Efectividad del programa educativo “Sonrisas desde el vientre”. Hogar Materno Isabel María de Valdivia en Sancti Spíritus / Effectiveness of the educational program "Smiles from the womb". Isabel María de Valdivia Maternity Home in Sancti Spíritus

Fundamentación:En el período de gestación el organismo de la mujer sufre modificaciones, transformaciones fisiológicas y psicológicas, además de cambios en los tejidos bucales y cambios de conducta que pueden iniciar enfermedades bucodentales o agravar las ya establecidas.Objetivo:Evaluar la efectividad del programa educativo “Sonrisas desde el vientre” en embarazadas del Hogar Materno Isabel María de Valdivia en Sancti Spíritus.Metodología:Se realizó un estudio preexperimental, con diseño antes y después en el período de enero a junio del 2022, la población estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Se utilizaron métodos del nivel teórico, empírico (encuesta) y estadísticos. Se midió la variable conocimiento sobre salud bucodental.Resultados:Los conocimientos antes de la aplicación de programa educativo eran insuficientes (65 porciento), después de aplicado el programa educativo el 75 porciento de las embarazadas presentó conocimientos suficientes.Conclusiones:Al culminar la implementación del programa educativo “Sonrisas desde el vientre”, se logró un nivel de conocimiento suficiente sobre salud bucodental en la tercera parte de las embarazadas de este hogar materno.[AU]

Efectividad del programa educativo "Sonrisas desde el vientre". Hogar Materno Isabel María de Valdivia en Sancti Spíritus / Effectiveness of the educational program " Smiles from the womb". Isabel María de Valdivia Maternity Home in Sancti Spíritus

Fundamentación: En el período de gestación el organismo de la mujer sufre modificaciones, transformaciones fisiológicas y psicológicas, además de cambios en los tejidos bucales y cambios de conducta que pueden iniciar enfermedades bucodentales o agravar las ya establecidas. Objetivo: Evaluar la efectividad del programa educativo "Sonrisas desde el vientre" en embarazadas del Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Metodología: Se realizó un estudio preexperimental, con diseño antes y después en el período de enero a junio del 2022, la población estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Se utilizaron métodos del nivel teórico, empírico (encuesta) y estadísticos. Se midió la variable conocimiento sobre salud bucodental. Resultados: Los conocimientos antes de la aplicación de programa educativo eran insuficientes (65 %), después de aplicado el programa educativo el 75 % de las embarazadas presentó conocimientos suficientes. Conclusiones: Al culminar la implementación del programa educativo "Sonrisas desde el vientre", se logró un nivel de conocimiento suficiente sobre salud bucodental en la tercera parte de las embarazadas de este hogar materno.

Background: During pregnancy, the women's body goes through many changes, physiological and psychological transformations, as well as changes in the oral cavity tissues and behavioral changes that may initiate oral diseases or aggravate the stablished ones. Objective: To evaluate the effectiveness of the educational program "Smile from the Womb" among pregnant women at the Isabel María de Valdivia Maternity Home in Sancti Spíritus. Methodology: A pre-experimental study with a before and after design was conducted from January to June 2022, the population consisted of 20 pregnant women hospitalized at Isabel María de Valdivia Maternity Home in Sancti Spíritus. Theoretical, empirical (survey) and statistical methods were used. The variable oral health knowledge was measured. Results: Before applying the educational program the knowledge was insufficient (65%), after applying the educational program 75% of pregnant women showed sufficient knowledge. Conclusions: By the end of the "Smile from the Womb" educational program, one third of the pregnant women in this maternity home had achieved a sufficient level of knowledge about oral and dental health.

Adaptación y validación en adultos peruanos del instrumento Perfil de impacto de la salud oral / Adaptation and validation of the tool Oral Health Impact Profile in Peruvian adults

Introducción: La calidad de vida relacionada con la salud oral es un indicador relevante de salud pública; por lo tanto, es necesario contar con instrumentos para su medición, contextualizados y con adecuadas propiedades métricas. Objetivo: Adaptar y validar el instrumento Perfil de impacto de la salud oral en la calidad de vida en una muestra de adultos peruanos. Métodos: Estudio de tipo instrumental, participaron 415 adultos de la provincia de Ica, Perú. Se realizó un análisis factorial exploratorio para valorar la estructura interna de la escala y un análisis factorial confirmatorio que incluyó el método de estimación de máxima verosimilitud robusta. Luego se evaluó la confiabilidad del instrumento y, finalmente, se comparó el impacto de la salud bucal en la calidad de vida, según variables de caracterización. Resultados: Se obtuvo una versión de 14 ítems agrupados en siete factores que explicaron el 88,50 por ciento de la varianza total y un ajuste aceptable, x2/gl = 3,72; NNFI = 0,98; CFI = 0,99; SRMR = 0,031; RMSEA =0,081 (IC 90 por ciento: 0,070-0,093). La consistencia interna de la escala global mostró un índice satisfactorio (α = 0,95) y las subescalas valores que oscilaron entre α = 0,88 y α=0,78; con excepción de la dimensión malestar psicológico (α = 0,66). La validez discriminante fue demostrada al encontrar diferencias significativas entre las variables sociodemográficas y los puntajes de severidad. Conclusiones: La nueva versión del instrumento presenta propiedades métricas aceptables, por lo tanto, puede ser usado en futuras investigaciones y estudios de validación(AU)

ABSTRACT Introduction: Oral health-related quality of life is a relevant public health indicator. Therefore, its measurement should be performed with contextualized tools and appropriate metric techniques. Objective: Adapt and validate the tool Oral Health Impact Profile in the quality of life of a sample of Peruvian adults. Methods: An instrumental study was conducted of 415 adults from the province of Ica, Peru. The internal structure of the scale was evaluated by exploratory factor analysis. Confirmatory factor analysis was also performed, which included robust maximum likelihood estimation. The reliability of the tool was then tested, and a comparison was finally made of the impact of oral health on quality of life, according to characterization variables. Results: The version obtained consists of 14 items grouped into seven factors explaining 88.50 percent of the total variance and an acceptable fit, x2/gl = 3.72; NNFI = 0.98; CFI = 0.99; SRMR = 0.031; RMSEA = 0.081 (CI 90 percent: 0.070-0.093). Internal consistency of the overall scale exhibited a satisfactory index (α = 0.95), whereas the subscales showed values of α = 0.88-0.78, except for the dimension of psychological distress (α = 0.66). Discriminant validity was demonstrated by finding significant differences between sociodemographic variables and severity scores. Conclusions: The new version of the tool has acceptable metric properties. Therefore, it may be used in future research and validation studies(AU)

Dental Status of Firefighters of Rio de Janeiro State and Comparison with Brazilian Oral Health Surveys

ABSTRACT Objective: This cross-sectional study aimed to assess clinical dental status in military firefighters of Rio de Janeiro State and compare data with Brazilian National and Regional oral health surveys. Material and Methods: A sample of 926 military firefighters was examined using the visible biofilm index, the DMFT index and the Community Periodontal Index (CPI). Clinical exams were performed by 15 trained dentists. The Kruskal-Wallis test and Mann-Whitney test with Bonferroni correction were used. Results: Higher biofilm accumulation was associated with increased age. The mean DMFT index for the whole sample of this study was 12.74 (±7.03), and the 'filled' component was the most prevalent (69.9%), whereas the 'decayed' and 'missing' components were, respectively, 8.4% and 21.7%. There was a higher prevalence of periodontal diseases with increasing age, ranging from 57.1% in firefighters of 34 years or less to 70.5% in the ones between 35 and 44 years old and 75.4% in participants at age 45 years or older. Clinical dental status of the military firefighters who belonged to the age group 35-44 was better than the one observed for the Brazilian population at the same age range. However, pathological conditions that can be solved with health promotion strategies associated with dental procedures of low complexity still persist. Conclusion: These results suggest that the availability of dental health care services itself does not represent the most effective approach to the oral health problems found in the studied population.

Construção de um inventário de problemas éticos na Atenção Primária para a saúde bucal / Constructing an inventory of ethical problems in primary health for oral health / Construcción de un inventario de problemas éticos en la atención primaria para la salud bucal

Considerando-se as especificidades dos problemas éticos em saúde bucal, esta pesquisa objetivou construir uma proposta de Inventário de Problemas Éticos na Atenção Primária à Saúde (IPE-APS) para a saúde bucal (SB), estudo metodológico desenvolvido por um comitê de juízes. Após levantamento prévio de 32 problemas éticos específicos, fez-se sua equivalência com quarenta itens do IPE-APS: de itens; de semântica e conteúdo; de avaliação dos itens não equivalentes; de avaliação dos problemas específicos não equivalentes. Apontaram-se 18 itens do IPE-APS equivalentes a 17 problemas específicos, confluindo para 16 itens finais. Dos 22 itens não equivalentes, 5 foram mantidos. Incluíram-se os 15 problemas éticos específicos não equivalentes. Evidenciou-se a complexidade do trabalho de equivalência de inventários de natureza ética. Chegou-se à proposta de um IPE-APS-SB de 36 itens. (AU)

Considering the specificities of ethical problems in oral health, the aim of this study was to develop a proposal for an Inventory of Ethical Problems in Primary Health Care (IPE-APS) for oral health (SB). A methodological study was developed by a committee of judges. Thirty-two previously identified specific ethical problems were matched to the 40 items of the IPE-APS: items; semantics and content; evaluation of unmatched items; evaluation of unmatched specific problems. Eighteen of the items of the IPE-APS were matched to 17 specific problems, converging into 16 final items. Five of the 22 unmatched items were maintained and 15 unmatched specific ethical problems were included. The findings reveal the complexity of matching ethical Inventories. We achieved the aim of proposing a 46-item IPE-APS for oral health. (AU)

Llevando en consideración las especificidades de los problemas éticos en salud bucal, esta investigación tuvo el objetivo de construir una propuesta de Inventario de Problemas Éticos en la Atención Primaria de la Salud (IPE-APS) para la salud bucal (SB). Estudio metodológico desarrollado por un comité de jueces. Después de un levantamiento de 32 problemas éticos específicos, se realizó su equivalencia con cuarenta ítems del IPE-APS: de ítems; semántica y de contenido; evaluación de los ítems no equivalentes; evaluación de los problemas específicos no equivalentes. Se señalaron 18 ítems del IPE-APS equivalentes a 17 problemas específicos, confluyendo para 16 ítems finales. De los 22 ítems no equivalentes, 5 se mantuvieron. Se incluyeron los 15 problemas éticos específicos no equivalentes. Se dejó en evidencia la complejidad del trabajo de equivalencia de inventarios de naturaleza ética. Se llegó a la propuesta de un IPE-APS-SB de 36 ítems. (AU)

Conocimientos, Actitudes y prácticas de prevención de riesgo del cáncer bucal en población mayor de 15 años. Panamá. / [Knowledge, attitudes and practices of prevention of oral cancer risk in popul oral cancer risk in population over 15 years old. Panama.

Introducción: El Cáncer Bucal es una enfermedad de importancia en Salud Pública. En Panamá, se desconoce la incidencia y prevalencia de la enfermedad y no se dispone de información por tipo de patología, lesión, localización, ni estudios de conocimientos, ac­ titudes y prácticas, relacionados a los factores de riesgo. Objetivo General: analizar los conocimientos, actitudes y prácticas de prevención de Cáncer Bucal en la población mayor de 15 años. Materiales y Método: estudio descriptivo transversal, realizado en las Regiones Sanitarias de San Miguelito, Metropolitana y Panamá Oeste. Se realizó un muestreo por conveniencia en 42 instalaciones de salud del primer nivel de atención, a la población que acudió al servicio odontológico durante cuatro meses. Se aplicó una encuesta de Conocimiento, Actitudes y Prácticas de prevención de factores de riesgo al cáncer bucal, considerando variables de estilo de vida. Para el análisis estadístico, se utilizaron los programas Epi Info versión 7.2 y XLSTAT 2019 y presentados los datos en medidas paramétricas y no paramétricas. Resultados: se encuestó un total de 3,832 personas mayores de 15 años. La mayor proporción fueron mujeres en edades de 25 y 34 años. En relación al conocimiento, el 81% desconoce los factores de riesgo de cáncer bucal y según la actitud, el 63% no asiste al control odontológico periódicamente. Las prácticas reflejaron hábitos relaciona­ dos al consumo de tabaco y alcohol. Conclusión: La población mayor de 15 años del estudio, desconoce los factores de riesgo del cáncer bucal y manifiesta limitada actitud de práctica preventiva.

Introduction: Oral Cancer is an importance disease in Public Health. In Panama, the in­ cidence and prevalence of the disease is unknown and there is no information available by type of pathology, injury, location, or studies of knowledge, attitudes and practices re­ lated to risk factors. General Objective: to analyze the knowledge, attitudes and practi­ ces of prevention of Oral Cancer in the population over 15 years old. Materials and Methods: cross­sectional descriptive study, carried out in San Miguelito, Metropolitan and Panamá Oeste Health Regions. Sampling was carried out for convenience in 42 health facilities of the first level of health care, to the population that attended the dental service during four months. A survey of Knowledge, Attitudes and Practices of preven­ tion of risk factors to oral cancer was applied, considering Lifestyle variables. For the statistical analysis, the Epi Info version 7.2 and XLSTAT 2019 programs were used and the data presented in parametric and non­parametric measurements. Results: a total of 3,832 people over 15 years of age were surveyed. The highest propor­ tions were women between the ages of 25 and 34. In relation to knowledge, 81% do not know the risk factors for oral cancer and according to the attitude, 63%, do not attend pe­ riodically to a dental control. The practices reflected habits related to consumption of to­ bacco and alcohol. Conclusion: The population over 15 years old of the study ignores the risk factors of oral cancer and manifests a limited attitude of preventive practice.

Disparities in Caries Experience and Socio-Behavioural Risk Indicators Among Private School Children in Lagos, Nigeria

Abstract Objective: To determine the prevalence and socio-behavioural risk factors for dental caries among children at selected LGAs in Lagos State. Material and Methods: This was a descriptive study of 592 school children in four Local Government Areas of Lagos, Nigeria. The presence of caries was recorded using the World Health Organization criteria. Descriptive statistics were reported for analysis of comparative DMFT and SiC scores in relation to age, gender, and other socio-demographic variables. Logistic regression analysis was used to analyze the differential impact of the variables on the probability of being in the high caries prevalence group. Results: The prevalence of dental caries was 16.0% with mean dmft for age 6 being 1.3 ± 1.57 while the mean DMFT for age 12 was 0.15 ± 0.67. The mean Sic for age 6 was 1.5 ± 0.53 while the mean SiC for age 12 was 1.09 ± 0.29. The mean SiC values was significantly higher in the primary and permanent dentition among those who had never visited the dentist, female students, those who don't use fluoridated toothpaste and those who eat sweets and candy several times a day. After logistic regression analysis, those with no previous dental visit (OR=3.05; CI: 1.72-4.67) and females (OR=1.55; CI: 1.16-1.62) still had significantly higher SiC Values. Conclusion: The prevalence of caries was low in the study population. Being female, non-use of fluoride-containing toothpaste and not visiting the dentist were significant predictors of dental caries among children attending private schools.

Oral Hygiene and Dental Caries Status on Systemic Lupus Erythematosus Patients: A Cross-Sectional Study

Abstract Objective: To evaluate the oral hygiene and dental caries status on Systemic Lupus Erythematosus (SLE) patients, also it's with SLE disease activity. Material and Methods: This is a descriptive study with a cross-sectional approach. The study was conducted on 93 SLE patients from 2017 to 2019 on Saiful Anwar Hospital Indonesia. All SLE patients had clinical examination using DMF-T, Personal Hygiene Performance-Modified (PHP-M), Calculus Index (CI), Debris Index (DI), Plaque Index (PI) and Simplified Oral Hygiene Index (OHI-S). Clinical examination and laboratory tests are conducted to assess the activity of SLE measured using. The data were analyzed by One Way ANOVA test. Results: A total of 74% of subjects with SLE had dental caries. PHP-M with SLE severity was found significant (p<0.001) and a strong positive correlation (r=0.982). Plaque with SLE severity was found significant (p=0.001) and a strong positive correlation (r=0.938). OHI-S with SLE severity was found significant (p<0.001) and a strong positive correlation (r=0.953). DMF-T levels with SLE severity was found significant (p=0.001) and a strong positive correlation (r=0.974). It showed that the severity of disease activity was related to poor oral hygiene and a high incidence of dental caries. Conclusion: There is a correlation between oral hygiene, dental caries and SLE severity.

Association Between Psychosocial Status and Orthodontic Treatment Needs in Indonesian High School Students

Abstract Objective: To determine whether psychosocial status is associated with orthodontic treatment needs in high school students using the Psychosocial Impact of the Dental Aesthetic Questionnaire (PIDAQ) and the Index of Orthodontic Need (IOTN). Material and Methods: This cross-sectional study comprised 95 adolescents, both genders, aged 15-17 years old. PIDAQ was used to assess psychosocial status. The IOTN Aesthetic Component (IOTN-AC) and the IOTN Dental Health Component (DHC) was used to assess treatment needs. Examination of the oral cavity was carried out with the help of the IOTN ruler by observing the MOCDO components: missing teeth, overjet, crossbite, displacement, and overbite. The Chi-square test was used to determine the association of psychosocial status and orthodontic treatment need. The reliability test was carried out by using Cronbach's Alpha test (0.978). Results: There was an association between psychosocial status and orthodontic treatment need based on the IOTN-AC (p=0.001) and between psychosocial status and orthodontic treatment need based on the IOTN-DHC (p=0.140). Conclusion: There is an association between psychosocial status based on the PIDAQ and subjective orthodontic treatment need based on the IOTN-AC, but there is no association between psychosocial status based on the PIDAQ and objective orthodontic treatment need based on the IOTN-DHC in students of SMAN 27 Jakarta.

Assessing the oral health of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool© and its association with dental examinations.

Aims : To compare assessment of the oral health conditions and behaviors of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool (C-DiOHAT©) with dental examinations. Methods : A cross-sectional design was used. A nurse assessed 60 in-patients using the C-DiOHAT© (a formatted questionnaire to assess four factors of patients' oral health conditions and behaviors : oral health conditions, oral hygiene behaviors, sharing health information among patients and dental/medical professionals, and perception and knowledge of oral health) while a dentist examined their oral health conditions. Results : "Use of supplementary tools (e.g., interdental brush, dental floss)" in the item of C-DiOHAT© was significantly associated with dental examination of "the number of present teeth" and "no recommendation of further dental visit". "Symptoms of gingival swelling" in the item of C-DiOHAT© was also significantly associated with "recommendation of dental visit". "Knowledge of a relationship between periodontal disease and systemic disease including diabetes" was significantly associated with Community Periodontal Index. Conclusions : These results suggest that nurses should prioritize these assessment items to most quickly acquire useful information about patients' oral health. It is important to encourage nurses to be interested in patients' oral health by such small pile of clue. J. Med. Invest. 66 : 328-336 August, 2019.

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013.

INTRODUCTION: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. OBJECTIVE: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. METHODS: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. RESULTS: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. CONCLUSION: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.

Determinantes sociales y condiciones de salud bucal de los adultos mayores / Social determinants and oral health conditions in the elderly

RESUMEN Introducción: El proceso salud-enfermedad en el adulto mayor está influenciado directamente por los determinantes sociales de la salud, por tanto, la salud bucal no escapa de ello. Objetivo: Determinar el comportamiento de los determinantes sociales y las condiciones de salud bucal en adultos mayores. Métodos: Se realizó un estudio descriptivo de corte transversal en 339 individuos de 60 años y más del Consultorio No. 5 del Policlínico Plaza de la Revolución, durante el periodo comprendido desde mayo de 2015 a enero 201. Se utilizó el interrogatorio y el examen clínico de la cavidad bucal, previo consentimiento informado de los participantes. Las variables estudiadas fueron: edad, sexo, ocupación, bienestar económico, estructura y funcionamiento familiar, condiciones de la vivienda, hábitos alimentarios y condiciones de salud bucal. Resultados: El grupo de edad más representado fue el de 60 a 69 años con el 53,4 por ciento, con predominio del sexo femenino. Solo el 27,9 por ciento de los adultos mayores que trabajaban tenían buenas condiciones de salud bucal y más del 60 por ciento de los examinados que refirieron no tener bienestar económico, presentaron una salud bucal regular. Predominaron las familias funcionales con condiciones de salud bucal evaluadas de buena y regular. El 73,5 por ciento de los que habitaban en viviendas en buen estado presentaron también buenas condiciones de salud bucal. Los adultos mayores con buenas condiciones de salud bucal representaron el 82,4 por ciento de los que poseen hábitos alimentarios adecuados. Conclusiones: El comportamiento favorable de los determinantes analizados pone de manifiesto su influencia positiva sobre el estado de salud bucal de los adultos mayores(AU)

ABSTRACT Introduction: The health-disease relationship in the elderly is directly influenced by social health determinants, and such influence includes oral health. Objective: Determine the behavior of social determinants and oral health conditions in the elderly. Methods: A cross-sectional descriptive study was conducted of 339 subjects aged 60 years and over from Consultation Office No. 5 of Plaza de la Revolución Polyclinic from May 2015 to January 2016. The study was based on interrogation and clinical examination of the oral cavity, prior informed consent by participants. The variables analyzed were age, sex, occupation, economic status, family structure and functioning, housing conditions, eating habits and oral health conditions. Results: The 60-69 age group was the best represented (53.4 percent), with a predominance of the female sex. Only 27.9 percent of the elderly people who had a regular job had good oral health conditions, and more than 60 percent of the patients examined who reported a low economic status had fair oral health conditions. There was a predominance of functional families with oral health conditions evaluated as good or fair. 73.5 percent of those with good housing conditions also had good oral health conditions. Elderly patients with good oral health conditions represented 82.4 percent of those with adequate eating habits. Conclusions: The favorable behavior of the determinants analyzed reflects their positive influence on the oral health status of elderly people(AU)

Sampling strategy of an epidemiological survey using a satellite image program.

OBJECTIVE: To describe the sampling strategy of an epidemiological survey with the aid of satellite images, including details of the multistage probability sampling process. METHODS: A probability sample of individuals living in the rural area of Rosário do Sul, state of Rio Grande do Sul, Brazil, aged 15 years old or more, was evaluated. Participants answered questionnaires (medical history, sociodemographic characteristics, habits, alcohol use, quality of life, stress, rumination, and self-perceived periodontal diseases), and were subjected to clinical oral examinations as well as anthropometric measurements (blood pressure, height, weight, abdominal and waist circumferences). Oral evaluation comprehended a complete periodontal exam at six sites per tooth, including the following assessments: furcation involvement; dental abrasion; tooth decay, including the indexing of missing and filled surfaces; O'Brien index; gingival abrasion; oral cavity and lip lesions; complete periapical radiographic exam, and use of prostheses. Besides this oral clinical approach, subgingival plaque, crevicular gingival fluid, saliva, and blood samples were collected. Examiners were trained and calibrated during previous evaluations. A pilot study allowed the logistic of the performed exams to be adjusted as needed. RESULTS: Among 1,087 eligible individuals, 688 were examined (63.3%). Age, sex, and skin color data were compared to data from the last demographic census (2010) of the Brazilian Institute of Geography and Statistics, which served to validate the sampling strategy. CONCLUSIONS: The careful methods used in this study, in which satellite images were used in the delimitation of epidemiological areas, ensure the quality of the estimates obtained and allow for these estimates to be used in oral health surveillance and health policies improvements.

Oral health profile among community-dwellingelderly and its association with self-rated oral health. / Perfil de saúde bucal de idosos não institucionalizados e sua associaçãocom autoavaliação da saúde bucal.

INTRODUCTION: The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. OBJECTIVES: The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. METHODS: Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. RESULTS: The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. CONCLUSION: There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.

INTRODUÇÃO: O uso de prótese e a perda dentária em idosos estão associados a impactos significativos na saúde geral e na qualidade de vida. A avaliação contínua do perfil de saúde bucal dessa população é importante para o planejamento das ações e políticas da área. OBJETIVO: Foram objetivos deste trabalho avaliar a prevalência de perda dentária e uso de próteses entre idosos em diferentes períodos, verificar as características sociodemográficas associadas à dentição funcional (mais de 20 dentes) e avaliar o impacto do uso de prótese e da perda dentária na autoavaliação da saúde bucal. MÉTODOS: A amostra foi composta por pessoas de 60 anos ou mais, participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). A avaliação da prevalência de perda dental e uso de próteses foi feita a partir da comparação dos dados coletados nos anos de 2000, 2006 e 2010. As análises dos fatores associados à dentição funcional e autoavaliação de saúde bucal foram realizadas com base nos dados coletados no ano de 2010. A comparação do perfil de saúde bucal ao longo dos três períodos foi feita por meio de análises descritivas e comparação de intervalos de confiança. Realizou-se análise de regressão logística múltipla para avaliar os fatores associados à dentição funcional e à autoavaliação da saúde bucal. RESULTADOS: A prevalência de perda dental e uso de próteses se manteve constante ao longo dos três anos analisados. A dentição funcional foi significativamente associada à escolaridade, sexo e cor/gênero. Idosos com necessidade de próteses e bolsa periodontal apresentaram mais chances de autoavaliação ruim. CONCLUSÃO: Não houve redução da prevalência de perda dentária e uso de próteses ao longo de dez anos na população estudada. A dentição funcional está associada a desigualdades sociodemográficas. A autoavaliação de saúde bucal está associada à necessidade de próteses.

Sampling strategy of an epidemiological survey using a satellite image program

ABSTRACT OBJECTIVE To describe the sampling strategy of an epidemiological survey with the aid of satellite images, including details of the multistage probability sampling process. METHODS A probability sample of individuals living in the rural area of Rosário do Sul, state of Rio Grande do Sul, Brazil, aged 15 years old or more, was evaluated. Participants answered questionnaires (medical history, sociodemographic characteristics, habits, alcohol use, quality of life, stress, rumination, and self-perceived periodontal diseases), and were subjected to clinical oral examinations as well as anthropometric measurements (blood pressure, height, weight, abdominal and waist circumferences). Oral evaluation comprehended a complete periodontal exam at six sites per tooth, including the following assessments: furcation involvement; dental abrasion; tooth decay, including the indexing of missing and filled surfaces; O'Brien index; gingival abrasion; oral cavity and lip lesions; complete periapical radiographic exam, and use of prostheses. Besides this oral clinical approach, subgingival plaque, crevicular gingival fluid, saliva, and blood samples were collected. Examiners were trained and calibrated during previous evaluations. A pilot study allowed the logistic of the performed exams to be adjusted as needed. RESULTS Among 1,087 eligible individuals, 688 were examined (63.3%). Age, sex, and skin color data were compared to data from the last demographic census (2010) of the Brazilian Institute of Geography and Statistics, which served to validate the sampling strategy. CONCLUSIONS The careful methods used in this study, in which satellite images were used in the delimitation of epidemiological areas, ensure the quality of the estimates obtained and allow for these estimates to be used in oral health surveillance and health policies improvements.

Development and Evaluation: The Satisfaction of Using an Oral Health Survey Mobile Application.

INTRODUCTION: Surveying oral health at the community level should be done at regular intervals. Dental health personnel must assess the oral health status and needs of the community through the collection and interpretation of reliable health information. Thus, the aims of this study were (1) to develop a mobile application for oral health surveys, (2) to analyze the oral status of school children in Bangkok using the newly developed application, and (3) to evaluate user satisfaction with using the Oral Health Survey Mobile Application (OHSMA). MATERIALS AND METHODS: The OHSMA Android app was created to facilitate the collection and transfer of oral health status data. The survey data on the oral health status of Grades 1-6 Thai schoolchildren were collected and analyzed using the OHSMA. A 5-point Likert scale questionnaire was used to evaluate the satisfaction of 125 dental students when using this new application compared with using paper forms. RESULTS: The prevalence of dental caries in 441 schoolchildren was 79.7%. The total mean decayed, missing, and filled for primary teeth (dmft) and decayed, missing, and filled for permanent teeth (DMFT) were 4.09 (d + D = 3.29, m + M = 0.15, and f + F = 0.65). Users indicated high satisfaction scores for three OHSMA features: font, color, and proper size. The results showed that paper forms were easier for inputting and recording the data compared with the OHSMA. However, the OHSMA was significantly easier for searching data and reporting data compared with paper forms (OHSMA 3.80, paper forms 3.35; p < 0.001, and OHSMA 3.80, paper forms 3.51; p < 0.001), respectively. CONCLUSIONS: Despite some limitations, this study suggests that the mobile application has the potential to collect valuable oral health survey data.

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013 / Desigualdades de renda na saúde bucal e no acesso aos serviços odontológicos na população brasileira: Pesquisa Nacional de Saúde, 2013

ABSTRACT: Introduction: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. Objective: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. Methods: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. Results: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. Conclusion: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.

RESUMO: Introdução: Apesar da melhora das condições de saúde bucal constatada na população brasileira, persistem elevadas desigualdades sociais que precisam ser monitoradas. Objetivo: Avaliar a desigualdade de renda nas práticas de higiene bucal, nas condições bucais e no uso de serviços odontológicos na população brasileira de adultos e idosos. Métodos: Foram utilizados dados da Pesquisa Nacional de Saúde realizada em 2013 (PNS 2013) referentes à população de 18 anos ou mais. Resultados: Detectaram-se desigualdades entre os estratos de renda na maioria dos indicadores de saúde bucal avaliados. As desigualdades de maior magnitude foram verificadas no uso de fio dental, nas práticas de higiene (RP = 2,85 nos adultos e RP = 2,45 nos idosos), e na perda de todos os dentes (RP = 6,74 nos adultos e RP = 2,24 nos idosos) e dificuldade de mastigar (RP = 4,49 nos adultos e RP = 2,67 nos idosos) entre os indicadores de condições bucais. Na maioria dos indicadores de condições bucais a magnitude das desigualdades foi elevada em ambos os grupos. A renda mostrou-se um fator que persiste limitando o acesso aos serviços odontológicos e, mesmo os segmentos de menor renda apresentaram elevados percentuais que pagam por consulta odontológica. Conclusão: Por meio dos dados da primeira PNS, os achados do estudo permitiram identificar aspectos de saúde e de atenção bucais mais comprometidos pelos diferenciais de renda, podendo, nesse sentido, contribuir para o planejamento da assistência odontológica no país e para estimular o monitoramento destas disparidades com dados das próximas pesquisas.

Development and evaluation of CARIES-QC: a caries-specific measure of quality of life for children.

BACKGROUND: Existing paediatric oral health-related quality of life (OHRQoL) measures are generic instruments designed to evaluate a range of oral conditions. It has been found that disease-specific measures may be more adept at detecting subtle changes which occur following treatment of the condition in question. Furthermore, existing self-report OHRQoL measures have not involved children at all stages of development of the measure. The aim of this study was to develop a caries-specific measure of quality of life for children. METHODS: The first stage of the study involved a qualitative enquiry with children, aged 5-16 years, to inform the development of the measure. Children generated the potential items, contributed to item reduction and questionnaire design and participated in the testing of face and content validity. The resulting measure was evaluated in a cross-sectional validation study. Ethical approval was granted for the study. RESULTS: The qualitative study found that children discussed a number of caries-related impacts which affected their daily lives. These were incorporated into a draft measure which was further refined following testing of face and content validity. This resulted in the production of the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), comprising 16 items and one global question. Two hundred participants with a mean (range) age of 8.1 (5-16) years took part in the further evaluation of CARIES-QC. Four items, which did not fit the Rasch model, were removed from further analysis. The remaining 12 items demonstrated good internal consistency (alpha = 0.9) and the total score showed significant correlations with the number of decayed teeth, presence of pain, pulpal involvement, the Child Perceptions Questionnaire (16-item short form) and the global score (p < 0.01, Spearman's rho). CONCLUSION: In conclusion, children's input allowed the development of a valid and reliable child-centred caries-specific quality of life measure. CARIES-QC can now be used to evaluate which interventions for dental caries are most effective in reducing impacts from the child's perspective.

Longitudinal measurement invariance and explanatory IRT models for adolescents' oral health-related quality of life.

BACKGROUND: Longitudinal invariance is a perquisite for a valid comparison of oral health-related quality of life (OHRQoL) scores over time. Item response theory (IRT) models can assess measurement invariance and allow better estimation of the associations between predictors and latent construct. By extending IRT models, this study aimed to investigate the longitudinal invariance of the two 8-item short forms of the Child Perception Questionnaire (CPQ11-14) regression short form (RSF:8) and item-impact short form (ISF:8) and identify factors associated with adolescents' OHRQoL and its change. METHODS: All students from S1 and S2 (equivalent to US grades 6 and 7) who were born in April 1997 and May 1997 (at age 12) from 45 randomly selected secondary schools were invited to participate in this study and followed up after 3 years. Data on the CPQ11-14 RSF:8 and CPQ11-14 ISF:8, demographics, oral health behavior and status were collected. Explanatory graded response models were fitted to both short forms of the CPQ11-14 data for assessing longitudinal invariance and factors associated with OHRQoL. The Bayesian estimation method - Monte Carlo Markov Chain (MCMC) with Gibbs sampling was adopted for parameter estimation and the credible intervals were used for inference. RESULTS: Data from 649 children at age 12 at baseline and 415 children at age 15 at follow up were analyzed. For the 12 years old children, healthier oral health behavior, better gum status, families with both parents employed and parents' education level were found to be associated with better OHRQoL. Four items among the 2 short forms lacked longitudinal invariance. With statistical adjustment of longitudinal invariance, OHRQoL were found improved in general over the 3 years but no predictor was associated with OHRQoL in follow-up. For those with decreased family income, their OHRQoL had worsened over 3 years. CONCLUSIONS: IRT explanatory analysis enables a more valid identification of the factors associated with OHRQoL and its changes over time. It provides important information to oral healthcare researchers and policymakers.

Impact of different detection criteria on caries estimates and risk assessment.

AIM: This study aimed to compare the prevalence and extent of dental caries according to the standard World Health Organization (WHO), modified WHO and International Caries Detection and Assessment System (ICDAS) criteria among 12-year-old Brazilian schoolchildren and to assess the impact of these detection criteria on the assessment of sociodemographic risk indicators for dental caries. METHODS: This cross-sectional survey used a multistage probability sampling strategy to select a representative sample of 12-year-old schoolchildren. After tooth cleaning and drying, a single examiner recorded the presence of non-cavitated and cavitated caries lesions. A questionnaire gathered demographic and socio-economic information. Three proposed thresholds for caries detection were used: standard WHO criteria (only cavitated lesions); modified WHO criteria (active non-cavitated lesions and cavitated lesions); and ICDAS (all non-cavitated and cavitated lesions). Prevalence ratios (PR), rate ratios (RR) and 95% confidence intervals (95% CI) were estimated using survey Poisson regression analysis. RESULTS: In total, 1,528 of 1,837 eligible schoolchildren participated. Caries prevalence (standard WHO, 55.23%; modified WHO, 63.33%; ICDAS, 79.82%) and decayed, missing and filled teeth (DMFT) index (standard WHO, 1.39; modified WHO, 1.95; ICDAS, 3.78) increased as the detection criteria became more sensitive. Compared with the standard WHO criteria, ICDAS had a greater impact on caries estimates, mainly in schoolchildren of higher socio-economic background. All socio-economic variables were significantly associated with dental caries, irrespective of the detection criteria. CONCLUSION: The inclusion of non-cavitated lesions impacted estimates of prevalence and extent of dental caries, mainly when ICDAS was used. No impact was observed on the association between caries and socio-economic variables.