Do network centrality measures predict dental outcomes of Indigenous children over time?

BACKGROUND: Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions. AIM: We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5 years. DESIGN: A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5 years. RESULTS: Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5 years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated. CONCLUSION: Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.

Factors associated with utilisation of dental services by the elders from São Paulo, Brazil.

BACKGROUND: Population ageing in Brazil is rapid and is likely to place additional pressure over the Brazilian public health system. OBJECTIVE: This study aims to examine the factors associated with utilisation of dental services in the previous year among a representative sample of older adults from São Paulo, Brazil. METHODS: The sample included 5951 older adults who participated in the SBSP-15 study, an epidemiological survey conducted in 2015 in the State of São Paulo, Brazil. The outcome "utilisation of dental services" was defined as having visited a dentist in the previous year. Chi-square tests were employed in the bivariate analyses and Poisson regressions with robust variance in the multilevel analysis. RESULTS: Only 30.5% of the participants had their last dental appointment within the previous year. Number of teeth and dental pain presented the strongest effects on the investigated outcome. Education, income, age, ethnicity, living alone, higher Family Health Strategy coverage and the Metropolitan area were associated with having visited a dentist in the previous year. Older adults who rated their oral health as positive did not report treatment need nor prosthodontic need, presented negative oral health-related quality of life, had their last dental appointment in the public health system and sought treatment due to pain or extraction also were more likely to report the utilisation of dental services in the previous year. CONCLUSION: Regional, sociodemographic and subjective factors are associated with utilisation of dental services in the previous year among the elders from the State of São Paulo, Brazil.

Perspectives of patients, dental professionals, and stakeholders on the use of silver diamine fluoride for the management of dental caries: A qualitative systematic review.

OBJECTIVES: This qualitative systematic review and meta-aggregation aimed to synthesise evidence regarding perceptions of patients, practitioners, and stakeholders on the use of Silver Diamine Fluoride (SDF) for the management of dental caries. DATA: This review was reported in alignment with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and is registered with PROSPERO (CRD42023390301) and the Joanna Briggs Systematic Reviews register. SOURCES: References were retrieved from PubMed, Web of Science, Scopus, and EMBASE using a pre-established search strategy. STUDY SELECTION: Qualitative and mixed-methods studies examining perspectives of patients, practitioners, and/or stakeholders on the use of SDF were included. The initial search identified 650 articles eligible for inclusion, out of which 14 articles were included in the review. Reviewers synthesised findings and generated 11 distinct categories grouped into three synthesised findings: 1) Clinical use; 2) Staining; 3) Facilitators and barriers. CONCLUSIONS: Practitioners and patients viewed SDF as a therapeutic option with multiple benefits. While aesthetic concerns may be a barrier to some groups, the acceptance of the treatment was influenced by other factors, such as trusting professional advice. CLINICAL SIGNIFICANCE: Patient education is key for increased SDF acceptance. This systematic review can assist clinicians in addressing concerns regarding SDF therapy. Findings have the potential to inform policy decisions that address oral health inequities through patient-centred health care models.

Oral Health Literacy and Periodontal Disease in Primary Health Care Users.

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.

Dynamics in oral health-related factors of Indigenous Australian children: A network analysis of a randomized controlled trial.

OBJECTIVES: Network analysis is an innovative, analytic approach that enables visual representation of variables as nodes and their corresponding statistical associations as edges. It also provides a new way of framing oral health-related questions as complex systems of variables. We aimed to generate networks of oral health variables using epidemiological data of Indigenous children, and to compare network structures of oral health variables among participants who received immediate or delayed delivery of an oral health intervention. METHODS: Epidemiological data from 448 mother-child dyads enrolled in a randomized controlled trial of dental caries prevention in South Australia, Australia, were obtained. Networks were estimated with nodes representing study variables and edges representing partial correlation coefficients between variables. Data included dental caries, impact on quality of life, self-rated general health, self-rated oral health, dental service utilization, knowledge of oral health, fatalism and self-efficacy in three time points. Communities of nodes, centrality, clustering coefficient and network stability were estimated. RESULTS: The oral health intervention interacted with the network through self-rated general health and knowledge of oral health. Networks depicting groups shortly after receiving the intervention presented higher clustering coefficients and a similar arrangement of nodes. Networks tended to return to a preintervention state. CONCLUSION: The intervention resulted in increased connectivity and changes in the structure of communities of variables in both intervention groups. Our findings contribute to elucidating dynamics between variables depicting oral health networks over time.

Association between oral health literacy and dental outcomes among users of primary healthcare services.

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.

A psychometric network perspective to oral health literacy: Examining the replicability of network properties across the general community and older adults from Brazil.

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.

Household food insecurity, dental caries and oral-health-related quality of life in Brazilian Indigenous adults.

Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Network analysis and psychometric properties of the Brazilian version of the eHealth Literacy Scale in a dental clinic setting.

BACKGROUND: The eHealth Literacy Scale (eHEALS) has become a standard tool for the evaluation of digital health literacy. OBJECTIVES: This study aims to examine the validity and reliability of the Brazilian version of the eHEALS in a sample of patients from a dental clinic setting. MATERIAL AND METHODS: A cross-sectional survey was conducted in a dental setting. The sample included patients from the Dental Clinic of the Dentistry School of the University of São Paulo between September 2019 and March 2020. The underlying structure of the data was exploratorily investigated using Exploratory Graph Analysis, a network analysis method. The internal reliability was assessed using the McDonald's Omega coefficient. Confirmatory Factor Analysis (CFA) was used to assess the fit of the structure identified by the network analysis. Convergent validity was assessed using the Average Variance Extracted, and measurement invariance was examined using nested models in multigroup CFA. Criterion-related validity was examined calculating the latent mean differences between subgroups (genders, age groups, and educational levels). RESULTS: The sample included 132 adults aged 18 to 82 years (mean 44.7 years). The eHEALS network indicated that items form a single-factor structure. The 1-factor model presented adequate fit (χ2 (18) = 29.873, p < 0.039; R-CFI = 0.997; R-TLI = 0.996; R-RMSEA = 0.032, 90% CI [0.000, 0.052]), good internal reliability, and convergent validity. Configural invariance was found for genders, educational levels, and age groups. Scalar invariance was observed for genders and age, whereas partial scalar invariance was confirmed for education. Participants aged 18 to 45 and those with higher education presented greater latent means for eHEALS subscales. There were no differences between genders. CONCLUSION: The BR-eHEALS presented good internal reliability, convergent validity, measurement invariance, and was able to discriminate the levels of eHealth literacy among groups with different ages and educational levels. These findings demonstrate that the tool is valid and reliable for use in a dental setting with the Brazilian population.

Factors associated with poor oral health-related quality of life among non-institutionalized Brazilian older adults: Oral health and quality of life in older adults.

AIMS: To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults. METHODS AND RESULTS: A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL. CONCLUSION: Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL.

The utility of network analysis in the context of Indigenous Australian oral health literacy.

BACKGROUND: The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach. METHODS: Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks. RESULTS: Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient. CONCLUSION: Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.

Dental caries in South American Indigenous peoples: A systematic review.

OBJECTIVES: To determine the severity of dental caries in South American Indigenous peoples. METHODS: A systematic review was conducted regarding the severity of dental caries in South American Indigenous peoples using the following electronic databases: MEDLINE/PubMed, SCOPUS, SciELO, LILACS and grey literature up to March 2018. Literature search was conducted up to March 2018. No restrictions on language or year of publication were applied. Descriptive analysis and meta-analysis of studies were performed to determine mean dmft/DMFT index (decayed, missing and filled teeth) and temporal trends for selected age brackets. RESULTS: The search strategy retrieved 698 studies, of which 70 full-text articles were assessed for eligibility and 28 were included in the qualitative analysis. Finally, 18 papers were included in the meta-analysis. Publication year ranged from 1964 to 2018. Mean dmft for 5-year-old children was 5.73 (95% CI 4.67-6.79), and mean DMFT for 12-year-olds was 3.14 (95% CI 1.88-4.40). Estimated DMFT for 15-19 years, 35-44 years and 65-74 years was 5.53 (95% CI 2.97-8.09), 19.41 (95% CI 11.88-26.93) and 28.19 (24.83-31.55), respectively. DMFT was higher than that reported in general population surveys in Brazil, Chile, Uruguay and Venezuela for all age brackets with available data. Heterogeneity was observed in all age brackets, ranging from 79.7 to 99.7%. CONCLUSION: Dental caries remains a significant public health problem for South American Indigenous peoples. Prevention and treatment strategies that consider cultural specificities are needed.

Epidemiological profile of caries and need for dental extraction in a Kaingang adult Indigenous population.

INTRODUCTION: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. OBJECTIVE: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. METHODS: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. RESULTS: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. CONCLUSION: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

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

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

Patient ́s oral health literacy and associations with sociodemographic, source of information, and oral health variables

O objetivo desse estudo foi avaliar os níveis de Letramento em Saúde Bucal (LSB) de pacientes adultos atendidos em uma clínica odontológica universitária (COU) e associações com diversas variáveis. Foi realizado um estudo transversal com amostra de 312 usuários adultos de uma COU, no período de fevereiro a julho de 2018. A coleta de dados foi feita por meio de um questionário autoaplicável incluindo dados demográficos, HeLD-14 para avaliação do LSB, fontes de acesso a informações sobre saúde bucal, autoavaliação de saúde bucal (ASB) e motivos para procurar o dentista. Análises de regressão logística simples e múltipla foram realizadas para avaliar o nível de associação entre as variáveis independentes e dependente (LSB). O valor mediano para HeLD-14 foi de 44,2 (dp=7,8). No modelo final, os seguintes usuários tiveram uma probabilidade significativamente maior de apresentar níveis de OHL mais baixos em relação aos seus pares: aqueles com até o ensino fundamental (OR: 3,82, IC 95%: 1,85-7,88), aqueles com renda menor ou igual a 2 Salários Mínimos (OR: 3,65, IC 95%: 1,37-9,76), aqueles que utilizam televisão/rádio/jornal/revistas/outros como principal fonte de informação sobre saúde bucal (OR: 1,97, IC 95%:1,17 -3,30), os que classificaram sua ASB como regular/ruim (OR: 1,88, IC 95%:1,08-3,26), e os que foram ao dentista pela última vez por dor/extração (OR: 2,28, 95% IC: 1,35-3,85). Os níveis de LSB dos usuários estiveram associados a variáveis sociodemográficas, fontes de informação e saúde bucal, fato que deve ser considerado pelos estudantes de odontologia e seus docentes, nos processos de comunicação e educação em saúde com os usuários da COU, para uma melhor assistência à saúde bucal a eles (AU).

The objective of this study was toevaluate the levels of Oral Health Literacy (OHL) among adult patients attending in a university dental clinic (UDC) and associations with diverse variables. A cross-sectional study was conducted with a sample of 312 adultusers of aUDC, from February to July 2018. Data collection was done by using a self-administered questionnaire including demographics, HeLD-14 for evaluating OHL, sources for accessing information about oral health, self-rated oral health (SROH), and reasons to look for the dentist.Simple and multiple logistic regression analyses were performed to assess the level of association between independent and dependent variables (OHL). The median value for HeLD-14 was 44.2 (sd=7.8). In the final model, the following users had a significantly higher likelihood of presenting lower OHL levels compared to their counterparts: those with up to elementary school (OR: 3.82, 95%CI: 1.85-7.88), those whose income was less than or equal to 2 Brazilian Minimum Wages (OR: 3.65, 95%CI: 1.37-9.76), those who use television/radio/newspaper/magazines/others as their main source of oral health information (OR: 1.97, 95%CI:1.17-3.30), those who classified their SROH as fair/poor (OR: 1.88, 95%CI: 1.08-3.26), and those who had gone to the dentist the last time due to pain/extraction (OR: 2.28, 95%CI: 1.35-3.85). The users' OHL levels were associated with sociodemographic variables, sources of information, and oral health, a fact that must be considered by dental students and their professors, in the processes of communication and health education with UDC users, to provide better oral health care for them (AU).

Association between oral health literacy and dental outcomes among users of primary healthcare services

Abstract 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.

Processo de mentoring: análise da percepção do estudante da disciplina de Gestão e Planejamento em Odontologia da FOUSP / Mentoring process: analysis of students' perception of the discipline of Management and Planning in Dentistry at FOUSP

O objetivo da presente pesquisa foi analisar a percepção dosestudantesde graduação do último ano do Curso de Odontologia da Faculdade de Odontologia da Universidade de São Paulo (FOUSP) em relação ao processo de mentoring. A amostra foi de 122 estudantes que estavam matriculados na disciplina de Gestão e Planejamento daFOUSP, os quais foram divididos em grupos de 8 integrantese, durante o semestre, as reuniões de tutoria eram realizadas pelos pós-graduandos, para debater questões pessoais e profissionais. Ao final do semestre os estudantes responderam a um questionário sobreoprocesso dementoringrealizado e a respeito de pontos positivos e negativos da disciplina. O treinamento dos tutores foi realizado no semestre anterior, juntamente com um estudo piloto com 20 graduandos. Foi realizada uma análise de correspondência para a avaliação da disciplina com o mentoringe uma análisequantitativa textual por meio do softwareIramuteq para avaliação das respostas da questão aberta. Dos estudantes incluídos, 96,7% participaram da pesquisa.Quanto àavaliação da disciplina, 55,1% dos respondentes aconsideraram boa e 33,9%como ótima. Em relação ao processo de mentoring, 62,7% consideraram ótimo e 32,2% bom. Quando questionados quais eram os pontos positivos da disciplina, 48,3% dos estudantes destacaram a tutoria. Ao verificar a coocorrência e conectividade das palavras, foi constatada uma forte relação entre os termos reunião, grupo, aluno e futuro. Diante disso, é possível concluir que a percepção do aluno de graduação é positiva em relação ao processo de mentoring, no qual além de ser um processo de instrução, serve também de apoio para o aluno do último ano (AU).

This study aimed to analyze the perception of graduate students in the last year of the Dentistry Course at the University of São Paulo School of Dentistry (FOUSP) ofthe mentoring process implemented in the discipline of Management and Planning. The sample comprised 122 students enrolled in the Management and Planning discipline at FOUSP. During mentoring, students were divided into groups of eight members, and tutoring meetings were held by post-graduate students to discuss personal and professional issues. At the end of the semester, students answered a questionnaire about the mentoring process and the positive and negative aspects of the discipline. Tutors were trained in the previous semesteralongsidea pilot study with 20 graduate students. A correspondence analysis was conducted to evaluate the discipline, and a quantitative textual analysis using the Iramuteq software was used to assess the responsesto the open questions. Approximately 97% of the students participated in the survey. The majority rated the discipline as good (55.1%) and excellent (33.9%). Regarding the mentoring process, 62.7% considered the activities excellent and 32.2% good. When asked about the strengths of the discipline, 48.3% of students highlighted tutoring. When verifying the co-occurrence and connectivity of the words, a strong relationship was found between the terms "meeting," "group," "student," and "future." Thus, graduate students' perception ofthe mentoring processis positive, which in addition to being aninstructional process,also serves as support for the final year at the university (AU).

Household food insecurity, dental caries and oral-health-related quality of life in Brazilian Indigenous adults / Insegurança alimentar domiciliar, cárie dentária e qualidade de vida relacionada à saúde bucal em Indígenas adultos brasileiros

Abstract Food insecurity is a complex phenomenon that affects the health and wellbeing of vulnerable families. The aim of this study was to investigate the relationship between household food insecurity, dental caries, oral health-related quality of life, and social determinants of health among Indigenous adults. A cross-sectional study was conducted among Kaingang adults aged 35-44 years old from the Guarita Indigenous Land, Brazil. Food insecurity was assessed through the EBIA scale. Dental caries was assessed using the DMFT index. Participants answered the OHIP-14 questionnaire and a structured interview. Descriptive and multivariate analyzes using Poisson regression models were performed. The final sample included 107 adults from 97 households. Approximately 95% lived in food insecure families. Severe food insecurity was present in 58% of the households. The phenomenon was associated to the Bolsa Família benefit, household size, and greater perception of oral health impacts on quality of life. The high number of families affected by food insecurity reveals the social vulnerability of the Kaingang people. Food insecurity in Kaingangs adults is associated to oral health perception and social determinants of health.

Resumo Insegurança alimentar é um fenômeno complexo que afeta a saúde e o bem-estar de famílias vulneráveis. Este estudo objetivou investigar a relação entre insegurança alimentar domiciliar, cárie dentária, qualidade de vida relacionada à saúde bucal, e determinantes sociais de saúde entre indígenas adultos. Foi conduzido um estudo transversal com adultos Kaingang entre 35-44 anos da Terra Indígena Guarita, Brasil. Insegurança alimentar foi avaliada pela escala EBIA. Cárie dentária foi avaliada pelo índice CPOD. Participantes responderam o questionário OHIP-14 e uma entrevista estruturada. Foram realizadas análises descritivas e multivariadas usando modelos de regressão de Poisson. A amostra incluiu 107 adultos Kaingang de 97 domicílios. Aproximadamente 95% dos participantes viviam em famílias com insegurança alimentar. Insegurança alimentar grave esteve presente em 58% dos domicílios. O fenômeno foi associado ao Bolsa Família, densidade familiar e percepção dos impactos da saúde bucal na qualidade de vida. O alto número de famílias afetadas pela insegurança alimentar revela a vulnerabilidade social do povo Kaingang. Insegurança alimentar em adultos Kaingang está associada à percepção da saúde bucal e determinantes sociais da saúde.

Análise de redes aplicada a fatores relacionados à saúde bucal de populações indígenas / Network analysis applied to oral health-related factors of Indigenous populations

A análise de redes representa um conjunto de métodos e teorias com grande utilidade para descrever, explorar e compreender a estrutura de relações estatísticas em sistemas complexos de variáveis. Esta é uma importante ferramenta analítica com aplicações que variam desde análise exploratória até o desenvolvimento de intervenções. O objetivo desta tese foi mapear a arquitetura de interações entre fatores de saúde bucal de populações indígenas como sistemas de redes complexas. Este volume apresenta um compilado de quatro artigos científicos que investigaram: 1) o letramento em saúde bucal e fatores associados em uma população indígena australiana; 2) a validade estrutural do questionário Oral Health Impact Profile (OHIP-14) entre populações indígenas e não indígenas do Brasil e da Austrália; 3) as dinâmicas entre fatores relacionados à saúde bucal de crianças indígenas australianas ao longo do tempo; e 4) a habilidade de medidas de centralidade de uma rede transversal para predizer desfechos de saúde bucal longitudinalmente. Foram estimadas redes de correlação parcial, regularizadas, não direcionadas, baseadas em Modelos Gráficos Gaussianos. As propriedades de rede analisadas incluíram medidas de centralidade, coeficientes locais de agrupamento e coeficientes globais de agrupamento. A estabilidade das redes foi verificada através de um procedimento bootstrap de reamostragem. A Análise Exploratório de Gráficos foi utilizada para verificar a validade estrutural do instrumento de mensuração da qualidade de vida relacionada à saúde bucal. Foram analisadas as associações entre as medidas de centralidade de uma rede transversal com dados de mulheres grávidas e dois desfechos relacionados à saúde bucal de crianças indígenas mensurados aos 5 anos por meio de regressões lineares. Foi estimada uma rede que compreende as diferenças de pontuação dos desfechos relacionados à saúde bucal de crianças indígenas entre 2 e 5 anos ajustada pela rede de dados maternos. As correlações entre as medidas de centralidade dos modelos ajustado e não ajustado foram examinadas. Itens de letramento em saúde bucal pertencentes aos mesmos domínios conceituais da escala apresentaram fortes conexões positivas. Diferentes estruturas de rede emergiram para grupos de participantes que possuíam baixo e alto níveis de letramento em saúde bucal. A Análise Exploratória de Gráficos identificou quatro comunidades de nós referentes ao instrumento Oral Health Impact Profile em todas as amostras analisadas, embora populações indígenas apresentaram consistência estrutural reduzida em comparação com seus pares não indígenas. A intervenção de saúde bucal interagiu com a rede de fatores relacionados à saúde bucal por meio da percepção da saúde geral da criança e do conhecimento da saúde bucal infantil. Foram identificadas diferentes conexões entre experiência de cárie dentária e fatores relacionados à saúde bucal em cada fase do estudo. As redes tenderam a retornar a um estado inicial após a intervenção. Força foi a única medida de centralidade associada aos valores preditivos dos nós em relação aos desfechos de saúde bucal das crianças. Valores de Força explicaram 51% e 45% da variação nos valores preditivos dos nós em relação à experiência de cárie dentária e à utilização de serviços odontológicos aos 5 anos, respectivamente. Esta tese demonstrou diferentes aplicações da análise de redes no contexto da saúde bucal indígena. Fatores relacionados à saúde bucal de populações indígenas da Austrália e do Brasil emergiram como redes. Os achados empíricos apresentados contribuem para uma compreensão abrangente das múltiplas interações entre fatores relacionados à saúde bucal destas populações e apresentam implicações para a representação de construtos psicométricos, investigação de fenômenos em saúde bucal e desenvolvimento de intervenções.

Functional dentition and prosthodontic status in an Indigenous population from the South of Brazil

Aim: to analyze the prevalence of different definitions of functional dentition, prosthodontic status and associated factors, in an indigenous population from Brazil. Methods: a cross-sectional oral health survey was conducted with Indigenous adults aged 35-44 years. A single examiner collected clinical data through oral examinations and sociodemographic data using a structured questionnaire. Dentitions were classified according to four classification systems of functional dentition: FDWHO (> 20 teeth), FDGROUP2 (> 10 teeth in each arch), FDGROUP3 (all anterior teeth), and FDGROUP4 (> 10 teeth in each arch, all anterior teeth, and sufficient posterior region). Use and need of prosthodontics was also evaluated. Uni and multivariate analysis were conducted at the level of significance of 5%. Results: Indigenous adults presented considerably low frequencies of prosthodontic use and functional dentition, independently of the definition analyzed. Substantial differences of prevalence rates were observed among the four definitions of functional dentition, ranging from 48.62% to 11.93%. Age and municipality were associated with use of dental prosthesis and prosthodontic need, respectively. Significant discrepancies in functional dentition rates were observed regarding sex and time of the last dental appointment. Conclusions: Indigenous adults are severely affected by tooth loss and, consequently, by low frequencies of functional dentition. The scenario is worsened by the elevated need of the population for prosthodontics. The phenomenon was associated with age, sex, access to specialized dental care and time of the last dental visit