RESUMO
AIM: To identify the individual and contextual factors associated with the absence of Brazilians at a scheduled appointment in Dental Specialties Centers (DSC). METHODS: This cross-sectional design uses the National Program for Improving Access and Quality of Dental Specialties Centers database, 2018. The outcome was the users' lack of at least one of the scheduled appointments. Contextual and individual independent variables were used, considering Andersen's behavioural model. The analyses were performed with the R Core Team and SAS (Studio 3.8, Institute Inc, North Carolina, U.S, 2019) programs. RESULTS: Of the 10,391 patients interviewed, 27.7% missed at least one of the consultations. In the adjusted multivariate model, the interpretation based on the effect size and 95% CI showed that the behaviour individual predisposing factors such as age ≤ 42 years (OR = 1.10; 95%CI:1.01-1.21), individual need factors such as participation in the "Bolsa Família" program (OR = 1,14; 95%CI:1.02-1.27), not being covered by the Family Health Strategy (OR = 1.15; 95% CI:1.02-1.30), and users of periodontics services (OR = 1.22;95%CI:1.05-1.40) were associated with absences. The behavioural factor associated with the outcome was that the DSC facilities were not in good condition (OR = 1.18; 95%CI:1.03-1.34). DSC located in the capital (OR = 1.12; 95% CI: 0.92-1.48) were 12% more likely to have dental absences than those in the interior region. CONCLUSION: There are individual and contextual barriers associated with patients not attending specialised public dental consultations. DSC should offer adequate hours to patients, especially young adults and vulnerable people.
Assuntos
Agendamento de Consultas , Assistência Odontológica , Adulto , Brasil , Estudos Transversais , Humanos , Encaminhamento e Consulta , Adulto JovemRESUMO
The aim of this study was to investigate associations of sociodemographic, lifestyle, medical conditions, and caries experience with oral health-related quality of life (OHRQoL) in a large sample of adults with mental disorders. A sample of 753 adults diagnosed with schizophrenia or depression, who were users of 10 public mental health outpatient clinics located in the city of São Paulo, Brazil, participated in the study. Participants provided data on sociodemographic characteristics, psychiatric diagnosis, medication use, and health behaviors. Oral examinations to evaluate dental caries (using the decayed, missing, and filled teeth ([DMFT] index) and dental plaque (using the Silness-Löe plaque index) were conducted. Oral health-related quality of life was evaluated using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire. Log-Poisson regression was used to evaluate associations between the outcome and independent variables. The prevalence of one or more OHIP-14 impacts occurring fairly often/often was 72.3%. Physical pain was the OHIP domain with the highest prevalence, followed by psychological discomfort. Multivariable analysis showed that higher prevalence of the reponses 'fairly often/often' in the OHIP-14 was associated with being female, aged 35 to 54 years, having a low family income, a diagnosis of depression, a smoking habit, and fewer than 20 teeth. Adults with mental disorders had a high prevalence of impacts on their OHRQoL, which were associated with caries experience, sociodemographic characteristics, type of psychiatric diagnosis, and behavioral risk indicators.
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Cárie Dentária , Transtornos Mentais , Adulto , Brasil , Estudos Transversais , Cárie Dentária/epidemiologia , Feminino , Humanos , Transtornos Mentais/epidemiologia , Saúde Bucal , Qualidade de VidaRESUMO
The aim of this study was to investigate associations between oral health literacy (OHL), self-rated oral health (SROH), and oral health-related quality of life (OHRQoL) in Brazilian adults. A sample of 523 Brazilian adults completed the short-form Health Literacy in Dentistry (HeLD-14) and the Oral Health Impact Profile-14 (OHIP-14) instruments that measure OHL and OHRQoL, respectively. The prevalence ratios (PRs) for outcome variables and their 95% CIs were quantified. Multivariable log-binomial regression models were applied, as the statistical models, to estimate bivariate and multivariable relationships of oral health outcomes with OHL, after adjusting for covariates. No significant association was found between poor SROH (as measured by single items) and OHL (PR = 1.28; 95% CI: 0.87-1.88); by contrast, significant associations were found between poor SROH and income (PR = 1.52; 95% CI: 1.04-2.21), toothbrushing frequency (PR = 1.69; 95% CI: 1.11-2.58), reason for dental visiting (PR = 1.48; 95% CI: 1.03-2.13), and self-rated general health (PR = 3.44; 95% CI: 2.38-4.97). The OHL level (PR = 1.76; 95% CI: 1.21-2.56), educational level (PR = 0.62; 95% CI: 0.41-0.93), reason for dental visiting (PR = 1.84; 95% CI: 1.30-2.61), and self-rated general health (PR = 1.51; 95% CI: 1.03-2.23) were associated with poor OHRQoL.
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Letramento em Saúde , Saúde Bucal , Adulto , Brasil , Estudos Transversais , Humanos , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To investigate the influence of oral health literacy (OHL) and associated factors on dissatisfaction with oral health (DOH) among older people. BACKGROUND: Oral health literacy is a recent field of research that has been considered an important mediator between socioeconomic variables and oral health outcomes. However, there are few studies with older people. MATERIALS AND METHODS: A cross-sectional study was conducted with 535 non-institutionalised older people aged 60-100 years from Brazil. Individuals completed a questionnaire on general health, sociodemographic information and usual reason for dental visit. OHL was assessed using the Health Literacy in Dentistry questionnaire (HeLD-14), validated in Brazil. DOH was the outcome of interest. Poisson regression with robust standard errors was applied as a statistical model to estimate bivariate and multivariable relationships of DOH with OHL after adjusting for sex, age, social characteristics and general health using the P-value of ≤ .05. RESULTS: The overall prevalence of DOH was 21.1%. Multivariable regression analysis showed that older people with low OHL (HeLD-14 score ≤35) had 1.28 times the odds of having DOH than those with high OHL (HeLD14 score >46), after adjusting for sociodemographic, economic and health outcomes. CONCLUSIONS: Dissatisfaction with oral health in older people is a complex issue associated with OHL, social and behavioural factors. Health services should give greater attention to developing health literacy competences in older adults in order to empower them to achieve optimal oral health.
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Letramento em Saúde , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Humanos , Pessoa de Meia-Idade , PrevalênciaRESUMO
PURPOSE: To compare 2-year cumulative survival rates in first permanent molars (FPM) with and without MIH and to investigate risk factors associated with caries incidence. MATERIALS AND METHODS: A total of 142 children aged 5 to 6 years were recruited from all public schools in Botelhos, Minas Gerais, Brazil and 536 FPM were examined. A questionnaire was designed to collect sociodemographic background and behavioural information about children and their parents. Caries in FPM was recorded per surface in accordance with WHO methodology at baseline and once every 6 months over a period of two years. The survival analysis was conducted using the Weibull regression model with cure fraction. RESULTS: MIH was present in 16.19% of children. The 2-year cumulative survival rates for FPM with and without MIH showed statistically significant differences, and visible plaque on anterior teeth had an effect on the survival rates. CONCLUSION: Children with MIH and visible plaque on anterior teeth at baseline had a high risk for developing new caries lesions in their FPM over the course of two years. These variables should be considered in caries risk assessment in paediatric dental care.
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Cárie Dentária/epidemiologia , Hipoplasia do Esmalte Dentário/epidemiologia , Placa Dentária/epidemiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incisivo , Masculino , Dente Molar , Estudos Prospectivos , Fatores de RiscoRESUMO
BACKGROUND: Oral problems can cause strong impact on functional, emotional, and social aspects of children and adolescents, as well as changes in school performance. AIM: To evaluate the associations of subjective perceptions of parents, socio-economic factors, and oral clinical conditions of children with their school performance. DESIGN: A case-control design was used with a sample of 1411 schoolchildren aged 8-10 years from city of Piracicaba, São Paulo, Brazil. Clinical conditions were evaluated using the DMFT and dmft indexes. Socio-economic data were obtained using a questionnaire sent to schoolchildren's parents. School performance was evaluated by the final scores of each schoolchild at the end of the 2011 school year. RESULTS: According to the final logistic regression model, the schoolchildren who had carious lesions and underwent curative dental treatment at the beginning of the academic year presented 1.51 more chance of having low performance compared with schoolchildren who had no caries lesions. In addition, socio-economic and demographic variables were associated with a greater chance of poor school performance. CONCLUSION: Socio-economic factors and presence of caries lesions, even if treated, were risk indicators for poor school performance.
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Cárie Dentária/epidemiologia , Avaliação Educacional , Saúde Bucal , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Índice CPO , Feminino , Humanos , Masculino , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
PURPOSE: To evaluate the influence of clinical variables, individual and contextual characteristics on the quality of life (QL) of underprivileged adolescents in a municipality in the interior of the State of São Paulo, Brazil. METHODS: An analytical cross-sectional study was conducted in Piracicaba, in 2012, with 1,172 adolescents aged 15-19 years, from 21 state schools and 34 Family Health Units. The dependent variables included the socio-dental impact (OIDP) and quality of life (WHOQOL-bref) indices. The dependent variables were classified as individual (DMFT index, CPI Index, age, sex, income, parents' educational level) and contextual (Social Exclusion Index) variable. The multilevel regression model was estimated by the PROC GLIMMIX ("Generalized Linear Models-Mixed") procedure, considering the individuals' variables as being Level 1 and the contextual variables as being Level 2, and the statistical significance was evaluated at level of significance of 5 %. RESULTS: Girls were found to have the worst QL (p < 0.000) and greatest OIDP (p = 0.000). There was an increase in OIDP (p < 0.001) and diminished QL (p < 0.052) with an increase in the periodontal index. This result is marginally significant since the significance probability is marginally greater than 0.05. In turn, there was an increase in QL (p = 0.000) and reduction in OIDP (p < 0.000) with an increase in the family income. Adolescents who resided in areas of greatest social exclusion (p = 0.031) and with greater OIDP (p < 0.000) presented the worst QL. CONCLUSION: Individual and contextual variables were related to the OIDP and QL in underprivileged Brazilian adolescents.
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Nível de Saúde , Saúde Bucal/estatística & dados numéricos , Doenças Periodontais/epidemiologia , Qualidade de Vida , Populações Vulneráveis/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Renda , Masculino , Fatores Sexuais , Estudantes , Inquéritos e Questionários , Adulto JovemRESUMO
PURPOSE: To examine the impact of oral disorders, socioenvironmental factors and subjective perceptions on children's school performance. MATERIALS AND METHODS: The sample of 515 12-year-old children was randomly selected by conglomerate analysis. The children were clinically evaluated (DMFT index, bleeding on probing and DAI index) and asked to complete the questionnaire about family environment, self-perception of health status, oral health-related quality of life (OHRQoL) and school (questions in Child Perceptions Questionnaire - CPQ11-14). A questionnaire about socioeconomic status and perceptions about their children's health was sent to the parents. School performance was measured. RESULTS: In a multivariate logistic model, the following variables remained statistically significant when associated with adolescents' poor school performance in the final model: number of people living in household, household overcrowding, parental perceptions about their children's oral health, presence of carious lesions and a question from CPQ11-14 about difficulty in paying attention in class because of their teeth, lips, jaws or mouth. CONCLUSION: The results of this study showed that socioenvironmental factors, subjective perceptions and oral health status of children - particularly carious lesions, have an important impact on school performance, demonstrating the need for planning public health dentistry based on intersectoral public policies.
Assuntos
Logro , Doenças Periodontais/psicologia , Autoimagem , Meio Social , Doenças Dentárias/psicologia , Atitude Frente a Saúde , Criança , Estudos Transversais , Aglomeração/psicologia , Índice CPO , Cárie Dentária/psicologia , Escolaridade , Características da Família , Feminino , Nível de Saúde , Humanos , Renda , Índice de Necessidade de Tratamento Ortodôntico , Masculino , Má Oclusão/psicologia , Mães/educação , Saúde Bucal , Pais/psicologia , Índice Periodontal , Vigilância da População , Qualidade de Vida , Classe SocialRESUMO
BACKGROUND: The aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil. METHODS: A random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05. RESULTS: The mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life. CONCLUSION: This study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.
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Alcoolismo/psicologia , Saúde Bucal , Qualidade de Vida , Classe Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Assistência Ambulatorial , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack , Estudos Transversais , Índice CPO , Escolaridade , Feminino , Humanos , Renda , Masculino , Abuso de Maconha/psicologia , Pobreza , Fumar/psicologiaRESUMO
BACKGROUND: Investigate the individual and contextual variables related to caries in underprivileged adolescents, and the disparity in distribution of the disease. METHODS: Cross-sectional analytical study, conducted in the city of Piracicaba, SP, Brazil, in 2012. The probabilistic sample was composed of 1,179 adolescents from 15-19 years of age, randomly selected from 21 state schools and 34 Primary Health Units--Family Health (PHU-FH). The dependent variables studied were number of decayed teeth and caries experience (DMFT). The independent variables were classified into individual (clinical, sociodemographic, psychosocial, self-perception, impact on oral health, access to services, and quality of life) and contextual (social exclusion index, total number of residents in suburb, literacy rate, and the following variables given in percentages: residences in the home ownership category, provision of domestic sewerage, trash collection, families with income of over 1 minimum wage per month, and families without monthly income) variables. The multilevel regression model was estimated by the PROC GLIMMIX (Generalized Linear Models-Mixed) procedure, considering the individual variables as Level 1 and the contextual variables of the suburbs as Level 2. Adjustment of the model was evaluated by -2 Res Log Likelihood with α = 0.05. RESULTS: As regards the individual variables, adolescents who declared having a prison inmate in the Family and resided in homes with a larger number of persons, showed a higher number of decayed teeth. There were a larger number of decayed teeth, a higher DMFT value, and worse self-perception as regards the health of their teeth and mouth. Other variables, such as being of the female gender, age and time since last visit to the dentist were related to the DMFT index. As regards the contextual variables, the DMFT was lower in suburbs with greater access to domestic sewage, and the number of decayed teeth was higher in suburbs with the worst social exclusion indices. CONCLUSION: Individual and contextual variables were associated with the presence of caries and DMFT index in underprivileged adolescents, indicating that they must be taken into consideration in the formulation of policies directed towards oral health promotion and prevention activities in this group.
Assuntos
Cárie Dentária/epidemiologia , Populações Vulneráveis/estatística & dados numéricos , Adolescente , Atitude Frente a Saúde , Brasil/epidemiologia , Estudos Transversais , Índice CPO , Assistência Odontológica/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Habitação/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Alfabetização , Masculino , Propriedade/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Qualidade de Vida , Eliminação de Resíduos/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Autoimagem , Classe Social , Isolamento Social , População Suburbana/estatística & dados numéricos , Adulto JovemRESUMO
The aim of this cross-sectional study was to investigate the associations between oral health-related quality of life (OHRQoL) and socioeconomic and demographic variables, suicidal ideation, self-perception of oral health, and experiences of dental care in the Brazilian adult LGBTIQ+ population. A sample of 464 participants completed self-administered online questionnaires and provided information for OHRQoL assessment, using the OHIP-14 instrument at three hierarchical levels of explanatory variables: LGBTIQ+ identities; socioeconomic and demographic data and existential suffering; and self-perception of oral health and experience of dental care. The collected data were fitted to hierarchical multiple logistic regression models, in which the associations between each independent variable with the OHIP-14 prevalence outcome were analyzed. The OHIP-14-prevalence index showed that 33.2% of the participants answered 'frequently' or 'always', and the highest frequencies were obtained for the psychological discomfort (27.8%), psychological disability (18.3%), and physical pain (17.5%) domains. According to the adjusted final model, LGBTIQ+ individuals who were more likely to have their OHRQoL affected were those who were indifferent (OR=3.21; 95% CI: 1.26-8.20), dissatisfied (OR=10.45; 95% CI: 3.86-28.26), or very dissatisfied (OR=53.93; 95% CI: 12.12-239.93) with their oral health status, and also those who had or have difficulty accessing dental treatment (OR=2.06; 95% CI: 1.24-3.41) (p<0.05). It may be concluded that the OHRQoL of the investigated Brazilian LGBTIQ+ population showed associations with individual aspects and with access to dental services.
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Saúde Bucal , Qualidade de Vida , Autoimagem , Fatores Socioeconômicos , Humanos , Qualidade de Vida/psicologia , Saúde Bucal/estatística & dados numéricos , Feminino , Masculino , Estudos Transversais , Adulto , Brasil/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Inquéritos e Questionários , Assistência Odontológica/estatística & dados numéricos , Assistência Odontológica/psicologia , Ideação Suicida , Adolescente , Modelos Logísticos , IdosoRESUMO
BACKGROUND: Recent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ11-14). METHODS: A cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ11-14, as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child's parents asking them about family socioeconomic status. The chi-square test and Poisson's regression analysis were performed. RESULTS: After adjusting for potential confounders, variables sex, monthly family income, mothers' education showed a statistically significant association with all health domains of the CPQ11-14. The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021). CONCLUSIONS: Clinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.
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Saúde Bucal , Psicologia da Criança , Qualidade de Vida , Análise de Variância , Brasil , Distribuição de Qui-Quadrado , Criança , Estudos Transversais , Índice CPO , Feminino , Nível de Saúde , Humanos , Masculino , Modelos Psicológicos , Análise de Regressão , Autoavaliação (Psicologia) , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The objective of this study was to compare the socioeconomic and family characteristics of underprivileged schoolchildren with and without curative dental needs participating in a dental health program. METHODS: A random sample of 1411 of 8-to-10 year-old Brazilian schoolchildren was examined and two sample groups were included in the cross-sectional study: 544 presented curative dental needs and the other 867 schoolchildren were without curative dental needs. The schoolchildren were examined for the presence of caries lesions using the DMFT index and their parents were asked to answer questions about socioenvironmental characteristics of their families. Logistic regression models were adjusted estimating the Odds Ratios (OR), their 95% confidence intervals (CI), and significance levels. RESULTS: After adjusting for potential confounders, it was found that families earning more than one Brazilian minimum wage, having fewer than four residents in the house, families living in homes owned by them, and children living with both biological parents were protective factors for the presence of dental caries, and consequently, curative dental needs. CONCLUSIONS: Socioeconomic status and family structure influences the curative dental needs of children from underprivileged communities. In this sense, dental health programs should plan and implement strategic efforts to reduce inequities in oral health status and access to oral health services of vulnerable schoolchildren and their families.
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Assistência Odontológica , Características da Família , Necessidades e Demandas de Serviços de Saúde , Classe Social , Populações Vulneráveis , Brasil , Cuidadores , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/terapia , Escolaridade , Feminino , Acessibilidade aos Serviços de Saúde , Habitação , Humanos , Renda , Masculino , Ocupações , Propriedade , Pais/educação , Pobreza , Assistência Pública , Meio SocialRESUMO
The aim of this study was to investigate associations of health literacy (HL), general self-efficacy (GSE), and sociodemographic variables with non-adherence to dental treatment among Brazilian young adults. This is a cross-sectional study based on a cohort study of 248 young adults aged 19 to 25 years followed up in an earlier study. The participants completed the perceived general self-efficacy scale (GSE), a questionnaire on socioeconomic and demographic variables and were examined for oral conditions. HL was measured using the Brazilian version of the health literacy questionnaire (HLQ-Br), which provides nine individual scores based on an average of the items within each of the nine scales. Dental treatment adherence was evaluated as the decision of young adults to seek a dentist to finish the recommended restorative treatment for dental caries. The effects of HL domains on the adherence to dental treatment were analyzed by logistic regression and the effect was adjusted for sex, age, family income, paternal and maternal education, type of housing, and self-efficacy. The results of the adjusted analysis showed associations among young adults who did not adhere to dental treatment with lower self-efficacy levels, living in non-owner-occupied homes, and lower HL levels in almost all of the HL domains (p < 0.05). Only the HLQ6 domain "Ability to actively engage with healthcare providers" was not associated with the outcome (p>0.05). Adherence to dental treatment in primary care among young adults was associated with their general self-efficacy levels, socioeconomic characteristics, and individual's lower HL aspects.
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Cárie Dentária , Letramento em Saúde , Humanos , Adulto Jovem , Estudos de Coortes , Estudos Transversais , Autoeficácia , Assistência OdontológicaRESUMO
BACKGROUND: Oral health literacy (OHL) is a key factor for reducing inequalities in oral health and promoting better health outcomes, including those related to periodontal health. This study aimed to evaluate associations between OHL and periodontal disease amongst users of primary health care services. METHODS: This cross-sectional study was carried out with a sample of 250 adult users of primary health care services in Brazil. OHL was measured using the Oral Health Literacy Instrument-Brazilian (OHLA-B). Participants also answered a structured questionnaire addressing sociodemographic and behavioural data. Clinical oral examination was performed using the Community Periodontal Index. Analyses of the crude associations were performed by simple logistic regression models, and estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Variables associated with a significance level <0.20 in bivariate analyses were included in hierarchical multiple logistic regression models. RESULTS: Amongst participants, 62% were female with an average age of 37.2 years. Adults aged 37 years or older (OR, 5.48; 95% CI, 2.68-11.21), with fewer years of study (OR, 3.34; 95% CI, 1.66-6.71), with low OHL levels (OR, 5.91; 95% CI, 1.71-20.49), and who smoked (OR, 3.29; 95% CI, 1.34-8.09) were more likely to have periodontal pockets compared to their counterparts. CONCLUSIONS: Primary health care users with low OHL levels presented with more severe periodontal diseases.
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Letramento em Saúde , Periodontite , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Bucal , Atenção Primária à SaúdeRESUMO
INTRODUCTION: Basic and daily oral hygiene care is essential for maintaining oral health in adults with special needs. The caregivers act in this process and need to be understood about the difficulties and the resources they use to deal with this demand. The aim of this qualitative study was to understand the difficulties and strategies of caregivers regarding oral hygiene for adults with special health care needs (SHCN) METHODS: Twenty-one caregivers of adults with SHCN participated in an interview in which the following questions were asked: What are the greatest difficulties in performing oral hygiene for the adult with SHCN you take care? and "How do you overcome these difficulties?" The interviews were recorded and the qualitative data were analyzed using the Discourse of the Collective Subject technique RESULTS: All respondents were female with a mean age of 58.5 years (± 10.8) and the adults with SHCN presented mean age of 30 years (± 18). The greatest difficulty pointed out by caregivers regarding oral hygiene for adults with SHCN was their non-cooperation to do such activity. Regarding coping strategies, caregivers pointed out several strategies to perform oral hygiene in adults with SHCN, such as supervising their brushing, seek for a qualified dentist to assist with this task, performing oral hygiene during the bath, performing physical restraint, among others CONCLUSION: The caregivers' perspectives indicate feelings of failure, discomfort, but also the use of creative resources to deal with the task. The results bring up themes that refer to anxieties and are related to technical and dental issues, that could be explored and need to be recognized by the reference oral healthcare team, whose responsibility it is also to work for the empowerment of caregivers.
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Cuidadores , Higiene Bucal , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Masculino , Escovação Dentária , Saúde Bucal , Adaptação PsicológicaRESUMO
OBJECTIVES: To evaluate the replicability of oral health literacy (OHL) network models across the general community and a sample of older adults from Brazil. METHODS: Data were obtained from two oral health surveys conducted with a total of 1138 participants. OHL was measured using the short form Health Literacy in Dentistry scale (HeLD-14). A regularized partial correlation network was estimated for each sample. Dimensionality and structural stability were examined via exploratory graph analysis. Network properties compared included global strength, edge weights, and centrality estimates. Model replicability was examined fitting the general community model to the older participants' data. RESULTS: Six dimensions with the exact same item composition were detected in both network models. Only the Receptivity domain in the older adults sample yielded low structural stability. Strong correlations were observed between edge weights (τ: 0.68; 95% CI: 0.62-0.74) and between node strength estimates (τ: 0.63; 95% CI: 0.36-0.89). No statistically significant differences were found for global strength. The fit of the older adults sample to the HeLD-14 network structure of the general community sample was satisfactory. CONCLUSION: Network models OHL replicated across the general community and a sample of older adults. The psychometric network approach is a useful tool to evaluate the measurement equivalence of OHL instruments across populations.
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Letramento em Saúde , Idoso , Brasil , Estudos Transversais , Humanos , Saúde Bucal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes "tooth loss" and "reason for the last dental appointment" were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.
Assuntos
Cárie Dentária , Letramento em Saúde , Adulto , Brasil/epidemiologia , Estudos Transversais , Cárie Dentária/epidemiologia , Humanos , Saúde Bucal , Atenção Primária à Saúde , Fatores SociodemográficosRESUMO
PURPOSE: To evaluate the validity of the visual exam and adjunct diagnostic technologies for posterior permanent teeth under epidemiological conditions. METHODS: A probabilistic sample of 165 12-year-old schoolchildren from Piracicaba, São Paulo, Brazil, was examined by visual exam (VI1), visual exam + artificial lighting (VI2), bitewing (BW), fiber optic transillumination (FOTI), DIAGNOdent and the associations among them. The D1+D3 and D3 diagnostics criteria, under epidemiological conditions, were adopted. The sensitivity, specificity and accuracy were calculated to determine the validity of the exams. RESULTS: The most accurate diagnostic method was VI2+BW exam for all dental surfaces under both diagnostic criteria. It was concluded that the BW was the best adjunct diagnostic technology on epidemiological dental caries surveys, increasing the validity of the dental exams.
Assuntos
Cárie Dentária/diagnóstico , Brasil/epidemiologia , Criança , Cárie Dentária/epidemiologia , Humanos , ProbabilidadeRESUMO
PURPOSE: To evaluate the reproducibility of visual exams under natural light (VE1), visual exams under artificial light (VE2), radiographic bitewing exams (BW), fibre optic transillumination exams (FOTI) and DIAGNOdent exams (DD) in epidemiological settings. MATERIALS AND METHODS: Three examiners and one benchmark examiner examined thirteen 12-year-old schoolchildren under epidemiological conditions for the D3 (carious lesions in dentin) and D1+D3 (carious lesions in enamel or dentin) diagnostic criteria. RESULTS: The reproducibility (intra/interexaminer agreement) under both diagnostic criteria was 'almost perfect' for the exams VE1 (D3: κintra = 0.91/κinter = 0.85; D1+D3: κintra = 0.89/κinter = 0.84), VE2 (D3: κintra = 0.91/κinter = 0.85; D1+D3: κintra = 0.88/κinter = 0.83), BW (D3: κintra = 0.95/κinter = 0.92; D1+D3: κintra = 0.99/κinter = 0.90) and FOTI (D3: κintra = 0.97/κinter = 0.93; D1+D3: κintra = 0.87/κinter = 0.83) exams and 'fair' for the DD exam (D3: κintra = 0.36/κinter = 0.35; D1+D3: κintra = 0.30/κinter = 0.32). CONCLUSION: It was concluded that the VE1, VE2, BW, and FOTI exams presented good reproducibility under epidemiological conditions, and can be used accurately in epidemiological surveys.