Factors associated with vertical transmission of syphilis in a city in the State of São Paulo / Fatores associados à transmissão vertical de sífilis em um município do Estado de São Paulo / Factores asociados a transmisión vertical de sífilis en una ciudad del Estado de São Paulo

Background and Objectives: Syphilis is a sexually transmitted infection with low-cost and accessible treatment; however, it is considered a public health problem. Further studies are needed to improve knowledge about the factors that may contribute to the mother-to-child transmission of syphilis. Given its high detection rate in pregnant women and the possible adverse events of syphilis in Brazil, the objective was to evaluate the association of individual and clinical characteristics of syphilis with the incidence of congenital syphilis in pregnant women. Methods: This retrospective study was performed in a medium-size municipality in the State of São Paulo. Notification forms from the Notifiable Diseases Information System were used and the occurrence of congenital syphilis was the outcome of the study. Bivariate analyses and logistic regression were performed with variables that obtained p values <0.25. Results: Most pregnant women were 20-34 years old (62.2%) and had white skin (63.2%) and incomplete elementary schooling (35.4%). The occurrence of congenital syphilis was associated with the maternal syphilis diagnosis (p<0,001) and with not performing the treponemal test during the prenatal examination (p =0.014). There was a greater risk for the occurrence of congenital syphilis in cases with late diagnosis during pregnancy (OR=16.48; 95%CI 3.22-84.26) and tertiary/latent clinical classification (OR=7.62; 95%CI 1.40-41.54). Conclusion: Maternal diagnosis in the third trimester of pregnancy and tertiary/latent clinical classification were the main risk factors for the occurrence of congenital syphilis, reinforcing the importance of a quality prenatal examination performed timely.(AU)

Justificativa e Objetivos: A sífilis é uma Infecção Sexualmente Transmissível, com tratamento de baixo custo e acessível; porém, ela é considerada um problema de saúde pública. Para aprimorar o conhecimento sobre os fatores que podem contribuir para transmissão vertical da sífilis, mais estudos são necessários. Diante da elevada taxa de detecção em gestantes e dos possíveis eventos adversos da sífilis no Brasil, o objetivo foi avaliar a associação das características individuais e clínicas de sífilis com a incidência de sífilis congênita em gestantes. Métodos: Este estudo retrospectivo foi realizado em um município de médio porte no Estado de São Paulo. Foram usadas as fichas de notificação do Sistema de Informação de Agravos de Notificação e o desfecho do estudo foi a ocorrência de sífilis congênita. Foram realizadas análises bivariadas e regressão logística com as variáveis que obtiveram valores de p<0,25. Resultados: As maioria das gestantes tinha 20-34 anos (62,2%), era branca (63,2%), com escolaridade fundamental incompleta (35,4%). A ocorrência de sífilis congênita esteve associada ao diagnóstico de sífilis materno no terceiro trimestre de gestação (p<0,001) e com a não realização de teste treponêmico durante o pré-natal (p=0,014). Houve maior risco para a ocorrência de sífilis congênita os casos com diagnóstico tardio na gestação (OR=16,48; IC95% 3,22-84,26) e classificação clínica terciária/latente (OR=7,62; IC95% 1,40-41,54). Conclusão: Os principais fatores de risco para ocorrência de sífilis congênita foram o diagnóstico materno no terceiro trimestre de gestação e classificação clínica terciária/latente, reforçando a importância de um exame pré-natal de qualidade e em tempo oportuno.(AU)

Justificación y objetivos: La sífilis es una Infección de Transmisión Sexual con tratamiento accesible y de bajo coste, sin embargo, es considerada un problema de salud pública. Se necesitan más estudios para mejorar el conocimiento sobre los factores que pueden contribuir a la transmisión maternoinfantil de la sífilis. Dada su alta tasa de detección en gestantes y los posibles eventos adversos de la sífilis en Brasil, el objetivo fue evaluar la asociación de las características individuales y clínicas de la sífilis con la incidencia de sífilis congénita en gestantes. Métodos: Estudio retrospectivo realizado en una ciudad de mediano porte del Estado de São Paulo. Fueran utilizados formularios de notificación obligatoria del Sistema de Información de Enfermedades de Declaración Obligatoria y el desenlance fue la ocurrencia de sífilis congénita. Se realizaron análisis bivariados y regresión logística con las variables que obtuvieron p-value<0,25. Resultados: La mayoría de las mujeres embarazadas tenían entre 20 y 34 años (62,2%), eran blancas (63,2%), con instrucción primaria incompleta (35,4%). La aparición de sífilis congénita se asoció con el diagnóstico de sífilis materna en el tercer trimestre del embarazo (p<0,001) y con la no realización de prueba treponémica durante el prenatal (p=0,014). Hubo un mayor riesgo de sífilis congénita en los casos diagnosticados tardíamente en el embarazo (OR=16,48; IC95% 3,22-84,26) y clasificación clínica terciaria/latente (OR=7,62; IC95% 1,40-41,54). Conclusiones: Los principales factores de riesgo de aparición de sífilis congénita fueron el diagnóstico materno en el tercer trimestre de gestación y la clasificación clínica terciaria/tardía, lo que refuerza la importancia de una atención prenatal de calidad y oportuna.(AU)

Seroepidemiological investigation of COVID-19: A cross-sectional study in Jundiai, São Paulo, Brazil.

The dramatic increase in the number of COVID-19 cases has been a threat to global health and a challenge for health systems. Estimating the prevalence of infection in the population is essential to provide support for action planning. Within this scenario, the aim of the present study was to analyze the seroprevalence and associated factors of COVID-19 Jundiaí, São Paulo, Brazil. This cross-sectional study was conducted from June 1st to June 19th, 2020. The participants were patients with respiratory symptoms who sought Primary Care Units (UBS) (n = 1,181) and subjects recruited from randomly selected households by probability sampling (n = 3,065), as screening strategy. All participants, in both phases, were submitted to SARS-CoV-2 rapid antigen tests (IgG and IgM) and responded to a questionnaire including sociodemographic characteristics based on Behavioural Insights for COVID-19. Total seroprevalence (positive/negative) was the outcome and the independent variables were sociodemographic variables, health behavior and signs/symptoms. The chi-squared test was used for association analysis (p<0.05) and variables with p<0.20 were entered into the logistic regression model (p<0.05). A total of 1,181 subjects from the UBS and 3,065 from the selected households participated in the study. The seroprevalence was 30.8% in the UBS and 3.1% in the households. The adjusted logistic regression identified that lower educational level (OR 2.68; 95%CI 1.59-4.54), household member testing positive (OR 1.67; 95%CI 1.16-2.39), presence of anosmia (OR 3.68, 95%CI 2.56-5.28) and seeking UBS (OR 3.76; 95%CI 2.08-6.82) was risk factors to test positive for SARS-CoV-2. Estimating the seroprevalence in the population was important to know the disease extension that was higher than the notified cases. These results showed socioeconomic aspects associated with COVID-19 even adjusted by symptoms. Populational epidemiologic studies that investigate the associated factors of COVID-19 are relevant to plan strategies to control the pandemic.

The role of health literacy as a factor associated with tooth loss.

OBJECTIVE: The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS: The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS: The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS: tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.

Effects of the intervention of the Multicenter Study IDEFICS on the prevalence of caries in Spanish children

Aim: To evaluate the effects of an intervention for the prevention of obesity on the prevalence of dental caries disease in Spanish children. Methods: Two cities participated intervention study nested in a cohort IDEFICS (Identification and prevention of dietary and lifestyle induced health effects in children and infants): Huesca, where there was a 2-year intervention, which encouraged less sugar consumption; and Zaragoza (control). The prevalence of caries was evaluated by examining the 1st permanent molars in the 7-11 age range, using the ICDAS (International Caries Detection and Assessment System). These teeth erupt at 6 years of age and at the baseline (2007-2008) were free of caries because they were not present in the oral cavity. As outcomes, white spots were selected, combining the ICDAS criteria 1 and 2, and untreated caries, combining criteria 4, 5 and 6. Their association with socioeconomic variables, BMI (Body Mass Index), frequency of sugar intake, sex and parents' perceptions of their children, was investigated. To do so, the chi-square test was applied (p<0.05). Results: The sample consisted of 281 children. The prevalence of white spots and untreated caries was higher in Huesca, despite the intervention. There was no association between the outcomes and the variables studied (p>0.05). Conclusion: The intervention for the prevention of obesity did not exert any association with the prevalence of caries in Spanish children

Epidemiological profile, spatial distribution, and syphilis time series: a cross-sectional study in a Brazilian municipality.

INTRODUCTION: Syphilis is an infectious disease of bacterial nature, acting on organs and/or systems. The increase in the number of cases worldwide has been of concern and the infection has been considered a public health problem. Given this scenario, this study evaluates the epidemiological profile, spatial distribution, and time series of the cases of acquired syphilis, syphilis in pregnant women, and congenital syphilis in a Brazilian municipality. METHODOLOGY: This is a cross-sectional and descriptive study with second data of the notified cases. For the definition of the population universe, an initial survey of syphilis cases notified in the municipality was carried out, from January 1, 2013 to December 31, 2017. RESULTS: There was an increase in the notified cases and the detection/incidence rates of syphilis. The epidemiological profile was composed of men (76.7%), adults (24.8%), white (60.4%), with eight or more years of study (53.7%) in addition to pregnant adolescents (36.7%) and young adults (26.0%), with inadequate treatment and untreated partners. A concentration of cases was identified in the regions with the lowest monthly income and the time series showed an increasing trend (p-value < 0.001). CONCLUSIONS: Health actions should continue to improve access to diagnosis and to notification, focusing on treatment, cure and health education actions to control and prevent new cases.

COVID-19 in Jundiaí/SP: temporal dynamics of notifications and spatial analysis of seroepidemiological prevalence / COVID-19 em Jundiaí/SP: dinâmica temporal das notificações e análise espacial da prevalência soroepidemiológica / COVID-19 em Jundiaí/SP: dinâmica temporal de notificaciones y análisis espacial de prevalencia seroepidemiológica

Justificativa e Objetivos: A pandemia pela COVID-19 trouxe um cenário desafiador para a saúde pública em todo o mundo, devido ao pouco conhecimento sobre a infecção e seu aumento exponencial. O objetivo é analisar a tendência temporal e a distribuição espacial dos casos positivos para COVID-19 na cidade de Jundiaí/SP, Brasil, bem como sua correlação com a renda e densidade populacional dos bairros. Métodos: Estudo transversal, conduzido no período de fevereiro a junho de 2020. Os dados foram obtidos a partir dos casos confirmados pela Vigilância Epidemiológica e por levantamento soroepidemiológico realizado em duas etapas: 1) com usuários sintomáticos para Síndrome Respiratória Aguda Grave que buscaram atendimento nas Unidades de Saúde; 2) amostragem probabilística dos domicílios. Realizou-se análise da série temporal dos casos confirmados pela Vigilância Epidemiológica e foram elaborados mapas com a densidade de Kernel e Índice de Moran Local (p < 0,05) dos casos diagnosticados no levantamento soroepidemiológico. Resultados: Houve aumento do número de casos no período estudado (2,35%), bem como distribuição heterogênea no território, com concentração em áreas periféricas da cidade. Houve autocorrelação espacial fraca entre média da renda per capita (I = 0.11; valor de p < 0,001) e densidade populacional por bairros (I = 0.05; valor de p = 0,03). Conclusão: A análise do comportamento da infecção no tempo e espaço podem contribuir com ações de enfrentamento com base nas necessidades locais.(AU)

Background and Objectives: The COVID-19 pandemic brought a challenging scenario for public health worldwide, due to little knowledge about the infection and the exponential increase in new cases. This study aims to analyze the temporal trend and the spatial distribution of the positive cases for COVID-19 in the city of Jundiaí/SP, Brazil, as well as its correlation with the income and population density of the neighborhoods. Methods: Cross-sectional study, conducted from February to June 2020. Data were obtained from cases confirmed by the Epidemiological Surveillance and by a seroepidemiological survey carried out in two stages: 1) with symptomatic users for Severe Acute Respiratory Syndrome who sought care in Basic Health Units; 2) probabilistic sampling of households. An analysis of the time series of the cases confirmed by the Epidemiological Surveillance was carried out and maps with Kernel density and Local Moran Index (p <0.05) of the cases diagnosed in the seroepidemiological survey were prepared. Results: There was an increase in the number of cases in the period studied (2.35%), as well as the heterogeneous distribution in the territory, with a concentration in peripheral areas of the city. There was weak spatial autocorrelation between average per capita income (I = 0.11; p value <0.001) and population density by neighborhood (I = 0.05; p value = 0.03). Conclusion: The analysis of infection behavior in time and space can contribute to coping actions based on local needs.(AU)

Justificación y Objetivos: La pandemia por COVID-19 trajo un escenario desafiante para la salud pública a nivel mundial, debido al escaso conocimiento sobre la infección y su aumento exponencial. El objetivo es analizar la tendencia temporal y la distribución espacial de casos positivos para COVID-19 en la ciudad de Jundiai/SP, Brasil, así como su correlación con el ingreso per cápita y la densidad poblacional de los barrios. Métodos: Estudio transversal, realizado de febrero a junio de 2020. Se obtuvieron datos de casos confirmados por la Vigilancia Epidemiológica y por encuesta seroepidemiológica realizada en dos etapas: 1) con usuarios sintomáticos por Síndrome Respiratorio Agudo Severo que acudieron a las Unidades de Salud; 2) muestreo probabilístico de hogares. Se realizó un análisis de la serie temporal de los casos confirmados por la Vigilancia Epidemiológica y, se elaboraron mapas con densidad de kernel e índice de Moran local (p <0.05) de los casos diagnosticados en la encuesta seroepidemiologica. Resultados: hubo un incremento en el número de casos en el período estudiado (2,35%), así como una distribución heterogénea de casos en el territorio, con concentración en áreas periféricas de la ciudad. Hubo una autocorrelación espacial débil entre el ingreso per cápita promedio (I = 0.11; valor de p <0.001) y la densidad de población por vecindario (I = 0.05; valor de p = 0.03). Conclusión: El análisis del comportamiento de la infección en el tiempo y el espacio puede contribuir a acciones de afrontamiento basadas en las necesidades locales.(AU)

The role of health literacy as a factor associated with tooth loss / O papel da literacia em saúde como fator associado às perdas dentárias

ABSTRACT OBJECTIVE The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.

RESUMO OBJETIVO O objetivo foi analisar o papel da Literacia em Saúde (LS) como fator associado às perdas dentárias entre usuários do Sistema Único de Saúde com doenças crônicas não transmissíveis. MÉTODOS O estudo transversal e analítico foi conduzido com usuários adultos e idosos selecionados em dez Unidades de Saúde da Família sorteadas, em Piracicaba - SP, Brasil. Foi aplicado um questionário com dados sociodemográficos (sexo, idade, cor da pele e escolaridade), comportamentais (escovação e uso de fio dental), determinantes em saúde (tipo e frequência de uso de serviço de saúde médico e odontológico) e clínica (dor). As condições bucais foram coletadas por exame intrabucal do biofilme dental visível e Índice Pediodontal Comunitário. As condições clínicas sistêmicas (glicemia, hemoglobina glicada e pressóricas) foram extraídas dos prontuários. A variável explanatória foi a LS (baixa, média e alta), medida pelo Health Literacy Scale (HLS-14). RESULTADOS O desfecho foi à perda dentária medida pelo Índice de dentes permanentes cariados, perdidos e obturados. Foi realizada regressão logística com uso de um modelo conceitual para a LS (p < 0,05). Para os 238 indivíduos, a média de idade foi 62,7 anos (± 10,55). A perda dentária esteve associada à LS nos modelos de regressão ajustados por tipo de serviço odontológico, frequência odontológica e uso de fio dental. No modelo final, a perda dentária teve como fatores associados a maior idade (OR = 1,12; IC95% 1,07-1,17), menor escolaridade (OR = 3,43; IC95% 1,17-10,10), ao uso irregular de fio dental (OR = 4,58; IC95% 1,75-7,31), uso irregular do serviço odontológico (OR = 2,60; IC95% 1,32-5,12), bolsa periodontal (> 4mm) (OR = 0,31; IC95% 0,01-0,08), ter biofilme dental visível (OR = 7,23; IC95% 3,19-16,41) e maior índice de glicemia (OR = 1,98; IC95% 1,00-3,92). CONCLUSÕES A perda dentária esteve associada à LS quando ajustada por comportamentos em saúde, a partir da inclusão das variáveis sociodemográficas e condições clínicas ela perdeu a significância. No modelo final, comportamentos, determinantes em saúde e condições clínicas foram indicadores de risco da perda dentária, demonstrando a multifatorialidade envolvida neste fenômeno.

O impacto da depressão pós-parto no aleitamento materno e no desenvolvimento infantil: uma revisão integrativa / The impact of postpartum depression on breastfeeding and child development: an integrative review / El impacto de la depresión posparto en la lactancia y el desarrollo infantil: una revisión integral

O objetivo foi identificar o impacto da depressão pós-parto no aleitamento materno e no desenvolvimento infantil. Tratou-se de uma Revisão Integrativa de Literatura realizada a partir da busca de artigos nas bases de dados Pubmed e Biblioteca Virtual em Saúde. Inicialmente foram encontrados 1.413 artigos, entretanto, após aplicação dos critérios de exclusão, foram selecionados oito artigos. A sintomatologia da depressão pós-parto materna pode ter implicações no aleitamento materno e, também, implicações duradouras no desenvolvimento infantil, que podem estender-se até a vida adulta. A literatura evidenciou que intervenções precoces e preventivas envolvendo mães com sintomas sugestivos de depressão pós-parto são necessárias e reduzem o impacto deste quadro no aleitamento materno e no desenvolvimento infantil, principalmente se forem identificadas e tratadas no período pré-natal. Os profissionais de saúde são uma rede de apoio essencial na identificação e encaminhamento de mães com sinais sugestivos de depressão pós-parto para avaliação,tratamento e rede de apoio.(AU)

The objective was to identify the impact of postpartum depression on breastfeeding and child development. This was an Integrative Literature Review based on the search articles in the Pubmed and Virtual Health Library databases. Initially, 1413 articles were found, however, after applying the exclusion criteria, eight articles were selected. Symptoms of maternal postpartum depression may fave implications for breastfeeding as well as lasting implications for child development, wich may extend into adulthood. The literature has shown that early and preventive interventions involving mothers with symptoms suggestive of postpartum depression are necessary and reduce the impact of this condition on breastfeeding and child development, especially if they are identified and treated in the prenatal period. Health professionals are an essential support network in the identification and referral of mothers with signs suggestive of postpartum depression for evaluation, treatment and support network.(AU)

El objetivo fue identificar el impacto de la depresión posparto en la lactancia materna y el desarrollo infantil. Esta fue uma Revisión Integral de Literatura basada en la búsqueda de artículos em las bases de datos Pubmed y Biblioteca Virtual em Salud. Inicialmente, se encontraron 1413 artículos, sin embargo, después de aplicar los criterios de exclusión, se seleccionaron ocho artículos . Los sintomas de la depresión pós-parto materna pueden tener implicaciones para la lactancia materna, así como implicaciones duraderas para el deserrollo infantil, que puedem extenderse hasta la edad adulta. La literatura ha demostrado que las intervenciones tempranas y preventivas que involucran a madres con síntomas sugestivos de depresión posparto son necesarias y reducen el impacto de esta afección en la lactancia materna y el desarrollo infantil, especialmente si se identifican y tratan en el período prenatal. Los profesionales de la salud son una red de apoyo esencial en la identificación y derivación de madres con signos que sugieren depresión posparto para evaluación,tratamento y red de apoyo.(AU)

Distribuição espacial do uso dos serviços odontológicos por adultos em um município de médio porte do estado de São Paulo / Spatial distribution of the access to dental services by adults and the elderly in a mid-sized city of the State of São Paulo

Objetivo: Avaliar os fatores sociodemográficos e de acesso associados ao tipo de serviços odontológicos utilizado por adultos e idosos. Métodos: Trata-se de um recorte transversal aninhado à 'Coorte de Saúde Bucal de Adultos de Piracicaba/SP' iniciada em 2011. Em 2015, aamostra foi composta por adultos e idosos (23 e 69 anos) e a coleta de dados foi realizada em domicílio por meio de questionário estruturado com dados sociodemográficos e de acesso aos serviços odontológicos. O desfecho do estudo foi o serviço utilizado na última consulta (público, particular ou convênio) e as variáveis independentes foram agrupadas em sociodemográficas e de acesso. Para associação, utilizou-se o Teste Qui-quadrado, com o ajuste de Bonferroni (p < 0,05). Resultados: Houve georreferenciamento dos indivíduos conforme o serviço utilizado e análise da distância entre a residência e serviços de saúde odontológico público, a partir do cálculo da distância linear (em metros), considerando a menor distância. Participaram do estudo 144 adultos e idosos, sendo a maioria de mulheres (72,2%), de 23 a 48 anos (47,9%), brancas (68,5%) e com união estável (75,7%). A maioria utilizou o serviço odontológico particular (50,0%), havia buscado atendimento há menos de um ano (60,0%), tendo como principal motivo a rotina (43,1%). Conclusão: houve maior oferta de serviços odontológicos públicos na região norte do município, entretanto, a busca por este tipo de atendimento foi maior na região leste. Evidenciou-se que todos os adultos e idosos residiam próximo a um serviço público com atendimento odontológico. Os adultos e idosos com baixa renda usaram mais o serviço público na última consulta, sendo que os que buscaram por atendimento por convênio apresentavam união estável, tendo como motivo de procura a rotina.

Aim: to evaluate the sociodemographic and access factors associated with the type of dental services used by adults and the elderly. Methods: this is a cross-sectional view nested in the 'Cohort of Adult Oral Health in Piracicaba/SP', started in 2011. In 2015, the sample consisted of adults and the elderly (23 and 69 years of age), and data collection was carried out though a structured questionnaire with sociodemographic data and access to dental services. The study's outcome was the service used in the last dental appointment (public, private, or health insurance), and the independent variables were grouped into sociodemographic and access. For association, the Chi-square test was used, together with the Bonferroni adjustment (p < 0.05). Results: individuals were georeferenced according to the type of service used and analysis of the distance between the home and public dental health services, based on the calculation of the linear distance (in meters), considering the shortest distance. This study counted on the participation of 144 adults and the elderly, the majority of whom were women (72.2%), from 23 to 48 years of age (47.9%), white (68.5%), and in a stable union (75.7%). Most used private dental services (50.0%), had sought care for less than a year (60.0%), with routine dental visit as the main reason (43.1%). Conclusion: there was a greater offer of public dental services in the northern region of the city; however, the search for this type of care was greater in the eastern region. It was evident that all adults and the elderly lived close to a public service with dental care. Low-income adults and the elderly used public dental services more often in their last dental appointment, and those who sought dental care by health care insurance reported being in a stable union, who sought ought services due to a routine dental visit.