[The construction behind chosen names of transgender individuals and related aspects in a medium-sized city in the South of Brazil]. / Construção do nome social de pessoas trans e aspectos relacionados em um município de porte médio do Sul do Brasil.

This study analyzed the construction process of the chosen name and related aspects among transgender individuals from a medium-sized municipality in southern Brazil. Qualitative data from a descriptive and exploratory mixed-method study was used. Self-declared trans people aged 18 or over were included. Three focus groups were conducted with ten participants. These individuals, aged between 19 and 52 years, have a documented chosen name, but half have not yet changed their civil records. The content analysis technique produced two categories: "construction of the chosen name as an instrument for validating the transgender identity" and "impacts of the construction of the chosen name on self-acceptance and on family and social relationships." The results reinforce the importance of respecting the name as a way of contributing to the gender affirmation of transgender individuals. The name was linked to the experiences, individuality and values of these individuals. Its proper use, much more than respect for legislation, meant respect for the different possibilities of human existence. It is expected that the results presented can be used as a tool for recognizing the issues and nuances that permeate the construction of the chosen name and contribute to identity validation.

O trabalho analisou o processo de construção do nome social e aspectos relacionados em pessoas trans de um município de porte médio do Sul do Brasil. Foram utilizados dados qualitativos de um estudo de método misto descritivo e exploratório. Incluíram-se pessoas autodeclaradas trans com 18 anos ou mais. Foram conduzidos três grupos focais com dez participantes. Estes, com idade variando entre 19 e 52 anos, apresentam nome social documentado, porém metade ainda não fez a alteração nos registros civis. A técnica da análise de conteúdo produziu duas categorias: "construção do nome social como instrumento de validação da identidade trans" e "impactos da construção do nome social na autoaceitação e nas relações familiares e sociais". Os resultados reforçam a importância do respeito ao nome como forma de contribuição para a afirmação de gênero de sujeitos trans. O nome esteve atrelado às suas vivências, individualidades e valores. Seu uso adequado, muito mais do que o cumprimento de uma legislação, significou respeito às possibilidades diversas da existência humana. Espera-se que os resultados apresentados possam ser utilizados como ferramenta de reconhecimento acerca das questões e nuances que permeiam a construção do nome social, bem como contribuam para a validação identitária.

Construção do nome social de pessoas trans e aspectos relacionados em um município de porte médio do Sul do Brasil / The construction behind chosen names of transgender individuals and related aspects in a medium-sized city in the South of Brazil

Resumo O trabalho analisou o processo de construção do nome social e aspectos relacionados em pessoas trans de um município de porte médio do Sul do Brasil. Foram utilizados dados qualitativos de um estudo de método misto descritivo e exploratório. Incluíram-se pessoas autodeclaradas trans com 18 anos ou mais. Foram conduzidos três grupos focais com dez participantes. Estes, com idade variando entre 19 e 52 anos, apresentam nome social documentado, porém metade ainda não fez a alteração nos registros civis. A técnica da análise de conteúdo produziu duas categorias: "construção do nome social como instrumento de validação da identidade trans" e "impactos da construção do nome social na autoaceitação e nas relações familiares e sociais". Os resultados reforçam a importância do respeito ao nome como forma de contribuição para a afirmação de gênero de sujeitos trans. O nome esteve atrelado às suas vivências, individualidades e valores. Seu uso adequado, muito mais do que o cumprimento de uma legislação, significou respeito às possibilidades diversas da existência humana. Espera-se que os resultados apresentados possam ser utilizados como ferramenta de reconhecimento acerca das questões e nuances que permeiam a construção do nome social, bem como contribuam para a validação identitária.

Abstract This study analyzed the construction process of the chosen name and related aspects among transgender individuals from a medium-sized municipality in southern Brazil. Qualitative data from a descriptive and exploratory mixed-method study was used. Self-declared trans people aged 18 or over were included. Three focus groups were conducted with ten participants. These individuals, aged between 19 and 52 years, have a documented chosen name, but half have not yet changed their civil records. The content analysis technique produced two categories: "construction of the chosen name as an instrument for validating the transgender identity" and "impacts of the construction of the chosen name on self-acceptance and on family and social relationships." The results reinforce the importance of respecting the name as a way of contributing to the gender affirmation of transgender individuals. The name was linked to the experiences, individuality and values of these individuals. Its proper use, much more than respect for legislation, meant respect for the different possibilities of human existence. It is expected that the results presented can be used as a tool for recognizing the issues and nuances that permeate the construction of the chosen name and contribute to identity validation.

Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis. / Razões e consequências das perdas dentárias em adultos e idosos no Brasil: metassíntese qualitativa.

The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.

O objetivo foi analisar e sistematizar evidências levantadas por estudos qualitativos sobre razões e consequências de perdas dentárias em adultos e idosos no Brasil. Foi executada revisão sistemática da literatura de pesquisas de métodos qualitativos, e metassíntese dos resultados. A população de estudo foi de adultos acima de 18 anos e idosos brasileiros. Foi realizada busca nas bases de dados BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO e SciELO. A síntese temática definiu oito temas analíticos sobre razões das perdas dentárias e três temas analíticos sobre as consequências. A dor dentária, o modelo de atenção, a situação financeira e o desejo de reabilitação protética foram fatores determinantes para as exodontias. Houve reconhecimento da negligência com o cuidado bucal e da naturalidade das perdas dentárias ligada à velhice. Dentes perdidos causaram impactos psicológicos e fisiológicos. É imperativo verificar se os fatores que causaram as perdas dentárias persistem, e quanto influenciam as decisões de extrair dentes na população jovem e adulta atual. Há que se mudar o modelo de atenção pela inclusão e qualificação da atenção em saúde bucal da população adulta jovem e idosa, sob pena de persistir o modelo de mutilação dentária e a cultura de edentulismo.

Razões e consequências das perdas dentárias em adultos e idosos no Brasil: metassíntese qualitativa / Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis

Resumo O objetivo foi analisar e sistematizar evidências levantadas por estudos qualitativos sobre razões e consequências de perdas dentárias em adultos e idosos no Brasil. Foi executada revisão sistemática da literatura de pesquisas de métodos qualitativos, e metassíntese dos resultados. A população de estudo foi de adultos acima de 18 anos e idosos brasileiros. Foi realizada busca nas bases de dados BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO e SciELO. A síntese temática definiu oito temas analíticos sobre razões das perdas dentárias e três temas analíticos sobre as consequências. A dor dentária, o modelo de atenção, a situação financeira e o desejo de reabilitação protética foram fatores determinantes para as exodontias. Houve reconhecimento da negligência com o cuidado bucal e da naturalidade das perdas dentárias ligada à velhice. Dentes perdidos causaram impactos psicológicos e fisiológicos. É imperativo verificar se os fatores que causaram as perdas dentárias persistem, e quanto influenciam as decisões de extrair dentes na população jovem e adulta atual. Há que se mudar o modelo de atenção pela inclusão e qualificação da atenção em saúde bucal da população adulta jovem e idosa, sob pena de persistir o modelo de mutilação dentária e a cultura de edentulismo.

Abstract The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.

Tutorial Education Program at a dental school in Southern Brazil: A transforming experience.

BACKGROUND: The Tutorial Education Program (PET), regulated in 2005 by Law no. 11.180/2004, in addition to transforming higher education in Brazil, has been an essential component for the development of academic students, expanding the education perspective. AIMS: This article aims to report the actions developed regarding these three pillars and the experience of undergraduate dentistry students, who are members of the Tutorial Education Program at the Federal University of Santa Maria. METHODS: Through teaching, research, and extension activities, which are the structuring pillars of Brazilian universities, PET enables the improvement of education and pedagogical projects in higher education courses. RESULTS: With regard to teaching and the search for knowledge construction, the group has been conducting six projects focused on dental students, in the form of lectures and workshops, as well as innovated the teaching-learning process through the preparation of video classes and the monitoring of freshmen students. Regarding the production of new knowledge through research, three projects focused on dental trauma, xerostomia, and the impact of COVID-19 on the teaching of dental students. As an exchange between community and university, in the extension pillar, the group participates in three projects aimed at blood donation, divulgation of the university, and the elderly public. During the 2020 pandemic, the group made adaptations and created new actions. CONCLUSION: Therefore, the activities planned and performed by the Tutorial Education Program have developed its members' skills and contributed to improvements in the quality of Brazilian higher education.

Predictors of tooth loss in Brazilian older adults: An 8-year follow-up.

OBJECTIVE: To investigate the risk factors for tooth loss after 8 years among community-dwelling older adults in a southern Brazilian city. METHODS: In 2004, 388 dentate community-dwelling older adults from Carlos Barbosa, southern Brazil, were selected using simple random sampling. In 2012, the follow-up consisted of 199 (51.3%) participants. Data collection comprised an interview with data about socio-demographic, behavioural and access to services and an oral examination. The outcome variable of this study is the ratio between the sum of the teeth lost during the 8-year period of follow-up, and the sum of the teeth present in 2004, per person, modelled through binomial regression analysis. RESULTS: Being older (IOR = 1.03, 95% CI: 1.00-1.06), living in a rural area (IOR = 1.56, 95% CI: 1.17-2.07), earning two or more monthly minimum wages (IOR = 1.46, 95% CI: 1.09-1.96), living alone (single, widowed or divorced; IOR = 1.36, 95% CI: 1.00-1.85), having more gingival bleeding sites (IOR = 1.01, 95% CI: 1.00-1.02) and wearing partial removable prosthesis (IOR = 2.82, 95% CI: 2.15-3.71) were risk factors for tooth loss. Approximately 48% of the participants lost one or more teeth over the 8-year follow-up period. CONCLUSION: Socio-demographic, economic and clinical variables were associated with the risk for tooth loss. This might be a result of social determinants of health influencing people's access to oral health care, oral health behaviours and oral health status. Public policy aimed at older adults living in rural areas, living alone and using removable dentures may contribute to reducing the risk of tooth loss.

Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study.

OBJETIVE: To investigate the relationship between the masticatory function and the frailty of older people. METHODS: Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS: 2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION: This study found an association between masticatory function and a greater chance of frailty among the studied population.

Functional dentition and associated factors: the evaluation of three indicators

Studying the different indicators of functional dentition classification can contribute to the understanding of the associated factors, and thus help in the definition of strategies associated with oral health care. This approach has been little explored in the literature, especially when considering the older age group. Aim:The aim of this study is to evaluate the factors associated with three distinct functional dentition classification. Methods: Cross-sectional exploratory study using secondary data from the Frailty in Older Brazilians (FIBRA) Project of 876 older adults living in Campinas, Brazil. The indicators of dental function assessed was number of natural teeth present, occluding pairs of teeth and the Eichner index, which were verified by trained dentists, following the World Health Organization criteria for epidemiological studies in oral health. The explanatory variable assessed was the self-perception of oral health-related quality of life measured by the Geriatric Oral Health Assessment Index (GOHAI) and its dimensions. It was also collected sociodemographic information such as age, gender, race/ethnicity, schooling, family income, smoking behavior and frailty status. The association was verified through Poisson regressions for number of teeth and pairs of teeth in occlusion and multinomial regression for the Eichner index, adjusted by sociodemographic and health variables. Results: Lower prevalence of participants with less than 21 teeth who negatively perceived GOHAI ́s pain and discomfort dimension and higher prevalence of having less teeth among the ones that negatively perceived GOHAI ́s physical and functional dimensions. No association was found between the perception of quality of life and occlusion pairs of teeth and the Eichner Index. Conclusion: Two out of three indicators assessed were associated with quality of life. Therefore, it is important to select sensitive indicators to be able to identify and better comprehend this relationship

Self-assessed masticatory function and frailty in Brazilian older adults: the FIBRA Study

ABSTRACT OBJETIVE To investigate the relationship between the masticatory function and the frailty of older people. METHODS Exploratory cross-sectional study using secondary data from the FIBRA Project on the frailty conditions of older people living in urban areas of six Brazilian municipalities, from 2008 to 2009. The population consisted of older adults aged 65 and over with no cognitive impairment. A single session identification questionnaire and the Mini-Mental State Examination (MMSE) were applied, followed by collecting sociodemographic data and data on the participants' self-assessment of masticatory function, general health, and oral health. RESULTS 2,341 older people (164 frail older adults), of whom 63.2% reported not having seen a dentist in the last year, and approximately 26% of them had three or more functional feeding problems. Older participants (OR = 2.88; 95%CI: 2.01-4.13), who are retired (OR = 2.31; 95%CI: 1.18-5.53), those who were depressed (OR = 2.31; 95%CI: 1.58-3.38), and those who self-assessed their general health as worse compared to others of the same age (OR = 3.91; 95%CI: 2.39-6.40) were at higher risk of frailty. Three or more problems related to the functional aspects of mastication were associated with a greater chance of frailty (OR = 2.06; 95%CI: 1.25-3.41). CONCLUSION This study found an association between masticatory function and a greater chance of frailty among the studied population.

Perda de função mastigatória e risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo / Masticatory function loss and frailty risk in community-dwelling older people in the State of São Paulo

Resumo Objetivo Verificar se a perda de função mastigatória aumenta o risco de fragilidade em idosos vivendo em domicílios familiares no Estado de São Paulo. Métodos Foi adotado um delineamento de coorte prospectivo sobre a base de dados do estudo FIBRA (Fragilidade em Idosos Brasileiros), com linha de base realizada em 2008-2009 e seguimento em 2016-2018, transcorrendo em média 100,2 ± 9,2 meses. A variável desfecho foi a incidência de fragilidade, a variável de exposição foi a função mastigatória conforme a condição de edentulismo e autorrelato de dificuldade mastigatória. As variáveis de ajuste foram condições sociodemográficas, comportamentais e de saúde geral. Foi utilizado um modelo de regressão de Poisson, com variância robusta, estimando o risco relativo Resultados a incidência acumulada de fragilidade aos oito anos em média foi de 30 casos a cada 100 participantes edêntulos com dificuldade mastigatória, que apresentaram maior risco de desenvolver fragilidade (RR:1,75 IC 95% 1,09-2,81) do que os idosos dentados sem dificuldade mastigatória, independentemente de tabagismo (RR: 1,71 IC 95% 1,07-2,73) e de condição socioeconômica (RR: 1,72 IC 95% 1,13-2,62). Conclusão A perda de função mastigatória aumentou o risco de fragilidade em idosos.Futuras pesquisas deverão estudar se a reabilitação da função mastigatória contribui para diminuir esse risco.

Abstract Objective To verify if the loss of masticatory function increases the risk of frailty in community-dwelling older people in the state of São Paulo. Methods A prospective cohort design was adopted based on the FIBRA study database (Fragility in Brazilian Elderly), with a baseline performed in 2008-2009 and follow-up in 2016-2018, elapsed on average 100.2 ± 9.2 months. The outcome variable was the incidence of frailty. The exposure variable was masticatory function according to edentulism and self-reported chewing difficulty. Adjustment variables were sociodemographic, behavioral, and general health conditions. A Poisson regression model with robust variance was used to estimate the relative risk. Results the cumulative incidence of frailty over eight years was 30 cases per 100 edentulous participants with chewing difficulties, who had a higher risk of developing frailty (RR: 1.75 95% CI 1.09-2.81) than the dentate elderly without chewing difficulties, regardless of smoking (RR: 1.71 95% CI 1.07-2.73) and socioeconomic status (RR: 1.72 95% CI 1.13-2.62) Conclusion Loss of masticatory function increases the risk of frailty in older people. Future research should study whether the rehabilitation of oral function reduces this risk.

Oral health and Obesity in Brazilian elders: A longitudinal study.

OBJECTIVES: Obesity is an important risk factor for chronic diseases and can also result in greater mortality. The aim of this longitudinal study was to investigate whether poor oral health acts as a risk factor for obesity as indicated by body mass index (BMI) and waist circumference (WC). METHODS: We included in this analysis all participants who volunteered in a cohort study entitled 'Carlos Barbosa Cohort Study-CBCS' in the city of Carlos Barbosa, Southern Brazil. The interview questionnaire comprised socio-demographic information, behavioural questions and medical history. Oral examinations and anthropometric assessments were carried out. The outcome was obesity measured by both BMI (≥30 kg/m2 ) and WC (>0.80 for women and >0.94 for men). Variables were collected longitudinally. Those associated with the outcome and epidemiologically relevant to the conceptual framework participated in the analysis and were adjusted for socio-demographic, behavioural, general and oral health conditions. RESULTS: Six hundred and thirty-three independently living elders participated. The baseline mean age was 67.5 ± 6.1 years. Individuals who never visited a dentist (OR = 3.02, 95% CI: 1.25-7.26) as well as participants who needed a dental prosthesis in the lower arch (OR = 4.38, 95% CI: 1.34-14.32) were more likely to be obese, through BMI and WC measures, respectively. Edentulous participants with complete dentures in both arches (OR = 0.23, 95% CI: 0.06-0.84) and those who perceived their oral health as unsatisfactory (OR = 0.41, 95% CI: 0.19-0.88) had a lower likelihood of being obese, according to BMI and WC measures. CONCLUSIONS: Older persons with poor oral health may be at risk for general and central obesity, a relationship that may have important clinical implications.

Self-rated general and oral health and associated factors in independently-living older individuals.

The aim of this study was to verify the association between sociodemographic, general health, and oral health data with self-rated general health (SRGH) and self-rated oral health (SROH) in independent-living older Brazilians. This cross-sectional study was part of a larger study with older individuals living independently in the city of Campinas, Brazil - the "Rede FIBRA" Study (the Frailty in Brazilian Elderly Study). A random sample of 688 older individuals responded the SRGH and 673, the SROH. SRHG and SROH were both assessed using a single item. The questionnaire included sociodemographic, general, and oral health data. The mean age was 72.28 ± 5.4 years. The adjusted analysis revealed that the probability of rating general health as bad was higher for illiterate participants (PR: 1.77, 95%CI: 1.13-2.77) or with low educational level (PR: 1.76, 95%CI: 1.17-2.65), those with depressive symptoms (PR: 1.45, 95%CI:1.21-1.74), participants that self-reported food limitation due to problems with denture or lack of it (PR: 1.29, 95%CI: 1.05-1.56), and those with xerostomia (PR 1.40, 95%CI: 1.17-1.67). The probability of rating general health as bad was lower for participants that presented 0-2 chronic diseases (PR: 0.64, 95%CI: 0.53-0.78) and were pre-frail (PR: 0.76, 95%CI: 0.61-0.96). With regard to SROH, the probability of rating oral health as bad was higher for participants with natural teeth (PR:1.61, 95%CI: 1.24-2.08), that reported xerostomia (PR: 1.44, 95%CI: 1.13-1.84), and food limitation due to problems with denture or lack of it (PR: 1.43, 95%CI: 1.07-1,91), and lower for participants that reported having enough money to cover daily expenses (PR: 0.78, 95%CI: 0.61-0.99). Oral health data and income seem to be related to self-perceptions of general and oral health.

Perceived discrimination in health services and preventive dental attendance in Brazilian adults.

OBJECTIVES: It is evident that discriminatory attitudes affect different dimensions of personal life, including health. This study aimed to verify the association between perceived discrimination in health services and preventive dental attendance in Brazilian adults. METHODS: This cross-sectional study used secondary data from the 2013 National Health Survey (PNS), a representative survey of the Brazilian population. The response rate was 91.9%, with 60,202 adults agreeing to complete the oral health self-perception questionnaire. Data were analysed using the software STATA 14.0. A descriptive sample analysis was conducted that considered sample weight as well as an association between health discrimination and factors associated with preventive dental attendance through Poisson regression models. RESULTS: Adjusted analysis demonstrated that, regarding the reasons that led to discrimination, lack of money, social class and type of working occupation showed a negative association with preventive dental attendance. CONCLUSION: Our findings show that discrimination perpetuates health inequities. Those with worse social conditions need more assistance as they struggle with discrimination and end up going for a check-up after the disease is established or advanced. Preventive care, which could change the health condition of the disadvantaged population, is often a reality only for those less vulnerable.

Avaliação dos serviços de saúde bucal na atenção primária à saúde: perspectivas regionais com base no PMAQ / Evaluation of oral health services in primary health care: regional perspectives based on PMAQ / Evaluación de los servicios de salud bucal en la atención primaria de salud: perspectivas regionales basadas en PMAQ

Objetivo:O objetivo do estudo foi analisar o perfil epidemiológico da assistência odontológica dos municípios da 4ª Coordenadoria Regional de Saúde do Rio Grande do Sul (4ª CRS/RS) a partir dos dados gerados no 2ª ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). Metodologia:Trata-se de um estudo observacional transversal utilizando como instrumento os microdados da avaliação externa do PMAQ-AB divididos nas dimensões de estrutura das unidades básicas, processo de trabalho das equipes de atenção à saúde bucal e usuários do serviço. Dos 32 municípios pertencentes à 4ª CRS/RS, 21 aderiram ao programa e fazem parte deste estudo, sendo que estes sãodivididos em duas regiões de saúde. Esse estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Santa Maria e a análise estatística dos dados foi realizada através do programa Stata 14.0, onde foram realizadas análises de frequência para variáveis selecionadas. Resultados:Participaram da avaliação 56 Unidades de Atenção Básica, 44 equipes de saúde bucal e 261 usuários do serviço de atenção básica e com isso observamos que, apesar da maioria das unidades possuírem atendimento odontológico com agendamento e capacidade de resolução dos casos, a maioria dos usuários não o utilizam. Conclusão:Com estes resultados almejamos desencadear processos que tragam melhorias para as unidades, equipes e usuários da atenção básica no que tange o planejamento, organização e cuidado em saúde e concluímos que este tipo de avaliação se mostra importante para o desenvolvimento de ações de saúde pública. (AU)

Objective: The aim of this study was to analyze the epidemiological profile of dental attendance of the municipalities of the 4th Regional Health Coordination of Rio Grande do Sul (4th CRS/RS) from the data generated in the 2nd cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB). Methods: This is an observational cross-sectional study using microdata of the external evaluation of PMAQ-AB divided into the structure dimensions of the basic units, work process of the oral health care teams and service users. Of the 32 municipalities belonging to the 4th CRS/RS, 21 joined the program and are part of this study, and these are divided into two health regions. This study was approved by the Research Ethics Committee of the Federal University of Santa Maria and the statistical analysis of the data was performed using the software Stata 14.0, where frequency analyzes were performed for selected variables. Results: Participated in this evaluation 56 Primary Care Units, 44 oral health teams and 261 users of the primary care service. Thus, despite the fact that most units have dental care with programming and resolution of cases, most users do not use it. Conclusion: With these results we intention to provoke processes that bring improvements to primary care units, teams and users regarding planning, organization and health care and we conclude that this type of evaluation is important for the development of public health actions. (AU)

Objetivo: El objetivo del estudio fue analizar el perfil epidemiológico de la atención odontológica de los municipios de la 4ta Coordinación Regional de Salud de Rio Grande do Sul (4to CRS/RS) a partir de los datos generados en el 2do ciclo del Programa Nacional de Mejora del Acceso y Calidad de la Atención Primaria (PMAQ-AB). Metodología: Este es un estudio observacional transversal de evaluación externa de PMAQ-AB divididos en las dimensiones de la estructura de las unidades básicas, el proceso de trabajo de atención de la salud bucal y los usuarios del servicio. De los 32 municipios que pertenecen al 4to CRS/RS, 21 se unieron al programa. Este estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Federal de Santa María y el análisis estadístico de los datos se realizó utilizando el programa Stata 14.0, donde se realizaron análisis de frecuencia para variables seleccionadas. Resultados: Participaron en la evaluación 56 Unidades de Atención Primaria, 44 equipos de salud bucal y 261 usuarios del servicio, a pesar de que la mayoría de las unidades tienen atención dental con programación y resolución de casos, la mayoría de los usuarios no lo usan. Conclusión: Con estos resultados, nuestro objetivo es desencadenar procesos que traigan mejoras a las unidades de atención primaria, los equipos y los usuarios con respecto a la planificación, la organización y la atención médica y odontológica y concluimos que este tipo de evaluación es importante para el desarrollo de acciones de salud pública. (AU)

Baixa cobertura de saúde bucal: como potencializar o cuidado? / Low oral health coverage: how to improve care? / Un informe de experiencia del proyecto de extensión de cuidado dental vinculado al sistema único de salud de Brasil

Objetivo:Este estudo trata-se de um relato de experiência acerca de um programa da prefeitura da cidade de Santa Maria, sul do Brasil, vinculado à um projeto de extensão denominado Sorria Santa Maria que teve seu início em 2017 e permanece em andamento. Nosso objetivo com isso foi, além de contribui com os usuários que têm dificuldade em acessar os atendimentos odontológicos na atenção básica, promover e demonstrar as práticas em saúde coletiva, construídas em diferentes processos de trabalho e estreitamente ligadas a estruturas da sociedade.Relato de experiência:O programa destina-se aos usuários do Sistema Único de Saúde do município que não conseguem acessar as Unidades Básicas de Saúde, devido à baixa cobertura de saúde bucal municipal e às funções profissionais exercidas durante horário comercial pelos usuários. Os agendamentos são realizados segundo uma lista de espera com o contato de pacientes que manifestaram desejo de uma avaliação odontológica. Nas consultas, realiza-se então acolhimento, avaliação e atendimento destes pacientes até a conclusão do plano de tratamento. Conclusão:Importantes impactos foram alcançados até o presente momento, tanto em relação ao expressivo número de atendimentos odontológicos realizados quanto à redução das listas de espera para atendimento odontológico. Além disto, ressaltam-se que as ações de promoção de saúde ligadas ao projeto resultamem uma maior integração entre ensino-serviço-comunidade no município. (AU)

Objective: This study is an experience report about an extension project linked to a program of the city of Santa Maria, southern Brazil, called Sorria Santa Maria that started in 2017 and remains in progress. Our aim with this was, in addition to contributing with the users who have difficulty accessing dental attendance in primary care, promoting and demonstrating collective health practices, built on different work processes and closely linked to societal structures. Experience report: The program is intended for users of the municipality's Unified Health System who cannot access the Basic Health Units, due to the low coverage of municipal oral health and the professional functions performed during business hours by users. Arranges are made according to a waiting list with the contact of patients who expressed the desire for a dental evaluation. In consultations, these patients are welcomed, evaluated and treated until the treatment plan is completed. Conclusion: Important impacts have been achieved until now, both in relation to the significant number of dental cares, provided and the reduction of waiting lists for dental attendance. In addition, the health promotion actions linked to the project result in greater integration between teaching-service-community in the municipality. (AU)

Objetivo: Este estudio es un informe de experiencia sobre un proyecto de extensión vinculado a un programa de la ciudad de Santa María, sur de Brasil, llamado Sorria Santa María, que comenzó en 2017 y sigue en progreso. Nuestro objetivo con esto era, además de contribuir a los usuarios que tienen dificultades para acceder a la atención dental en la atención primaria, promover y demostrar prácticas colectivas de salud, basadas en diferentes procesos de trabajo y estrechamente vinculados a las estructuras sociales. Informe de experiencia: El programa está destinado a usuarios del Sistema de Salud Unificado de la municipalidad que no pueden acceder a las Unidades Básicas de Salud, debido a la baja cobertura de salud bucal municipal y las funciones profesionales realizadas por los usuarios durante el horario comercial. Los horarios se hacen de acuerdo con una lista de espera con el contacto de pacientes que expresaron el deseo de una evaluación dental. En las consultas, estos pacientes son bienvenidos, evaluados y tratados hasta que se completa el plan de tratamiento. Conclusión: Hasta ahora se han logrado impactos importantes, tanto en relación con el número significativo de atención dental brindada como con la reducción de las listas de espera para la atención dental. Además, es digno de mención que las acciones de promoción de la salud vinculadas al proyecto dan como resultado una mayor integración entre la comunidad de servicios de enseñanza en el municipio. (AU)

Self-rated general and oral health and associated factors in independently-living older individuals

Abstract The aim of this study was to verify the association between sociodemographic, general health, and oral health data with self-rated general health (SRGH) and self-rated oral health (SROH) in independent-living older Brazilians. This cross-sectional study was part of a larger study with older individuals living independently in the city of Campinas, Brazil - the "Rede FIBRA" Study (the Frailty in Brazilian Elderly Study). A random sample of 688 older individuals responded the SRGH and 673, the SROH. SRHG and SROH were both assessed using a single item. The questionnaire included sociodemographic, general, and oral health data. The mean age was 72.28 ± 5.4 years. The adjusted analysis revealed that the probability of rating general health as bad was higher for illiterate participants (PR: 1.77, 95%CI: 1.13-2.77) or with low educational level (PR: 1.76, 95%CI: 1.17-2.65), those with depressive symptoms (PR: 1.45, 95%CI:1.21-1.74), participants that self-reported food limitation due to problems with denture or lack of it (PR: 1.29, 95%CI: 1.05-1.56), and those with xerostomia (PR 1.40, 95%CI: 1.17-1.67). The probability of rating general health as bad was lower for participants that presented 0-2 chronic diseases (PR: 0.64, 95%CI: 0.53-0.78) and were pre-frail (PR: 0.76, 95%CI: 0.61-0.96). With regard to SROH, the probability of rating oral health as bad was higher for participants with natural teeth (PR:1.61, 95%CI: 1.24-2.08), that reported xerostomia (PR: 1.44, 95%CI: 1.13-1.84), and food limitation due to problems with denture or lack of it (PR: 1.43, 95%CI: 1.07-1,91), and lower for participants that reported having enough money to cover daily expenses (PR: 0.78, 95%CI: 0.61-0.99). Oral health data and income seem to be related to self-perceptions of general and oral health.

Factors associated with hyposalivation and xerostomia in older persons in South Brazil.

OBJECTIVE: This study aimed to investigate characteristics associated with xerostomia and hyposalivation in older persons. BACKGROUND: Saliva is one of the most important body fluids and plays an important role in food bolus formation, lubricating the oral mucosa and protecting teeth against demineralisation. MATERIALS AND METHODS: This is a cross-sectional study nested within a cohort and includes a sample of 872 older persons living independently in the community, both in rural and urban areas in Carlos Barbosa, Brazil. Data collection included standardised interviews to identify sociodemographic, behavioural and health-related variables, as well as oral clinical examination performed by two trained/calibrated dentists. Poisson regressions with robust variance were used to calculate the crude and adjusted prevalence ratios (PR) and their respective 95% confidence intervals. RESULTS: The mean age was 68.5 ± 6.7 years, and the majority of the sample consisted of women (65.3%). The prevalence of xerostomia, of low stimulated salivary flow rate and low at rest salivary flow rate were 338 (38.8%), 494 (56.6%), 320 (36.7%), respectively. In the final adjusted model, women had a significantly increased prevalence of xerostomia (PR = 1.34; 95% CI: 1.12-1.61), as well as participants taking medication continuously (PR = 1.45; 95% CI: 1.16-1.82) and those with depressive symptoms (PR = 1.49; 95% CI: 1.27-1.76). Lower at rest (PR = 1.45, 95% CI: 1.22-1.72) and lower stimulated salivary flow were more prevalent in women (PR = 1.27, 95% CI: 1.11-1.44), while lower stimulated salivary flow was more prevalent in older persons taking medication continuously (PR = 1.24, 95% CI: 1.07-1.43). CONCLUSION: Salivary hypofunction and xerostomia were more prevalent in women and in those with continuous medication use; however, depressive symptoms were associated only with xerostomia. Measures are required to promote oral comfort in cases of xerostomia, thereby reducing the unpleasant sensation of dry mouth and hyposalivation consequences in clinical practice.

Validity of self-report of oral conditions in older people

Aim: To verify if self-report is a valid instrument to study the clinical oral condition in older people without cognitive deficit. Methods: A Cross-sectional study was conducted with 647 older people from the community, without cognitive deficit, living in Campinas, Brazil. A self-report questionnaire assessing the presence or absence of teeth (edentulism) and use of complete denture was applied, identifying the location of the denture, whether in the upper and/or lower arch. In the same session oral clinical exams were performed, considered the gold standard. The self-report validation was performed by calculating sensitivity, specificity, predictive values, odds ratios and Kappa agreement. Results: There were high percentages of sensitivity (95­99%), specificity (84­97%), positive (81­97%) and negative (95­98%) predictive values, obtaining an elevated level of confidence and quality intrinsic value of self-report. Agreement with the clinical examination was excellent for all variables (greater than 0.80). The likelihood ratios showed compelling evidence that with self-report an edentulous individual (+LR 32), non-edentulous (-LR 0.06) and absence of complete denture (-LR 0.01) could be correctly identified, with moderate evidence to identify the presence and location of complete denture use (+LR 6.5 to 6.9). Conclusion: Self-report is a valid instrument to study the clinical oral condition in the older people of the community

[Self-perceived oral health status, chewing ability and longevity in the elderly]. / Condição de saúde bucal autopercebida, capacidade mastigatória e longevidade em idosos.

The scope of this article is to assess the oral health conditions and self-perceived chewing ability among the elderly seniors (≥ 80 years). Data from the FIBRA multicentric study were used. The sample consisted of 2,341 individuals with no cognitive impairment, aged ≥ 65 years, between 2008 and 2009, where the elderly were subjected to data collection. Regarding the outcome, age was dichotomized into 65-79 and 80 and over. The association between longevity and the socio-demographic and behavioral variables, general and oral health and self-perceived chewing ability was assessed by Poisson regression. Complete data are now available for 2,126 seniors. The mean age was 70.91 (SD =± 4.11) years among the young elderly and 82.70 (SD =± 2.61) among the elderly seniors. The sample of individuals aged ≥ 80 years was 11.7%. Low education, single marital status and lack of work were associated with longevity, as well as self-reporting of having no natural teeth and difficulty or pain when chewing hard foods. The results suggest an association between longevity with sociodemographic characteristics and oral health.

O objetivo deste artigo é verificar a condição bucal e a capacidade mastigatória autopercebidas em idosos longevos (≥ 80 anos). Foram utilizados dados do estudo multicêntrico FIBRA. A amostra foi composta por 2.341 indivíduos com ausência de déficit cognitivo, com idade ≥ 65 anos, no período entre 2008 e 2009, quando os idosos foram submetidos à coleta de dados. Quanto ao desfecho, a idade foi dicotomizada em 65-79 e 80 anos ou mais. A associação entre longevidade e as variáveis sociodemográficas, comportamentais, de saúde geral e bucal e a capacidade mastigatória autopercebida foram avaliadas pela regressão de Poisson. Dados completos disponíveis para 2.126 idosos. A idade média foi 70,91 (DP = ±4,11) anos entre os idosos jovens e 82,70 (DP = ±2,61) entre os longevos. A amostra de idosos com idade ≥ 80 anos foi de 11,7%. Baixa escolaridade, estado civil solteiro e ausência de trabalho estiveram associados à longevidade, assim como autorrelato de não possuir dentes naturais e dificuldade ou dor ao mastigar alimentos duros. Os resultados sugerem a associação entre longevidade com características sociodemográficas e de saúde bucal.

Condição de saúde bucal autopercebida, capacidade mastigatória e longevidade em idosos / Self-perceived oral health status, chewing ability and longevity in the elderly

Resumo O objetivo deste artigo é verificar a condição bucal e a capacidade mastigatória autopercebidas em idosos longevos (≥ 80 anos). Foram utilizados dados do estudo multicêntrico FIBRA. A amostra foi composta por 2.341 indivíduos com ausência de déficit cognitivo, com idade ≥ 65 anos, no período entre 2008 e 2009, quando os idosos foram submetidos à coleta de dados. Quanto ao desfecho, a idade foi dicotomizada em 65-79 e 80 anos ou mais. A associação entre longevidade e as variáveis sociodemográficas, comportamentais, de saúde geral e bucal e a capacidade mastigatória autopercebida foram avaliadas pela regressão de Poisson. Dados completos disponíveis para 2.126 idosos. A idade média foi 70,91 (DP = ±4,11) anos entre os idosos jovens e 82,70 (DP = ±2,61) entre os longevos. A amostra de idosos com idade ≥ 80 anos foi de 11,7%. Baixa escolaridade, estado civil solteiro e ausência de trabalho estiveram associados à longevidade, assim como autorrelato de não possuir dentes naturais e dificuldade ou dor ao mastigar alimentos duros. Os resultados sugerem a associação entre longevidade com características sociodemográficas e de saúde bucal.

Abstract The scope of this article is to assess the oral health conditions and self-perceived chewing ability among the elderly seniors (≥ 80 years). Data from the FIBRA multicentric study were used. The sample consisted of 2,341 individuals with no cognitive impairment, aged ≥ 65 years, between 2008 and 2009, where the elderly were subjected to data collection. Regarding the outcome, age was dichotomized into 65-79 and 80 and over. The association between longevity and the socio-demographic and behavioral variables, general and oral health and self-perceived chewing ability was assessed by Poisson regression. Complete data are now available for 2,126 seniors. The mean age was 70.91 (SD =± 4.11) years among the young elderly and 82.70 (SD =± 2.61) among the elderly seniors. The sample of individuals aged ≥ 80 years was 11.7%. Low education, single marital status and lack of work were associated with longevity, as well as self-reporting of having no natural teeth and difficulty or pain when chewing hard foods. The results suggest an association between longevity with sociodemographic characteristics and oral health.