Association Between Sense of Coherence and Tobacco Use Among Brazilian Adolescent Students.

Background: Investigating tobacco use and associated factors is essential to set priorities and health promotion strategies among adolescents. Several studies examined the relationship between this behavior and the psychosocial salutogenic construct Sense of Coherence (SOC), but the evidence is limited to adolescents in high-income countries. This study aimed to analyze the association between tobacco use and SOC among Brazilian adolescent students. Methods: A cross-sectional school-based survey was conducted in 2018. Dependent variables were categorical binary (Yes/No): (1) Smoking experimentation (at least one puff in a lifetime); (2) Current smoking (at least one cigarette smoked in the last 30 days); (3) Daily cigarette smoking; and (4) Experimentation with hookah and/or other tobacco products (at least once in a lifetime). Independent variable SOC was assessed with the SOC-13 item scale. Independent-samples t-Test and Logistic regression were used in the statistical analyses. Potential confounders were identified using a Directed Acyclic Graph. Results: Participants were 3034 adolescents aged 13-19. The mean SOC scores were higher among adolescents who answered no to each of the dependent variables than among those who answered yes (p < .05). In the regression analysis, those with higher SOC scores were less likely to report smoking experimentation, current use, daily use, and experimentation with hookah and/or other tobacco products, than those with lower SOC scores. The associations remained after controlling for sociodemographic and/or social-environmental factors. Conclusion: An inverse relationship between SOC and tobacco use was observed among Brazilian adolescent students.

Implementação do Programa Saúde na Escola: relação com aspectos da saúde bucal dos estudantes / Implementation of the School Health Program: relationship with aspects of students' oral health

RESUMO O estudo objetivou investigar a associação entre a implementação do Programa Saúde na Escola (PSE) e aspectos relacionados com a saúde bucal de adolescentes escolares que frequentam escolas públicas no Brasil. Foi realizado estudo transversal exploratório utilizando dados da Pesquisa Nacional de Saúde Escolar (PeNSE) 2015 em uma amostra de 81.154 estudantes de 13 a 15 anos frequentando escolas públicas das capitais, Distrito Federal e interior. Os dados foram obtidos por meio de questionários respondidos pelos alunos e responsáveis pelas escolas. Foi realizada análise bivariada de associação entre a variável 'implementação das ações do PSE pela escola' (Sim/Não) e aspectos relativos à saúde bucal dos estudantes. Em comparação com escolas sem implementação do PSE, as que haviam implementado o Programa apresentavam melhores indicadores de comportamento (consumo de alimentos com açúcar adicionado, cigarro e álcool); venda de alimentos saudáveis ou com açúcar adicionado; existência de grupo/comitê de saúde, ações do Programa Mais Educação e ações em conjunto com a Unidade Básica de Saúde (p<0,05). Concluiu-se que houve associação entre a implementação do PSE e aspectos mais favoráveis relacionados com a saúde bucal, referentes a alimentação, uso de cigarro e álcool entre os escolares, e ações de saúde e educação nas escolas.

ABSTRACT This study aimed to investigate the association between the School Health Program (PSE) implementation and aspects related to the oral health of adolescent students attending public schools in Brazil. An exploratory cross-sectional study was conducted using data from the 2015 National School Health Survey (PeNSE) in a sample of 81,154 students aged 13 to 15 in the capitals, Federal District, and inland cities. Data were retrieved from questionnaires answered by students and those responsible for the schools. We performed a bivariate analysis of the association between the variable 'implementation of PSE actions by the school' (Yes/No) and aspects related to the students' oral health. Compared to schools without PSE implementation, those that had implemented the Program had better behavioral indicators (consumption of sugar-added foods, cigarettes, and alcohol); selling healthy or sugar-added foods; availability of a health group/committee, and actions of the More Education Program and with Primary Health Care Units (p<0.05). We concluded that there was an association between the implementation of the PSE and more favorable aspects related to oral health regarding the students' diet, tobacco use, and alcohol consumption, and school health and education actions.

Religiosity is associated with caregivers' perception of preschool children's dental health.

The aim of the study was to investigate the association between psychosocial factors and perception of caregivers about the dental health of their preschool children. A cross-sectional analysis was performed with 146 caregiver-child dyads attended at Pediatric Dentistry school clinics in Goiânia, Midwest Brazil. Data were collected through a structured interview and a questionnaire with the caregivers and the children's dental records. The study outcome was caregivers' perception of children's dental health (positive or negative). The independent psychosocial variables were religiosity (Duke University Religion Index - DUREL) and Sense of Coherence (Antonovsky's SOC-13 scale). Sociodemographic data and oral health-related variables were also collected as covariates. Bivariate analysis (Pearson's chi-square, T-test, and Mann-Whitney) and Poisson regression with robust variance were performed. The prevalence of negative perception was 54.8%. In bivariate analysis, negative perception was associated with caries experience and report of dental pain at any time in the child's life. In the adjusted regression model, prevalence of caregivers with negative perception of their children's dental health was 1.38 times higher in the group with low organizational religiosity (PR = 1.38; 95%CI 1.05-1.81) and 2.35 times higher in the group of children with high caries experience (PR = 2.35; 95%CI 1.54-3.60). In conclusion, religiosity was associated with caregivers' perception of dental health of their preschool children undergoing treatment in specialized dental clinics, regardless of their caries experience.

[Periodontal status of temporarily institutionalized homeless adults and associated factors]. / Condição periodontal de adultos em situação de rua temporariamente institucionalizados e fatores associados.

The scope of this cross-sectional study was to describe the periodontal status and its association with sociodemographic, oral-health related behaviors and use of drugs among temporarily institutionalized homeless adults. The data were collected through oral clinical examination and a questionnaire with 102 adults attending the only public institution for this group in Goiânia, Goiás, Brazil. The periodontal condition was measured by the presence of bleeding on probing, dental calculus and pockets, according to the Community Periodontal Index (CPI). Chi-square test and Poisson regressions with robust variance were performed. The prevalence of CPI>1 was 83.3%. Approximately 68% of the sample had bleeding, 82.4% had calculus and 9.8% had periodontal pockets. In the bivariate analyses, those who reported having used illicit drugs had a higher prevalence of calculus; males and unmarried adults had a higher prevalence of pockets. In the adjusted analysis, individuals who used dental floss had a lower prevalence of bleeding (PR=0.58; 95%CI=0.35-0.96). The remaining covariates were not associated with the outcomes. It was concluded that the prevalence of periodontal alteration was high, the most frequent condition was calculus and the only independent association was between bleeding and the use of dental floss.

O objetivo deste estudo transversal foi descrever a condição periodontal e sua associação com fatores sociodemográficos, comportamentos em saúde bucal e uso de drogas entre indivíduos em situação de rua temporariamente institucionalizados. Os dados foram coletados por meio de exame clínico e questionário com 102 adultos atendidos na única instituição pública para este grupo em Goiânia, Goiás. A condição periodontal foi avaliada pela presença de sangramento à sondagem, cálculo dentário e bolsas, de acordo com o Índice Periodontal Comunitário (CPI). Foram realizados o teste Qui-quadrado e regressões de Poisson com variância robusta. A prevalência de CPI>1 foi de 83,3%. Cerca de 68,0% da amostra apresentou sangramento, 82,4% cálculo e 9,8% bolsa periodontal. Nas análises bivariadas, os que tinham usado drogas ilícitas alguma vez tinham maior prevalência de cálculo; os homens e os indivíduos sem união estável tinham maior prevalência de bolsa. Na análise ajustada, indivíduos que usavam fio dental tiveram menor prevalência de sangramento (RP=0,58; IC95%=0,35-0,96). As demais covariáveis não foram associadas aos desfechos. Concluiu-se que a prevalência de alteração periodontal foi alta, houve predomínio de cálculo e a única associação independente foi entre sangramento e uso de fio dental.

Condição periodontal de adultos em situação de rua temporariamente institucionalizados e fatores associados / Periodontal status of temporarily institutionalized homeless adults and associated factors

Resumo O objetivo deste estudo transversal foi descrever a condição periodontal e sua associação com fatores sociodemográficos, comportamentos em saúde bucal e uso de drogas entre indivíduos em situação de rua temporariamente institucionalizados. Os dados foram coletados por meio de exame clínico e questionário com 102 adultos atendidos na única instituição pública para este grupo em Goiânia, Goiás. A condição periodontal foi avaliada pela presença de sangramento à sondagem, cálculo dentário e bolsas, de acordo com o Índice Periodontal Comunitário (CPI). Foram realizados o teste Qui-quadrado e regressões de Poisson com variância robusta. A prevalência de CPI>1 foi de 83,3%. Cerca de 68,0% da amostra apresentou sangramento, 82,4% cálculo e 9,8% bolsa periodontal. Nas análises bivariadas, os que tinham usado drogas ilícitas alguma vez tinham maior prevalência de cálculo; os homens e os indivíduos sem união estável tinham maior prevalência de bolsa. Na análise ajustada, indivíduos que usavam fio dental tiveram menor prevalência de sangramento (RP=0,58; IC95%=0,35-0,96). As demais covariáveis não foram associadas aos desfechos. Concluiu-se que a prevalência de alteração periodontal foi alta, houve predomínio de cálculo e a única associação independente foi entre sangramento e uso de fio dental.

Abstract The scope of this cross-sectional study was to describe the periodontal status and its association with sociodemographic, oral-health related behaviors and use of drugs among temporarily institutionalized homeless adults. The data were collected through oral clinical examination and a questionnaire with 102 adults attending the only public institution for this group in Goiânia, Goiás, Brazil. The periodontal condition was measured by the presence of bleeding on probing, dental calculus and pockets, according to the Community Periodontal Index (CPI). Chi-square test and Poisson regressions with robust variance were performed. The prevalence of CPI>1 was 83.3%. Approximately 68% of the sample had bleeding, 82.4% had calculus and 9.8% had periodontal pockets. In the bivariate analyses, those who reported having used illicit drugs had a higher prevalence of calculus; males and unmarried adults had a higher prevalence of pockets. In the adjusted analysis, individuals who used dental floss had a lower prevalence of bleeding (PR=0.58; 95%CI=0.35-0.96). The remaining covariates were not associated with the outcomes. It was concluded that the prevalence of periodontal alteration was high, the most frequent condition was calculus and the only independent association was between bleeding and the use of dental floss.

Educational quality and oral health promotion in Brazilian schools: a multilevel analysis of national data.

The aim of this study was to investigate whether educational quality is associated with schools' potential support for oral health promotion in Brazil, using a multilevel model. An ecological study was carried out using data from 940 public schools (school level) from the 27 Brazilian state capitals (city-level). The explanatory variable was educational quality, measured by the Basic Education Development Index (IDEB) for each city, and the four dependent variables referred to the Oral Health Promotion School Environment (OHPSE) indicator and its dimensions: Dimension 1 (In-school aspects), Dimension 2 (Aspects of the school surroundings), and Dimension 3 (Prohibitive policies at school). The OHPSE was developed using categorical principal components analysis (CATPCA) of data from the 2015 National Adolescent School-Based Health Survey (PeNSE). Covariates were human development index and oral health care coverage of cities. Multilevel Poisson regression models with robust variance were undertaken (p < 0.05). Bivariate associations were found between the IDEB and each Total OHPSE and OHPSE-Dimension 1 (In-school aspects: sale of foods with added sugar and health promotion actions/programs). After adjustment, IDEB (PR: 1.38, 95%CI: 1.01-1.90; p = 0.045) and oral health care coverage (PR: 1.01; 95%CI: 1.00-1.02; p = 0.001) remained associated with the OHPSE Dimension 1. It was concluded that educational quality measured by the IDEB was associated with schools' potential support for oral health promotion regarding the sale of foods with added sugar and health promotion actions/programs in schools.

Orthodontists' criteria for prescribing cone-beam computed tomography-a multi-country survey.

OBJECTIVES: This study aimed to describe and compare CBCT imaging prescription in clinical practice among orthodontists from five countries in Europe and America. Additionally, it investigated factors associated with the prescribing and the use of guidelines for CBCT imaging. MATERIALS AND METHODS: A cross-sectional survey was carried out using an online questionnaire sent to all registered orthodontists in Belgium, Brazil, Canada, Romania, and the United States of America (USA). The data were analyzed by descriptive statistics, bivariate tests, and Poisson regression. RESULTS: The final sample consisted of 1284 participants. CBCT was prescribed by 84.4% of the participants for selected cases (84.9%), mainly for impacted teeth (92.4%), presurgical planning (54.1%), and root resorption (51.9%). High cost was most frequently the limiting factor for CBCT prescription (55.4%). Only 45.2% of those who were using CBCT imaging reported adhering to guidelines. CBCT imaging prescription was associated with the orthodontists' countries (p < .009, except for Belgium, p = .068), while the use of guidelines was associated with the respondents' country and additional training on CBCT imaging (p < .001). CONCLUSIONS: Orthodontists refer patients for CBCT for selected indications (impacted teeth, root resorption, presurgical planning, dentofacial deformities, as suggested by the international guidelines, and also for upper airway and temporomandibular joint evaluation). Many do not adhere to specific guidelines. There are substantial variations between the countries about the orthodontists' referral for CBCT and guideline usage, irrespective of gender. CBCT prescription may be limited by financial barriers, adhering to specific guidelines and prior CBCT training. CLINICAL RELEVANCE: CBCT prescription among orthodontists must be based on prescription criteria and current guidelines. It is advised to improve CBCT education and training to enhance CBCT selection, referral, analysis, and interpretation in orthodontic practice.

Satisfaction with oral health and associated factors among homeless people in Midwest Brazil.

BACKGROUND: Self-perceived oral health has been extensively investigated, but studies on homeless people are scarce, and there is currently no evidence from Latin America. OBJECTIVE: To investigate the prevalence and factors associated with satisfaction with the oral health of homeless individuals in one Brazilian capital of the Midwest region. SUBJECT AND METHODS: A cross-sectional study was carried out with 351 adult individuals attending a temporary public shelter who were interviewed about sociodemographic and psychosocial aspects, drugs use and oral health. The outcome was satisfaction with oral health (satisfied/dissatisfied). Pearson's chi-square test and Poisson regression with robust variance were used for statistical analysis. RESULTS: The prevalence of dissatisfaction with oral health was 68.9% (95% CI = 63.9-73.6). After adjusting for covariates, dissatisfaction was more frequent among individuals who were married/in a stable relationship (PR = 1.18; 95% CI = 1.02-1.36), with felt need for treatment (PR = 2.27; 95% CI = 1.23-4.17) or complete prosthesis (PR = 1.35; 95% CI = 1.18-1.55), and those who used illicit drugs in the past six months (PR = 1.22; 95% CI = 1.06-1.39). CONCLUSION: The prevalence of dissatisfaction with oral health in the homeless individuals studied was high and associated with their marital status, use of illicit drugs and self-reported need for dental treatment and complete prosthesis.

Religiosity is associated with caregivers' perception of preschool children's dental health

Abstract The aim of the study was to investigate the association between psychosocial factors and perception of caregivers about the dental health of their preschool children. A cross-sectional analysis was performed with 146 caregiver-child dyads attended at Pediatric Dentistry school clinics in Goiânia, Midwest Brazil. Data were collected through a structured interview and a questionnaire with the caregivers and the children's dental records. The study outcome was caregivers' perception of children's dental health (positive or negative). The independent psychosocial variables were religiosity (Duke University Religion Index - DUREL) and Sense of Coherence (Antonovsky's SOC-13 scale). Sociodemographic data and oral health-related variables were also collected as covariates. Bivariate analysis (Pearson's chi-square, T-test, and Mann-Whitney) and Poisson regression with robust variance were performed. The prevalence of negative perception was 54.8%. In bivariate analysis, negative perception was associated with caries experience and report of dental pain at any time in the child's life. In the adjusted regression model, prevalence of caregivers with negative perception of their children's dental health was 1.38 times higher in the group with low organizational religiosity (PR = 1.38; 95%CI 1.05-1.81) and 2.35 times higher in the group of children with high caries experience (PR = 2.35; 95%CI 1.54-3.60). In conclusion, religiosity was associated with caregivers' perception of dental health of their preschool children undergoing treatment in specialized dental clinics, regardless of their caries experience.

Educational quality and oral health promotion in Brazilian schools: a multilevel analysis of national data

Abstract: The aim of this study was to investigate whether educational quality is associated with schools' potential support for oral health promotion in Brazil, using a multilevel model. An ecological study was carried out using data from 940 public schools (school level) from the 27 Brazilian state capitals (city-level). The explanatory variable was educational quality, measured by the Basic Education Development Index (IDEB) for each city, and the four dependent variables referred to the Oral Health Promotion School Environment (OHPSE) indicator and its dimensions: Dimension 1 (In-school aspects), Dimension 2 (Aspects of the school surroundings), and Dimension 3 (Prohibitive policies at school). The OHPSE was developed using categorical principal components analysis (CATPCA) of data from the 2015 National Adolescent School-Based Health Survey (PeNSE). Covariates were human development index and oral health care coverage of cities. Multilevel Poisson regression models with robust variance were undertaken (p < 0.05). Bivariate associations were found between the IDEB and each Total OHPSE and OHPSE-Dimension 1 (In-school aspects: sale of foods with added sugar and health promotion actions/programs). After adjustment, IDEB (PR: 1.38, 95%CI: 1.01-1.90; p = 0.045) and oral health care coverage (PR: 1.01; 95%CI: 1.00-1.02; p = 0.001) remained associated with the OHPSE Dimension 1. It was concluded that educational quality measured by the IDEB was associated with schools' potential support for oral health promotion regarding the sale of foods with added sugar and health promotion actions/programs in schools.

[Timeframe for initiating oral cancer treatment in Brazil since approval of new legislation in 2012: time trend, 2013-2019]. / Tempo máximo para o início do tratamento do câncer de boca no Brasil após a publicação da legislação de 2012: tendência no período 2013-2019.

The study aimed to investigate whether the maximum delay (60 days) for initiating oral cancer treatment following diagnosis, as provided in Federal Law n. 12,732/2012, was achieved in Brazil from 2013 to 2019 and to describe the trend in the number of cases that initiated treatment within this timeframe. A time series was performed with treatment data (N = 37,417) from the Oncology Dashboard of the Brazilian Health Informatics Department (DATASUS) database, according to the patient's region of residence. Analysis of trend used Prais-Winsten regression. In 2018 and 2019, we observed higher percentages of treatments within 60 days, and especially within 30 days. In 2019, 61.5% of treatments began within 60 days, with the highest proportions in the South (71.3%), Southeast (60.1%), and Central-west (59.1%) regions of Brazil. The time trend for the category from 0-60 days was upward in the North of Brazil, with 15.7% annual percent change (APC), and was stationary in the other four major geographic regions of Brazil. The time trend for 0-30 days was only upward in the North and Northeast, with APCs of 29.75% and 20.56%, respectively. In conclusion, since 2018 there were more cases that initiated oral cancer treatment within the stipulated timeframe, as provided in Law n. 12,732/2012 (up to 60 days), with regional differences and a stationary trend in most regions and in Brazil as a whole. Partial achievement of the target, the predominance of a stationary trend, and regional inequalities indicate the need to continue monitoring time-to-treatment for oral cancer in Brazil and to intensify efforts to guarantee timely healthcare.

O estudo buscou investigar se o tempo máximo de demora (60 dias) para o início do tratamento dos pacientes com câncer de boca a partir do diagnóstico, previsto na Lei Federal nº 12.732/2012, foi alcançado no Brasil no período de 2013-2019 e descrever a tendência do número de casos que iniciaram o tratamento no tempo máximo. Realizou-se um estudo de séries temporais utilizando dados dos tratamentos (N = 37.417) do Painel-Oncologia, disponível no Departamento de Informática do SUS (DATASUS), segundo região de residência dos pacientes. Para análise da tendência executou-se a regressão de Prais-Winsten. Nos anos 2018 e 2019 foram observados percentuais mais elevados para os tratamentos em até 60 dias, sendo mais acentuado no intervalo de até 30 dias. Em 2019, 61,5% dos tratamentos iniciaram em até 60 dias, com maiores proporções nas regiões Sul (71,3%), Sudeste (60,1%) e Centro-oeste (59,1%). A tendência temporal da categoria 0-60 dias foi crescente na Região Norte, com variação percentual anual (VPA) de 15,7% e estacionária nas demais regiões e para o Brasil. A tendência do tempo de 0-30 dias foi crescente apenas para as regiões Norte e Nordeste, com VPA de 29,75% e 20,56%, respectivamente. Conclui-se que a partir de 2018 houve um maior número de casos que iniciaram o tratamento do câncer de boca no tempo de demora, conforme previsto na Lei nº 12.732/2012 (até 60 dias), com diferenças regionais e tendência estacionária na maioria das regiões e no Brasil. O alcance parcial da meta, o predomínio da tendência estacionária e as desigualdades regionais indicam a necessidade de continuar monitorando o tempo de demora para o início do tratamento do câncer no país e intensificar esforços para garantir o cuidado em saúde.

El estudio tuvo como meta investigar si el tiempo máximo de demora (60 días) para el inicio del tratamiento de los pacientes con cáncer de boca, a partir del diagnóstico previsto en la Ley Federal nº 12.732/2012, se alcanzó en Brasil durante el período 2013-2019, y describir la tendencia del número de casos que comenzaron el tratamiento en el tiempo máximo. Se realizó un estudio de series temporales utilizando datos de los tratamientos (N = 37.417) del Panel-oncología, disponible en Departamento de Informática del Sistema Único de Salud (DATASUS), según la región de residencia de los pacientes. Para el análisis de la tendencia se realizó la regresión de Prais-Winsten. En los años 2018 y 2019 se observaron porcentajes más elevados para los tratamientos en hasta 60 días, siendo más acentuado en el intervalo de hasta 30 días. En 2019, un 61,5% de los tratamientos comenzaron en hasta 60 días, con mayores proporciones en las regiones Sur (71,3%), Sudeste (60,1%) y Centro-oeste (59,1%). La tendencia temporal de la categoría 0-60 días fue creciente en la Región Norte, con variación porcentaje anual (VPA) de un 15,7% y estacionaria en las demás regiones y en Brasil. La tendencia del tiempo de 0-30 días fue creciente solamente para las regiones Norte y Nordeste, con VPA de 29,75% y 20,56%, respectivamente. Se concluye que a partir de 2018 hubo un mayor número de casos que comenzaron el tratamiento de cáncer de boca durante el tiempo de demora, conforme lo previsto en la Ley nº 12.732/2012 (hasta 60 días), con diferencias regionales y tendencia estacionaria en la mayoría de las regiones y en Brasil. El alcance parcial de la meta, el predominio de la tendencia estacionaria y las desigualdades regionales indican la necesidad de continuar supervisando el tiempo de demora para el inicio del tratamiento de cáncer en el país e intensificar esfuerzos para garantizar el cuidado en salud.

Religiosity is Associated with Motivation to Start and Stop Smoking Among Adolescent Students in Brazil.

This study aimed to estimate associations between adolescents' religiosity and their motivation to start and stop smoking. A school survey was carried out in Midwestern Brazil. Participants were never-smokers (n = 2073) and smokers (n = 116) aged 13-19 who answered a questionnaire. Religiosity was measured with the Duke Religion Index, and motivation with questions based on the Prime Theory of Motivation. Organizational, non-organizational, and intrinsic religiosity were associated with motivation to start smoking among never-smokers. Intrinsic religiosity was associated with smokers' motivation to quit. Findings indicate the protective role of religiosity in the motivational system that prompts smoking initiation and cessation during adolescence.

Subjective knowledge of school adolescents about the health effects of smoking and association with smoking status / Conocimiento subjetivo de los estudiantes adolescentes sobre los efectos del tabaquismo en la salud y asociación con el tabaquismo / Conhecimento subjetivo de escolares adolescentes sobre os efeitos do tabagismo na saúde e associação com status tabágico

This study aimed to assess the subjective knowledge (SK) of adolescents about the health effects of smoking and association with smoking status. A cross-sectional school survey was carried out in Goiás, Midwestern Brazil. Participants were 3034 students aged 13-19. SK was assessed by three questions about 'How do you evaluate your knowledge on:' (1) 'Effects of smoking on the general health of people who smoke', (2) 'Effects of smoking on the oral health of people who smoke', (3) 'Effects of other people smoking on the health of people who do not smoke (passive smokers)'. Smoking status categories were never-smoker, former smoker, and smoker. Poisson regression was used in the statistical analysis. Prevalence ratios and 95% confidence intervals (CI) are reported. About half of the participants had low SK about general health effects of smoking, and most had low SK about oral health (62.9%) and second-hand effects (61.5%). Compared with smokers and former smokers, never-smokers were more likely to have low SK about general (1.52; 95%CI=1.25-1.85), oral (1.17; 95%CI=1.03-1.32) and second-hand effects (1.21; 95%CI=1.16-1.38) of smoking. Adolescents' SK about the health effects of smoking tended to be low, especially among never smokers.

El estudio tuvo como objetivo evaluar el conocimiento subjetivo (CE) de los adolescentes sobre los efectos del tabaquismo en la salud y su asociación con el tabaquismo. Se realizó una encuesta escolar transversal en el estado de Goiás. Participaron 3.034 estudiantes de 13 a 19 años. El CS se evaluó mediante tres preguntas sobre '¿Cómo evalúa su conocimiento sobre:' (1) 'Efectos de los cigarrillos en la salud general de las personas que fuman', (2) 'Efectos de los cigarrillos en la salud bucal de las personas que fuman ', (3)' Efectos del humo del cigarrillo en la salud de las personas que no fuman (fumadores pasivos) '. Las categorías de tabaquismo fueron nunca fumadores, exfumadores y fumadores. Se utilizó la regresión de Poisson en el análisis estadístico. Se informan las razones de prevalencia y los intervalos de confianza (IC) del 95%. Aproximadamente la mitad de los participantes tenían un CS bajo sobre los efectos del tabaquismo en la salud general, y la mayoría tenía un CS bajo sobre los efectos sobre la salud oral (62,9%) y los efectos del tabaquismo pasivo (61,5%). En comparación con los fumadores y exfumadores, los que nunca habían fumado tenían más probabilidades de tener un CS bajo en el efecto sobre la salud general (1,52; IC del 95% = 1,25-1,85), oral (1,17; IC del 95% = 1,03-1,32) y los efectos de humo de segunda mano (1,21; IC del 95% = 1,16-1,38). El CS de los adolescentes sobre los efectos del tabaquismo en la salud tiende a ser bajo, especialmente entre aquellos que nunca han fumado.

O estudo visou avaliar o conhecimento subjetivo (CS) de adolescentes sobre os efeitos do tabagismo na saúde e associação com status tabágico. Realizou-se um inquérito escolar transversal no estado de Goiás. Participaram 3.034 alunos de 13-19 anos. O CS foi avaliado por três perguntas sobre 'Como você avalia seu conhecimento sobre:' (1) 'Efeitos do cigarro na saúde geral das pessoas que fumam', (2) 'Efeitos do cigarro na saúde bucal das pessoas que fumam', (3) 'Efeitos da fumaça do cigarro na saúde das pessoas que não fumam (fumantes passivos)'. As categorias do status tabágico foram nunca fumante, ex-fumante e fumante. Regressão de Poisson foi utilizada na análise estatística. Razões de prevalência e intervalos de confiança (IC) de 95% são reportados. Cerca de metade dos participantes tinha CS baixo sobre efeitos do tabagismo na saúde geral, e a maioria tinha CS baixo sobre efeitos na saúde bucal (62,9%) e efeitos do fumo passivo (61,5%). Comparados aos fumantes e ex-fumantes, os nunca fumantes foram mais propensos a ter baixo CS sobre o efeito na saúde geral (1,52; IC 95% = 1,25-1,85), oral (1,17; IC 95% = 1,03-1,32) e efeitos do fumo passivo (1,21; IC 95% = 1,16-1,38). O CS dos adolescentes sobre os efeitos do tabagismo na saúde tende a ser baixo, especialmente entre os que nunca fumaram.

Untreated dental trauma among homeless people in Midwest Brazil.

Homeless people are usually more exposed to traumatic events that may cause dental injuries than those with more stable housing. Previous studies on the oral health condition of this population group have shown high levels of dental caries, periodontal diseases, and tooth loss, but evidence on dental trauma is scarce. Furthermore, there is no report from Latin American countries. The aim of this study was to describe the prevalence of untreated traumatic dental injuries (TDI) among adult homeless people in a Brazilian capital city. A sample of 102 adults attending a public homeless shelter was clinically examined using the criteria of the 2010 Brazilian National Oral Health Survey. TDI was found in 10.8% of the participants, and the most common types of injury were enamel-dentin fractures and avulsion. The overall prevalence was relatively low, but the proportion of anterior tooth loss due to trauma and other reasons shows the need for more appropriate health care for this vulnerable population group.

Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015.

OBJECTIVE: To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals. METHODS: A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design. RESULTS: The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE. CONCLUSIONS: The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.

Tempo máximo para o início do tratamento do câncer de boca no Brasil após a publicação da legislação de 2012: tendência no período 2013-2019 / Timeframe for initiating oral cancer treatment in Brazil since approval of new legislation in 2012: time trend, 2013-2019 / Tiempo máximo para el inicio del tratamiento del cáncer de boca en Brasil tras la publicación de la legislación de 2012: tendencia en el período 2013-2019

O estudo buscou investigar se o tempo máximo de demora (60 dias) para o início do tratamento dos pacientes com câncer de boca a partir do diagnóstico, previsto na Lei Federal nº 12.732/2012, foi alcançado no Brasil no período de 2013-2019 e descrever a tendência do número de casos que iniciaram o tratamento no tempo máximo. Realizou-se um estudo de séries temporais utilizando dados dos tratamentos (N = 37.417) do Painel-Oncologia, disponível no Departamento de Informática do SUS (DATASUS), segundo região de residência dos pacientes. Para análise da tendência executou-se a regressão de Prais-Winsten. Nos anos 2018 e 2019 foram observados percentuais mais elevados para os tratamentos em até 60 dias, sendo mais acentuado no intervalo de até 30 dias. Em 2019, 61,5% dos tratamentos iniciaram em até 60 dias, com maiores proporções nas regiões Sul (71,3%), Sudeste (60,1%) e Centro-oeste (59,1%). A tendência temporal da categoria 0-60 dias foi crescente na Região Norte, com variação percentual anual (VPA) de 15,7% e estacionária nas demais regiões e para o Brasil. A tendência do tempo de 0-30 dias foi crescente apenas para as regiões Norte e Nordeste, com VPA de 29,75% e 20,56%, respectivamente. Conclui-se que a partir de 2018 houve um maior número de casos que iniciaram o tratamento do câncer de boca no tempo de demora, conforme previsto na Lei nº 12.732/2012 (até 60 dias), com diferenças regionais e tendência estacionária na maioria das regiões e no Brasil. O alcance parcial da meta, o predomínio da tendência estacionária e as desigualdades regionais indicam a necessidade de continuar monitorando o tempo de demora para o início do tratamento do câncer no país e intensificar esforços para garantir o cuidado em saúde.

The study aimed to investigate whether the maximum delay (60 days) for initiating oral cancer treatment following diagnosis, as provided in Federal Law n. 12,732/2012, was achieved in Brazil from 2013 to 2019 and to describe the trend in the number of cases that initiated treatment within this timeframe. A time series was performed with treatment data (N = 37,417) from the Oncology Dashboard of the Brazilian Health Informatics Department (DATASUS) database, according to the patient's region of residence. Analysis of trend used Prais-Winsten regression. In 2018 and 2019, we observed higher percentages of treatments within 60 days, and especially within 30 days. In 2019, 61.5% of treatments began within 60 days, with the highest proportions in the South (71.3%), Southeast (60.1%), and Central-west (59.1%) regions of Brazil. The time trend for the category from 0-60 days was upward in the North of Brazil, with 15.7% annual percent change (APC), and was stationary in the other four major geographic regions of Brazil. The time trend for 0-30 days was only upward in the North and Northeast, with APCs of 29.75% and 20.56%, respectively. In conclusion, since 2018 there were more cases that initiated oral cancer treatment within the stipulated timeframe, as provided in Law n. 12,732/2012 (up to 60 days), with regional differences and a stationary trend in most regions and in Brazil as a whole. Partial achievement of the target, the predominance of a stationary trend, and regional inequalities indicate the need to continue monitoring time-to-treatment for oral cancer in Brazil and to intensify efforts to guarantee timely healthcare.

El estudio tuvo como meta investigar si el tiempo máximo de demora (60 días) para el inicio del tratamiento de los pacientes con cáncer de boca, a partir del diagnóstico previsto en la Ley Federal nº 12.732/2012, se alcanzó en Brasil durante el período 2013-2019, y describir la tendencia del número de casos que comenzaron el tratamiento en el tiempo máximo. Se realizó un estudio de series temporales utilizando datos de los tratamientos (N = 37.417) del Panel-oncología, disponible en Departamento de Informática del Sistema Único de Salud (DATASUS), según la región de residencia de los pacientes. Para el análisis de la tendencia se realizó la regresión de Prais-Winsten. En los años 2018 y 2019 se observaron porcentajes más elevados para los tratamientos en hasta 60 días, siendo más acentuado en el intervalo de hasta 30 días. En 2019, un 61,5% de los tratamientos comenzaron en hasta 60 días, con mayores proporciones en las regiones Sur (71,3%), Sudeste (60,1%) y Centro-oeste (59,1%). La tendencia temporal de la categoría 0-60 días fue creciente en la Región Norte, con variación porcentaje anual (VPA) de un 15,7% y estacionaria en las demás regiones y en Brasil. La tendencia del tiempo de 0-30 días fue creciente solamente para las regiones Norte y Nordeste, con VPA de 29,75% y 20,56%, respectivamente. Se concluye que a partir de 2018 hubo un mayor número de casos que comenzaron el tratamiento de cáncer de boca durante el tiempo de demora, conforme lo previsto en la Ley nº 12.732/2012 (hasta 60 días), con diferencias regionales y tendencia estacionaria en la mayoría de las regiones y en Brasil. El alcance parcial de la meta, el predominio de la tendencia estacionaria y las desigualdades regionales indican la necesidad de continuar supervisando el tiempo de demora para el inicio del tratamiento de cáncer en el país e intensificar esfuerzos para garantizar el cuidado en salud.

Opinion of adolescent school smokers about smoking cessation counseling and treatment in health services: a cross-sectional study, Goiás, Brazil, 2018. / Opinião de escolares adolescentes fumantes sobre aconselhamento e tratamento para cessação do tabagismo em serviços de saúde: estudo transversal, Goiás, 2018.

Objective To know the opinion of adolescent school smokers about smoking cessation counseling and treatment, and to investigate whether negative opinion was associated with lack of motivation to stop smoking. Methods This was a cross-sectional study carried out in Goiás state, Brazil, with an intentional sample of adolescent students, in 2018. Poisson regression was used. Results One hundred and thirty adolescents took part. Most of them expressed a positive opinion on the three smoking cessation interventions surveyed: medical counseling (76.2%), dental counseling (70.0%), and smoking cessation treatment (66.2%). Negative opinions were more frequent among adolescents who were not motivated to stop smoking (p<0.05). Regression analyses revealed that lack of motivation to quit smoking was associated with a negative opinion about each intervention. Conclusion The adolescents had a positive opinion about counseling and treatment for smoking cessation in health services. Negative opinion was associated with lack of motivation to quit smoking.

Opinion of school adolescent smokers about smoking cessation counselling and treatment in health services: cross-sectional study, State of Goiás, Brazil, 2018 / Opinión de los escolares adolescentes fumadores sobre el asesoramiento y el tratamiento para dejar de fumar en los servicios de salud: un estudio transversal, Estado de Goiás, Brasil, 2018 / Opinião de escolares adolescentes fumantes sobre aconselhamento e tratamento para cessação do tabagismo em serviços de saúde: estudo transversal, estado de Goiás, 2018

Objective: To know the opinion of school adolescent smokers about counseling and treatment for smoking cessation, and investigate whether negative opinion was associated with lack of motivation to stop smoking. Methods: Cross-sectional study carried out in Goiás, Brazil, with an intentional sample of school adolescents, in 2018. Poisson Regression was used. Results: Participants were 130, most of them expressed a positive opinion on the three smoking cessation interventions surveyed: medical (76.2%) and dental counseling (70.0%), and smoking cessation treatment (66.2%). Negative opinions were more frequent among adolescents who were not motivated to stop smoking (p<0.05). Regression analyzes revealed that lack of motivation to quit was associated with a negative opinion about each intervention. Conclusion: The adolescents had a positive opinion about counseling and treatment for smoking cessation in health services. Negative opinion was associated with a lack of motivation to quit the habit.

Objetivo: Conocer la opinión de escolares fumadores adolescentes sobre asesoramiento y tratamiento para dejar de fumar en servicios de salud, e investigar si opinión negativa se asoció con falta de motivación para parar de fumar. Métodos: Estudio transversal realizado en Goiás, Brasil, con muestra intencional de escolares adolescentes, en 2018; se utilizó la Regresión de Poisson. Resultados: Participaron 130 adolescentes, la mayoría expresaron una opinión positiva sobre las tres intervenciones para cesación encuestadas: asesoramiento médico (76,2%) y dental (70,0%), y tratamiento para cesación (66,2%). Opiniones negativas fueron más frecuentes entre adolescentes sin motivación para parar de fumar (p<0.05). Los análisis de regresión revelaron que falta de motivación para parar se asoció con opinión negativa sobre cada intervención. Conclusión: Los adolescentes tenían una opinión positiva sobre asesoramiento y tratamiento para dejar de fumar en servicios de salud. Opinión negativa se asoció con una falta de motivación para dejar el hábito.

Objetivo: Conhecer a opinião de escolares adolescentes fumantes sobre aconselhamento e tratamento para cessação do tabagismo, e investigar se uma opinião negativa estava associada à falta de motivação para parar de fumar. Métodos: Estudo transversal, realizado no estado de Goiás, Brasil, com amostra intencional de escolares adolescentes, em 2018. Utilizou-se regressão de Poisson. Resultados: Participaram 130 adolescentes. A maioria manifestou opinião positiva sobre as três intervenções para cessação do tabagismo pesquisadas: aconselhamento médico (76,2%), aconselhamento odontológico (70,0%) e tratamento para cessação (66,2%). Opiniões negativas foram mais frequentes entre jovens desmotivados a abandonar o tabagismo (p<0,05). Análises de regressão revelaram a falta de motivação para parar de fumar associada à opinião negativa sobre cada uma das três intervenções. Conclusão: Os adolescentes apresentaram opinião positiva sobre oferta de aconselhamento e tratamento para cessação do tabagismo em serviços de saúde. Opinião negativa foi associada à falta de motivação para cessar o tabagismo.

Indicators proposed by the Brazilian Ministry of Health for monitoring and evaluating oral health actions in the National Health System: documentary research, 2000-2017. / Indicadores de saúde bucal propostos pelo Ministério da Saúde para monitoramento e avaliação das ações no Sistema Único de Saúde: pesquisa documental, 2000-2017.

OBJECTIVE: to present the indicators for monitoring and evaluation of oral health actions in the Brazilian National Health System (SUS), proposed in the period 2000-2017. METHODS: documental research conducted on the Ministry of Health website regarding government guidelines on oral health monitoring and evaluation systems; the indicators were classified according to the following categories: access to care; resolutive capacity and continuity; and availability of oral health services. RESULTS: oral health indicators were identified in the following guidelines: 'Health Services Performance Evaluation Methodology Project', 'SUS Qualification Evaluation Program', 'National Program for Improving Primary Care Access and Quality', and 'SUS Performance Index'; most of them refer to access to services and resolutive capacity and continuity of care. CONCLUSION: oral health indicators in the four government guidelines identified provide important input for health management, but new indicators are needed for effective monitoring and evaluation of oral health actions.