Counterfactual approach on the effect of metabolic syndrome on tooth loss: A population-based study.

BACKGROUND: This study aimed to investigate the effect of metabolic syndrome (MetS) on tooth loss in adults from a population-based sample. METHODS: Cross-sectional analysis based on data from a cohort study (2009 to 2014) with adults from Southern Brazil. MetS (exposure), lack of functional dentition and number of lost teeth (outcomes) were assessed using self-reported, laboratory and clinical data. Possible confounders included sex, age, family income, education level, smoking status, and sugar consumption. The effect of MetS on the outcomes was estimated using conventional logistic or negative binomial regression models. Marginal structural modeling (MSM) with stabilized weights (a counterfactual analytical method) was also used to enhance group comparability and estimate causal effects. RESULTS: A total of 1,283 participants had available information for the outcomes. Individuals with MetS were more likely to experience a lack of functional dentition than those without MetS (odds ratio [OR] from logistic regression, 1.7; 95% CI, 1.0 to 2.9; OR from MSM, 3.2; 95% CI, 2.3 to 4.6). Moreover, the number of teeth lost was 20% higher in participants with MetS compared with those without MetS in conventional analysis (mean ratio [MR], 1.2; 95% CI, 1.1 to 1.3). The MR increased to 1.7 (95% CI, 1.5 to 2.0) when using MSM. CONCLUSION: Our findings provide evidence on the effect of MetS on tooth loss.

Training and work process in Multiprofessional Residency in Health as innovative strategy.

OBJECTIVES: reflect about education in health and work process on three programs of multiprofessional residency in Florianópolis/SC. METHOD: Reflexive study about Multiprofessional Residency Health Programs of Florianópolis. RESULTS: Multiprofessional Residency characterizes training health professionals through service education. Developing these professionals' specialization with assignments that promote professional exercise and magnifies multiprofessional work at the same time, for excellency in unabridged healthcare. FINAL CONSIDERATIONS: Multiprofessional Residency Programs make interdisciplinary education, sharing knowledge between residents and other professionals stimulating development of innovation skills.

Training and work process in Multiprofessional Residency in Health as innovative strategy / La formación y el proceso de trabajo en la Residencia Multiprofesional De Salud como estrategia innovadora / A formação e o processo de trabalho na Residência Multiprofissional em Saúde como estratégia inovadora

ABSTRACT Objectives: To reflect about education in health and work process on three programs of multiprofessional residency in Florianópolis/SC. Method: Reflexive study about Multiprofessional Residency Health Programs of Florianópolis. Results: Multiprofessional Residency characterizes training health professionals through service education. Developing these professionals' specialization with assignments that promote professional exercise and magnifies multiprofessional work at the same time, for excellency in unabridged healthcare. Final Considerations: Multiprofessional Residency Programs make interdisciplinary education, sharing knowledge between residents and other professionals stimulating development of innovation skills.

RESUMEN Objetivo: Reflexionar sobre la formación en salud y el proceso de trabajo de los tres programas de residencia multiprofesional de la ciudad de Florianópolis, Santa Catarina. Método: Se trata de un estudio reflexivo sobre los Programas de Residencia Multiprofesional de Salud de la ciudad de Florianópolis. Resultados: La Residencia Multiprofesional está caracterizada por la capacitación de los profesionales de la salud mediante la educación en servicio, desarrollando la especialización de dichos profesionales con atribuciones que promueven el ejercicio profesional, y al mismo tiempo exaltan la labor multiprofesional para alcanzar excelencia en la atención integral de la salud. Consideraciones finales: Los Programas de Residencia Multiprofesional llevan a cabo una formación interdisciplinaria, comparten saberes entre los residentes y demás profesionales y estimulan el desarrollo de habilidades volcadas hacia la búsqueda de la innovación.

RESUMO Objetivo: Refletir a formação em saúde e o processo de trabalho nos três programas de residência multiprofissional do município de Florianópolis/SC. Método: Trata-se de um estudo reflexivo acerca dos Programas de Residência Multiprofissional em Saúde do município de Florianópolis. Resultados: A Residência Multiprofissional caracteriza-se por formar profissionais de saúde por meio da educação em serviço. Desenvolvendo a especialização desses profissionais com atribuições que promovem o exercício profissional, e ao mesmo tempo enaltecem o trabalho multiprofissional, para a excelência no cuidado integral à saúde. Considerações finais: Os Programas de Residência Multiprofissional realizam a formação interdisciplinar, partilhando os saberes entre os residentes e demais profissionais e estimulando o desenvolvimento de competências voltadas para a busca pela inovação.

Association between metabolic syndrome and tooth loss: A systematic review and meta-analysis.

BACKGROUND: The authors conducted a systematic review and meta-analysis to verify the existence and level of scientific evidence concerning the association between metabolic syndrome (MetS), as the main exposure, and tooth loss (TL), as the outcome. TYPES OF STUDIES REVIEWED: Through electronic databases and partially through gray literature, the authors identified observational studies in adults. The authors used no date or language restrictions. The authors evaluated the studies' methodological quality by using the Newcastle-Ottawa Scale. The authors conducted a random-effects model meta-analysis. The authors assessed the quality of evidence by using the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS: Twelve studies met the eligibility criteria, and 9 were retained for the meta-analysis. Most were cross-sectional studies with good methodological quality. Participants with MetS had fewer teeth (standardized mean difference, -2.77; 95% confidence interval, -4.56 to -0.98) and an increased likelihood of lacking functional dentition (odds ratio, 2.37; 95% confidence interval, 1.89 to 2.96) than did those without MetS. The overall quality of evidence was very low. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Better-conducted longitudinal studies are necessary to establish a causal relationship between MetS and TL to inform the best strategies to prevent TL in populations with MetS.

A produção científica da Odontologia e a Agenda Nacional de Prioridades de Pesquisa em Saúde / The scientific production of Dentistry and the National Agenda for Priorities in Health Research

O estudo analisou a produção atual do conhecimento científico em saúde bucal nos cursos de pósgraduação em Odontologia (stricto-sensu) sul-brasileiros, relacionando-a às diretrizes traçadas pela Agenda Nacional de Prioridades de Pesquisa em Saúde (ANPPS). Trata-se de uma pesquisa de abordagem quanti-qualitativa, de natureza exploratório-descritiva a partir de análise documental. Os dados, coletados de sítios eletrônicos oficiais no primeiro semestre de 2015, consistem em teses e dissertações produzidas entre 2011 e 2015, pelos programas de pós-graduação stricto-sensu em "Odontologia" ou "Ciências Odontológicas", de Universidades Federais do Sul do país. Após leitura dos títulos e resumos, procedeu-se a classificação quanto à aderência das produções aos eixos da ANPPS, com posterior organização, tabulação, análise quantitativo-descritiva e análise qualitativa, discutindose possíveis lapsos entre políticas públicas e práticas, na implementação da ANPPS. A maior parte da produção de teses e dissertações analisadas não apresentou aderência aos tópicos da ANPPS (56,13%) relacionados à saúde bucal, sendo que as áreas de Odontopediatria e Saúde Coletiva detiveram as maiores médias de produção vinculadas (40,8%). Embora existam movimentos de assimilação e incorporação à ANPPS na pesquisa em saúde bucal, disciplinas clínicas tradicionais ainda não referenciam à Agenda e sua prioridade em estudos voltados às necessidades populacionais e interesses do Sistema de Saúde. A incorporação da ANPPS à pesquisa odontológica pode transformar a Odontologia brasileira em nova referência de construção de conhecimento para além do contexto nacional (AU).

The study analyzed the current production of oral health scientific knowledge in Southern Brazil dentistry stricto-sensu post-graduation programs and the relation with the National Agenda for Priorities in Health Research guidelines. It is an exploratory-descriptive research, with a quantitative-qualitative approach, based on documentary analysis. The data, collected from the post-graduation electronic sites in 2015, consisted of theses and dissertations produced between 2011 and 2015, by the "Dentistry" or "Dental Sciences" programs of Federal Universities of Southern Brazil. After reading the titles and abstracts, the productions were classified according to the Agenda axes, with the subsequent organization, tabulation, quantitative and qualitative analysis. It was discussed possible lapses between public policies and practices, in the implementation of the Agenda. Most of the theses and dissertations analyzed did not show adherence to the Agenda axes, with Pediatric Dentistry and Public Health areas having the highest associated production. Although there are movements of incorporation of the Agenda in oral health research, traditional clinical disciplines still are not used to refer it or to focus on the population needs and the Health System interest. The incorporation of the Agenda into dental research can possibly transform Brazilian dentistry in a new reference of construction of knowledge beyond the national context (AU).

Trends in dental caries among Brazilian schoolchildren: 40 years of monitoring (1971-2011).

The study aimed to estimate the prevalence, severity, and inequality in the distribution of dental caries in schoolchildren from Florianópolis, Santa Catarina, Brazil, in 2011, and to compare the results with data from previous studies carried out since 1971. All 12- and 13-year-old schoolchildren enrolled in a public school were eligible. Dental caries were assessed according to the World Health Organisation diagnostic criteria. Decayed, missing and filled surfaces and teeth (DMFS/DMFT) indexes, the Significant Caries Index (SiC) and the Gini coefficient (to assess inequalities in the distribution of dental caries) were estimated. The response rate was 82.3% (n = 130). The prevalence of dental caries decreased from 98.0% (95% CI 96.0-100.0) in 1971 to 36.9% (95% CI 28.5-45.3) in 2011. The mean DMFT ranged from 9.2 in 1971 to 0.7 in 2011. The mean DMFS index was 1.2 (95% CI 0.8-1.6) in 2011. The Gini coefficient was 0.624 in 2002 but increased to 0.725 in 2011; the Lorenz curve showed that 70-75% of dental caries attacks was restricted to 20% of the population in 2011. A reduction of 41.2% in the mean SiC index was observed between 2002 (3.4, 95% CI 3.0-3.8) and 2011 (1.9, 95% CI 1.6-2.1). An effective decline in the prevalence and severity of dental caries in schoolchildren was observed throughout 40 years of monitoring. However, a small proportion of the population has experienced most of the caries burden in the recent years studied.

Trends in dental caries rates in 12- and 13-year-old schoolchildren from Florianópolis (Brazil) between 1971 and 2005.

PURPOSE: To estimate dental caries prevalence and severity among all 12- and 13-year-old schoolchildren enrolled in a public school in 2005 and to establish comparisons with the results of studies previously conducted in the same school in 1971, 1997 and 2002. METHODS: A cross-sectional study involving 190 children was carried out. A single calibrated examiner collected the clinical data according to the World Health Organization (1997) criteria. RESULTS: The response rate was 90.0%. Between 1971 and 2005, the observed reduction in caries prevalence was 58.2%, whereas the mean DMFT Index declined from 9.2 to 0.8, which corresponds to a reduction of 91.3%. The significant caries index (SiC) reduced from 3.4 (CI 95% 3.0-3.8) in 2002 to 2.2 (CI 95% 1.8-2.5) in 2005. CONCLUSION: This study indicates an actual decline in dental caries prevalence and severity among the schoolchildren during the studied period, even though different diagnostic criteria were used.