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1.
Artigo em Inglês | MEDLINE | ID: mdl-32987661

RESUMO

The aim of the study was to evaluate the impact of the coronavirus pandemic on the willingness, anxiety and concerns of Italian people on undergoing dental appointments. An anonymous survey was posted online on social media on 11 May 2020 and was completed by 1003 respondents in one week. Multiple correspondence analysis and multiple logistic regression were used to evaluate the association between socio-demographic characteristics, dental care access, contagion fear of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), trust in dentists regarding sanitization procedures and perception of the impact of the risk of contagion on dental care. Subjects with a high level of education, attending public dental offices and that are used to go to dental offices for urgent care would not feel comfortable in undergoing a dental appointment and would prefer to postpone or cancel dental visits, waiting for a decrease in the number of the contagions. Moreover, the risk of canceling or postponing the appointment at the dentist was 1.59 times greater in those who claimed to be strongly influenced by SARS-CoV-2. Fear of coronavirus disease (COVID-19), new cases decrease and the not urgent nature of dental visits influenced more than the lowered income household on upcoming or resuming dental appointments. In the next months, despite the forecasted economic crisis caused by coronavirus pandemic, fear and anxiety generated by the spread of the virus will impact more than the lowered familiar income with regards to access to dental care.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência Odontológica/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Ansiedade , Betacoronavirus , Humanos , Itália/epidemiologia , Pandemias , Fatores Socioeconômicos
3.
Med Care ; 58(8): 749-755, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32692142

RESUMO

BACKGROUND: Low-income adults in the United States have historically had poor access to dental services largely due to limited dental coverage. OBJECTIVE: We examined the effects of recent Medicaid income-eligibility expansions under the Affordable Care Act on dental visits separately for preventive care and treatments. RESEARCH DESIGN: We used restricted data from the 2011 to 2016 Medical Expenditure Panel Survey with state geocodes. The main analytical sample included nearly 21,000 individuals who were newly eligible for Medicaid. We employed a quasi-experimental difference-in-differences design to identify the impact of the state Medicaid expansions effective in 2014 on dental services use by the level of state Medicaid dental benefit for the newly eligible. RESULTS: Expanding Medicaid in 2014 with extensive or limited dental coverage increased preventive dental visits and use of major dental treatments by over 5 percentage-points in 2014 and 2015. The increase in preventive visits continued in 2016 in expanding states with extensive coverage, while increase in major dental treatments continued in 2016 in expanding states with limited coverage. There is some but less consistent evidence of an increase in dental treatment with emergency-only coverage. CONCLUSIONS: Medicaid expansions with dental coverage beyond emergency-only services have increased access of the newly eligible low-income adults to dental treatments and preventive services, with extensive coverage showing continuing increase in preventive services use 3 years after the expansion. With limited coverage, there is some evidence of individuals needing to stretch treatments over a longer period. Providing comprehensive dental coverage can address unmet dental needs and improve oral health among low-income adults.


Assuntos
Assistência Odontológica/economia , Medicaid/tendências , Patient Protection and Affordable Care Act/tendências , Adulto , Assistência Odontológica/métodos , Assistência Odontológica/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Medicaid/estatística & dados numéricos , Pessoa de Meia-Idade , Patient Protection and Affordable Care Act/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
4.
Br J Oral Maxillofac Surg ; 58(7): 834-837, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32631754

RESUMO

An integrated Urgent Dental Care Centre with Tier 2 Oral Surgery support was set up in Blackpool starting 24th March 2020. This was in reaction to the COVID-19 pandemic. In the first month 1433 patients had telephone consultations and 713 extractions were performed. The challenges surrounding set up and continuity of care are discussed.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus , Assistência Odontológica/estatística & dados numéricos , Pandemias , Pneumonia Viral , Telemedicina , Triagem/métodos , Instituições de Assistência Ambulatorial , Infecções por Coronavirus/epidemiologia , Assistência Odontológica/organização & administração , Humanos , Pneumonia Viral/epidemiologia
5.
BMC Oral Health ; 20(1): 185, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615975

RESUMO

BACKGROUND: It is unclear how many community-dwelling elderly (≥75 years) experience oral health problems (e.g. pain, dry mouth, chewing problems) and how they manage their dental care needs. This study aimed to assess self-reported oral health problems in elderly who are frail or have complex care needs, and their ability to organize dental care when reporting oral pain. METHODS: Three thousand five hundred thirty-three community-dwelling elderly participating in the "Embrace" project were asked to complete questionnaires regarding oral status and oral health problems. Frailty was assessed with the Groningen Frailty Indicator (GFI). Intermed for Elderly Self-Assessment (IM-E-SA) was used to determine complexity of care needs. Next, elderly who reported oral pain were interviewed about their oral pain complaints, their need for dental care, and their ability to organize and receive dental care. For statistical analyses Chi2-tests and the one-way ANOVA were used. RESULTS: One thousand six hundred twenty-two elderly (45.9%) completed the questionnaires. Dry mouth (11.7%) and oral pain (6.2%) were most frequently reported. Among the elderly reporting oral pain, most were registered at a local dentist and could go there when needed (84.3%). Robust elderly visited the dentist independently (87%), frail (55.6%) and complex (26.9%) elderly more often required assistance from caregivers. CONCLUSIONS: Dry mouth and oral pain are most reported oral health problems among community-dwelling elderly. Elderly with complex care needs report most oral health problems. In case an elderly seeks dental treatment to alleviate an oral pain complaint, most elderly in this study were able to organize dental care and transport to the dentist. Frail and complex elderly often need assistance from caregivers to visit the dentist. Therefore caretakers should keep in mind that when frailty progresses, visiting a dentist may become more and more difficult and the risk for poor oral health increases.


Assuntos
Assistência Odontológica para Idosos/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Idoso Fragilizado , Avaliação Geriátrica , Serviços de Saúde para Idosos , Humanos , Vida Independente , Autorrelato
6.
Sante Publique ; Vol. 32(1): 87-95, 2020 Jun 18.
Artigo em Francês | MEDLINE | ID: mdl-32706229

RESUMO

CONTEXT: The demography of dentist-surgeons in the Centre-Val de Loire region is far inferior to the national average and characterized by many territorial inequalities of health. The aim of this study is to provide details concerning the dental hygienic care-seeking consumption habits in this region based on one dental care treatment, dental scaling, which allows for the mechanical elimination of dental plaque in order to prevent periodontal diseases. METHOD: This retrospective study is based on data from several databases of the National Health Insurance Cross-Schemes Information System (Sniiram) for the year 2016, analyzed by the Statistical Institute of Liberal Health Professionals. RESULTS: It can be observed that less scaling treatments have been sought out in this region in comparison with metropolitan France and certain territories which also face difficulties in terms of care treatment offers and scaling treatment inferior to the regional average. Although the care offer is unequally distributed, it seems to have little influence on the number of treatment acts consumed per patient and notably scaling treatments. Inversely, indicators of wealth or poverty do have an impact on treatment consumption HBJD001. CONCLUSION: This study suggests that the consumption of scaling treatment is independent from the dental care offers, but linked to the social gradient of the population. It points to the deficit in the consumption of this treatment in comparison to metropolitan France. The potential role of the HBJD001 treatment as a marker of the trajectory of preventive health care as well as the necessity of the adjustment of the zones determined by the ARS are put forward.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Doenças Periodontais/prevenção & controle , Bases de Dados Factuais , França , Humanos , Programas Nacionais de Saúde , Estudos Retrospectivos , Fatores Socioeconômicos
7.
BMC Oral Health ; 20(1): 145, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429976

RESUMO

BACKGROUND: Dental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. In Enugu state, Nigeria, there is minimal access to adequate and proper oral health care. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care. METHOD: This was a mixed-method cross-sectional descriptive urban-rural study conducted in selected oral health facilities offering primary oral health care in Enugu state. The study was conducted in two phases over a 2 month period. Quantitative data was initially collected from all selected oral health care providers using a survey questionnaire format after which qualitative data were collected through in-depth interviews of heads of the selected oral health facilities. The determinants of dental caries treatment services were explored with a focus on provider behavior, cost of dental services, human resource availability and availability of dental equipment. RESULTS: Quantitative findings show that to a larger extent, the cost of raw materials (100%), human resources (98.1%), infection control resources (98.1%), geographical location (98.1), Government policies (88%) and the price of other goods (80.8%) influence provision of dental caries treatment services. Qualitative results show that location and number of oral health facilities, government funding and policies for oral health, cost of dental equipment and materials, the ability of consumers to pay, human resource availability and consumer awareness of oral health are also factors that influence the provision of dental caries treatment services. CONCLUSION: Adequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country's drive to achieve universal health coverage. In order to address this, oral health facilities need to be strategically located and have adequate materials, equipment and skilled staff. There is a need to incorporate oral health into the general health care system and improve government policies and funding for oral health.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/terapia , Serviços de Saúde Bucal/organização & administração , Saúde Bucal/estatística & dados numéricos , Estudos Transversais , Cárie Dentária/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Nigéria/epidemiologia , Atenção Primária à Saúde , Pesquisa Qualitativa , População Rural , População Urbana
8.
Rev Saude Publica ; 54: 37, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32267371

RESUMO

OBJECTIVE: To evaluate if factors related to the mother's previous guidance on her children's dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS: A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children's care in daycare centers or schools and maternal guidance on the child's dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS: The prevalence of regular use was 11.4% (95%CI 7.5-15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38-4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77-9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION: When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Assistência Odontológica/métodos , Educação em Saúde Bucal , Saúde Bucal/educação , Instituições Acadêmicas/estatística & dados numéricos , Adolescente , Adulto , Brasil , Pré-Escolar , Estudos Transversais , Assistência Odontológica/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Relações Mãe-Filho , Saúde Bucal/estatística & dados numéricos , Prevalência , Saúde da População Rural , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
9.
Braz Oral Res ; 34: e029, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236318

RESUMO

The aim of this study was to describe and evaluate access to oral health services among adolescents enrolled in public schools of Campina Grande, Paraíba, Brazil, a large-size municipality in the Northeast of Brazil. An observational, descriptive, analytical, quantitative, and cross-sectional study was carried out through a school survey, in which four validated questionnaires were applied to 438 adolescents aged 12 to 19 years. Data were processed using the SPSS statistical software version 20.0, with bivariate analysis and multivariate analysis through Poisson regression. About 90.9% of adolescents reported having visited the dentist at least once; however, when considering the last 6 months, this percentage fell to 48.4%. Adolescents used private services (50.2%) or the public service (49.8%). About 70.6% of interviewees reported dental treatment (61.1%) as the main reason for seeking the service. Through multivariate analysis, it was observed that the demand for the service was higher among female adolescents (60.5%, p <0.001); the other variables did not present statistically significant differences. In conclusion, the access to oral healthcare services reported by adolescents was good, but there is still a considerable part of this population with no access. Variables that presented significant associated with dental services were gender and toothache history, but only gender remained significant in the multivariate model.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Saúde Bucal , Setor Público , Instituições Acadêmicas , Fatores Sexuais , Inquéritos e Questionários , Odontalgia/epidemiologia , Adulto Jovem
10.
BMC Oral Health ; 20(1): 121, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316958

RESUMO

BACKGROUND: All adults over 17 years of age have access to the Public Dental Service after the Finnish Dental Care Reform in 2001-2002. This study aimed to survey the treatment needs and treatment measures provided for adult patients and changes in these during the period 2001-2013. METHODS: Sing each person's unique identifier, demographic data on dental visits during the period 2001-2013 were collected from municipal databases in five PDS-units covering 320,000 inhabitants. The numbers of visitors, those in need of basic periodontal or caries treatment (CPI > 2 and D + d > 0) were calculated for three age groups. Treatment provided was also calculated in 13 treatment categories. Trend analyses were performed to study changes during the study period. RESULTS: Restorative treatments (968,772; 23.6%), examinations (658,394; 16.1%), radiographs taken (529,875; 12.9%) anaesthesia used (521,169; 12.7%) and emergency treatments (348,229; 8.5%) made up 73.8% of all treatment measures during the entire study period. Periodontal treatment (7.8%) and caries prevention (3.9%) made up a small part of the care provided and prosthetics and treatment of TMJ disorders were extremely uncommon (fewer than 1%). Treatments related to caries (restorative treatment, examinations, endodontics, emergencies, anaesthesia and radiographs) made up 60.4% of the dental personnel's treatment time. During the study period, statistically significant increasing trends were found for radiographs (p < 0.001***), anaesthesia (p = 0.003**) and total number of treatments (p = 0.009**). There was a slight decreasing trend in treatment need among the youngest adults (18-39 years; p = 0.033*). CONCLUSION: Compared with the results of national epidemiological studies, insufficient periodontal treatment is provided and prosthetic treatment is almost totally neglected in the PDS. Rather, adults' dental treatment concentrates on treatment of caries. The unmet needs may be due to tradition, inadequate treatment processes or a lack of resources or failed salary incentives.


Assuntos
Anestesia Dentária , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/terapia , Serviços de Saúde Bucal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Cárie Dentária/epidemiologia , Finlândia/epidemiologia , Humanos , Pessoa de Meia-Idade , Saúde Bucal , Resultado do Tratamento
11.
Clin Oral Investig ; 24(5): 1861-1864, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32246280

RESUMO

OBJECTIVES: To assess the status of health services provision of public tertiary dental hospitals during the COVID-19 epidemic in China and to evaluate the regional difference of telehealth. MATERIALS AND METHODS: The health services provision of public tertiary dental hospitals in China mainland during the COVID-19 epidemic was inquired. The status of non-emergency dental services, emergency dental services, and online professional consultation and the hospitals' geographical distribution were recorded and analyzed. RESULTS: All the 48 public tertiary dental hospitals suspended general non-emergency dental treatment while providing emergency dental services only. Ninety percent of them notified the change of dental services online, and 69% of them offered free online professional consultations. The penetration rate of online technology was significantly higher in the eastern region than that of the central and western regions. CONCLUSIONS: There was a significant change in the health service provision of Chinese public tertiary dental hospitals during the COVID-19 epidemic and wider use of telehealth in the eastern region. CLINICAL RELEVANCE: This report demonstrated that dental health services were significantly affected by the COVID-19 epidemic in China, which might lead to a long-time impact on dental care in the future.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Assistência Odontológica , Serviços Médicos de Emergência , Pandemias , Pneumonia Viral , Centros de Atenção Terciária , China , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Assistência Odontológica/normas , Assistência Odontológica/estatística & dados numéricos , Humanos , Pneumonia Viral/epidemiologia , Consulta Remota
12.
BMC Oral Health ; 20(1): 124, 2020 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321493

RESUMO

BACKGROUND: Dental sealants have been covered by the National Health Insurance Service (NHIS) since December 2009 in South Korea. This study aims to determine whether the socioeconomic inequality in untreated dental caries decreased after implementing the extended coverage policy for dental sealant. METHODS: The data were derived from the fourth (2007-2009) and sixth (2013-2015) waves of the Korean National Health and Nutrition Examination Survey (KNHANES) conducted by the Korea Centers for Disease Control and Prevention (KCDC). Dental caries and sealant experience by income quartiles were tested using the Rao-Scott chi-squared test. In order to examine socioeconomic inequalities and their trends over time, the prevalence ratios (PRs), slope index of inequality (SII), and relative index of inequality (RII) were estimated for each wave and age group. All analyses were conducted using SAS version 9.3. RESULTS: The adjusted PRs of untreated dental caries and sealants in the poorest in the aged 6-11 group were significantly higher and lower, respectively, compared to the most affluent quartile group for the fourth wave; however, all significant differences disappeared for the sixth wave, after the sealant coverage. The gap between the lowest and the highest was similar for the aged 12-18 group but it widened in the untreated dental caries even after the sealant coverage. The statistical significance of the PRs was maintained at the sixth wave for both caries and sealants. Children showed decreases in both SII and RII over time so its significance disappeared. The SII among adolescents decreased over time but the RII of untreated dental caries increased. CONCLUSIONS: This study found that the NHIS coverage expansion of dental care had a positive effect on overall status in dental health among children and adolescents. However, younger children benefited more in terms of inequalities. Our findings indicate that strategies to enhance access to preventive dental services should consider the differential effects for the vulnerable population in terms of socioeconomic status and age from the beginning stage of the policy.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/economia , Cárie Dentária/terapia , Política de Saúde , Acesso aos Serviços de Saúde/economia , Fatores Socioeconômicos , Adolescente , Criança , Cárie Dentária/epidemiologia , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Renda , Masculino , Inquéritos Nutricionais , República da Coreia/epidemiologia , Determinantes Sociais da Saúde
13.
BMC Oral Health ; 20(1): 120, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32312257

RESUMO

BACKGROUND: This study aims to explore the difference in the utilization pattern of dental services among pregnant, post-partum and six-month post-partum women. METHODS: This cross-sectional questionnaire survey was performed at two maternity and child care hospitals in India that primarily cater to middle and low income communities. Data were collected from 3 groups: 1) pregnant women in their first trimester; 2) post-partum women (< 48 h after delivery); and 3) six-month post-partum women. The primary outcome of interest was dental service utilization during pregnancy. Self-perceived oral health (SPOH) was calculated based on the four global dimensions- knowledge, function, quality of life and social. Multiple logistic regression analysis was carried out to assess the effect of each independent variable after adjustment for the effect of all other variables in the model. RESULTS: Responses of 450 (150 pregnant, 150 post-partum and 150 six-month post-partum) women were analyzed (response rate = 72%). Significant differences in the dental attendance pattern was observed between the study groups (p < 0.01). Dental attendance among pregnant and six-month post-partum women were 60 and 75%, respectively, however, only about 15% of the post-partum women reported to have sought dental care within the 6 months prior to the study. Post-partum women had the highest SPOH scores, indicating poor self-perceived oral health, followed by pregnant and then six-month post-partum women, which was statistically significant (p < 0.05). A significantly higher percentage of post-partum women reported to have poor oral and general health, as compared to both, pregnant and six-month post-partum women (p < 0.01). Higher percentage of women reporting 'good' oral and general health had sought dental care compared with others (p < 0.01). After adjusting for all the other variables in the model, women with lower levels of education (ORa = 1.42; 95% CI: 1.01-2.00), women with poor self-perceived oral health (ORa = 1.08; 95% CI: 1.02-1.14) and post-partum women (ORa = 0.15; 95% CI: 0.09-0.24) were found to be less likely to seek regular dental care. CONCLUSION: Pattern of dental service utilization among women in this population varied according to their pregnancy status, level of education and self-perceived oral health.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Criança , Estudos Transversais , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Renda , Índia , Período Pós-Parto , Gravidez , Gestantes , Classe Social , Inquéritos e Questionários
14.
Rev Epidemiol Sante Publique ; 68(2): 83-90, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32111348

RESUMO

BACKGROUND: Older persons comprise a growing proportion of the European population and may have a distinct epidemiological oral profile requiring specific preventive and curative care poorly documented. The objectives of this study were to assess the oral health status of people ≥90 years of age in France, to compare their perceived and observed oral care needs and to investigate the oral problems associated with a low oral health-related quality-of-life (OHRQoL). METHODS: An oral cross-sectional study was performed during the 25th follow-up of a cohort of older persons being followed up prospectively for screening of dementia over a 15-year period in Gironde and Dordogne, France. Clinical oral indices were determined by oral examinations conducted at the participants' place of living. Cohen's Kappa coefficient was used to assess the agreement between perceived and observed oral care needs. Oral problems associated with a low OHRQoL, measured with the Geriatric Oral Health Assessment Index (GOHAI<50) were investigated with logistic regression. Odds ratios (OR) were estimated with their 95% confidence intervals (CI). RESULTS: Data from 90 persons were analysed (76% female; median age=93 years; 20% living in an institution). Plaque and calculus were present in 93% and 58% respectively, of the 74 dentate participants. The mean number of decayed, missing, and filled teeth was 26.5 (±5.3); 66% of the participants had at least one untreated decayed tooth. Among the 85 participants with tooth loss not replaced by a fixed denture, two thirds had a removable dental prosthesis; 84% of these prostheses were considered to be maladapted. Among the 39 participants who felt unable to consult a dentist (43%), lack of transportation was the most frequently cited reason. Although 88% of the participants needed oral care, only 26% perceived that they had such a need (Kappa=0.06). Oral problems associated with a GOHAI<50 were the absence of posterior occluding teeth (OR=7.15; 95%CI=1.53-33.35; P=0.012), feeling of dry mouth (OR=11.94; 95%CI=3.21-44.39; P=0.0002) and oral pain (OR=9.06; 95%CI=1.91-69.00; P=0.033). CONCLUSIONS: Persons ≥90 years of age have considerable preventive and curative dental care needs that impact their quality-of-life but they are rarely aware and lack transportation. NCT04065828.


Assuntos
Assistência Odontológica , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde para Idosos , Doenças da Boca/terapia , Saúde Bucal , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Atitude Frente a Saúde , Estudos de Coortes , Estudos Transversais , Assistência Odontológica/normas , Assistência Odontológica/estatística & dados numéricos , Feminino , França/epidemiologia , Avaliação Geriátrica , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde para Idosos/organização & administração , Serviços de Saúde para Idosos/normas , Serviços de Saúde para Idosos/estatística & dados numéricos , Nível de Saúde , Humanos , Masculino , Doenças da Boca/epidemiologia , Doenças da Boca/prevenção & controle , Saúde Bucal/normas , Saúde Bucal/estatística & dados numéricos , Medicina Preventiva/normas , Medicina Preventiva/estatística & dados numéricos , Qualidade de Vida , Perda de Dente/epidemiologia
15.
BMC Oral Health ; 20(1): 73, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32183780

RESUMO

BACKGROUND: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. METHODS: This was a multilevel cross-sectional study with data from 9564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. RESULTS: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. CONCLUSIONS: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Saúde Bucal , Perda de Dente , Adulto , Brasil , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Análise Multinível , Fatores Socioeconômicos
16.
Braz Oral Res ; 34: e011, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130361

RESUMO

Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided.


Assuntos
Recursos Humanos em Odontologia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Assistência Odontológica/estatística & dados numéricos , Serviços de Saúde Bucal/normas , Recursos Humanos em Odontologia/educação , Odontólogos/educação , Educação a Distância/métodos , Educação a Distância/estatística & dados numéricos , Feminino , Humanos , Masculino , Saúde Bucal , Atenção Primária à Saúde/métodos , Valores de Referência , Inquéritos e Questionários , Telemedicina/métodos , Fatores de Tempo
17.
Cien Saude Colet ; 25(2): 673-682, 2020 Feb.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32022207

RESUMO

The aim of this study was to describe and analyze history of toothache and associated factors among adolescent students enrolled in public schools of a city in Northeastern Brazil. An observational, descriptive, quantitative and cross-sectional study was conducted through the application of 4 questionnaires with 458 adolescents. By bivariate analysis, the prevalence of toothache in life was higher among younger adolescents (76.9%; p = 0.004), who have visited the dentist at least once (74.8%; p = 0.001) and who reported fear (74.9%; p = 0.006). The occurrence of dental pain in the last 6 months was low, where male (77.4%; p = 0,001) and older adolescents (73.1%; p = 0.031) reported no occurrence of pain. Through multivariate analysis, the highest prevalence of dental pain in life remained among younger adolescents (76.9%; p = 0.003) and who reported dental fear (74.9%; p = 0.006). The prevalence of toothache in the last 6 months remained low through multivariate analysis, among male and older adolescents. It could be concluded that the prevalence of toothache in life was higher than in the last 6 months, showing significant association with gender, age, visit to the dentist and dental fear.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Assistência Odontológica/estatística & dados numéricos , Odontalgia/epidemiologia , Adolescente , Fatores Etários , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
18.
Qual Life Res ; 29(6): 1621-1630, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32020562

RESUMO

PURPOSE: The aim of this cross-sectional study was to examine the oral health-related quality of life (OHRQoL) in patients after heart transplantation (HTx) and those with heart failure (HF). METHODS: In total, 186 participants (HTx: 104, HF: 82) were recruited from the University Department for Cardiac Surgery, Leipzig Heart Centre, Germany. OHRQoL was assessed with the German short form of the oral health impact profile (OHIP-G14). Health-related quality of life (HRQoL) was evaluated using the short form 36 survey (SF-36). Furthermore, the dental and periodontal treatment need was recorded. RESULTS: With an OHIP-G14 sum score of 6.58 ± 6.40 [5; 2.5-8] in the HTx group and 5.54 ± 5.47 [5; 2-7] in the HF group, no clinically relevant or statistically significant difference was apparent (p = 0.39). The SF-36 scales for physical functioning, role-physical, general health and vitality were significantly worse in the HF group compared with the HTx group (pi < 0.01). A worse SF-36 physical component summary was significantly associated with a higher OHIP-G14 sum score (HTx: p < 0.01, HF: p = 0.04). In the HTx group, a significant association was also observed for the mental component summary (p < 0.01). Multiple regression analysis revealed physical component summary (p = 0.04) and mental component summary (p < 0.01) in HTx, and physical component summary (p = 0.02), mental component summary (p = 0.02) and smoking (p < 0.01) as significant predictors for OHIP G14 in HF. CONCLUSION: The OHRQoL in HF and HTx patients appears to be mainly associated with general HRQoL. Therefore, multidisciplinary dental care concepts may be recommended to improve oral health conditions in these patients.


Assuntos
Insuficiência Cardíaca/psicologia , Transplante de Coração/psicologia , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Adulto , Estudos Transversais , Assistência Odontológica/estatística & dados numéricos , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/terapia , Inquéritos e Questionários
19.
Cien Saude Colet ; 25(2): 533-540, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32022193

RESUMO

The present study aimed to analyze factors associated with access of dental care services by Brazilian hemodialysis patients. A cross-sectional study was carried out with 467 hemodialysis patients aging from 19 to 90 years in two renal therapy centers located in the cities of Contagem and Belo Horizonte, Southeastern Brazil. Data were collected through an oral clinical examination of the patients and the application of a structured questionnaire. The dependent variable was the access to dental care, measured by the question "Have you consulted with a dentist in last six months?". The mean age of participants was 49.9 years. The average number of teeth present in the mouth was 19.3. An average of 1.5 teeth with dental caries cavities lesion was diagnosed among hemodialysis patients. One-third of the sample had gone to the dentist in the last six months (27.8%). The access to dental care was associated with formal education (OR = 1.5 [1.1-2.4]), professional advising to consult with a dentist (OR = 2.1 [1.2-3.8]) and prevalence of dental caries (OR = 2.1 [1.3-3.2]). Hemodialysis patients with eight or more years of formal education, who received professional advising to consult with a dentist and without dental caries cavities had higher chances obtaining access to dental care.


Assuntos
Cárie Dentária/epidemiologia , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Diálise Renal , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Assistência Odontológica/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
20.
Rev Epidemiol Sante Publique ; 68(2): 91-98, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-32089349

RESUMO

BACKGROUND: People with chronic disease often have dental (especially periodontal) disorders. Nevertheless, people with chronic disease seek dental care less often than others. We wanted to know if there is a relationship between the consumption of medical care and the consumption of dental care, and if so if the relationship is especially strong for people with chronic disease. METHODS: We conducted a longitudinal study that combined two data-sets: consumption data from the French National Health Insurance Fund and health and socioeconomic welfare data collected with a dedicated national survey. We studied healthcare expenditure and analyzed the association between healthcare consumption, health status and healthcare expenditure over a four-year period (2010-2013). RESULTS: People who did not seek medical or dental care in 2010 exhibited irregular consumer behavior thereafter. This pattern was particularly evident among those with chronic disease whose healthcare expenditures did not stabilize during the study period compared with the rest of the study population. Among people who did not seek medical care in 2010, variation in average dental care expenditure was 91% in people with chronic disease versus 42% for those without chronic disease. Lack of medical care during the first year of the study was also associated with greater expenditure-delay in people with chronic disease (77%) compared with 15% in people without chronic disease. CONCLUSION: The lack of medical or dental care in 2010 for people with chronic disease did not lead to an increase in medical and dental consumption in the following years. The catch-up delay was longer than four years. This highlights a problem of monitoring and identifies a marginalized population within the healthcare system.


Assuntos
Doença Crônica , Assistência Odontológica/economia , Gastos em Saúde , Acesso aos Serviços de Saúde/economia , Disparidades em Assistência à Saúde/economia , Adulto , Idoso , Doença Crônica/economia , Doença Crônica/epidemiologia , Doença Crônica/terapia , Conjuntos de Dados como Assunto/estatística & dados numéricos , Assistência Odontológica/normas , Assistência Odontológica/estatística & dados numéricos , Feminino , França/epidemiologia , Gastos em Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças da Boca/economia , Doenças da Boca/epidemiologia , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Saúde Bucal/economia , Saúde Bucal/normas , Saúde Bucal/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto Jovem
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