Assessing the impact of oral health disease on quality of life in Ecuador: a mixed-methods study.

Introduction: Globally, oral health diseases surpass all other non-communicable diseases in prevalence; however, they are not well studied in underserved regions, where accessibility to dental services and oral health education is disparately worse. In Ecuador, further research is needed to understand such disparities better. We aimed to assess the effect of oral health disease on individuals' quality of life and how social disparities and cultural beliefs shape this. Methods: Individuals 18 or older receiving care at mobile or worksite clinics from May to October 2023 were included. A mixed-methods approach was employed, involving semi-structured interviews, Oral Health-Related Quality of Life (OHRQoL) measures, and extra-oral photographs (EOP). Results: The sample (n = 528) included mostly females (56.25%) with a mean age of 34.4 ± 9.44. Most participants (88.26%) reported brushing at least twice daily, and less than 5% reported flossing at least once per day. The median OHRQoL score was 4 (min-max), significantly higher among individuals ≥40 years old, holding high school degrees, or not brushing or flossing regularly (p < 0.05). Identified barriers to good oral health included affordability, time, and forgetfulness. Participants not receiving care with a consistent provider reported fear as an additional barrier. Participants receiving worksite dental services reported these barriers to be alleviated. Dental providers were the primary source of oral hygiene education. Most participants reported oral health concerns, most commonly pain, decay, dysphagia, and halitosis - consistent with EOP analysis. Discussion: Findings underscore a need for multi-level interventions to advance oral health equity.

Prácticas de salud bucal durante los primeros 1000 días de vida: Revisión de la literatura

Objetivo: Realizar una revisión bibliográfica de la literatura sobre las buenas prácticas en salud bucal, durante los primeros 1000 días de vida, el cual abarcó el periodo de gestación y los dos primeros años del niño. Materiales y métodos: Se realizó una revisión de la literatura científica desde febrero a marzo de 2022, para lo cual se utilizó las bases de datos Pubmed y Scopus. Los criterios de inclusión abarcaron artículos originales y revisiones sistemáticas (con o sin metanálisis) publicados entre 2016 y 2022. Se emplearon estrategias de búsqueda usando palabras clave, en inglés, derivadas del MeSH. Además, se revisó la literatura gris para definir algunos conceptos clave. Resultados: Se seleccionaron 72 artículos científicos y cuatro referencias de la literatura gris (una guía de práctica clínica y tres reportes). Los temas identificados se categorizaron en: buenas prácticas de higiene bucal, buenas prácticas de alimentación de la gestante y el infante, hábitos parafuncionales, y visitas al odontólogo. De acuerdo a los resultados, las recomendaciones clave para promover buenas prácticas de salud bucal durante este periodo crucial incluyen el uso de pasta dentífrica con flúor para la higiene dental una vez que erupcionan los dientes, evitar el consumo de azúcar libre, fomentar la lactancia materna en vez del uso del biberón y las visitas al odontólogo desde antes del nacimiento. Conclusión: Las buenas prácticas en salud bucal durante los primeros 1000 días de vida influyen significativamente en la salud oral y general del niño, por lo que es necesario adoptar medidas preventivas desde la gestación, enfocadas en la higiene oral y nutrición. La colaboración de un equipo de salud multidisciplinario, durante el embarazo y los dos primeros años de vida, es vital para mejorar la salud bucodental y general de la población.

Objective: To conduct a bibliographic literature review on current good practices in oral health during the first 1000 days of life, encompassing the gestation period and the initial two years of the child. Materials and methods:A scientific literature review was conducted in February and March 2022, utilizing the Pubmed and Scopus databases. The inclusion criteria encompassed original articles and systematic reviews (with or without meta-analysis) published between 2016 and 2022. Search strategies incorporating English keywords derived from MeSH were employed. Additionally, the grey literature was reviewed to define some key concepts. Results:72 scientific articles, and four references from the grey literature (one clinical practice guide and three reports) were selected. The identified themes were categorized as follows: good oral hygiene practices, good feeding practices for pregnant women and infants, parafunctional habits, and dental visits. Based on the findings, the key recommendations for promoting good oral health practices during this crucial period include the use of fluoride toothpaste for oral hygiene once teeth erupt, avoidance of free sugar consumption, encouragement of breastfeeding over bottle-feeding, and early dental visits before birth. Conclusion:Good oral health practices during the first 1000 days of life significantly impact the child's oral and general health, necessitating preventive measures starting from gestation, with a focus on oral hygiene and nutrition. The collaborative efforts of a multidisciplinary healthcare team during pregnancy and the initial two years of life are vital for enhancing both oral and general health outcomes for the population.

Quality of education and adolescents' oral health-related behaviours: a multilevel analysis.

PURPOSE: The school environment may positively influence student health behaviours and learning. This study aimed to investigate the association between cities' quality of education and adolescent students' oral health-related behaviours. METHODS: Cross-sectional study using data of the 2015 Brazilian National Adolescent School-Based Health Survey and other public databases. The sample was composed of adolescents (N = 23,674) from public schools of the 27 Brazilian state capitals. Outcomes were four oral health-related behaviours: toothbrushing, sweets and soft-drink consumption, and dental visits. The explanatory variable was the cities' quality of education, measured by the Brazilian Basic Education Development Index. Covariates were individual (sociodemographic) and contextual (socioeconomic, oral health coverage and oral health-promoting schools). Multilevel logistic regression was performed considering two levels: individual (adolescents) and contextual (city). RESULTS: The prevalence of the outcomes were: low daily toothbrushing frequency 6.7% (95% CI 6.0-7.4); high weekly sweets consumption 41.5% (95% CI 40.3-42.7); high weekly soft-drink consumption 28.5% (95% CI 27.2-29.9); and low frequency of annual dental visits 31.2% (95% CI 30.1-32.3). In the adjusted models, cities whose schools had higher scores of education quality were more likely to have students with low toothbrushing frequency and high frequency of sweets consumption. CONCLUSION: The cities' quality of education was associated with unhealthy oral health-related behaviours, particularly the frequency of toothbrushing and sweets consumption. Therefore, appropriate health promotion strategies as well as high-quality education are needed in schools.

Oral Health Knowledge, Attitudes and Behaviour of Parents and Caregivers of Preschool Children: Implications for Oral Health Promotion.

PURPOSE: The aim of this study was to describe oral health knowledge, attitudes and behaviours of parents and caregivers of preschool children in order to inform an oral health promotion strategy. MATERIALS AND METHODS: A sample of parents and caregivers of children attending nine randomly selected preschools in central Trinidad were invited to complete a self-administered questionnaire on early childhood oral health. RESULTS: A total of 309 parents and caregivers participated: 88% were female, 74.4% were of Indian ethnicity, with 50.4% in manual employment, and 50.2% educated to secondary level. 59.1% felt a child's first dental visit should be when all primary teeth are present. 64% had not taken their child for a dental visit. 81.6% rated their child's oral health as good or better and 28% would want an asymptomatic, decayed primary tooth extracted rather than filled. Over 80% used fluoride toothpaste. 52.8% always supervised their child's toothbrushing, and 44% claimed to be using the recommended pea-size amount. 26.2% reported having used a sweetened feeding bottle or infant feeder at night. CONCLUSION: Parents and caregivers of preschool children in this sample had reasonable oral health knowledge. However, despite generally positive attitudes towards preventive oral healthcare, confusion regarding dental attendance, supervised toothbrushing, fluoride use and sugar intake suggests that these items require particular emphasis in oral health promotion programmes aimed at improving early childhood oral health.

Intersectoral oral health promotion interventions for schoolchildren living in remote rural Andean communities: a realist evaluation.

BACKGROUND: Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. OBJECTIVES: To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions' current effects on schoolchildren living in remote rural Andean communities. METHOD: A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. RESULTS: Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. CONCLUSION: This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions.

Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol.

BACKGROUND: Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. METHODS AND ANALYSIS: Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. ETHICS AND DISSEMINATION: This research project has received approval from the Comité d'éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences.

Oral health promotion intervention in rural contexts: impact assessment: Córdoba, Argentina / Intervención para la promoción de salud bucal en contextos rurales: evaluación de impacto: Córdoba, Argentina

Introduction: The study was carried out in Cruz del Eje Department, Cordoba Province, Argentina. It was based on diagnosis of conceptions of health, concentration of fluoride in drinking water and accessibility to dental coverage in 71 rural schools. Additionally, parents and teachers’ conceptions of general and oral health, dental clinical status and sialochemistry of students from eight schools were considered. Objective: To evaluate a community intervention strategy for promoting oral health in rural contexts. Through the participation of the teacher as a mediator of healthy pattern, this strategy was developed. Methods: In order to elaborate oral health promoting strategies, educational workshops, epistolary communication and on site tutorials meetings were implemented. Specific health projects to be added to the Educational Institutional Programs, as a contextualized mediating strategy for promoting oral health were designed by teachers. The strategy was evaluated comparing dental caries increase (CI) detected the previous year and the one following the implementation of the educational plans. Mac Nemar's test was applied, and p<0.05 was set to indicate statistical differences between both periods. Results: A 30.43 percent CI (p<0.0001) was observed the year before implementing the educational programs as well as a CI reduction to 17.39 percent (p=0.0002) a year after their application. Conclusion: The drop off in 57.14 percent of the CI in rural areas, confirms the intervention strategy of designed for this particular context.

Introducción: El trabajo se desarrolló en el Departamento Cruz del Eje, Córdoba, Argentina, en base a diagnósticos sobre concepciones de salud, tenor de fluoruro en el agua de bebida y accesibilidad a la cobertura odontológica realizado en 71 escuelas rurales, y sobre concepciones de salud general y bucal de padres y maestros, estado clínico odontológico y condiciones sialoquímicas de escolares de 8 escuelas. Objetivo: Evaluar una estrategia de intervención comunitaria, para la promoción de salud bucal en contextos rurales, desarrollada a través de la participación del docente como mediador de pautas saludables. Material y método: Para el desarrollo de las estrategias de promoción de la salud bucal se implementaron talleres docentes, comunicación epistolar y encuentros tutoriales en terreno. Los maestros diseñaron proyectos específicos de salud integrados en los Programas Educativos Institucionales, como estrategia mediadora contextualizada de promoción de salud bucal. Se evaluó la estrategia comparando el incremento de caries (IC) detectado en el año previo y en el siguiente a la implementación de los planes educativos. Se aplicó la prueba de Mac Nemar, fijando p<0.05 para indicar diferencias estadísticas entre ambos períodos. Resultados: Se observó 30,43 por ciento de IC (p<0.0001) en el año previo a la implementación de los planes educativos y una reducción del IC al 17,39 por ciento (p =0.0002) al año de comenzada la aplicación de los mismos. Conclusión: La disminución en un 57,14 por ciento del IC en los escolares rurales, valida la estrategia de intervención construida para estos contextos particulares.

Dental health knowledge and attitudes of primary school teachers toward developing dental health education / Conocimiento de la salud dental y actitudes de los maestros de la escuela primaria hacia el desarrollo de la educación de la salud dental

OBJECTIVE: To assess the dental health knowledge of primary school teachers, their attitudes toward the prevention of dental diseases and to identify any barriers to the implementation of oral health promotion programmes in schools. METHOD: Teachers' knowledge of the causes and prevention of dental decay and gum disease, their attitudes toward oral health and barriers to the implementation of dental health education programmes were assessed using a self-administered questionnaire. RESULTS: School teachers were generally very well informed about the causes and prevention of dental decay and gum disease. Knowledge of the appropriate management of serious dental trauma was very poor among this group although they seemed to have greater awareness of the appropriate management for less serious dental injuries. The majority of teachers demonstrated positive attitudes toward dental health and its incorporation into the school curriculum. Teachers' attitudes to their own involvement in school-based dental health education were also positive. Lack of training and resources and time within the curriculum were identified as major barriers to the implementation of a dental health education programme in primary schools. CONCLUSION: Developing teacher training programmes that include oral health knowledge and an evidence-based approach to dental health education within a school setting could enable primary school teachers to play a significant part in oral health promotion for young children in Trinidad.

OBJETIVO: Evaluar el conocimiento de los maestros de escuela primaria sobre salud dental, y sus actitudes hacia la prevención de enfermedades dentales, e identificar cualquier barrera a la implementación de programas de promoción de la salud oral en las escuelas. MÉTODO: Haciendo uso de un cuestionario auto-administrado, se evaluó el conocimiento de los maestros sobre las causas y prevención de las caries dentales, y las enfermedades de la encía, así como las actitudes de aquellos hacia la salud oral y las barreras a la aplicación de programas de educación de salud dental. RESULTADOS: Los maestros escolares estaban generalmente muy bien informados acerca de las causas y prevención de las caries dentales y las enfermedades de la encía. El conocimiento sobre el tratamiento apropiado del trauma dental serio era muy pobre entre este grupo, aunque parecían tener mayor conciencia del tratamiento apropiado para las lesiones dentales menos serias. La mayoría de los maestros demostró poseer actitudes positivas hacia la salud dental y su incorporación en el plan de estudios. Las actitudes de los maestros hacia su propia participación en la educación para la salud dental con base en la escuela, fueron también positivas. La falta de entrenamiento, así como de recursos y tiempo dentro del plan de estudios, fueron identificados como las barreras principales a la implementación de un programa de educación de salud dental en las escuelas primarias. CONCLUSIÓN: El desarrollo de programas de entrenamientos para los maestros, que incluyan conocimientos de salud oral y un enfoque de la educación para la salud dental, basado en evidencias, dentro del contexto de la escuela, podría permitirles a los maestros escolares primarios desempeñar un papel significativo en la promoción de la salud oral entre los niños jóvenes en Trinidad.

Perfil e práticas de saúde bucal do agente comunitário de saúde em municípios piauienses de pequeno porte / Profile and procedures of the community health agents regarding oral health in the countryside of Piauí State, Brazil

O objetivo desta pesquisa foi traçar o perfil demográfico e práticas de saúde bucal do ACS, em cidades de pequeno porte do Estado do Piauí. Foram selecionados quatro municípios: Água Branca, Piracuruca, Queimada Nova e Simões. O método utilizado foi o transversal observacional descritivo. Foram aplicados questionários a 109 ACS, constituídos de 28 perguntas fechadas. Os dados foram transferidos para planilha do programa ExcelÒ, tabulados e analisados. Pelos dados obtidos, foi possível concluir que: (1) o agente comunitário de saúde do interior do Piauí é predominantemente do sexo feminino, casado, com idade entre 20-39 anos, tem em média de um a três filhos, com grau de escolaridade médio acima de nove anos, renda de um salário mínimo, residindo em média há 24 anos na comunidade; (2) a grande maioria dos ACS não foi capacitada, não assistiu palestras educativas sobre saúde bucal; entretanto, quase a metade realiza atividades em saúde bucal, mas não as registra; (3) a autopercepção sobre o conhecimento em saúde bucal pelos ACS predominou entre conceitos regular e bom, o que coincidiu com o percentual de acertos ao questionário aplicado.

The aim of this survey was to draw the demographic profile and the actions concerning oral health carried out by the communitarian agents of health, in small towns of Piauí State, Brazil. Four towns were chosen: Água Branca, Piracuruca, Queimada Nova e Simões. The method used was observational descriptive cross-sectional. One hundred and nine agents were assessed through questionnaires, with 28 multiples choice questions. Data was analyzed in Excel. It was possible to conclude that: the communitarian agents on the countryside of Piauí are predominantly females, married, age between 20-39, with one to three children, nine years of formal education, monthly income of one minimum salary, and has been living in their community for 24 years in average; the large majority of the agents has not received specific qualification to carry out their job, has not attended lectures on oral health, although almost half of them works on activities related to oral health, despite not registering them properly; they perceive themselves as having a fair knowledge of oral health, which coincided with the assessment collected by the questionnaire.

Educação em saúde como estratégia de promoção de saúde bucal em gestantes / Health education as a strategy for the promotion of oral health in the pregnancy period

O objetivo desta revisão da literatura é discutir a importância da educação em saúde como estratégia de promoção de saúde bucal no período gestacional. Foram estudadas as manifestações bucais mais comuns na gestação, concluindo-se que, embora a gestação por si só não seja responsável por tais manifestações como, por exemplo, a cárie dentária e a doença periodontal, faz-se necessário o acompanhamento odontológico no pré-natal, considerando-se que as alterações hormonais da gravidez poderão agravar as afecções já instaladas. Destacou-se na promoção de saúde bucal na gestante a educação em saúde bucal, considerando-a parte importante do Programa de Atenção à Saúde da Mulher, conforme recomendado pelas atuais Diretrizes da Política Nacional de Saúde Bucal. Considera-se que, por meio de ações de educação em saúde bucal, desenvolvidas no pré-natal por uma equipe multiprofissional, orientada por um cirurgião-dentista, a mulher poderá se conscientizar da importância de seu papel na aquisição e manutenção de hábitos positivos de saúde bucal no meio familiar e atuar como agente multiplicador de informações preventivas e de promoção de saúde bucal.

This literature revision is intended to discuss the importance of health education as a strategy to oral health promotion in the pregnancy period. The most common mouth manifestations during pregnancy have been studied, and the conclusion is that, although pregnancy itself is not responsible for such manifestations in the mouth, e.g. dental decay and periodontal diseases, a dentistry follow-up during prenatal care is necessary, considering that hormonal alterations in pregnancy may aggravate the diseases contracted. The oral health promotion for pregnant women has been focused on mouth health education, considering it an important part of the Program of Attention to Women's Health, as recommended by the current National Politics' Mouth Health Policy. It is considered that, by means of mouth health education activities, implemented during prenatal care by a multiprofessional team, under an oral surgeon, women may be aware of the importance of their role in the attainment and maintenance of positive mouth health habits in family environment and act as an agent to multiply preventive and mouth-health-promotion information.

Intervención educativa sobre salud bucal para la tercera edad en centros comunitarios de salud mental / Educational intervention about oral health for the old age in community centers of mental health

A medida que mejora la duración media de la vida y la pirámide de población se va ensanchando, los casos de longevidad excepcional son cada vez más numerosos. Objetivo: evaluar el impacto de las técnicas afectivo- participativas para la promoción de salud bucal en los ancianos de los Centros Comunitarios de Salud Mental del municipio Camagüey. Método: se realizó un estudio experimental del tipo antes y después sin grupo control mediante una intervención comunitaria en el municipio de Camagüey, durante el período comprendido de junio del 2007 a junio del 2008. El universo estuvo constituido por doscientos sesenta y nueve ancianos y la muestra quedó integrada por setenta gerontes. A ellos se les aplicó una entrevista estructurada para determinar el nivel de información higiénico-sanitaria-bucal, factores de riesgo e higiene bucal y protésica. Resultados: los factores de riesgos que prevalecieron fueron el tabaquismo con un 25,3%, el uso continuo de prótesis dentales con un 52% para los pacientes portadores de prótesis y la higiene bucal deficiente con un 60% en los pacientes dentados. Conclusiones: la información higiénico-sanitaria-bucal se comportó como satisfactoria en más de las tres cuartas partes de los ancianos. La eficiencia de la higiene de las prótesis mejoró en casi la totalidad de los ancianos. Hubo una percepción favorable de los mismos con respecto a la intervención, pues la mayoría reconoce que incorporaron una acción por la acción al observar cambios beneficiosos para su salud, que generó experiencias positivas en el grupo estudiado.

As the middle duration of life improves and population's pyramid goes getting wider, the cases of exceptional longevity are more and more numerous. Objective: to evaluate the impact of the affective-participatory techniques for the oral health promotion in the elderly of the Community Centers of Mental Health in Camagüey municipality. Method: an experimental study of the type before and later without control group by means of a community intervention in Camagüey municipality was performed, from June 2007 to June 2008. The universe was constituted by two-hundred sixty nine old men and the sample was integrated by seventy old men. To them a structured interview to determine the level of hygienic-sanitary-oral information, risk factors, oral and prosthetic hygiene was applied. Results: the risk factors that prevailed were the tabagism with 25, 3%, the continuous use of dental prosthesis with 52%, for the patients with prosthesis and deficient oral hygiene with 60% in toothed patients. Conclusions: the hygienic-sanitary-oral information behaved as satisfactory in more than the fourth three parts of the old men. The efficiency of the prosthesis´ hygiene improved in almost the entirety of the old men. There was a favorable perception of the same ones with regard to the intervention, because the majority recognizes that incorporated an action by the action when observing beneficial changes for their health that generated positive experiences in the studied group.

Promoção em saúde bucal para gestantes: uma revisão de literatura / Oral health promotion for pregnant women: a review of literature

Esta revisão de literatura tem por objetivo buscar uma reflexão sobre as atuais práticas de saúde bucal em gestantes através da abordagem do conhecimento sobre transmissibilidade das doenças bucais, identificando riscos à saúde do binômio: mãe-bebê, hábitos orais inadequados e práticas de prevenção; considerando a gravidez o período mais suscetível para incorporação de novos hábitos, atitudes e comportamentos. O acesso à consulta odontológica no pré-natal precisa tornar-se rotina na Estratégia de Saúde da Família (ESF), trata-se de um espaço privilegiado para promover Saúde Bucal e através da Educação em Saúde desenvolver a consciência de responsabilidade da gestante pela sua saúde e a dos seus filhos, atuando de maneira positiva na prevenção primária. É importante conhecer a condição de saúde bucal e a percepção da gestante em relação à atenção odontológica, desmistificando crenças que ainda persistem envolvendo o tratamento odontológico, este quando necessário deve ser realizado e com resolutividade, evitando agravos à saúde bucal. A consolidação dos novos conceitos de Promoção de Saúde requer dos cirurgiões-dentistas, sensibilização e consciência do seu papel na Saúde Bucal Coletiva. É dever do Estado, direito da gestante, receber atenção odontológica na gravidez, parte da Saúde Integral da Mulher, como determinan as Políticas Públicas de Saúde.

This review of literature aims to seek a reflection on the current practice of oral health in pregnant women through addressing the transmission of knowledge about dental diseases, identifying risks to the health of the binomial: mother-baby, oral habits and practices, inadequate prevention, considering the pregnancy period most susceptible to the incorporation of new habits, attitudes and behaviors. Access to dental consultation in prenatal care needs to become routine in the FHS (Family's Health Strategy), it is a privileged space to promote Oral Health and through the Health Education develop an awareness of responsability for the health of pregnant women and their children, acting in a positive manner in primary prevention. It is important to know the condition of oral health of pregnant and perception regarding dental care, demystitying beleifs that still exist concerning the dental treament, this must be done when be done when necessary and with resolution, avoiding the oral health disorders. The consolidation of new concepts for the Promotion of Health requires surgeons, dentists, awareness and consciousness of their role in Oral Health Collective. It is the duty of the State, the rights of pregnant women receive dental care during pregnancy, part of the Integral Health of Women, and determine the politics of Public Health.

Promoción de salud bucal en la tercera edad en un centro comunitario de salud mental / Oral health promotion in the elderly in a mental health community justify

Los ancianos arriban a la vejez sometidos a un gran número de factores de riesgo y enfermedades bucodentales prevenibles, y una deficiente información higiénico-sanitaria bucal. Objetivo: Aplicar técnicas afectivo-participativas para la promoción de salud bucal en los ancianos. Método: Se realizó un estudio experimental de intervención comunitaria en el círculo de abuelos del Centro Comunitario de Salud Mental del área norte en el período comprendido de Junio del 2005 a Junio del 2007. La muestra estuvo constituida por 35 ancianos, a quienes se les aplicó una entrevista estructurada para determinar el nivel de información higiénico-sanitaria-bucal, factores de riesgo e higiene bucal y protésica. Resultados: La información higiénico-sanitaria-bucal se comportó como satisfactoria en 27 personas, 77,1 por ciento. La eficiencia de la higiene de las prótesis mejoró en más de la mitad de los gerontes. Hubo una percepción favorable de los mismos con respecto a la intervención, pues la mayoría reconoce que incorporaron una acción al observar cambios beneficiosos para su salud, que generó experiencias positivas en el grupo estudiado.

The elderly arrive to the old age submitted to a great number of risk factors and preventive buccodental diseases, and deficient oral hygienic-sanitary information. Objective: To apply affective-participatory techniques for the oral health promotion in the elderly. Method: A community intervention experimental study in the grandparents´ circle of the Mental Health Community justify from the north area was carried out from June 2005 to June 2007. The sample was constituted by 35 old men, to them they were applied a structured interview to determine the level of hygienic-sanitary-oral information, risk factors, oral and prosthetic hygiene. Results: The hygienic-sanitary-oral information behaved as satisfactory in 27 people (77,1percent). The efficiency of the prosthesis´ hygiene improved in more than half of the elderly. There was a favorable perception of them regarding to the intervention, because the majority recognize that they incorporated an action for the action when observing beneficial changes for their health that generated positive experiences in the studied group.

Relação entre consulta odontológica e ansiedade ao tratamento odontológico: estudo com um grupo de adolescentes / Relationship between dental appointment and dental anxiety: study with adolescent's group

Introdução: Cuidar da saúde bucal é primordial a qualquer indivíduo, independentemente de sua faixa etária, nível de escolaridade ou classe social, porém, em virtude de diversos fatores, grande parte das pessoas enfrenta dificuldades para acessar serviços odontológicos. No entanto há um elemento que interfere no comportamento de muitas pessoas que buscam atendimento odontológico: o medo. Objetivo: Verificar a freqüência e as causas de consultas odontológicas de um grupo de estudantes do ensino fundamental em relação ao grau de ansiedade ao tratamento odontológico. Material e métodos: Foram selecionadas, aleatoriamente, cinco escolas de uma cidade da região da foz do rio Itajaí (SC), onde foram avaliados 1.806 alunos. O instrumento para a determinação do grau de ansiedade ao tratamento odontológico foi uma adaptação da Dental Anxiety Scale. Para caracterizar os sujeitos quanto a gênero, idade, freqüência e causas da consulta ao dentista, foi aplicado um questionário. Resultados: A maioria (76,7%) havia consultado algum dentista no período de até dois anos antes da data da coleta de dados. Observou-se uma tendência de crescimento linear da categoria “ter realizado consulta em relação à redução ou inexistência de ansiedade”. Entre os que realizaram a consulta, as meninas de 11 a 13 anos foram as que mais a efetivaram. As principais causas da consulta, para os portadores de alto grau de ansiedade, relacionaramse aos procedimentos endodônticos; entre os sem ansiedade, foram os preventivos. Conclusão: No grupo investigado, encontrou-se associação entre grau de ansiedade ao tratamento odontológico e freqüência e causas da consulta odontológica.

Introduction: The oral health care is essential to every human being, despite the age, education level or social class. Nevertheless most people have difficulties to access dental services, due to many factors. However, one element interferes in the behavior of many people who search for dental service: the fear. Objective: To evaluate the frequency and the motives of dental appointments in relation to dental anxiety in students of elementary school. Material and methods: Five schools situated in one city localized in the region of Foz do Rio Itajaí (SC) were randomly selected and 1.806 students were evaluated. To determine the anxiety level to dental treatment it has been used an adapted tool from the Dental Anxiety Scale. To define the individuals by gender, age, frequency and causes of the appointments, it was applied a questionnaire. Results: Most of them (76.7%) had taken a dental appointment in a period which is in its maximum two years before the data collection. A tendency of linear growth in the number of realized appointment has been noticed due to reduction of anxiety or its inexistence. Among the individuals who have taken the appointments, girls between 11 and 13 years old were the highest number. The main cause of the dental appointments, for individuals with high level of anxiety, is endodontics procedures; for the group without anxiety, is preventive procedures. Conclusion: The researched group shows a relation with the anxiety level to dental treatment and the frequency and motives of dental appointments.