RESUMO
The aim of this study was to evaluate the social characteristics and form of admission of dental students in the university, associating these characteristics with the discriminatory experiences lived by then, through an intersectional analysis. A crosssectional multicenter study was conducted with Brazilian dental students, selected through a snowball sample. The study was approved by the Ethics Committee for Human Research of the Federal University of Minas Gerais (CAAE: 47622121.4.0000.5149). The discriminatory experiences were measured by the total score of Explicit Discrimination Scale (EDS). To evaluate the other variables, a questionnaire was created with thematic blocks: sociodemographic and socioeconomic characteristics and admission at dental school. After the development of the questionnaire, meetings with experts on the subject and on the scientific methods were conducted to adjust it. Next, cognitive interviews with six volunteer students were conducted to verify the applicability and understanding of the instrument. After the adjusts, a pilot study was conducted, and no changes were needed. Students were invited to answer the full questionnaire and the EDS via Google Forms. Data was analyzed by descriptive analysis, bivariate analysis using MannWhitney and Kruskal-Wallis with post-hoc test. Multiple analysis using Poisson regression with robust variance was performed to measure the intersectionality. The significance level was set at 5% (p<0.05). 531 students from 15 different Brazilian institutions participated of this study; 74.2% were female, 53.3% white, 99.6% cisgenders and 85.5% heterosexuals. The mean age was 25.4 (±6.3) years. The means of discriminatory experiences were higher in students who work and support themselves (7.27±6.6) or use public policies (7.03±5.79) to access the university. Four models were built for an intersectional analysis. In the first model with non-adjusted analysis, black students were more likely to have had discriminatory experiences (PR:1,503 95% CI: 1.305-1.731). In the second model, the variable sex was incorporated, and the association between race and discriminatory experiences were kept (PR:1.513; 95% CI: 1.314-1.742). The monthly income was incorporated in the third model. Black race (PR=1.502; 95% CI: 1.304-1.729) and lower monthly income (PR=1.234; 95% CI: 1.057-1.442) were statistically associated with discriminatory experience. The last adjusted model was composed by race, sex, monthly income and sexual orientation and it was observed that black students (PR=1.484; 95% CI: 1.291- 1.705; p<0.001), women (PR=1.227; 95% CI: 1.030 -1.462; p=0.022), with lower monthly income (PR=1.212; 95% CI: 1.043-1.409; p=0.012) and LGBTQIAP+ (PR=1.466; 95% CI: 1.238-1.735; p<0.001) had higher probability of having discriminatory experiences when compared to whites, men, with higher monthly income and heterosexuals. It can be concluded that the profile of dental students maintained a certain pattern: white, heterosexual and cisgender. Students who use public policies of access have higher averages of discrimination. Also, black female students with lower monthly income and LGBTQIAP+ were more likely to have had discriminatory experiences when compared to white men with highly monthly income and heterosexual.
The aim of this study was to evaluate the social characteristics and form of admission of dental students in the university, associating these characteristics with the discriminatory experiences lived by then, through an intersectional analysis. A crosssectional multicenter study was conducted with Brazilian dental students, selected through a snowball sample. The study was approved by the Ethics Committee for Human Research of the Federal University of Minas Gerais (CAAE: 47622121.4.0000.5149). The discriminatory experiences were measured by the total score of Explicit Discrimination Scale (EDS). To evaluate the other variables, a questionnaire was created with thematic blocks: sociodemographic and socioeconomic characteristics and admission at dental school. After the development of the questionnaire, meetings with experts on the subject and on the scientific methods were conducted to adjust it. Next, cognitive interviews with six volunteer students were conducted to verify the applicability and understanding of the instrument. After the adjusts, a pilot study was conducted, and no changes were needed. Students were invited to answer the full questionnaire and the EDS via Google Forms. Data was analyzed by descriptive analysis, bivariate analysis using MannWhitney and Kruskal-Wallis with post-hoc test. Multiple analysis using Poisson regression with robust variance was performed to measure the intersectionality. The significance level was set at 5% (p<0.05). 531 students from 15 different Brazilian institutions participated of this study; 74.2% were female, 53.3% white, 99.6% cisgenders and 85.5% heterosexuals. The mean age was 25.4 (±6.3) years. The means of discriminatory experiences were higher in students who work and support themselves (7.27±6.6) or use public policies (7.03±5.79) to access the university. Four models were built for an intersectional analysis. In the first model with non-adjusted analysis, black students were more likely to have had discriminatory experiences (PR:1,503 95% CI: 1.305-1.731). In the second model, the variable sex was incorporated, and the association between race and discriminatory experiences were kept (PR:1.513; 95% CI: 1.314-1.742). The monthly income was incorporated in the third model. Black race (PR=1.502; 95% CI: 1.304-1.729) and lower monthly income (PR=1.234; 95% CI: 1.057-1.442) were statistically associated with discriminatory experience. The last adjusted model was composed by race, sex, monthly income and sexual orientation and it was observed that black students (PR=1.484; 95% CI: 1.291- 1.705; p<0.001), women (PR=1.227; 95% CI: 1.030 -1.462; p=0.022), with lower monthly income (PR=1.212; 95% CI: 1.043-1.409; p=0.012) and LGBTQIAP+ (PR=1.466; 95% CI: 1.238-1.735; p<0.001) had higher probability of having discriminatory experiences when compared to whites, men, with higher monthly income and heterosexuals. It can be concluded that the profile of dental students maintained a certain pattern: white, heterosexual and cisgender. Students who use public policies of access have higher averages of discrimination. Also, black female students with lower monthly income and LGBTQIAP+ were more likely to have had discriminatory experiences when compared to white men with highly monthly income and heterosexual.
Assuntos
Fatores Socioeconômicos , Odontologia , Racismo , Sexismo , Enquadramento InterseccionalRESUMO
O presente estudo longitudinal prospectivo teve como objetivo avaliar a cronologia, sinais e sintomas da erupção dos incisivos inferiores decíduos em crianças nascidas pré-termo e/ou baixo peso (NPTBP). A amostra consistiu de 46 crianças em acompanhamento no Ambulatório da Criança de Risco (ACRIAR) do Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG). Foram incluídas crianças com idade mínima de quatro meses em acompanhamento no ACRIAR, sendo excluídos pacientes com síndromes e que já houvessem passado pela erupção de algum dente. As variáveis dependentes foram cronologia e sinais e sintomas clínicos de erupção dentária. Para estes diagnósticos, as crianças tiveram as cavidades bucais examinadas mensalmente por um cirurgião dentista treinado e calibrado (Kappa intra e inter-examinador >0,81). As variáveis independentes foram prematuridade e baixo peso ao nascer, sexo, histórico de amamentação e hábitos bucais da criança, histórico de intubação orotraqueal, tempo de permanência na Unidade de Tratamento Intensivo (UTI) e histórico de Continuous Positive Airway Pressure (CPAP). Os dados foram analisados por meio da análise de sobrevida pelo método de Kaplan-Meier e pelo teste Log Rank. Além disso, foram realizadas análisesbivariadas utilizando-se os testes Mann Whitney e Kruskal Wallis. A regressão de Poisson com variância robusta foi usada para análise multivariada (p<0,05). A média de idade da erupção dos incisivos inferiores decíduos foi de 11 meses para ambos os sexos. Não foi verificada associação entre idadegestacional e o peso ao nascer com o atraso na erupção (p>0,05). Houve associação estatisticamente significativa entre a erupção e a relação peso/comprimento/idade gestacional, sendo que crianças que nasceram pequenas para a idade gestacional (PIG) tiveram a erupção mais tardiamente do que aqueles que nasceram grandes para a idade gestacional (GIG) (dente 71: p=0,030; dente 81: p=0,017). Intubação, permanência na UTI e uso de CPAP também tiveram associação com a cronologia de erupção (p>0,05). Salivação aumentada, aumento da sucção digital, coceira/irritação gengival e irritabilidade foram os sintomas de erupção relatados com maior frequência. Conclui-se que crianças PIG tem erupção atrasada em relação a aquelas GIG, apesar do nascimento pré-termo e de baixo peso isoladamente não apresentarem influencia na erupção dos incisivos inferiores decíduos. Sintomas como a salivação aumentada e irritabilidade são frequentemente associados com a erupção dentária em crianças NPTBP
The present prospective longitudinal study aimed to evaluate the chronology, signs and symptoms of eruption of primary lower incisors in preterm and/or low birth weight children. The sample was comprised of 46 children in follow-up at the Children's Risk Clinic (ACRIAR) at the Clinical Hospital of the Federal University of Minas Gerais. Children with a minimum age of four months in eruption stage of primary incisors and ACRIAR followed up were included. Patients with syndromes who had undergone a tooth eruption were excluded. The dependent variables were chronologyand clinical signs and symptoms of tooth eruption, and were evaluated monthly by clinical exams by a trained and calibrated dentist (Kappa intra and inter-examiner> 0.81). The independent variables were prematurity and low birth weight, sex, history of breastfeeding and oral habits of the child, history of orotracheal intubation, length of stay in the Intensive Care Unit (ICU) and history of Continuous Positive Airway Pressure (CPAP). Data were analyzed using Kaplan-Meier survival analysis and the Log Ranktest. Mann Whitney and Kruskal Wallis tests were used for bivariate analysis and Poisson regression with robust variance was used for multivariate analysis (p<0.05). The mean age of eruption of primary mandibular incisors was 11 months for both sexes. There was no association between gestational age and birth weight with delayed eruption (p>0.05). There was a statistically significant association between eruption and weight/length/gestational age. Children who were born small for gestational age had the eruption later than those born large for gestational age (tooth 71: p=0.030; tooth 81: p=0.017). Intubation, ICU period stay and CPAP use were not associated with chronology of eruption (p>0.05). Increased salivation, digital suction, gingival itching/irritation, and irritability were the most frequently reported eruption symptoms. In conclusion, small children for gestational age had a late eruption compared to those large for gestational age. Additionally, preterm and low birth weight was not associated with delayed eruption of the primary lower central incisors. Symptoms such as increased salivation and irritability were often associated with tooth eruption in preterm and/or low birth weight children
