Association between shortened dental configurations and health outcomes: a scoping review.

This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.

A systematic review of measurement instruments for oral health assessment of older adults in long-term care facilities by nondental professionals.

BACKGROUND: Regular oral health assessment of older adults living in Long-term Care Facilities (LTCF) can improve their oral health. AIMS: This study aimed to systematically review studies describing the development of instruments employed by nondental professionals to assess the oral health of older adults in LTCF and to evaluate their measurement properties. MATERIAL & METHODS: Electronic searches were conducted in the MEDLINE (PubMed), Embase, Web of Science, Scopus, and LILACS databases. Measurement properties of the identified instruments were evaluated using the Consensus-based Standards to select health Measurement Instruments (COSMIN) checklist. Studies assessing at least one measurement property (validity, reliability, or responsiveness) of instruments used to assess oral health of older adults living in LTCF by nondental professionals were considered. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) checklist was used to evaluate the quality of evidence. RESULTS: Fifteen studies reporting measurement properties of seven instruments were selected. The ohr-interRAI and the OHAT were considered to have sufficient content validity, with high and moderate evidence quality, respectively. OHAT, BOHSE, and DHI showed acceptable results on reliability but with very low quality of evidence. DHI and OHSTNP also showed acceptable results for criterion validity, but, with low quality of evidence, insufficient or unclear results were observed for the remaining measurement properties. Studies evaluating the validity criteria of BOHSE and hypotheses testing of ohr-MDS were considered to have high evidence quality. DISCUSSION AND CONCLUSION: The ohr-interRAI can be provisionally recommended for use until further evidence is provided. Further methodologically rigorous studies are needed to assess the measurement properties of the existing instruments.

Recomendações para o enfrentamento da pandemia de COVID-19 em Instituições de Longa Permanência para Idosos: rapid review / Recommendations for managing COVID-19 pandemic in long-term care facilities for the older people: a rapid review

Resumo Introdução O controle da disseminação do coronavírus em Instituições de Longa Permanência para Idosos (ILPI) é considerado um desafio, uma vez que os idosos fazem parte do grupo de risco e apresentam prognóstico bastante desfavorável e também alta letalidade. Objetivo Conduzir uma rapid review para mapear e sintetizar a literatura sobre medidas de enfrentamento de Coronavirus Disease-2019 (COVID-19) em ILPI. Método Foi realizada uma Rapid review, e as buscas foram conduzidas nas bases de dados eletrônicas Biblioteca Cochrane, Web of Science, Scopus, Scielo, Medline/Pubmed e Google Scholar. Foram incluídas publicações a partir de 2019, nos idiomas português, inglês ou espanhol. A seleção das publicações ocorreu em duas etapas: leitura dos títulos/resumos; e leitura na íntegra de todas as publicações selecionadas. As recomendações para enfrentamento da COVID-19 em Instituições de Longa Permanência para Idosos foram extraídas e agrupadas de acordo com o conteúdo. Resultados Foram selecionadas 59 publicações que descreviam recomendações referentes aos temas: controle da disseminação do vírus; formação / educação continuada dos trabalhadores responsáveis pelo cuidado ao idoso; bem como o cuidado no contexto da pandemia: residentes, trabalhadores e familiares, e planejamento e gerenciamento de ações para o enfrentamento. Conclusão As recomendações para o enfrentamento da COVID-19 demandam comportamentos para evitar a disseminação do vírus, adaptações nas dinâmicas de cuidado e de convivência nas instituições, planejamento de ações específicas e suporte familiar, institucional e do Estado para assegurar a proteção da saúde física e psicossocial dos idosos e trabalhadores.

Abstract Background Controlling the spread of the coronavirus in Long-Term Care Facilities for older adults is considered a challenge, since this group have a very unfavorable prognosis and also high lethality. Objective To conduct a rapid review of guidelines to manage COVID-19 in Long-Term Care Facilities for older adults. Method A Rapid review was carried out, searches were conducted in the electronic databases Cochrane Library, Web of Science, Scopus, Scielo and Medline/Pubmed. Publications from 2019 were included, in Portuguese, English, or Spanish. The selection of publications took place in two stages: reading the titles/abstracts and reading in full all selected publications by two independent researchers. Guidelines for managing COVID-19 in LCTFs were extracted and grouped according to content. Results 59 publications were selected describing guidelines regarding control of the spread of the virus; training/continuing education of staff responsible for caring for the elderly residents; care addressing residents, staff and family during the pandemic and planning and management of actions to manage the disease. Conclusion Guidelines for managing COVID-19 demand for behaviors to prevent the spread of the virus and adaptations in the dynamics of care and the coexistence inside facilities. They also require planning for specific actions that include family, institutional and State support so the protection of physical and psychosocial health of the elderly residents and staff is ensured.

COVID-19 Morbidity Among Oral Health Professionals in Brazil.

BACKGROUND: We evaluated and compared the cumulative incidence of confirmed COVID-19 cases between oral health professionals and the general population in Brazil. METHODS: Secondary data from notification of laboratory unconfirmed and confirmed cases of COVID-19 in the National data system for 41 epidemiological weeks were analysed and compared between oral health professionals (dentist + oral health technicians/assistants) and the general population. The cumulative incidences of COVID-19 were obtained by the ratio of the total number of confirmed cases to the total Brazilian population or the population of oral health professionals registered with the Federal Council of Dentistry and adjusted by age. The incidences were then compared. RESULTS: The age-standardised cumulative incidences were 18.70/1000 for oral health professionals and 17.71/1000 for the population, with a ratio of 1.05. The highest incidences were observed in the states of Roraima (67.05/1000), Tocantins (58.81/1000), and Amazonas (58.24/1000). In 14 states, the age-standardised cumulative incidences were higher among oral health professionals than in the general population. There was a decrease in the number of new cases between the 29th and 30th epidemiological weeks in both populations. CONCLUSIONS: COVID-19 infections among oral health professionals was similar to that of the general population. However, the cumulative incidence was 5% higher among oral health professionals, varying among Brazilian states. PRACTICAL IMPLICATIONS: Infection control practices might help lower the risk of contamination in dental settings.

Oral health assessment of older adults living in long-term care facilities by non-dental professionals: a systematic review protocol of instruments.

INTRODUCTION: Regular oral health assessment among older adults living in long-term care facilities (LTCF) can improve their oral health. Different instruments have been developed and used to evaluate the oral health of institutionalised older people by non-dental professionals. These instruments must demonstrate adequate measurement properties. This systematic review aims to examine the studies describing the instruments employed to assess the oral health of older adults living in LTCF by non-dental professionals. The study will also evaluate the measurement properties of such instruments using the checklist proposed by the Consensus-based Standards to select health Measurement Instruments (COSMIN). METHODS AND ANALYSIS: Studies describing the development of instruments for assessing oral health of institutionalised older adults by non-dental professionals will be included. Studies assessing at least one measurement property (validity, reliability or responsiveness) will be also considered. Electronic searches will be conducted on MEDLINE (PubMed, Ovid), Embase, Web of Science, Scopus and LILACS databases. Two independent reviewers will select the studies and will extract data concerning the characteristics of the research and the instrument. The measurement properties will be evaluated using the COSMIN checklist. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to grade the quality (or certainty) of evidence and strength of recommendations. ETHICS AND DISSEMINATION: No ethical approval is required. The results will be submitted for publication to a peer-review journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020191479.

Internet and decision-making regarding health among pregnant woman: cross-cultural adaptation of a questionnaire for use in Brazil.

The aim of this study was to translate and cross-culturally adapt the Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) to Brazilian Portuguese and analyze the psychometric properties of the Preparation for Decision Making Scale (PDMS). This study consisted of the following steps: translation, synthesis, back-translation, evaluation by the author of the original questionnaire, review by the panel of experts, and pretest of the WUIPQ. For such, Brazilian pregnant women and mothers who were members of Facebook groups participated in the study. We measured test-retest reliability as well as internal consistency and performed confirmatory factor analysis (CFA) of the B-PDMS. In the pretest, 88.14% of the participants considered the items of the B-WUIPQ to be clear and pertinent, and 84.09% rated the sequence and organization of the questionnaire as excellent/good. The intraclass correlation coefficient and Cronbach's alpha coefficient for the B-PDMS were 0.850 (95%CI: 0.791-0.899) and 0.91, respectively. CFA revealed factor loadings higher than 0.70 for most items, with a comparative fit index of 0.989, Tucker-Lewis index of 0.984, and root mean square error of approximation of 0.08 (95%CI: 0.06-0.09). The B-WUIPQ presented cross-cultural adapted, and the B-PDMS demonstrated satisfactory psychometric proprieties to Brazilian pregnant women.

Oral health work process: disparity between teams in Brazil, 2014. / Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014.

OBJECTIVE: To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. METHODS: This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. RESULTS: After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). CONCLUSION: Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

Internet and decision-making regarding health among pregnant woman: cross-cultural adaptation of a questionnaire for use in Brazil / A Internet e tomada de decisões sobre saúde entre gestantes: uma adaptação transcultural de um questionário para uso no Brasil / Internet y toma de decisiones respecto a la salud entre mujeres embarazadas: adaptación transcultural de un cuestionario para su uso en Brasil

The aim of this study was to translate and cross-culturally adapt the Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) to Brazilian Portuguese and analyze the psychometric properties of the Preparation for Decision Making Scale (PDMS). This study consisted of the following steps: translation, synthesis, back-translation, evaluation by the author of the original questionnaire, review by the panel of experts, and pretest of the WUIPQ. For such, Brazilian pregnant women and mothers who were members of Facebook groups participated in the study. We measured test-retest reliability as well as internal consistency and performed confirmatory factor analysis (CFA) of the B-PDMS. In the pretest, 88.14% of the participants considered the items of the B-WUIPQ to be clear and pertinent, and 84.09% rated the sequence and organization of the questionnaire as excellent/good. The intraclass correlation coefficient and Cronbach's alpha coefficient for the B-PDMS were 0.850 (95%CI: 0.791-0.899) and 0.91, respectively. CFA revealed factor loadings higher than 0.70 for most items, with a comparative fit index of 0.989, Tucker-Lewis index of 0.984, and root mean square error of approximation of 0.08 (95%CI: 0.06-0.09). The B-WUIPQ presented cross-cultural adapted, and the B-PDMS demonstrated satisfactory psychometric proprieties to Brazilian pregnant women.

O estudo teve como objetivos, traduzir e realizar a adaptação transcultural do Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) para português do Brasil e analisar as propriedades psicométricas da Preparation for Decision Making Scale (PDMS). O estudo consistiu nas seguintes etapas: tradução, síntese, retrotradução, avaliação pelo autor do questionário original, revisão pelo painel de especialistas e pré-teste do WUIPQ. Gestantes e mães brasileiras que pertenciam a grupos de Facebook participaram no estudo. Medimos a confiabilidade teste-reteste e a consistência interna e realizamos análise fatorial confirmatória (AFC) do B-PDMS. No pré-teste, 88,14% das participantes consideraram os itens do B-WUIPQ claros e pertinentes, e 84,09% avaliaram a sequência e organização do questionário como excelentes ou boas. Os coeficientes de correlação intraclasse e alfa de Cronbach para o B-PDMS foram 0,850 (IC95%: 0,791-0,899) e 0,91, respectivamente. A AFC revelou cargas fatoriais acima de 0,70 para a maioria dos itens, com um índice de ajuste comparativo de 0,989, índice de Tucker-Lewis de 0,984 e raiz da média dos quadrados dos erros de aproximação de 0,08 (IC95%: 0,06-0,09). O B-WUIPQ apresentou boa adaptação transcultural, e o B-PDMS demonstrou propriedades satisfatórias para gestantes brasileiras.

El objetivo de este estudio fue traducir y adaptar transculturalmente el Women's Use of the Internet in Pregnancy Questionnaire (WUIPQ) al portugués de Brasil y analizar las propiedades psicométricas de la Preparation for Decision Making Scale (PDMS). Este estudio consistió en los siguientes pasos: traducción, síntesis, traducción inversa, evaluación por parte del autor del cuestionario original, revisión de un panel de expertos, y pretest del WUIPQ. Para ello, mujeres embarazadas brasileñas, y madres que eran miembros de grupos de Facebook, participaron en el estudio. Se midió la fiabilidad del test-retest y la consistencia interna, y se realizó un análisis factorial confirmatorio (AFC) de la B-PDMS. En los pretest, 88,14% de las participantes consideraron los ítems del B-WUIPQ claros y pertinentes, y un 84,09% calificaron la secuencia y organización del cuestionario como excelente/buena. El coeficiente de correlación intraclase y el coeficiente alfa de Cronbach para la B-PDMS fueron 0,850 (IC95%: 0,791-0,899) y 0,91, respectivamente. El AFC reveló cargas factoriales superiores a 0,70 para la mayoría de los ítems, con un índice de ajuste comparativo de 0,989, índice de Tucker-Lewis de 0,984 y raíz de la media de los cuadrados de los errores de aproximación de 0,08 (IC95%: 0,06-0,09). El B-WUIPQ demostró estar transculturalmente adaptado, y la B-PDMS mostró propiedades psicométricas satisfactorias para las mujeres brasileñas embarazadas.

Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014 / Proceso de trabajo de salud bucal: disparidad entre equipos en Brasil, 2014 / Oral health work process: disparity between teams in Brazil, 2014

Objetivo: Comparar o desempenho das equipes de saúde bucal (ESBs) das modalidades I e II no processo de trabalho e as diferenças entre regiões brasileiras. Métodos: Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013-2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados: Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão: ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Objetivo: Comparar Equipos de Salud Bucal (ESB) modalidades I y II cuanto al desempeño en el proceso de trabajo y diferencias entre regiones brasileñas. Métodos: Estudio transversal con datos de la ESB adherida al Programa Nacional de Mejoramiento del Acceso y la Calidad en Atención Primaria (2013-2014). Análisis de Clases Latentes identificaron subgrupos de ESB según el desempeño (consolidado, en desarrollo o incipiente) en el proceso de trabajo (planificación de acciones, promoción de salud y atención integral). Se compararon las modalidades y se obtuvo el Índice de Disparidad. Resultados: Participaron 15.886 ESBs, las de modalidad II presentaron mayor porcentaje de proceso de trabajo consolidado en la región Sudeste (67,8% a 94,6%) y Sur (54,8% a 93,0%). La disparidad fue mayor entre la modalidad II (6,3 a 26,5) en comparación con la I (3,9 a 18,4). Conclusión: las ESBs modalidad II tienen potencial para obtener mejor desempeño en el proceso de trabajo, pero hubo disparidad regional.

Objective: To compare Modality I and Modality II Oral Health Teams (OHT) regarding work process performance and differences between Brazilian regions. Methods: This was a cross-sectional study with OHTs that took part in the National Program for Primary Health Care Access and Quality Improvement (2013-2014). Latent Class Analysis identified OHT subgroups according to work process (action planning, health promotion actions and comprehensive health care) performance (consolidated, developing or incipient). OHT modalities were compared, resulting in an Index of Disparity. Results: After evaluating 15,886 OHTs, Modality II OHTs were found to have a higher percentage of consolidated work processes in the Southeast (67.8%-94.6%) and Southern (54.8%-93.0%) regions. Disparity in the consolidated work process was greater among Modality II OHTs (6.3-26.5) compared to Modality I OHTs (3.9-18.4). Conclusion: Modality II OHTs have the potential for better performance regarding the work process, but with regional disparities.

Cuidados bucais em instituições de longa permanência para idosos / Oral health care in long-term care facilities for elderly people

Esta dissertação apresenta três artigos na temática de saúde bucal dos idosos institucionalizados que buscam avaliar os cuidados bucais prestados por profissionais de Instituições de Longa Permanência para Idosos e qualificar instrumentos que propõem tal avaliação quanto às suas propriedades de mensuração. Com o objetivo de mapear os instrumentos de avaliação da saúde bucal de pessoas idosas que vive em Instituições de Longa Permanência para Idosos (ILPI) por profissionais não dentistas e avaliar suas propriedades de mensuração foram desenvolvidos um protocolo de revisão sistemática e uma revisão sistemática. Foram incluídos estudos que descrevem o desenvolvimento de instrumentos de avaliação da saúde bucal de idosos institucionalizados por profissionais não dentistas. Estudos avaliando pelo menos uma propriedade de mensuração (validade, confiabilidade ou responsividade) foram considerados. Pesquisas eletrônicas foram realizadas e as propriedades foram avaliadas usando os parâmetros para avaliação do risco de viés de acordo com Consensus-based Standards for the selection of health Measurement INstruments (COSMIN). O Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) foi usado para classificar a qualidade da evidência e recomendar o instrumento mais adequado. 15 estudos relataram propriedades de mensuração de sete instrumentos, sendo o ohr-interRAI o instrumento com maior potencial para ser recomendado. Além dele, OHAT, DHI, OAS, OHSTNP tem potencial para uso. Considerando o nível de evidência disponível, recomenda-se o uso do ohr-inteRAI para fins avaliativos até que novas evidências de alta qualidade demonstrem propriedades de mensuração superiores para outros instrumentos com potencial para uso. Assim, há a necessidade de aprimorar os aspectos metodológicos dos estudos e realizar mais estudos consistentes para avaliação das propriedades de mensuração dos instrumentos já existentes que possuem potencial de serem indicados para uso. O terceiro estudo buscou descrever as práticas de higiene bucal de idosos institucionalizados dependentes de cuidados no contexto da pandemia de COVID-19 e analisar os fatores associados à realização desses procedimentos por profissionais que atuam em ILPI. Trata-se de um estudo transversal, de caráter exploratório, com uma amostra não probabilística de profissionais de ILPI. Dados sobre as práticas de higiene bucal, perfil sociodemográfico, atuação e capacitação profissional, estrutura da ILPI, processo de trabalho e percepção dos profissionais foram coletados por meio de um questionário online, previamente validado por Comitê de Especialistas, entre junho e dezembro de 2020. As associações foram investigadas por meio de Regressão Logística simples e múltipla. Dos 179 profissionais que responderam ao questionário da pesquisa original, 76,0% realizavam higiene bucal de idosos dependentes e, 42,5% relataram dificuldades, incluindo barreiras como a falta de cooperação do idoso (93,20%), falta de conhecimento (35,60%), falta de tempo (29,30%) e, falta de materiais necessários (27,6%). Possuir curso de capacitação para cuidador de idosos (OR = 3,27, IC 1,53 - 6,98) e para higiene bucal (OR = 2,19, IC 1,01 - 4,79) foram associados à maior frequência de realização de higiene bucal. As práticas de higiene bucal são realizadas nas ILPI do Brasil durante o contexto da pandemia de COVID-19 e a capacitação para cuidador de idosos e para os cuidados bucais podem favorecer a provisão desses cuidados.

This dissertation presents three articles on the topic of oral health of institutionalized elderly people that seek to evaluate the oral care provided by professionals of Long-Term Care Facilities (LTCF) for the elderly people and qualify instruments that propose such an assessment regarding their measurement properties. In order to map the instruments for assessing the oral health of elderly people living in LTCF by non-dentist professionals and to assess their measurement properties, a systematic review protocol and a systematic review were developed. Studies describing the development of instruments to assess the oral health of institutionalized old people by nondentist professionals were included. Studies evaluating at least one measurement property (validity, reliability or responsiveness) were considered. Electronic surveys were performed and properties were assessed using the parameters for risk of bias assessment according to the Consensusbased Standards for the selection of health Measurement INnstruments (COSMIN). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to rank the quality of evidence and recommend the most appropriate instrument. 15 studies reported measurement properties of seven instruments, with the ohr-interRAI being the instrument with the greatest potential to be recommended. In addition to it, OHAT, DHI, OAS, OHSTNP has potential for use. Considering the level of evidence available, the use of the ohr-interRAI for evaluative purposes is recommended until new high-quality evidence demonstrates superior measurement properties for other instruments with potential for use. Thus, there is a need to improve the methodological aspects of the studies and carry out more consistent studies to assess the measurement properties of existing instruments that have the potential to be indicated for use. The third study sought to describe the oral hygiene practices of institutionalized elderly people dependent on care in the context of the COVID-19 pandemic and to analyze the factors associated with the performance of these procedures by professionals working in LTCF. This is a cross-sectional, exploratory study with a non-probabilistic sample of LTCF professionals. Data on oral hygiene practices, sociodemographic profile, professional performance and training, structure of the LTCF, work process and perception of professionals were collected through an online questionnaire, previously validated by the Expert Committee, between June and December 2020. Associations were investigated using simple and multiple logistic regression. Of the 179 professionals who answered the original survey questionnaire, 76.0% performed oral hygiene for dependent elderly people and 42.5% reported difficulties, including barriers such as the elderly's lack of cooperation (93.20%), lack of knowledge (35.60%), lack of time (29.30%) and lack of necessary materials (27.6%). Having a training course for elderly caregivers (OR = 3.27, CI 1.53 - 6.98) and for oral hygiene (OR = 2.19, CI 1.01 - 4.79) were associated with a higher frequency of performing oral hygiene. Oral hygiene practices are carried out in LTCF in Brazil during the context of the COVID-19 pandemic and training for caregivers of the elderly and for oral care can favor the provision of such care.

The science of collective health in writing: contribution to studies in collective oral health. / A ciência da saúde coletiva por escrito: contribuição para estudos em saúde bucal coletiva.

Celebrating the 25 years of existence of the Journal Ciência & Saúde Coletiva (C&SC), this paper analyzed 375 documents published between 2000-2019 as an integral part of the editorial of collective oral health. The production analysis aimed to understand how oral health core appears in publications and how it could have contributed to knowledge on the population's health-disease, specific public policies, education, and management of oral health services in the SUS. The process employed bibliometric and documental analysis. We could show the authors' territorial distribution, their extensive collaboration network, and the dimension of citations in publications, including the international plan. The Brazilian states most present in the publications were São Paulo and Minas Gerais, followed by authors from Pernambuco, Rio Grande do Sul, and Santa Catarina. Citations were more frequent in Brazil (85.14%), followed by the United States (2.31%), Portugal (1.34%), and Australia (1.34%). We concluded that, despite the limitations, the C&SC showed unequivocally a powerful instrument for the dissemination of scientific production from the perspective of collective oral health, enabling the exchange of information and facilitating the integration between researchers and enabling a path to its consolidation.

Comemorando os 25 anos da Revista Ciência & Saúde Coletiva (C&SC), o presente artigo analisou 375 documentos publicados entre 2000-2019 neste periódico, como parte integrante da editoria de saúde bucal coletiva. A análise da produção visou compreender como o núcleo de saúde bucal aparece nas publicações e como poderia ter contribuído com o conhecimento sobre a saúde-doença da população, as políticas públicas específicas, o ensino e a gestão dos serviços de saúde bucal no SUS. O processo privilegiou a análise bibliométrica e a de documentos. Foi possível explicitar a distribuição institucional dos autores, sua expressiva rede de colaboradores e a dimensão das citações das publicações inclusive no plano internacional. Os estados brasileiros mais presentes nas publicações foram São Paulo e Minas Gerais, seguidos por autores de Pernambuco, Rio Grande do Sul e Santa Catarina. As citações foram mais frequentemente do Brasil (85,14%), seguido por Estados Unidos (2,31%), Portugal (1,34%) e Austrália (1,34%). Conclui-se que, mesmo com limitações, C&SC se mostrou, inequivocamente, um potente instrumento de divulgação da produção científica na perspectiva da saúde bucal coletiva, possibilitando a divulgação e o intercâmbio de informações, facilitando a integração entre os pesquisadores e possibilitando um caminho da sua consolidação.

A ciência da saúde coletiva por escrito: contribuição para estudos em saúde bucal coletiva / The science of collective health in writing: contribution to studies in collective oral health

Resumo Comemorando os 25 anos da Revista Ciência & Saúde Coletiva (C&SC), o presente artigo analisou 375 documentos publicados entre 2000-2019 neste periódico, como parte integrante da editoria de saúde bucal coletiva. A análise da produção visou compreender como o núcleo de saúde bucal aparece nas publicações e como poderia ter contribuído com o conhecimento sobre a saúde-doença da população, as políticas públicas específicas, o ensino e a gestão dos serviços de saúde bucal no SUS. O processo privilegiou a análise bibliométrica e a de documentos. Foi possível explicitar a distribuição institucional dos autores, sua expressiva rede de colaboradores e a dimensão das citações das publicações inclusive no plano internacional. Os estados brasileiros mais presentes nas publicações foram São Paulo e Minas Gerais, seguidos por autores de Pernambuco, Rio Grande do Sul e Santa Catarina. As citações foram mais frequentemente do Brasil (85,14%), seguido por Estados Unidos (2,31%), Portugal (1,34%) e Austrália (1,34%). Conclui-se que, mesmo com limitações, C&SC se mostrou, inequivocamente, um potente instrumento de divulgação da produção científica na perspectiva da saúde bucal coletiva, possibilitando a divulgação e o intercâmbio de informações, facilitando a integração entre os pesquisadores e possibilitando um caminho da sua consolidação.

Abstract Celebrating the 25 years of existence of the Journal Ciência & Saúde Coletiva (C&SC), this paper analyzed 375 documents published between 2000-2019 as an integral part of the editorial of collective oral health. The production analysis aimed to understand how oral health core appears in publications and how it could have contributed to knowledge on the population's health-disease, specific public policies, education, and management of oral health services in the SUS. The process employed bibliometric and documental analysis. We could show the authors' territorial distribution, their extensive collaboration network, and the dimension of citations in publications, including the international plan. The Brazilian states most present in the publications were São Paulo and Minas Gerais, followed by authors from Pernambuco, Rio Grande do Sul, and Santa Catarina. Citations were more frequent in Brazil (85.14%), followed by the United States (2.31%), Portugal (1.34%), and Australia (1.34%). We concluded that, despite the limitations, the C&SC showed unequivocally a powerful instrument for the dissemination of scientific production from the perspective of collective oral health, enabling the exchange of information and facilitating the integration between researchers and enabling a path to its consolidation.

Oral health work process: disparity between teams in Brazil, 2014 / Proceso de trabajo de salud bucal: disparidad entre equipos en Brasil, 2014 / Processo de trabalho em saúde bucal: disparidade entre as equipes no Brasil, 2014

Objective: To compare the Oral Health Teams (OHT) modalities I and II regarding performance in the work process and differences between Brazilian regions. Methods: Cross-sectional study with data from the OHT that joined to the National Program for Improving Access and Quality in Primary Care (2013/2014). Latent Class Analysis identified subgroups of OHT according to performance (consolidated, developing or incipient) in the work process (action planning, health promotion actions and integral health care). OHT modalities were compared and the Disparity Index was obtained. Results: 15,886 OHT participated. OHT modality II showed a higher percentage of consolidated work process in Southeast (67.8% to 94.6%) and South (54.8% to 93.0%) regions. Disparity in the consolidated work process was greater between OHT modality II (6.3 a 26.5) compared to I (3.9 a 18.4). Conclusion: OHT modality II has the potential to obtain better performance regarding the work process, but there was a regional disparity.

Objetivo: Comparar o desempenho das equipes de saúde bucal (ESB) das modalidades I e II no processo de trabalho e diferenças entre regiões brasileiras. Métodos: Estudo transversal, com dados das ESBs que aderiram ao Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (2013/2014). A análise de classes latentes identificou subgrupos de ESBs segundo desempenho (consolidado, em desenvolvimento ou incipiente) no processo de trabalho (planejamento das ações; promoção da saúde; atenção integral). Comparadas as modalidades, obteve-se o índice de disparidade. Resultados: Avaliadas 15.886 ESBs, as da modalidade II apresentaram maior percentual de processo de trabalho consolidado nas regiões Sudeste (67,8 a 94,6%) e Sul (54,8 a 93,0%); observou-se maior disparidade no processo de trabalho consolidado entre ESBs da modalidade II (6,3 a 26,5), comparadas à modalidade I (3,9 a 18,4). Conclusão: ESBs da modalidade II guardam potencial para melhor desempenho no processo de trabalho, com disparidades regionais.

Education and income-based inequality in tooth loss among Brazilian adults: does the place you live make a difference?

BACKGROUND: Socioeconomic inequalities in tooth loss might be minimized or potentialized by the characteristics of the context where people live. We examined whether there is contextual variation in socioeconomic inequalities in tooth loss across Brazilian municipalities. METHODS: Data from the 2010 National Oral Health Survey of 9633 adults living in 157 Brazilian municipalities were used. The individual socioeconomic indicators were education and household income. At the municipal level, we used the Municipal Human Development Index (HDI) as our contextual indicator of socioeconomic status (low:< 0.699 versus high: > 0.70). The Relative (RII) and Slope (SII) Indexes of Inequality, Relative (RCI), and Absolute (ACI) Concentration Indexes were calculated to compare the magnitude of education and income-based inequalities among municipalities with low versus high HDI. Multilevel Poisson regression models with random intercepts and slopes were developed. RESULTS: At the individual level, adults with lower education & income reported more tooth loss. The mean number of missing teeth was 9.52 (95% CI: 7.93-11.13) and 6.95 (95% CI: 6.43-7.49) in municipalities with low and high HDI, respectively. Municipalities with high HDI showed higher relative and absolute education-based inequality. For income-based inequalities, higher SII and RCI was observed in municipalities with lower HDI. A significant cross-level interaction indicated that high-education adults reported fewer missing teeth when they lived in municipalities with high HDI compared to adults with the same education level living in low HDI municipalities. For individuals with the lowest education level, there was no difference in the number of teeth between those from municipalities with high and low HDI. CONCLUSIONS: There was a social gradient in tooth loss by education and income. Living in disadvantaged municipalities cannot overcome the risk associated with low schooling. The protective effect of higher education can be reduced when people live in disadvantaged areas.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil.

This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Public oral health services performance in Brazil: Influence of the work process and service structure.

The quality of oral health care might be evaluated based on Donabedian's structure-process-outcome model. This study assessed the association between the oral health public services structure and work process of oral health teams (OHT) and performance indicators (access and problem-solving capacity) in Brazil. Secondary data from a national program obtained through interviews and by observation in 2013/2014 were analyzed. The performance indicators were Coverage of First Scheduled Dental Appointment (FDA) (< or ≥ the mean) and Ratio between Completed Treatments and First Scheduled Dental Appointments (CT/FDA) (< 1 or ≥ 1). The structure was assessed by the sum of available instruments, equipment, and supplies. Latent class analyses were used to identify similar groups (consolidated, developing, and incipient) of OHT according to the work process (planning of actions, health promotion and intersectoral actions, and integral health care). Each OHT was also described regarding the number of the health team in which the OHT operates, whether the primary care unit receives students/teaches, frequency of care provided outside of OHT coverage, and participation in telehealth. Multiple logistic regression models were adjusted for each performance indicator. A total of 16189 (99,8%) and 16192 (99,9%) OHTs located in 4344 (78,0%) municipalities had complete data on the work process and structure. 91.92% of OHTs presenting CT/FDA ≥ 1 and 37.05% presenting FDA ≥ the mean. Consolidated planning of actions and better structural conditions were associated with better performance. A higher frequency of CT/FDA ≥ 1 was observed among OHTs with consolidated integral health care and those that performed telehealth. OHTs that served individuals outside of OHT coverage daily and that worked with two to nine Health Teams presented a higher frequency of FDA ≥ the mean. OHTs with better structural and work process conditions had better performance.

Trends of maxillofacial injuries resulting from physical violence in Brazil.

BACKGROUND/AIM: A large proportion of interpersonal violence results in maxillofacial injuries. The monitoring of maxillofacial injuries in the context of gender violence has been little explored. The aim of this study was to analyze trends in cases of maxillofacial injuries resulting from interpersonal physical violence considering the gender of the victim and perpetrator. MATERIALS AND METHODS: A time-series study was conducted. Data regarding maxillofacial injury cases due to interpersonal physical violence were collected from reports at a forensic institute of a city in northeastern Brazil, between 2008 and 2014 (84 months). Rates of interpersonal physical violence per 100 000 inhabitants were determined for each gender. A negative binomial regression model was used to evaluate trends. The cycle plot was used to investigate the occurrence of seasonality, considering subseries for each month. RESULTS: A total of 3561 reports were analyzed, revealing higher rates of female victims and male perpetrators throughout the series. There was no indication of seasonality. The annual percentage of injuries involving male victims reduced significantly by 6.8% (P < .001), while injuries involving female victims increased significantly by 4.5% (P = .002). Regarding perpetrators, rates remained constant over time, following the same pattern for both genders. CONCLUSIONS: The data demonstrate greater victimization involving maxillofacial injuries against women perpetrated more often by men, with a trend toward an increase in female victims and a reduction in male victims.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil

Abstract This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Correction to: User satisfaction with public oral health services in the Brazilian unified health system.

Following publication of the original article [1], the authors have reported that there is an error in Table 2 - Distribution of users concerning satisfaction with oral health services: the categories 'No' and 'Yes' should swap places.

User satisfaction with public oral health services in the Brazilian Unified Health System.

BACKGROUND: User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. METHODS: Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan' model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user's viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. RESULTS: A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. CONCLUSIONS: Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.