significant impact on weight and WC, which highlights the importance of an integrated approach to health care among health care professionals.

Relationship between oral health and frailty in community-dwelling elderly individuals in Brazil.

OBJECTIVES: To test the hypothesis that clinical oral health conditions are associated with frailty independent of socioeconomic and general health status. DESIGN: Cross-sectional. SETTING: Population-based cohort study of health, well-being, and aging. PARTICIPANTS: One thousand three hundred seventy-four community-dwelling individuals representing 998,528 individuals aged 60 and older in the city of São Paulo, Brazil. MEASUREMENTS: Frailty was defined on the basis of five characteristics: weight loss, weakness, slowness, exhaustion, and low level of physical activity. Participants with three or more characteristics were classified as frail, with one or two as prefrail, and with zero as nonfrail. Oral health measures were number of teeth, use of dental prostheses, need for dental prostheses, presence of decayed teeth, clinical attachment loss of 4 mm or greater, and periodontal pocket of 4 mm or greater. Data on sociodemographic (age, sex, and schooling) and general health (number of self-reported chronic diseases and smoking status) data were assessed. RESULTS: The prevalence of frailty was 8.5%, with 50.8% considered nonfrail. Elderly individuals with a need for dental prostheses were significantly more likely to be prefrail and frail. Participants with 20 or more teeth had a lower chance of being frail than edentulous individuals. CONCLUSION: The need for dental prostheses was significantly associated with frailty, independent of socioeconomic and general health status.

Perfil de saúde bucal de idosos não institucionalizados e sua associaçãocom autoavaliação da saúde bucal / Oral health profile among community-dwellingelderly and its association with self-rated oral health

RESUMO: Introdução: O uso de prótese e a perda dentária em idosos estão associados a impactos significativos na saúde geral e na qualidade de vida. A avaliação contínua do perfil de saúde bucal dessa população é importante para o planejamento das ações e políticas da área. Objetivo: Foram objetivos deste trabalho avaliar a prevalência de perda dentária e uso de próteses entre idosos em diferentes períodos, verificar as características sociodemográficas associadas à dentição funcional (mais de 20 dentes) e avaliar o impacto do uso de prótese e da perda dentária na autoavaliação da saúde bucal. Métodos: A amostra foi composta por pessoas de 60 anos ou mais, participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). A avaliação da prevalência de perda dental e uso de próteses foi feita a partir da comparação dos dados coletados nos anos de 2000, 2006 e 2010. As análises dos fatores associados à dentição funcional e autoavaliação de saúde bucal foram realizadas com base nos dados coletados no ano de 2010. A comparação do perfil de saúde bucal ao longo dos três períodos foi feita por meio de análises descritivas e comparação de intervalos de confiança. Realizou-se análise de regressão logística múltipla para avaliar os fatores associados à dentição funcional e à autoavaliação da saúde bucal. Resultados: A prevalência de perda dental e uso de próteses se manteve constante ao longo dos três anos analisados. A dentição funcional foi significativamente associada à escolaridade, sexo e cor/gênero. Idosos com necessidade de próteses e bolsa periodontal apresentaram mais chances de autoavaliação ruim. Conclusão: Não houve redução da prevalência de perda dentária e uso de próteses ao longo de dez anos na população estudada. A dentição funcional está associada a desigualdades sociodemográficas. A autoavaliação de saúde bucal está associada à necessidade de próteses.

ABSTRACT: Introduction: The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. Objectives: The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. Methods: Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. Results: The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. Conclusion: There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.

Sintomas depressivos em idosos do município de São Paulo, Brasil: prevalência e fatores associados (Estudo SABE) / Depressive symptoms among the elderly in São Paulo city, Brazil: prevalence and associated factors (SABE Study)

RESUMO: Objetivo: Estimar a prevalência de sintomas depressivos em idosos do município de São Paulo, Brasil (Estudo SABE), em 2006 e identificar fatores de risco associados a essa prevalência em 2006 e fatores de proteção entre os idosos que não apresentaram sintomas depressivos nas avaliações realizadas em 2000 e 2006. Métodos: Estudo transversal e longitudinal que utilizou a Escala de Depressão Geriátrica na inclusão da coorte em 2000 e em 2006. Resultados: A prevalência de sintomas depressivos em 2006 foi de 14,2% (IC95% 11,8 - 16,7) e 74,8% dos participantes não apresentaram sintomas depressivos em 2000 nem em 2006. Foram construídos modelos de regressão logística, tendo como exposição diferentes grupos de variáveis (sociodemográficas; condições e percepção de saúde e memória) ajustando-se para sexo e idade. No modelo final da regressão logística, associaram-se a sintomas depressivos: autoavaliação da visão, da saúde bucal, da memória e da saúde geral como ruins, dependência para atividades básicas de vida diária e disfunção familiar moderada ou grave. Os fatores de proteção para não ter apresentado sintomas depressivos nas fases de 2000 e 2006 foram: sexo masculino, não referir doença pulmonar e avaliar positivamente a saúde. Conclusão: Sintomas depressivos nos idosos estudados foram frequentes e se associaram com piores condições de saúde, dependência e disfunção familiar e tais fatores devem ser considerados no planejamento de políticas de saúde para prestação de cuidados a esses idosos.

ABSTRACT: Objective: To estimate the prevalence of depressive symptoms in the elderly in São Paulo city, Brazil (SABE Study), in 2006 and to identify risk factors associated with the 2006 prevalence and protective factors among those who did not have depressive symptoms in the assessments conducted in 2000 and 2006. Methods: In this cross-sectional and longitudinal study, the Geriatric Depression Scale was used for inclusion in the cohort in 2000 and also in 2006. Results: The prevalence of depressive symptoms in 2006 was 14.2% (95%CI 11.8 - 16.7), and 74.8% of the participants did not present depressive symptoms in 2000 neither in 2006. Logistic regression models were constructed, with different groups of variables (socio-demographic variables, status and perception of health and memory) adjusted for sex and age. In the final logistic regression model, the following factors were associated with depressive symptoms: self-assessment of vision, oral health, memory and of general health as poor, dependence for basic activities of daily living, and moderate or severe family dysfunction. Protective factors against presenting depressive symptoms in the 2000 and 2006 phases were: being male, absence of pulmonary disease and positive self-assessment of health. Conclusion: Depressive symptoms were frequent among the elderly, and were associated with health problems, dependence and family dysfunction. These factors should be addressed in health policy planning for the care of these elderly.

Factors related to poor self-perceived oral health among community-dwelling elderly individuals in São Paulo, Brazil.

The present study investigated the prevalence of poor self-perceived oral health and its association with oral health, general health and socioeconomic factors among elderly individuals from São Paulo, Brazil. The sample consisted of 871 elderly individuals enrolled in the Health, Wellbeing and Aging cohort study. Self-perceived oral health was measured by the question: "How would you rate your oral health?". Most subjects self-rated their oral health as good. Among dentate individuals, poor oral health was related to depression, poor self-rated health, dental treatment, dental checkups and the psychosocial subscale scores of the Geriatric Oral Health Assessment Index. Edentulous individuals were more likely to report poor oral health, whereas those with higher psychosocial scores were less likely to report poor self-rated oral health. Poor self-rated oral health is associated with general health factors and the psychosocial impact of oral health on quality of life, regardless of socioeconomic and clinical health measures.

Relationship between oral health-related quality of life, oral health, socioeconomic, and general health factors in elderly Brazilians.

OBJECTIVES: To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors. DESIGN: Cross-sectional study. SETTING: Population-based cohort study on health, well-being, and aging. PARTICIPANTS: Eight hundred fifty-seven participants representing 588,384 community-dwelling elderly adults from the city of São Paulo, Brazil. MEASUREMENTS: Self-perceived impact of oral health on quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI), with scores categorized as good, moderate, or poor, indicating low, moderate, and high degrees of negative impact on quality of life, respectively. RESULTS: Nearly half of the individuals had good GOHAI scores (44.7% of overall sample, 45.9% of dentate participants, and 43.4% of edentulous participants). In the overall sample, those with poor self-rated general health and a need for dental prostheses were more likely to have poor and moderate GOHAI scores. Individuals with depression were significantly more likely to have poor GOHAI scores. No socioeconomic variables were related to the outcome, except self-perception of sufficient income, which was a protective factor against a poor GOHAI score in dentate participants. CONCLUSION: Moderate and high degrees of negative impact of oral health on quality of life were associated with general health and clinical oral health measures, independent of socioeconomic factors.

Correlates of change in self-perceived oral health among older adults in Brazil: findings from the Health, Well-Being and Aging Study.

BACKGROUND: Identifying changes in the oral health status of older populations, and their predictors and explanations, is necessary for public health planning. The authors assessed patterns of change in oral health-related quality of life in a large cohort of older adults in Brazil during a five-year period and evaluated associations between baseline characteristics and those changes. METHODS: The sample consisted of 747 older people enrolled in a Brazilian cohort study called the Health, Well-Being and Aging (Saúde, Bem-estar e Envelhecimento [SABE]) Study. Trained examiners measured participants' self-perceived oral health by using the General Oral Health Assessment Index (GOHAI). The authors calculated changes in the overall GOHAI score and in the scores for each of the GOHAI's three dimensions individually by subtracting the baseline score from the score at follow-up. A positive difference indicated improvement in oral health, a negative difference indicated a decline and a difference of zero indicated no change. RESULTS: The authors found that 48.56 percent of the participants experienced a decline in oral health and 33.48 percent experienced an improvement. Participants with 16 or more missing teeth and eight or more years of education were more likely to have an improvement in total GOHAI score. Deterioration was more likely to occur among those with two or more diseases. Improvement and decline in GOHAI functional scores were related to the number of missing teeth. The authors found no significant model for the change in the psychosocial score, and self-rated general health was the only variable related to both improvement and decline in pain or discomfort scores. CONCLUSIONS: The authors observed a bidirectional change in self-perceived oral health, with deterioration predominating. The strongest predictor of improvement in the total GOHAI score was the number of missing teeth, whereas the number of diseases was the strongest predictor of deterioration. CLINICAL IMPLICATIONS: Dental professionals and policymakers need to know the directions of change in older adults' oral health to establish treatment priorities and evaluate the impact of services directed at this population.

Estudo prospectivo da perda dentária em uma coorte de idosos dentados / Prospective study on tooth loss in a cohort of dentate elderly / Estudio prospectivo de la pérdida dental en una cohorte de ancianos dentados

Resumo: Este trabalho teve como objetivo avaliar fatores associados à perda dentária entre idosos de 60 anos e mais de idade num período de observação de quatro anos. Uma coorte de idosos dentados representativa da população da cidade de São Paulo, Brasil, participou do estudo. O desfecho foi a incidência de dentes perdidos entre os anos de 2006 a 2010. As variáveis independentes características demográficas, socioeconômicas, de uso e acesso a serviços de saúde, comportamento, morbidade referida, estado cognitivo, capacidade funcional, estado da dentição e uso de prótese foram medidas em 2006 e o desfecho em 2010. Utilizaram-se modelos de regressão binomial negativa. Participaram 440 indivíduos dentados. A análise final mostrou maior probabilidade de perda dentária em idosos que utilizavam duas próteses removíveis (RR = 1,57; IC95%: 1,02-2,41), que avaliaram sua saúde bucal como regular (RR = 1,62; IC95%: 1,11-2,36), ou ruim/muito ruim (RR = 1,87; IC95%: 1,11-3,17), do sexo masculino (RR = 1,74; IC95%: 1,28-2,37), e que moravam sozinhos (RR = 2,03; IC95%: 1,11-3,72).

Abstract: The aim of this study was to assess factors associated with tooth loss in elderly 60 years or older during a four-year observation period. A representative cohort of dentate elderly from the city of São Paulo, Brazil, participated in the study. The outcome was teeth loss incidence from 2006 to 2010. Demographic and socioeconomic characteristics, health services access and use, behavior, reported diseases, cognitive status, functional status, state of dentition, and use of dental prosthesis were recorded as independent variables in 2006 and the outcome was measured in 2010. Negative binomial regression models were used. Participation included 440 dentate elderly. Increased likelihood of tooth loss was associated with use of two removable prostheses (RR = 1.57; 95%CI: 1.02-2.41), fair self-rated oral health (RR = 1.62; 95%CI: 1.11-2.36), bad/very bad self-rated oral health (RR = 1.87; 95%CI: 1.11-3.17), male gender (RR = 1.74; 95%CI: 1.28-2.37), and living alone (RR = 2.03; 95%CI: 1.11-3.72).

Resumen: Este estudio tuvo como objetivo evaluar factores asociados a la pérdida dental entre ancianos de 60 años y más de edad, en un período de observación de 4 años. Participó en el estudio una cohorte de ancianos dentados, representativa de la población de la ciudad de São Paulo, Brasil. El resultado fue la incidencia de dientes perdidos entre los años de 2006 y 2010. Se midieron en 2006 las variables independientes, características demográficas, socioeconómicas, de uso y acceso a servicios de salud, comportamiento, morbilidad referida, estado cognitivo, capacidad funcional, estado de la dentición y el uso de prótesis. Se analizó el resultado en 2010. Se utilizaron modelos de regresión binomial negativa. Participaron 440 individuos dentados, cuyo análisis final mostró mayor probabilidad de pérdida dental en ancianos que utilizaban dos prótesis removibles (RR = 1,57; IC95%: 1,02-2,41), que evaluaron su salud bucal como regular (RR = 1,62; IC95%: 1,11-2,36) o mala/muy mala (RR = 1,87; IC95%: 1,11-3,17), del sexo masculino (RR = 1,74; IC95%: 1,28-2,37) y que vivían solos (RR = 2,03; IC95%: 1,11-3,72).

Factors related to poor self-perceived oral health among community-dwelling elderly individuals in São Paulo, Brazil / Fatores associados à autopercepção de saúde bucal ruim entre idosos não institucionalizados do Município de São Paulo, Brasil

The present study investigated the prevalence of poor self-perceived oral health and its association with oral health, general health and socioeconomic factors among elderly individuals from São Paulo, Brazil. The sample consisted of 871 elderly individuals enrolled in the Health, Wellbeing and Aging cohort study. Self-perceived oral health was measured by the question: "How would you rate your oral health?". Most subjects self-rated their oral health as good. Among dentate individuals, poor oral health was related to depression, poor self-rated health, dental treatment, dental checkups and the psychosocial subscale scores of the Geriatric Oral Health Assessment Index. Edentulous individuals were more likely to report poor oral health, whereas those with higher psychosocial scores were less likely to report poor self-rated oral health. Poor self-rated oral health is associated with general health factors and the psychosocial impact of oral health on quality of life, regardless of socioeconomic and clinical health measures.

Este estudo avaliou a prevalência de autopercepção de saúde bucal como ruim em idosos de São Paulo, Brasil, e investigou sua relação com a saúde bucal, saúde geral e fatores socioeconômicos. A amostra foi composta por 871 idosos do estudo de coorte Saúde, Bem-Estar e Envelhecimento. A autopercepção da saúde bucal foi medida pela pergunta: "Como você classifica a sua saúde bucal?". A maioria dos idosos apresentou autoavaliação de saúde bucal boa. A autopercepção de saúde bucal como ruim, entre indivíduos dentados, foi relacionada à depressão, autoavaliação de saúde ruim, check-up odontológico, tratamento dentário e dimensão psicossocial do Geriatric Oral Health Assessment Index. Desdentados com autoavaliação de saúde ruim apresentaram maior probabilidade de relatar saúde bucal ruim, enquanto aqueles com maior pontuação na dimensão psicossocial tiveram menor chance de autoavaliação ruim. A autoavaliação de saúde bucal ruim foi associada com fatores de saúde geral e com o impacto psicossocial da saúde bucal na qualidade de vida, independentemente de medidas socioeconômicas e clínicas de saúde bucal.

Estudo da emergência odontológica e traumatologia buco-maxilo-facial nas unidades de internaçäo e de emergência dos hospitais do Município de Säo Paulo / Study of dental morbidity in hospitals in the city of Säo Paulo, Brazil

A odontologia atende, através de seus serviços de emergência odontológica e traumatologia buco-maxilo-facial, diversos casos dentro desse contexto e prescinde de conhecer melhor essa morbidade, uma vez que näo existem estudos com abrangência populacional nessa área. Devido ao fato de a odontologia hospitalar atender casos com origem nas causas externas e também casos originados da falta de tratamento odontológico ambulatorial, a casuística encontrada é complexa. Estudar a morbidade observada através das consultas realizadas em unidades de internaçäo e emergência, segundo sexo, idade, diagnóstico e causa externa da lesäo. Triaram-se as instituiçöes que atendiam a emergência odontológica geral e a traumatologia buco-maxilo-facial, a partir das fontes de dados governamentais (SIH-SUS e SAI-SUS), tomando-se como base os meses ímpares dos anos de 1996 e 1997. Por meio de questionários, configurou-se a rede governamental para esses serviços. Para os vinte e um hospitais que atendiam esses casos elavorou-se uma amostra por conglomerado único, abrangendo 5 por cento dos atendimentos de cada uma das instituiçöes. Mais da metade (57 por cento) dos atendimentos está ligada à emergência odontológica comum e 34 por cento à traumatologia buco-maxilo-facial, área na qual aparece prioritariamente o adulto jovem do sexo masculino, configurando perfil semelhante ao encontrado na mortalidade por causas externas. Esta análise mostra que a sociedade observada ainda apresenta problemas odontológicos básicos, como a cárie e a doença periodontal, mas já indica o impacto das lesöes com origem nas causas externas. No grupo Lesöes, envenenamento e algumas outras consequências de causas externas evidencia-se a superioridade numérica dos casos para o sexo masculino e jovens. Verifica-se concentraçäo maior de casos paa diagnósticos mais graves, como as fraturas e ferimentos, do que para os traumatismos superficiais. Os ferimentos da cabeça e os traumatismos superficiais mostram uma distribuiçäo, segundo sexo, mais equitativa do que no grupo de fraturas da face, que tendem a acometer mais o sexo masculino. A distribuiçäo proporcional segundo as causas é semelhante em ambos os sexos, mas a mulher se expöe menos às lesöes por causas externas

Comparando a Classificaçäo Internacional de Doenças em Odontologia e Estomatologia (CID-OE) com a Classificaçäo Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10) / Comparing the International Classification of Disease to Dentistry and Stomatology (ICD-DA) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10)

Introduçäo: Nos estudos epidemiológicos de morbidade é necessário se adotar um sistema de classificaçäo de doenças. Na odontologia e nos traumatismos buco-maxilo-faciais pode-se usar a Classificaçäo Internacional de Doenças em Estomatologia e Odontologia (CID-OE) mas, em alguns casos esta classificaçäo näo é adequada. O objetivo deste estudo é comparar a aplicaçäo da CID-10 na classificaçäo de diagnósticos da área. Material e Métodos: Foram analisados 2372 casos atendidos em serviços de traumatismos buco-maxilo-faciais e emegências dentais no Município de Säo Paulo, Brasil, onde os diagnósticos encontrados foram codificados por ambas as classificaçöes. Resultados: A CID-OE especificou melhor 1117 casos mas, em 267, näo ofereceu possibilidade de codificaçäo. Em 978 casos, o detalhamento dado pela codificaçäo foi o mesmo em ambas as classificaçöes

A organizaçäo do atendimento da odontologia hospitalar e da traumatologia buco-maxilo-facil no município de Säo Paulo / The hospitalar odontology attendance organization and the Säo Paulo city's maxillofacial traumatology

Nas cidades da América Latina as lesöes causadas em acidentes e violências têm aumentado assustadoramente, seja decorrente da criminalidade, seja de acidentes decorrentes da falta de condiçöes habitacionais e de segurança no trabalho, no trânsito, nas práticas esportivas violentas ou lazer inadequado. Dentro desse quadro, a odontologia deve estar preparada para o atendimento da traumatologia dental e da buco-maxilo-facila. O objetivo deste artigo é mostrar a rede governamental de instituiçöes que atendem a emergência odontológica e a traumatologia buco-maxilo-facial no município de Säo Paulo e sua estruturaçäo no atendimento e na reabilitaçäo do paciente. As instituiçöes que atendiam a emergência odontológica geral e a traumatologia buco-maxilo-facial foram buscadas nas fontes de dados governamentais do ano de 1996 e 1997 (SIH-SUS e SIA-SUS), e nos relatórios da Secretaria Municipal da Saúde. Por meio de questionários, essas instituiçöes relataram o atendimento prestado na área odontológica. Os atendimentos säo feitos na maioria por unidades municipais, e os mais graves säo atendidos nos hospitais de ensino e pesquisa. As pessoas vítimas de traumatismos buco-maxilo-faciais recebem, na maioria das vezes, somente o primeiro atendimento, pois essas instituiçöes näo oferecem possibilidade de acompanhamento e de reabilitaçäo. Conclusäo: näo existe, no município de Säo Paulo, uma rede governamental que esteja preparada para atender a traumatologia dental e buco-maxilo-facil

A qualidade dos registros odontológicos dos hospitais do setor governamental do município de Säo Paulo / Quality of dental registrations in Säo Paulo Public Health System Care

Foram estudados 2.391 atendimentos odontológicos dos hospitais do setor governamental no município de Säo Paulo, em 1996/1997, onde se observou a qualidade dos registros. A maioria dos diagnósticos relatados foi vaga ou inespecífica e, em 54 casos, as anotaçöes näo permitiam sequer a identificaçäo correta do paciente. Em 25 por cento dos casos ligados a violência e acidentes estudados a descriçäo da causa externa da lesäo näo foi mencionada, impossibilitando a ligaçäo da lesäo à causa externa