FACTORS ASSOCIATED WITH THE PREVALENCE AND INTENSITY OF DENTAL PAIN IN CHILDREN IN THE MUNICIPALITIES OF THE CAMPINAS REGION, SÃO PAULO. / FATORES ASSOCIADOS À PREVALÊNCIA E INTENSIDADE DE ODONTALGIA EM CRIANÇAS DE MUNICÍPIOS DA REGIÃO DE CAMPINAS, SÃO PAULO.

OBJECTIVE: The aim of this study was to evaluate the prevalence and intensity of dental pain in children according to size of municipality, associated factors and absenteeism. METHODS: The sample consisted of children aged 12 years old from public and private schools drawn from eight cities in the region of Campinas (SP). A questionnaire was applied to obtain dental pain, demographic, socioeconomic data, and a clinical examination was carried out to evaluate the experience of having a cavity. The outcome for the logistic regression analysis was having pain and the outcome for the negative log-binomial regression was the intensity of pain. The significance level was 5%. RESULTS: The sample consisted of 1,233 children, and 16.7% reported pain in the last six months. Dental pain was the cause of 46.4% of school absenteeism during this period. The prevalence of pain was lower among households with high income (p=0.023) and higher among nonwhites (p=0.027). Pain intensity was lower in medium-sized cities (p=0.02) and small cities (p=0.004), and higher in children whose parents had a lower educational level (p=0.003), children who sought out a dentist for the pain (p=0.04) and who had untreated cavities (p=0.04). CONCLUSIONS: The prevalence and intensity of dental pain in children aged under 12 are related to socioeconomic aspects of the family, such as low-income and parents with a low level of education, which impact daily activities as seen through school absenteeism. Pain intensity was lower in medium and small cities. Oral health promotion strategies in this age group should be encouraged to avoid dental pain.

OBJETIVO: Avaliar a prevalência e a intensidade de odontalgia em crianças segundo porte populacional do município, fatores associados e absenteísmo. MÉTODOS: A amostra constituiu-se de crianças de 12 anos provenientes de escolas públicas e privadas, sorteadas em oito cidades da região de Campinas (SP). Foi aplicado um questionário com dados de odontalgia, demográficos, socioeconômicos bem como foi realizado exame clínico para avaliar a experiência de cárie. Ter dor foi o desfecho para análise de regressão logística e a intensidade da dor para a regressão log-binomial negativa. Adotou-se nível de significância de 5%. RESULTADOS: A amostra foi constituída de 1.233 crianças, sendo que 16,7% relataram dor nos últimos seis meses. A odontalgia foi causa de 46,4% do absenteísmo escolar nesse período. A prevalência de dor foi menor entre os de alta renda familiar (p=0,023) e maior entre não brancos (p=0,027). A intensidade da dor foi menor nos municípios de médio (p=0,02) e pequeno porte (p=0,004) e maior nas crianças cujos pais tinham menor nível de escolaridade (p=0,003), que procuraram o dentista por dor (p=0,04) e que apresentavam cárie não tratada (p=0,04). CONCLUSÕES: A prevalência e a intensidade da dor de dente em crianças de 12 anos estão relacionadas com aspectos socioeconômicos da família, como baixa renda e menor escolaridade dos pais, e causam impacto na atividade diária por meio do absenteísmo escolar. A intensidade foi menor em municípios de médio e pequeno porte. Estratégias de promoção de saúde bucal nessa faixa etária devem ser estimuladas para evitar a odontalgia.

Fatores associados à prevalência e intensidade de odontalgia em crianças de municípios da região de campinas, são paulo / Factors associated with the prevalence and intensity of dental pain in children in the municipalities of the campinas region, são paulo

RESUMO Objetivo: Avaliar a prevalência e a intensidade de odontalgia em crianças segundo porte populacional do município, fatores associados e absenteísmo. Métodos: A amostra constituiu-se de crianças de 12 anos provenientes de escolas públicas e privadas, sorteadas em oito cidades da região de Campinas (SP). Foi aplicado um questionário com dados de odontalgia, demográficos, socioeconômicos bem como foi realizado exame clínico para avaliar a experiência de cárie. Ter dor foi o desfecho para análise de regressão logística e a intensidade da dor para a regressão log-binomial negativa. Adotou-se nível de significância de 5%. Resultados: A amostra foi constituída de 1.233 crianças, sendo que 16,7% relataram dor nos últimos seis meses. A odontalgia foi causa de 46,4% do absenteísmo escolar nesse período. A prevalência de dor foi menor entre os de alta renda familiar (p=0,023) e maior entre não brancos (p=0,027). A intensidade da dor foi menor nos municípios de médio (p=0,02) e pequeno porte (p=0,004) e maior nas crianças cujos pais tinham menor nível de escolaridade (p=0,003), que procuraram o dentista por dor (p=0,04) e que apresentavam cárie não tratada (p=0,04). Conclusões: A prevalência e a intensidade da dor de dente em crianças de 12 anos estão relacionadas com aspectos socioeconômicos da família, como baixa renda e menor escolaridade dos pais, e causam impacto na atividade diária por meio do absenteísmo escolar. A intensidade foi menor em municípios de médio e pequeno porte. Estratégias de promoção de saúde bucal nessa faixa etária devem ser estimuladas para evitar a odontalgia.

ABSTRACT Objective: The aim of this study was to evaluate the prevalence and intensity of dental pain in children according to size of municipality, associated factors and absenteeism. Methods: The sample consisted of children aged 12 years old from public and private schools drawn from eight cities in the region of Campinas (SP). A questionnaire was applied to obtain dental pain, demographic, socioeconomic data, and a clinical examination was carried out to evaluate the experience of having a cavity. The outcome for the logistic regression analysis was having pain and the outcome for the negative log-binomial regression was the intensity of pain. The significance level was 5%. Results: The sample consisted of 1,233 children, and 16.7% reported pain in the last six months. Dental pain was the cause of 46.4% of school absenteeism during this period. The prevalence of pain was lower among households with high income (p=0.023) and higher among nonwhites (p=0.027). Pain intensity was lower in medium-sized cities (p=0.02) and small cities (p=0.004), and higher in children whose parents had a lower educational level (p=0.003), children who sought out a dentist for the pain (p=0.04) and who had untreated cavities (p=0.04). Conclusions: The prevalence and intensity of dental pain in children aged under 12 are related to socioeconomic aspects of the family, such as low-income and parents with a low level of education, which impact daily activities as seen through school absenteeism. Pain intensity was lower in medium and small cities. Oral health promotion strategies in this age group should be encouraged to avoid dental pain.

Baixa prevalência de cárie: grupo de polarização e a importância dos aspectos familiares / Low prevalence of caries: polarization group and the importance of family aspects

Objetivo: Investigou-se a influência de fatores, sociodemográficos, de acesso a serviços odontológicos na experiência de cárie dentária em grupo de alta experiência de cárie (Sic) de um município com características de país desenvolvido. Metodologia: Estudo transversal, com amostra de escolares de 12 anos. Foram feitos exames clínicos utilizando o índice CPOD (dentes permanentes cariados-perdidos-obturados), e para obtenção do grupo com alta experiência de cárie, o índice SiC; para as características sociodemográficas e de acesso a serviços odontológicos, um questionário foi respondido pelos pais dos alunos. A associação entre cárie dentária e as variáveis exploratórias foi verificada por análise de regressão logística simples e múltipla. Resultados: O CPOD no grupo Sic foi 3,16 (±1,37). As variáveis associadas com o grupo SiC foram: "consulta por rotina" RP=0,56), "ter somente o pai/mãe ou outro responsável pelo sustento do escolar" (RP=1,84), e "escolaridade da mãe" (RP=1,82). As variáveis independentes associadas com a presença de experiência de cárie (CPOD>0) foram: consulta por rotina" (RP=0,66), "nunca evitaram sorrir" (RP=0,66) e "escolaridade do pai" (RP=1,69). Conclusão: As variáveis socioeconômicas se associaram com experiência de cárie e com grupo Sic sendo que as de autopercepção se relacionaram com experiência de cárie, porém não com o grupo Sic.

We investigated the influence of sociodemographic, access to dental services in dental caries experience in the group of high caries experience (Sic) of a municipality with features of developed country. It is a cross-sectional study with a sample of schoolchildren aged 12 years. Clinical examinations using the DMFT (decayed, missing, filled permanent teeth), and to obtain the group with high caries experience, Sic index, for sociodemographics and access to dental services, a questionnaire was completed by parents students. The association between dental caries and the explanatory variables was verified by analysis of simple and multiple logistic regression. The DMFT index in the high caries experience (group SiC) was 3.16 (± 1.37). The variables associated with the group SiC were routinely query (PR = 0.56), or a parent or other person be responsible for supporting the school (PR = 1.84), and maternal education (PR = 1, 82). Independent variables associated with the presence of caries experience (DMFT> 0) were routinely query (PR = 0.66), never avoided smiling (PR = 0.66) and paternal education (PR = 1.69). The socioeconomic variables were associated with caries experience and Sic group being that of perception were related to caries experience but not with Sic group.

Relations between Dental Caries, Socioeconomic Variables and Access to Dental Services of Children from a Countryside city in the State of São Paulo, Brazil

Objective:To investigate the relations between the prevalence of dental caries, socioeconomic status and access to dental services of children aged 5 and 12 years, in Amparo, SPMaterial and Methods:The sample size was calculated for 5 and 12 year-old children in Amparo-SP. Children (5 years: n = 284; 12 years: n = 199) were examined by a previously calibrated team, to check dmft and DMFT according to WHO criteria. Caregivers answered questions about socioeconomic, demographic status and access to/use of dental services in the past six months. Association between outcome (caries experience) and independent variables was analyzed using the chi-square test. Variables with p value lower than or equal to 0.25 were tested in a multiple regression model (multivariate Poisson) with a statistical significance of 5%.Results:For the five-year-old population, the variables associated with caries experience (p <0.05) were: ethnicity (OR = 0.273 -non-white), household income (OR = 2.897 -Up to 3 minimum wages) and reason for dental care (OR = 4.511 -pain and treatment need). For 12-year-old population, only the variable income (OR = 3.073 -Up to 3 minimum wages) was significantly associated (p <0.05) in the final model for caries experience assessment.Conclusion:Dental caries experience in children from the city of Amparo-SP was influenced by socioeconomic and demographic factors, especially in the 5-year-old population

Dental caries trends among preschool children in Indaiatuba, SP, Brazil

AIM: To evaluate caries experience and associated factors in 5-year-old preschool children in the city of Indaiatuba, SP, Brazil. METHODS: This was a cross-sectional, representative study, conducted from an epidemiological oral health survey (2010) with 303 children. The sample was established by the systematic probabilistic method, in public and private schools, in accordance with WHO criteria. The sample was checked for caries experience (dmft) by four trained and calibrated dentists, reaching acceptable levels of agreement for data collection. Parents or guardians answered questions related to their education and monthly income, and the children answered questions related to dental care and pain. Descriptive and bivariate analyses of independent variables were performed. Variables with p<0.20 were included in the model (Poisson regression analysis). RESULTS: The sample consisted of 151 boys and 152 girls, with a mean dmft of 1.46. The reasons for visiting a dentist due to pain or need for treatment were associated with dmft > 0 (PR=3.76, 95%CI=2.06-6.84) after adjustment of the regression model. CONCLUSIONS: Among the preschool children of this study, pain or need for treatment due to caries disease in the primary dentition and the reason to visit the dentist due pain emphasizing the importance of the professional not only in curative actions, but as a health promoter at the first contact with the child.

Cuidados odontológicos e fatores associados em escolares do município de Indaituba-SP / Dental care and associated factors in school chidren in Indaiatuba, São Paulo, Brazil

Objetivo: Avaliar os cuidados odontológicos bem como fatores associados em escolares de 12 anosde idade, residentes em Indaiatuba-SP.Materiais e Métodos: Estudo transversal realizado a partir de um levantamento epidemiológico de saúde bucal em 151 estudantes provenientes de amostra probabilística por conglomerado e ponderada de escolas públicas e particulares, utilizando critérios da OMS. A amostra foi examinada quanto à experiência de cárie (CPOD), por quatro dentistas, treinados e calibrados, atingindo níveis de concordância aceitáveis para a coleta dos dados. Foi aplicado um questionário para obtenção de dados sociodemográficos. O índice de cuidados odontológicos foi calculado a partir da razão O/CPO multiplicadopor 100. O último quartil (75%) foi a variável dependente deste estudo: os que apresentaram maior cuidadoodontológico (O/CPO≥91%) e menor cuidado odontológico (< 91%). Foram realizadas análises bivariadas,sendo incluídas no modelo as variáveis com p≤0,25 para análise de Regressão de Poisson. Resultados: Das151 crianças examinadas, 52,3% (n=79) apresentavam-se livres de cárie, sendo o CPOD de 1,56 (±2,1). Nomunicípio a média do índice de cuidados odontológicos foi de 47,3%. Foram associados ao maior índice de cuidados odontológicos: procurar o dentista motivado por rotina (RP=2,32; IC 95%=1,29û4,19), utilizar serviço odontológico diferente do público (RP=2,37; IC 95%=1,11-5,48) e apresentar renda familiar mais alta(RP=2,68; IC95%= 2,10 - 7,66) após o ajuste do modelo de regressão.Conclusão: Os fatores renda, tipo deserviço odontológico e motivo da consulta odontológica foram associados ao maior cuidado odontológico.

[Factors associated with the incidence of dental caries among schoolchildren living in a municipality with low prevalence of dental caries]. / Fatores associados à experiência de cárie em escolares de um município com baixa prevalência de cárie dentária.

The literature has shown that poorer levels of oral health are more frequently related to lower socio-economic status, consequently this cross-sectional and exploratory study conducted in 2003 investigated the association between caries and socio-economic factors, access to care, self-perception and habits among 266 12-year-old schoolchildren living in a community with low prevalence of dental caries. World Health Organization dental caries diagnosis methodology was used, in addition to the application of socio-economic and behavioral questionnaires. To identify the factors associated with dental caries, multivariate logistic regression was used and the dependent variable was synthesized into DMFT=0 and DMFT>0. Bearing in mind the limitations of a cross-sectional study, disliking the appearance of teeth, seeking dental care because of pain, studying at a state school and the head of the family being a manual worker were independently associated with dental caries. Even in a municipality with low prevalence of caries, the socio-economic status, dental care and self-perception were important factors in the incidence of dental caries among schoolchildren, and it is recommended that many factors in the bio-psychosocial context of multi-factorial dental caries should be investigated.

Fatores associados à experiência de cárie em escolares de um município com baixa prevalência de cárie dentária / Factors associated with the incidence of dental caries among schoolchildren living in a municipality with low prevalence of dental caries

A literatura tem mostrado que piores níveis de saúde bucal estão mais frequentemente relacionados a baixos níveis socioeconômicos, assim este estudo transversal de caráter exploratório investigou a associação entre experiência de cárie e fatores socioeconômicos, acesso a serviços, autopercepção e hábitos em 266 escolares de 12 anos de idade de uma localidade com baixa prevalência de cárie dentária em 2003. Utilizou-se critérios de diagnóstico para cárie dentária da Organização Mundial da Saúde e aplicou-se questionário socioecômico e comportamental. Para a identificação dos fatores associados à experiência de cárie utilizou-se a análise de regressão logística multivariada. A variável dependente foi dicotomizada em CPOD=O e CPOD>0. Considerando as limitações de um estudo transversal, não gostar da aparência dos dentes, procurar atendimento odontológico por dor, estudar em escola pública e o responsável da família ser trabalhador manual foram independentemente associados à experiência de cárie. Mesmo em um município com baixa prevalência de cárie os fatores socioeconômicos, o acesso a serviço odontológico e a autopercepção da saúde bucal foram importantes para a ocorrência da cárie, recomendando-se que diversos fatores sejam investigados dentro do contexto biopsicossocial da sua multifatoriedade.

The literature has shown that poorer levels of oral health are more frequently related to lower socio-economic status, consequently this cross-sectional and exploratory study conducted in 2003 investigated the association between caries and socio-economic factors, access to care, self-perception and habits among 266 12-year-old schoolchildren living in a community with low prevalence of dental caries. World Health Organization dental caries diagnosis methodology was used, in addition to the application of socio-economic and behavioral questionnaires. To identify the factors associated with dental caries, multivariate logistic regression was used and the dependent variable was synthesized into DMFT=0 and DMFT>0. Bearing in mind the limitations of a cross-sectional study, disliking the appearance of teeth, seeking dental care because of pain, studying at a state school and the head of the family being a manual worker were independently associated with dental caries. Even in a municipality with low prevalence of caries, the socio-economic status, dental care and self-perception were important factors in the incidence of dental caries among schoolchildren, and it is recommended that many factors in the bio-psychosocial context of multi-factorial dental caries should be investigated.

[Inequalities in distribution of dental caries in teenagers of Indaiatuba, São Paulo State, 2004]. / Desigualdades na distribuição da cárie dentária em adolescentes de Indaiatuba (SP), 2004.

The objectives of this work was to know the dental caries prevalence and treatment need, besides the distribution of the dental caries in a population of 12 year-old teenagers with high incidence of dental caries. 309 adolescents of public schools of Indaiatuba, São Paulo State, in 2004, were examined. They were selected by process systematic random and the exams followed the World Health Organization criteria. The percentile of school caries free was of 38.8%. Among the adolescents examined, 36.6% (n=113) presented dental caries. DMFT was of 2.50 (IC95%=2.07-2.93). The decayed component was the highest (61.0%). The coefficient of Gini was 0.602 and SiC value was of 5.97 (IC95%=5.32-6.62); in this group especially, 74.7% (n=74) presented dental caries activity in the moment of the exam. Thus, it can be concluded that the adolescents of this city presented low dental caries experience; however, their needs were not assisted, once most of DMFT was formed of the decayed component at 12 years old. In the group SiC, it was verified that this came quite high, being recommended actions addressed to this specific group of adolescents.

Desigualdades na distribuição da cárie dentária em adolescentes de Indaiatuba (SP), 2004 / Inequalities in distribution of dental caries in teenagers of Indaiatuba, São Paulo State, 2004

Os objetivos deste trabalho foram conhecer a prevalência da cárie dentária e a necessidade de tratamento odontológico, além da distribuição da cárie dentária na população que apresenta índices de cárie mais elevados em escolares de doze anos. Foram examinados 309 adolescentes, de escolas públicas de Indaiatuba (SP), em 2004, selecionados mediante processo amostral aleatório sistemático e os exames seguiram os critérios da Organização Mundial de Saúde. O percentual de escolares livres de cárie foi de 38,8 por cento. Dentre os escolares examinados, 36,6 por cento (n=113) apresentaram atividade de cárie. O CPOD foi de 2,50 (IC95 por cento=2,07-2,93). O componente cariado foi o mais prevalente (61,0 por cento). O coeficiente de Gini foi 0,602 e o valor do índice SiC foi de 5,97 (IC95 por cento=5,32-6,62); neste grupo em especial, 74,7 por cento (n=74) apresentaram atividade de cárie no momento do exame. Desta forma, pode-se concluir que os escolares deste município apresentaram baixa experiência de cárie; entretanto, não apresentaram suas necessidades atendidas, uma vez que a maior parte do CPOD era formada do componente cariado, aos doze anos de idade. No grupo SiC, verificou-se que este apresentou-se bastante elevado, sendo recomendadas ações direcionadas a este grupo específico de adolescentes.

The objectives of this work was to know the dental caries prevalence and treatment need, besides the distribution of the dental caries in a population of 12 year-old teenagers with high incidence of dental caries. 309 adolescents of public schools of Indaiatuba, São Paulo State, in 2004, were examined. They were selected by process systematic random and the exams followed the World Health Organization criteria. The percentile of school caries free was of 38.8 percent. Among the adolescents examined, 36.6 percent (n=113) presented dental caries. DMFT was of 2.50 (IC95 percent=2.07-2.93). The decayed component was the highest (61.0 percent). The coefficient of Gini was 0.602 and SiC value was of 5.97 (IC95 percent=5.32-6.62); in this group especially, 74.7 percent (n=74) presented dental caries activity in the moment of the exam. Thus, it can be concluded that the adolescents of this city presented low dental caries experience; however, their needs were not assisted, once most of DMFT was formed of the decayed component at 12 years old. In the group SiC, it was verified that this came quite high, being recommended actions addressed to this specific group of adolescents.

Determinantes clínicos e sócio-comportamentais da cárie dentária nas dentições decídua e permanente em município com concentração ótima de fluoreto na água / Clinical and socio-behavioral determining factors of dental caries in deciduous and permanent dentitions in a city with optimal fluoride concentrations in the water supply

O objetivo deste estudo foi verificar a prevalência de lesões e atividade de cárie em escolares residentes em um município com concentração ótima de fluoreto na água e investigar os possíveis fatores associados. A amostra foi composta por 603 escolares, sendo 315 de 5 anos e 288 de 12 anos. As prevalências de lesões e atividade de cárie foram quantificadas de acordo com os critérios da OMS e de Nyvad, respectivamente. Variáveis sócio-demográficas e questões sobre saúde bucal foram investigadas através de um questionário enviado aos pais/responsáveis. Associações foram verificadas por meio de um modelo hierárquico de análise estatística baseado num quadro teórico de ocorrência de cárie. Aos 5 anos, o ceod foi 2,63 (±3,37) e a porcentagem de escolares com atividade de cárie foi de 62,2%. Aos 12 anos o CPOD foi igual a 2,23 (±2,57) e a porcentagem de escolares com atividade de cárie foi de 78,8%. O componente cariado foi o que apresentou maior percentual para dentições decídua e permanente. Na dentição decídua, a presença de lesões de cárie esteve associada à falta de automóvel na família (p=0,02) e à ausência de visita a cirurgião dentista no último ano (p=0,01). Atividade de cárie, em ambas as dentições, esteve associada à ausência de consulta a cirurgião-dentista no último ano (p=0,01). Nenhum fator esteve associado com lesões de cárie na dentição permanente. Os resultados deste estudo corroboram os relatos na literatura quanto à importância do monitoramento constante e a influência do fator socioeconômico na presença da doença cárie em ambas as dentições.

Dental caries experience in 12-year-old schoolchildren in southeastern Brazil.

The aim of this study was to evaluate the prevalence of caries-free children using DMFT and significant caries (SiC) indexes in different caries prevalence groups in cities of the region of Campinas, São Paulo State, Brazil. The methodology proposed by the World Health Organization (1997) was used for caries diagnosis in 2,378 individuals. According to the DMFT index obtained in each evaluated city, 3 prevalence groups with representative samples were formed, being classified as low, moderate and high. SiC index was used to classify the one third of the population with the highest caries prevalence. In the low prevalence group, 32.4% of the children were caries free (DMFT=0), with mean DMFT of 2.29 and SiC index of 4.93. In the moderate prevalence group, 21.8% of the children were caries free, with mean DMFT of 3.36 and SiC of 6.74. Only 6.9% of the children in the high prevalence group were caries free and the mean DMFT was 5.54 (SiC=9.62). There was a great heterogeneity in dental caries distribution within the studied population, as well as a high caries prevalence considering the 3 classifications. Other indexes besides DMFT could be used to improve oral health assessment during establishment of the treatment plan and intervention.

Dor de dente e sua relação com a experiência de cárie em adolescentes / Toothache and its relationship with caries experience in teenagers

Objetivo: Verificar a prevalência de dor de dente relatada por escolares e a sua relação com a experiência de cárie, bem como a necessidade de tratamento, em escolares de 12 anos de Paulínia, São Paulo. Métodos: Foram examinados 413 escolares de escolas públicas de Paulínia, São Paulo, em 2004, selecionados mediante processo amostral aleatório sistemático. Os selecionados responderam a um questionário sobre questões relacionadas a dor de dente e passaram por um exame bucal. Na análise estatística, utilizaram-se os testes Mann-Whitney e Qui-Quadrado, com nível de significância de 5%. Resultados: A prevalência de dor de origem bucal foi de 22,8% e o CPO-D no município foi de 0,9 (Intervalo de Confiança=0,8-1,1). Os estudantes que relataram dor apresentaram índice de CPO-D mais elevado e maior percentual de dentes cariados que os do grupo sem relato de dor (p<0,05). Além disto, os escolares com relato de dor apresentaram maior percentual de dentes com necessidade de tratamento curativo (p=0,033), apresentando mais indicação de restaurações com duas ou mais superfícies (p=0,017).Conclusão: Apesar de o município apresentar muito baixa experiência de cárie, um percentual considerável (22,8% dos adolescentes) relatou que sentiu dor de dente. O grupo que relatou dor teve piores condições de saúde bucal. Além disso, neste mesmo grupo, houve mais faltas à escola e um impacto negativo em relação à satisfação com a aparência dos dentes.

Objective: To verify the prevalence of toothache and its relationship with dental caries experience and treatment needs among schoolchildren aged 12 in the city of Paulínia, São Paulo, Brazil. Methods: The 413 schoolchildren chosen to participate in this survey were selected by systematic random sampling from public schools and were examined in 2004. The subjects answered a questionnaire and underwent an oral exam. For the statistical analysis, the Mann-Whitney and Chi-squared tests were used. Results: Prevalence of toothache was 22.8% and the DFMT was 0.9 (IC=0.8-1.1). The students that presented toothache showed a higher DFMT index and percentage of decayed teeth than the group that did not report pain (p <0.05). Moreover, schoolchildren who reported toothache had a higher percentage of teeth with restorative treatment needs (p=0.033). The most prevalent treatment needs were restorations in 2 or more surfaces (p=0.017). Conclusion: Although this city presented very low caries experience, a considerable percentage of the adolescents reported having toothache (22.8%), The group with toothache had the worst oral health conditions. Furthermore, in this same group, there were more absences from school and a negative impact on satisfaction with the appearance of the teeth.

Dental caries experience in 12-year-old schoolchildren in southeastern Brazil

The aim of this study was to evaluate the prevalence of caries-free children using DMFT and significant caries (SiC) indexes in different caries prevalence groups in cities of the region of Campinas, São Paulo State, Brazil. The methodology proposed by the World Health Organization (1997) was used for caries diagnosis in 2,378 individuals. According to the DMFT index obtained in each evaluated city, 3 prevalence groups with representative samples were formed, being classified as low, moderate and high. SiC index was used to classify the one third of the population with the highest caries prevalence. In the low prevalence group, 32.4 percent of the children were caries free (DMFT=0), with mean DMFT of 2.29 and SiC index of 4.93. In the moderate prevalence group, 21.8 percent of the children were caries free, with mean DMFT of 3.36 and SiC of 6.74. Only 6.9 percent of the children in the high prevalence group were caries free and the mean DMFT was 5.54 (SiC=9.62). There was a great heterogeneity in dental caries distribution within the studied population, as well as a high caries prevalence considering the 3 classifications. Other indexes besides DMFT could be used to improve oral health assessment during establishment of the treatment plan and intervention.

Cárie dentária, alterações de esmalte e necessidades de tratamento em pré-escolares e escolares de Araras, SP / Dental Caries, enamel defects and treatment needs in children from Araras, SP, Brazil

O objetivo deste estudo transversal foi descrever a prevalência de cárie dentária, hipoplasia, fluorose e opacidade demarcada de esmalte, assim como relatar as necessidades de tratamento em pré escolares de 5 anos e de escolares de 12 anos, do município de Araras, em 2004. A amostra probabilística consistiu de 381 indivíduos, sendo 186 pré-escolares de 5 anos e 195 escolares de 12 anos. Os exames epidemiológicos foram realizados por quatro examinadores previamente calibrados, sob luz natural, utilizando-se espelho bucal sonda ball point, seguindo as recomendações da OMS. Cárie dentária foi registrada utilizando-se os índices ceod e CPOD. As lesões sem cavidades ativas, necessidades de tratamento, hipoplasia e opacidade demarcada também foram avaliadas. A fluorose foi registrada seguindo o Índice de Dean nos escolares de 12 anos. Os resultados mostraram que o índice ceod aos 5 anos foi 2,07 (dp=3,21) e o CPOD aos 12 anos foi de 2,14 (dp=2,56). Dentre as crianças de 5 e 12 anos examinadas, 52,2% e 42,3% estavam livres de cárie, respectivamente. Aproximadamente um terço dos examinados apresentaram sinais de atividade de cárie. As restaurações de uma face foram as necessidades de tratamento predominantes tanto nos pré-escolares (42,1%) quanto nos escolares (39,0%). A opacidade demarcada esteve presente em 65,1% dos pré-escolares e 14,4% dos escolares; a hipoplasia em 5,9% e 1,5%, respectivamente, e 18% dos escolares de 12 anos apresentaram fluorose. Pode-se concluir que os pré-escolares e os escolares examinados apresentaram necessidades de baixa complexidade, uma vez que a proporção de livres de cárie foi alta e a atividade da doença foi baixa.

The aim of this cross-sectional study was to describe the prevalence of dental caries and enamel defects, such as hypoplasia, demarcated opacity and fluorosis, as well as to report the treatment needs in 5-year-old pre-schoolchildren and 12-year-old schoolchildren, from Araras, São Paulo State, Brazil, in 2004. The probabilistic sample consisted of 382 5-year-old pre-schoolchildren (n=186) and 12-year-old schoolchildren (n=196). The epidemiological examinations were performed by four calibrated examiners, under natural light, using mirrors and “ball point” probes, following the WHO recommendations. Dental caries was recorded using dmft and DMFT indexes. Fluorosis was recorded following the Dean index in 12-year olds. The results showed that the dmft index in 5 year-olds was 1.74(dp=3.04) and that the DMFT in 12-year-olds was 1.58 (dp=2.39). Among the 5-and 12-year-old children, 52.2% and 42.3% were caries free, respectively. Approximately one third of examined children presented signs of caries activity. The one surface filling was the most required treatment in both pre-schoolchildren (42.1%) and schoolchildren (39.0%). The demarcated enamel opacity was detected in 65.4% of pre-schoolchildren and 14.4% of schoolchildren and the hypoplasia in 5.9% and 1.5%, respectively...

[Relationship between fluoride levels in the public water supply and dental fluorosis]. / Relação entre níveis de fluoreto na água de abastecimento público e fluorose dental.

OBJECTIVE: To assess the prevalence of dental fluorosis among schoolchildren subjected to different fluoride concentrations in the public water supply of their cities. METHODS: The sample comprised 386 seven-year-old schoolchildren living in two municipalities in the State of São Paulo that practiced external control over the fluoridation of the water from 1998 to 2002: one with homogenous fluoride concentration and the other with oscillating concentration. Dental fluorosis was determined by dry examination of the upper permanent incisors using Dean's index. Scores classified as questionable were considered to represent fluorosis. Sociodemographic variables and questions regarding oral health were assessed using a structured questionnaire sent to the children's parents or the adults responsible for these children. Correlates of fluorosis were assessed using multivariate logistic regression (p<0.05). RESULTS: Both municipalities presented a mild degree of fluorosis. The prevalence of fluorosis in the municipality with oscillating fluoride content in the water was 31.4%, and it was 79.9% in the municipality with homogenous fluoride content. The prevalence of fluorosis was associated with the municipality with homogeneous fluoride levels in the water (OR=8.33, 95% CI: 5.15;13.45) and with not owning a car (OR=2.10, 95% CI: 1.27;3.49). CONCLUSIONS: The prevalence of dental fluorosis was higher in the city with better control of fluoride levels in the water supply, however, this higher prevalence was not related with children's satisfaction with the appearance of their teeth.

Relação entre níveis de fluoreto na água de abastecimento público e fluorose dental / Relationship between fluoride levels in the public water supply and dental fluorosis

OBJETIVO: Avaliar a prevalência da fluorose dentária em escolares sujeitos a diferentes concentrações de fluoreto na água de abastecimento público das suas cidades. MÉTODOS: A amostra foi composta de 386 escolares de sete anos de idade, moradores de dois municípios do estado de São Paulo que realizaram heterocontrole da fluoretação da água de 1998 a 2002, um deles apresentando concentração homogênea de fluoreto e o outro oscilante. Fluorose dental foi determinada examinando os incisivos superiores permanentes (secos) pelo índice de Dean, o grau de fluorose classificado como questionável foi considerado como fluorose. Variáveis sociodemográficas e questões sobre saúde bucal foram avaliadas com questionário estruturado enviado aos pais/responsáveis. Associações foram verificadas por meio de regressão logística múltipla (p<0,05). RESULTADOS: Ambos os municípios apresentaram grau leve de fluorose. A prevalência de fluorose no município com teores oscilantes de flúor na água foi de 31,4 por cento e no município com teores homogêneos foi de 79,9 por cento. A prevalência de fluorose foi associada com o município com teores de flúor homogêneos na água (OR=8,33, IC 95 por cento: 5,15;13,45) e não possuir automóvel (OR=2,10, IC 95 por cento: 1,27;3,49) CONCLUSÕES: Embora a prevalência de fluorose tenha sido maior nas crianças do município que possuía melhor controle da concentração ótima de fluoreto na água, esta não afetou a estética dental dos comprometidos.

OBJECTIVE: To assess the prevalence of dental fluorosis among schoolchildren subjected to different fluoride concentrations in the public water supply of their cities. METHODS: The sample comprised 386 seven-year-old schoolchildren living in two municipalities in the State of São Paulo that practiced external control over the fluoridation of the water from 1998 to 2002: one with homogenous fluoride concentration and the other with oscillating concentration. Dental fluorosis was determined by dry examination of the upper permanent incisors using Dean's index. Scores classified as questionable were considered to represent fluorosis. Sociodemographic variables and questions regarding oral health were assessed using a structured questionnaire sent to the children's parents or the adults responsible for these children. Correlates of fluorosis were assessed using multivariate logistic regression (p<0.05). RESULTS: Both municipalities presented a mild degree of fluorosis. The prevalence of fluorosis in the municipality with oscillating fluoride content in the water was 31.4 percent, and it was 79.9 percent in the municipality with homogenous fluoride content. The prevalence of fluorosis was associated with the municipality with homogeneous fluoride levels in the water (OR=8.33, 95 percent CI: 5.15;13.45) and with not owning a car (OR=2.10, 95 percent CI: 1.27;3.49). CONCLUSIONS: The prevalence of dental fluorosis was higher in the city with better control of fluoride levels in the water supply, however, this higher prevalence was not related with children's satisfaction with the appearance of their teeth.

Polarization of dental caries among individuals aged 15 to 18 years

OBJECTIVE: To evaluate the role of socioeconomic variables and self-perceived oral health in the polarization of caries among adolescents in Santa Bárbara D'Oeste, Brazil. MATERIAL AND METHODS: Cross-sectional study. Sampling was randomized and sample size was defined according to WHO criteria. Two hundred and seventy seven adolescents (15 to 18 year-old) were examined by five trained examiners that assessed DMFT index according to WHO criteria. Self-perceived oral health, access to dental services and socio-demographic variables were self-reported. Student's t tests, chi-square tests, and multivariate logistic regression (with significant caries index (SiC) as the outcome), were performed. RESULTS: Mean DMFT was 5.48 (±4.22) and the proportion of "caries free" subjects was 15.5 percent. Mean DMFT (9.71±2.85) and mean D (1.67±2.18) of SiC positive subjects were significantly higher than mean DMFT (2.88±2.17) and mean D (0.45±0.87) of SiC negative subjects (p<0.0001). Mean D of white (0.76±1.51) was significantly smaller than mean D of non-white subjects (1.32±2.01). The only variable independently associated with the "SiC positive" outcome was "report of toothache within six months prior to the study" [OR=1.83 (95 percentCI 1.08 to 3.12)], p<0.001. CONCLUSION: SiC was associated with "report of toothache" but not with socio-demographic variables in the studied population.

[Dental caries activity in primary dentition, Indaiatuba, São Paulo, Brazil, 2004]. / Atividade de cárie na dentição decídua, Indaiatuba, São Paulo, Brasil, 2004.

This study aimed to verify caries activity and analyze caries experience, treatment needs, and enamel defects in 5-year-old preschool children in Indaiatuba, São Paulo State, Brazil. 624 children were selected by systematic random sampling in 2004. WHO criteria were used to measure caries experience and treatment needs. Nyvad et al. diagnostic criteria were used to analyze caries activity. Mann-Whitney and chi-square tests were used to analyze the results, with 5% significance. 40.5% of schoolchildren displayed caries activity. The dfmt was 1.62 (95%CI: 1.35-1.89). Among children with dfmt > 0, the index was 3.81 (95%CI: 3.36-4.26), and 91.4% of these children presented caries activity. Care Index was 12.3%. These results suggest that treatment measures and health promotion should continue to be prioritized, since the control measures and caries interruption during the initial stages are well known. Dental care should especially target schoolchildren with more significant caries experience.