Autoestima e comportamentos de saúde bucal em adolescentes / Self-esteem and oral health behavior in adolescents

Resumo Este estudo investigou a mediação da autoestima nos comportamentos de saúde bucal dos adolescentes. Para avaliar a autoestima usou-se a escala de Rosenberg, já as características sociodemográficas e comportamentais foram analisadas por questões validadas em outros inquéritos. Com exceção da alimentação, a maior proporção dos adolescentes possuía bons comportamentos de saúde bucal. O número de adolescentes com alto nível de autoestima foi relevantemente menor que aqueles com baixa autoestima. A utilização dos serviços odontológicos, embora associado ao alto nível de autoestima, perdeu significância após ajustado pelo sexo, idade e escovação dos dentes. Porém, a análise de regressão logística múltipla, através das estimativas não-ajustadas e ajustadas com seus respectivos Intervalos de Confiança de 95%, evidenciou associação da autoestima com idade (p-valor=0,001) e frequência de escovação (p-valor=0,019). Independente do sexo, escolares maiores de 16 anos e com autoestima elevada, escovam seus dentes com maior frequência, adquirindo, possivelmente, melhor saúde bucal. Isto confirma a modulação da autoestima sobre os comportamentos de saúde bucal, e atesta a necessidade de implementar a análise e o exercício desse fator psicossocial na assistência à saúde bucal dos jovens.

Abstract This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data from socio-demographic and behavior characteristics were analyzed by questions validated in previous surveys. The teenagers had good oral health behavior, except unhealthy diet. The number of adolescents with high self-esteem was a lot smaller than those with low self-esteem. The use of dental services, even when associated with high self-esteem, lost significance after being adjusted by sex, age and tooth brushing frequency. Nevertheless, multiple logistic regression analysis, using unadjusted estimates and adjusted with their respective Confidence Intervals of 95%, showed a relationship of self-esteem with age (p-value=0.001) and tooth brushing frequency (p-value=0.019). Regardless of the sex, students over 16 years old with high self-esteem brush their teeth more often, having probably better oral health. These results confirm the modulation of self-esteem in oral health, and then it is necessary the analysis and the use of these psychosocial factors in the young oral health care.

Self-esteem and oral health behavior in adolescents. / Autoestima e comportamentos de saúde bucal em adolescentes.

This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data from socio-demographic and behavior characteristics were analyzed by questions validated in previous surveys. The teenagers had good oral health behavior, except unhealthy diet. The number of adolescents with high self-esteem was a lot smaller than those with low self-esteem. The use of dental services, even when associated with high self-esteem, lost significance after being adjusted by sex, age and tooth brushing frequency. Nevertheless, multiple logistic regression analysis, using unadjusted estimates and adjusted with their respective Confidence Intervals of 95%, showed a relationship of self-esteem with age (p-value=0.001) and tooth brushing frequency (p-value=0.019). Regardless of the sex, students over 16 years old with high self-esteem brush their teeth more often, having probably better oral health. These results confirm the modulation of self-esteem in oral health, and then it is necessary the analysis and the use of these psychosocial factors in the young oral health care.

Este estudo investigou a mediação da autoestima nos comportamentos de saúde bucal dos adolescentes. Para avaliar a autoestima usou-se a escala de Rosenberg, já as características sociodemográficas e comportamentais foram analisadas por questões validadas em outros inquéritos. Com exceção da alimentação, a maior proporção dos adolescentes possuía bons comportamentos de saúde bucal. O número de adolescentes com alto nível de autoestima foi relevantemente menor que aqueles com baixa autoestima. A utilização dos serviços odontológicos, embora associado ao alto nível de autoestima, perdeu significância após ajustado pelo sexo, idade e escovação dos dentes. Porém, a análise de regressão logística múltipla, através das estimativas não-ajustadas e ajustadas com seus respectivos Intervalos de Confiança de 95%, evidenciou associação da autoestima com idade (p-valor=0,001) e frequência de escovação (p-valor=0,019). Independente do sexo, escolares maiores de 16 anos e com autoestima elevada, escovam seus dentes com maior frequência, adquirindo, possivelmente, melhor saúde bucal. Isto confirma a modulação da autoestima sobre os comportamentos de saúde bucal, e atesta a necessidade de implementar a análise e o exercício desse fator psicossocial na assistência à saúde bucal dos jovens.

Identification of barriers and beliefs influencing engagement by adult and teen Mexican-Americans in oral health behaviors.

OBJECTIVE: To identify barriers and beliefs influencing oral health and dental care-seeking among Mexican-Americans. RESEARCH DESIGN: Interviews and Likert-scale survey questions were utilized to explore urgent and preventive dental care-seeking, oral hygiene habits and lifestyle practices. Thirty-three interviews were conducted with 16 adults (ages 33-52), and 17 adolescents (ages 14-19). RESULTS: Teens identified the same main barriers to accessing dental care as adults: high cost, financial limitations and lack of insurance. Most Mexican-Americans agreed with the belief that everyone will need urgent dental treatment and the majority believed that going to a dentist in private practice instead of the Emergency Room was important. Although adults recognized the importance of preventive dental care, half reported being unlikely to seek such care while half of teens reported that they were likely to do so. Adults reported relying equally on themselves and on peers to make dental care decisions, while teens mostly depended on others to make decisions about urgent and preventive care. Virtually all respondents believed regular brushing to be important and many flossing too. A major barrier to flossing was being unsure of the proper technique. Another barrier to better oral health was not having seen messages encouraging changes in lifestyle. CONCLUSIONS: This study found that Mexican-American teens and adults may experience oral health similarly. Teens do not have more positive oral health beliefs and encounter mostly the same barriers to care as adults.

Influence of family environment on children's oral health: a systematic review.

OBJECTIVE: To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. SOURCES: MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". SUMMARY OF THE FINDINGS: : 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. CONCLUSION: Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits.

Influência do ambiente familiar sobre a saúde bucal de crianças: uma revisão sistemática / Influence of family environment on children's oral health: a systematic review

OBJETIVO: Envolver modelos atuais e comprovações científicas sobre a influência de comportamentos de saúde bucal dos pais na cárie dentária de suas crianças. FONTES: Artigos do MEDLINE publicados entre 1980 e junho de 2012. Foram analisados artigos de pesquisa originais tratando do comportamento dos pais quanto à saúde bucal. Um total de 218 citações foi analisado e 13 artigos foram incluídos na análise. Os estudos foram considerados elegíveis para análise se atendessem aos seguintes critérios de inclusão: (1) avaliassem uma possível associação entre cáries dentárias e o comportamento dos pais relacionado à saúde bucal; e (2) se a metodologia do estudo incluísse exame clínico bucal. Os principais termos de pesquisa foram "saúde bucal", "atitudes dos pais", "conhecimento dos pais" e "cáries dentárias". RESUMO DOS ACHADOS: Ao todo, 13 estudos experimentais contribuíram com dados para a síntese. Também foram considerados trabalhos, revisões e capítulos originais em livros didáticos. CONCLUSÃO: Os hábitos de saúde dental dos pais influenciam a saúde bucal de seus filhos. São necessários programas de educação em saúde bucal com ações preventivas para proporcionar não apenas saúde bucal adequada às crianças, mas também uma melhor qualidade de vida. Deve ser dada atenção especial a toda a família, com relação a seu estilo de vida e hábitos relacionados à saúde bucal.

OBJECTIVE: To review current models and scientific evidence on the influence of parents' oral health behaviors on their children's dental caries. SOURCES: MEDLINE articles published between 1980 and June, 2012. Original research articles on parents' oral health behavior were reviewed. A total of 218 citations were retrieved, and 13 articles were included in the analysis. The studies were eligible for review if they matched the following inclusion criteria: (1) they evaluated a possible association between dental caries and parents' oral-health-related behaviors, and (2) the study methodology included oral clinical examination. The main search terms were "oral health", "parental attitudes", "parental knowledge", and "dental caries". SUMMARY OF THE FINDINGS: 13 experimental studies contributed data to the synthesis. Original articles, reviews, and chapters in textbooks were also considered. CONCLUSIONS: Parents' dental health habits influence their children's oral health. Oral health education programs aimed at preventive actions are needed to provide children not only with adequate oral health, but better quality of life. Special attention should be given to the entire family, concerning their lifestyle and oral health habits.

A comparative study of oral health attitudes and behavior using the Hiroshima University-Dental Behavioral Inventory (HU-DBI) between dental and civil engineering students in Colombia.

The aim of this study was to use the Hiroshima University - Dental Behavioral Inventory (HU-DBI) to compare oral health attitudes and behavior of dental and civil engineering students in Colombia. The HU-DBI's survey consisting of twenty dichotomous responses (agree-disagree) regarding tooth brushing, was completed at University Antonio Narino for the dental students and the University of Cauca for the civil engineering students. The Spanish version of the HU-DBI questionnaire was taken by 182 of 247 dental students and 411 of 762 engineering students. The data was-statistically analyzed by the chi-square test and backward logistic regression. Compared to the engineering students, the dental students were more likely to agree with questions such as "I am bothered by the color of my gums"(OR = 2.2, 95% CI: 1.3-3.7),"I think I can clean my teeth well without using toothpaste" (OR = 3.0, 95% CI: 1.5-5.9), "I have used a dye to see how clean my teeth are" (OR = 2.9, 95% CI: 1.9-4.3), and "I have had my dentist tell me that I brush very well" (OR = 2.0, 95% CI: 1.3-3.1). The dental education curriculum in a dental school compared to a civil engineering school in Colombia indicated that a three-phase curriculum in didactics and clinics increased oral health attitudes and behavior from entry to graduation.

Assessing changes in oral health-related quality of life and its factors in community-dwelling older Brazilians.

OBJECTIVE: To describe changes in oral health-related quality of life and to evaluate the associations of these changes in community-dwelling older people. MATERIALS AND METHODS: In this longitudinal study a representative sample of 872 older people, living in Brazil, was evaluated during 2004. The follow-up was carried out during 2008, with 587 older persons evaluated. A questionnaire assessing socio-demographic information, health history, oral health-impact profile and number of natural teeth was used. Changes in oral health-related quality of life were categorized as improvement or deterioration. Data analysis was performed using a hierarchical approach based in a conceptual framework. A hierarchal approach was carried out using Poisson regressions. RESULTS: Older persons living in rural areas, those who reported brushing once a day or less and older persons with fewer natural teeth had an increased chance of reporting deterioration in oral health-related quality of life. Women and participants who received a minimum wage of less than US $219.50 were more likely to report improvement in oral health-related quality of life. CONCLUSION: The results of this study suggest that changes in the oral health-related quality of life are influenced by many of the variables that were included in the conceptual framework.

Validade de medidas autoaplicáveis para estimar a frequência de escovação e ingestão de água e bebidas / Validity of self-administered instruments used to estimate the frequency of toothbrushing, water and beverage intake

Introdução - O uso do creme dental, da escova dental, a frequência de escovação e ingestão de água e bebidas representam exposições relacionadas à saúde bucal. Essa frequência em populações tem sido estimada por meio de medidas indiretas; entretanto, a validade dessa forma de mensuração não é conhecida e há carência de instrumentos para sua mensuração em nível populacional. Objetivos - Revisar as evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Determinar a validade da medida indireta da quantidade de creme dental utilizado, do tamanho da cabeça da escova e da frequência de escovação com creme dental. Comparar uma medida autoaplicável sobre ingestão de água e bebidas por adolescentes com Recordatórios de 24 horas. Procedimentos Metodológicos - Uma revisão sistemática da literatura foi realizada utilizando-se as bases de dados Pubmed e Embase, buscando evidências empíricas sobre a relação entre a frequência de uso de creme dental e os diferentes níveis de renda e escolaridade. Uma subamostra de escolares na faixa etária de 13 a 16 anos de idade, em 2011, residentes no município de Piracicaba (SP), foi selecionada a partir de uma amostra representativa da população que participou de um estudo transversal sobre risco de obesidade em adolescentes (FAPESP 06/61085-0). Com este procedimento assegurou-se as mesmas características da amostra na subamostra de adolescentes participantes do estudo de validade. Após pré-teste dos instrumentos, um estudo de validação dividido em três momentos em intervalos de 15 dias foi conduzido com cada sujeito da pesquisa. No primeiro momento foram coletados os dados de peso/estatura, foi entregue um tubo de creme dental e também foi aferida a quantidade de creme dental habitualmente colocada na escova. No segundo momento, o tubo de creme dental usado foi recolhido e foi aferida pela segunda vez a quantidade de creme dental colocada na escova. No terceiro momento, uma medida com perguntas foi aplicada. Nos três momentos foram aplicados Recordatórios de 24 horas (R24h). Os dados obtidos a partir das perguntas contidas na medida indireta, R24h, e medidas diretas relacionadas ao consumo de creme dental foram comparados. Para isso, foram calculados os valores ponderados da estatística Kappa. Resultados - Os dados obtidos a partir das perguntas contidas na medida indireta foram comparados com as estimativas produzidas pela medida direta

Sociobehavioral factors influencing toothbrushing frequency among schoolchildren.

BACKGROUND: Toothbrushing may help prevent some oral health diseases considered to be public health problems--in particular, certain presentations of chronic periodontal diseases and dental caries. The authors conducted a study to identify variables associated with frequency of toothbrushing with toothpaste among schoolchildren aged 6 to 12 years. METHODS: The authors collected data regarding sociodemographic, socioeconomic, oral hygiene and attitudinal variables through a cross-sectional questionnaire administered to 1,373 schoolchildren from Campeche, Mexico. They categorized toothbrushing frequency as "two times a day or fewer" and "three times a day or more." The authors used logistic regression to analyze the data. RESULTS: Multivariate analyses showed that girls (odds ratio [OR]=1.41), older children (OR=1.07) and offspring of mothers with higher levels of schooling (OR=1.07) were more likely to brush more frequently. The results showed an interaction between the attitude of the mother toward oral health and the use of dental care in the previous 12 months. When mothers had a positive attitude, the likelihood of their children's brushing more frequently was higher among those who received dental care in the previous 12 months (OR=2.43; P

Dental plaque removal efficacy of three toothbrushes with different designs: A comparative analysis.

PURPOSE: This study aimed to compare dental plaque removal efficacy of three manual toothbrushes. MATERIALS AND METHODS: Three toothbrushes (Colgate Flexível - Colgate (T1), Oral B Advantage Control Grip - Oral B (T2), Comfort Clean - Johnson & Johnson - Reach (T3) were evaluated for dental plaque removal in 17 subjects. Dental plaque was scored before and after seven days' use of each toothbrush, employing an adaptation of Quigley-Hein Index modified by Turesky (Plaque Index). Assessments were performed at days 0, 7, 14, 21, 28, and 35. At the end of the trial each subject was asked which toothbrush was preferred. RESULTS: Final dental plaque scores for toothbrush T3 were statistically different from toothbrushes T1 and T2, which in turn did not differ from each other. Subjects showed preference towards toothbrush T3. CONCLUSION: Toothbrush T3 was more efficient in terms of dental plaque removal when compared with toothbrushes T2 and T1.

The relationship between tooth cleaning behaviour and flexibility of working time schedule.

This study tested whether there is a relationship between levels of flexibility of working time schedule and the pattern (frequency of tooth cleaning), structure (range of items used in tooth cleaning), and performance (relative effectiveness of tooth cleaning measured by levels of dental plaque) of tooth cleaning. 471 Brazilian workers from both sexes aged 24 to 44 years were selected from factories, offices, banks, shops and hospitals. Behavioural, socio-economic and clinical data were collected through structured interviews and clinical examination. Data analysis included frequency distribution and simple and multiple logistic regression. The response rate was 92.5%. Simple logistic regression showed there was a highly statistically significant relationship between flexibility of the working time schedule and tooth cleaning frequency, the range of oral hygiene aids used and the level of dental plaque. All 3 associations remained highly statistically significant after adjusting for age, sex, socio-economic status and marital status. Socio-economic status was statistically significantly associated with tooth cleaning frequency, the use of oral hygiene aids and the level of dental plaque. It was concluded that high flexibility of working time schedule is related to pattern, structure and performance of tooth cleaning.

Necessidade de saúde bucal em gestantes dos Núcleos de Saúde em Bauru: conhecimentos com relaçäo à própria saúde bucal e à da criança / Oral health needs of the pregnants at the Health Center in Bauru: their knowledge about their Children's oral helth and their own

Com o objetivo de avaliar a necessidade de saúde bucal, a prática, o conhecimento sobre a sua própria saúde e a saúde de suas crianças, foi realizada uma entrevista com um grupo de gestantes cadastradas nos Núcleos de Saúde de Bauru, Säo Paulo. A amostra constou de 150 gestantes, com idades entre 13 e 44 anos, com nível sócio-econômico baixos. Várias questöes foram abordadas sobre o que elas entendiam sobre o processo saúde/doença bucal, os meios de prevençäo, cultura popular e gravidez, valor atribuído à saúde bucal, hábitos e práticas de auto-cuidado e busca de tratamento odontológico. Com relaçäo à intençäo das gestantes em saúde bucal da criança, foram elaboradas questöes sobre amamentaçäo, uso de mamadeira, preparo desta mamadeira, importância dos dentes decíduos, cuidados e prática sobre higiene bucal. Os resultados foram analisados na forma freqüência e porcentagem sendo possível concluir :1) as grávidas entrevistadas têm noçäo sobre a doença cárie e os meios de prevení-la; 2) existe uma certa valorizaçäo da saúde bucal, pois a perda dos dentes näo é uma situaçäo inevitável se as pessoas tiverem os devidos cuidados e tratamento; 3) a procura do tratamento odontológico näo é prioridade neste grupo. Há um certo receio das grávidas e do próprio dentista; 4) a maioria das gestantes já recebeu informaçöes sobre prevençäo, mas durante o período pré-natal elas näo receberam nenhuma informaçäo sobre saúde bucal; 5) o grupo de gestantes entrevistadas tem pouco conhecimento sobre a saúde bucal de seu filhos, em decorrência disso, ocorre o uso indevido da mamadeira, o consumo de açúcar e de quando levar ao cirurgiäo dentista pela primeira vez; 6) as gestantes entrevistadas mostraram grande interesse em adquirir conhecimentos sobre as questöes formuladas e sugeriu-se, portanto, a formaçäo de equipe pré-natal com participaçäo do cirurgiäo-dentista