Impact of Oral Conditions and Subjective Factors on Academic Performance

ABSTRACT Objective: To evaluate the influence of oral health clinical and non-clinical indicators on adolescents' academic performance. Material and Methods: A longitudinal design was performed with a random sample of 1,134 12-year-old Brazilian adolescents. In 2012, the adolescents were clinically assessed by calibrated dentists and investigated about demographics, socioeconomic factors, dental service use, toothache, and verbal bullying related to oral condition via structured questionnaires. The contextual variable was obtained from the city's official database. After two years, 771 adolescents were reassessed. The outcome adolescent's academic performance (good or poor) was collected through official school's register. Multilevel logistic regression analyses were performed to assess associated factors for adolescents' academic performance. Results: Adolescents with toothache (OR 1.74; CI 95%: 1.05-2.89), who have been a victim of bullying (OR 2.23; CI 95%: 1.21-4.09), and were male (OR 1.92; CI 95%: 1.19-3.09) had a lower academic performance. On the other hand, adolescents whose mothers had higher educational levels (OR 1.79; CI 95%: 1.08-2.97) and belonged to higher-income households (OR 1.95; CI 95%: 1.18-3.23) had higher academic performance when compared to their peers. Conclusion: Adverse oral conditions, as well as subjective and socioeconomic factors, impacted on adolescents' academic performance.

Binge drinking, alcohol outlet density and associated factors: a multilevel analysis among adolescents in Belo Horizonte, Minas Gerais State, Brazil / Consumo excessivo episódico de álcool, densidade de locais de venda de bebidas alcoólicas e fatores associados: uma análise multinível entre adolescentes em Belo Horizonte, Minas Gerais, Brasil / Consumo de alcohol compulsivo, densidad de locales de venta de alcohol y factores asociados: un análisis multinivel entre adolescentes procedentes de Belo Horizonte, estado de Minas Gerais, Brasil

Our study sought to evaluate the prevalence of binge drinking in adolescents and its association with density of alcohol outlets around schools. This cross-sectional study was conducted in Belo Horizonte, Minas Gerais State, Brazil, with 436 high-school students aged between 17 and 19 and enrolled in 18 public and private schools. The students completed the Alcohol Use Disorder Identification Test (AUDIT-C), consisting of questions about alcohol consumption by parents and siblings, and socioeconomic status (type of school, mother's education level). Data from geographic information systems were used to estimate the density of alcohol outlets around schools participating. The association between exploratory variables and binge drinking was investigated using multilevel logistic regression analysis (p < 0.05) with random intercepts and fixed slopes. A three-step sequential modeling strategy was adopted. The prevalence of binge drinking was 39.9%. The alcohol consumption among adolescents was lower for those studying in areas with low density of alcohol outlets around schools (OR = 0.32; 95%CI: 0.14; 0.73) and the consumption of alcohol by mothers was associated with binge drinking among adolescents (OR = 1.94; 95%CI: 1.14; 3.30). Our study concluded that binge drinking among adolescents was associated with density of alcohol outlets around the schools and mother's alcohol consumption.

O estudo teve como objetivo avaliar a prevalência de consumo excessivo episódico de álcool entre adolescentes e a associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas. Um estudo transversal foi realizado em Belo Horizonte, Minas Gerais, Brasil, com 436 estudantes de segundo grau entre 17 e 19 anos de idade matriculados em 18 escolas públicas e privadas. Os estudantes responderam perguntas do Alcohol Use Disorder Identification Test (AUDIT-C) sobre consumo de álcool pelos pais e irmãos, além de características socioeconômicas (tipo de escola, escolaridade materna). Foram utilizados dados de sistemas de informações geográficas para calcular a densidade de locais de venda de bebidas alcoólicas em torno das escolas participantes. A associação entre variáveis independentes e consumo excessivo episódico de álcool foi investigada por análise de regressão logística multivariada (p < 0,05) com interceptos randômicos e inclinações fixas. Foi adotada uma estratégia de modelagem sequencial em três passos. A prevalência de consumo excessivo episódico de álcool foi de 39,9%. O consumo de álcool entre adolescentes foi mais baixo naqueles que estudavam em áreas com baixa densidade de locais de venda de bebidas alcoólicas em torno das escolas (OR = 0,32; IC95%: 0,14; 0,73), e o consumo de álcool pelas mães esteve associado ao consumo excessivo episódico de álcool pelos adolescentes (OR = 1,94; IC95%: 1,14; 3,30), Em conclusão, consumo excessivo episódico de álcool por adolescentes mostrou associação com a densidade de locais de venda de bebidas alcoólicas no entorno das escolas e com o consumo materno de álcool.

El objetivo de este estudio fue evaluar la prevalencia del consumo compulsivo de alcohol por parte de adolescentes y su asociación con la densidad de establecimientos de venta de alcohol próximos a escuelas. Este estudio transversal se realizó en Belo Horizonte, Minas Gerais, Brasil, con 436 estudiantes de escuelas secundarias con edades comprendidas entre los 17-19 años, inscritos en 18 escuelas públicas y privadas. Los estudiantes completaron con Alcohol Use Disorder Identification Test (AUDIT-C) preguntas sobre el consumo de alcohol por parte de padres y hermanos, así como de su estatus socioeconómico (tipo de escuela, nivel de escolarización de la madre). Los datos del sistema de informaciones geográficas se usaron para calcular la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas participantes. La asociación entre las variables exploratorias y el consumo compulsivo de alcohol fue investigado usando un análisis de regresión logística multinivel (p < 0,05) con intersecciones aleatorias y curvas fijas. Se adoptó una estrategia de modelado secuencial en tres pasos. La prevalencia de consumo compulsivo de alcohol fue de 39,9%. El consumo de alcohol entre adolescentes fue más bajo entre quienes estudiaban en áreas con baja densidad de establecimientos de venta de alcohol alrededor de las escuelas (OR = 0,32; IC95%: 0,14; 0,73), además el consumo de alcohol en madres estuvo asociado con el consumo de alcohol en adolescentes (OR = 1,94; IC95%: 1,14; 3,30). La conclusión fue que el consumo compulsivo de alcohol en adolescentes estaba asociado con la densidad de establecimientos de venta de alcohol en los alrededores de las escuelas y el consumo de alcohol por parte de la madre.

Difference of Socioeconomic Factors among Mothers of Preterm and Full-Term Infant

Abstract Objective: To analyze the difference of socioeconomic factors among mothers of preterm and full-term infants. Material and Methods: A cross-sectional retrospective study was developed with 250 mothers of children aged three to five years. The sample was divided into two groups: 125 mothers of preterm infants from the referral center of a public hospital in the city of Belo Horizonte, Brazil and 125 mothers of children born full-term at a daycare center within the same city. A pre-tested questionnaire was used to collect socioeconomic data and type of breastfeeding. To verify if there was association between the dependent variable gestational age at birth and the independent variables, the chi-square test was used. A final model with multiple Poisson regression estimated prevalence ratio values for each independent variable was developed. Results: The final multiple regression model showed that mothers that have a low monthly income of up to USD 450.28 (PR = 1.979, 95% CI = 1.082-3.620), used drugs, cigarettes, or alcohol during their pregnancy (PR = 4.095, 95% CI = 2.422-6.921), and did not breastfeed (PR = 2.294, 95% CI = 1.205-4.369) were more likely to give birth to preterm infants. Conclusion: Low monthly family income, use of drugs, alcohol, or smoking during pregnancy and absence of breastfeeding were more frequent on mothers of preterm infants.

Influência do grupo de pares e uso de drogas ilícitas entre adolescentes brasileiros: um estudo transversal / Peer group influence and illicit drug use among adolescent students in Brazil: a cross-sectional study / La influencia del grupo y el consumo de drogas ilícitas entre estudiantes adolescentes en Brasil: un estudio transversal

O estudo teve como objetivo examinar o uso de drogas ilícitas e as associações com fatores socioeconômicos e influência do grupo de pares entre adolescentes brasileiros de 15 a 19 anos de idade. Foi adotada uma amostra de clusters em dois estágios, com a seleção aleatória de escolas públicas e privadas entre os nove distritos administrativos de uma capital de estado, e a seleção aleatória de turmas em cada escola. A variável de desfecho foi o uso de drogas ilícitas, medido pela seguinte pergunta: "Você já usou drogas ilícitas (maconha, inalantes, hipnóticos, cocaína/crack, alucinógenos, anfetaminas e/ou opióides) alguma vez na vida?". Os grupos de pares foram classificados como: escola, família, atividades religiosas e esportes/cultura. O nível socioeconômico foi avaliado com o Índice de Vulnerabilidade em Saúde (IVS) baseado em área. Foram analisados os dados de 91 adolescentes com o teste do qui-quadrado e regressão logística. A proporção global de uso de drogas ilícitas foi 15,2%. A heterogeneidade por gênero dentro de grupos (OR = 3,14; IC95%: 1,63-6,06), amizades baseadas em religião (OR = 0,36; IC95%: 0,17-0,75) e amizades baseadas em esportes/cultura (OR = 0,44; IC95%: 0,22-0,87) permaneceram associadas significativamente com o uso de drogas ilícitas. Os adolescentes que residiam em áreas menos vulneráveis mostraram maior probabilidade de uso de drogas ilícitas, quando comparados aos jovens em áreas mais vulneráveis. As amizades baseadas em religião e esportes/cultura parecem ter um efeito protetor contra o uso de drogas ilícitas. A heterogeneidade de gênero dentro de grupos e a residência em áreas menos vulneráveis aumentaram as chances de uso de drogas ilícitas por adolescentes.

The aim of the present cross-sectional study was to examine illicit drug use and associations with socioeconomic factors as well as peer group influence among Brazilian adolescents aged 15 to 19 years. Two-stage cluster sampling was adopted, involving the random selection of public and private schools from the nine administrative districts of a Brazilian state capital and the random selection of classrooms at each school. Illicit drug use was the outcome and was measured through the question: "Have you ever used any illicit drugs (marijuana, inhalants, hypnotics, cocaine/crack, hallucinogens, amphetamines and opioids) in your life?". The most important group of friends was ranked as school, family, religious activities and sports/culture. The area-based Health Vulnerability Index (HVI) was used to assess socioeconomic status. Data from 891 adolescents were analyzed using the chi-squared test and logistic regression. The overall rate of illicit drug use was 15.2%. Gender heterogeneity within groups (OR = 3.14; 95%CI: 1.63-6.06), religion-based friendships (OR = 0.36; 95%CI: 0.17-0.75) and sports/culture-based friendships (OR = 0.44; 95%CI: 0.22-0.87) remained significantly associated with illicit drug use. Adolescents who lived in less vulnerable areas had higher chance of drug use in comparison with those living in more vulnerable areas. Religion-based and sports/culture-based friendships seem to demonstrate a protective effect against lifetime illicit drug use. Gender heterogeneity within groups and residing in a less vulnerable area increased the chances of adolescents reporting illicit drug use.

El objetivo del presente estudio transversal fue examinar el consumo de drogas ilícitas, y su asociación con factores socioeconómicos, así como con la influencia del grupo entre adolescentes brasileños de 15 a 19 años de edad. Se adoptó una muestra del grupo en dos etapas, considerando una selección aleatoria de escuelas públicas y privadas de nueve distritos administrativos de una capital de estado brasileña y una selección aleatoria de clases en cada escuela. El consumo ilícito era el resultado que se midió a través de la pregunta: "¿Has consumido alguna vez drogas legales (marihuana, inhalantes, hipnóticos, cocaína/crack, alucinógenos, anfetaminas y opioides) en tu vida?" El grupo más importante de factores protectores fue categorizado como: escuela, familia, religioso y deportes/cultura. El área, basada en el Índice de Vulnerabilidad de la Salud (IVS), se usó para evaluar el estatus socioeconómico. Se analizaron los datos de 891 adolescentes, usando el test chi-cuadrado test y regresión logística. El porcentaje global de consumo de drogas ilícitas fue de un 15.2%. La heterogeneidad de género en los grupos (OR = 3.14; 95%CI: 1.63-6.06), amistad basada en la religión (OR = 0.36; 95%CI: 0.17-0.75) y amistades basadas en deporte/cultura (OR = 0.44; 95%CI: 0.22-0.87) quedaron significativamente asociadas con el consumo de drogas ilícitas. Los adolescentes que vivían en áreas menos vulnerables tenían una oportunidad más alta de consumo de drogas, en comparación con aquellos que vivían en áreas más vulnerables. Las amistadas basadas en la religión y deporte/cultura parece que demuestran ser un factor protector contra el consumo de drogas a lo largo de la vida. La heterogeneidad de género en los grupos y residir en áreas menos vulnerables incrementó la oportunidad en el consumo de ilícito de drogas.

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions

Abstract Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.

Correlates of binge drinking among Brazilian adolescents / Correlações do binge drinking entre adolescentes brasileiros

Abstract Adolescence is a vulnerable period for risk-taking tendencies, including binge drinking. The aim of this study was to examined the prevalence of binge drinking and its association with factors related to the consumption of alcoholic beverages by best friend, familial factors, socioeconomic status and religiosity. A Census of 633 students from public and private schools in Diamantina-MG was conducted. Participants completed a self-administered questionnaire, the Alcohol Use Disorders Identification Test-C (AUDIT-C) and, another on the consumption of alcohol by family and friends. Surveys inquiring about socioeconomic conditions were sent to parents/guardians. Descriptive and bivariate analyzes were performed (p < 0.05). The log-binomial model was used to calculate PR and 95% CI. The prevalence of binge drinking was 23.1%. The average age of onset of alcohol consumption was 10,8 years. Binge drinking was more prevalent among adolescents whose best friend [OR = 4.72 (95% CI 2.78-8.03)] and brother [PR = 1.46 (95% CI 1.10-1.92)] drink alcohol. Religiosity [PR = 0.40 (95% CI 0.27-0.62)] appeared as a possible protective factor. Our findings indicate that peer effects are important determinants of drinking and could be utilized as a potential target for interventions to reduce alcohol consumption rates.

Resumo A adolescência é um período vulnerável da tendência em assumir riscos, incluindo consumo excessivo de álcool. Avaliou-se a prevalência de "binge drinking" e sua associação com o consumo de bebidas alcoólicas pelo melhor amigo, fatores familiares, condição socioeconômica e religiosidade. Foi conduzido um censo de 633 alunos de escolas públicas e privadas em Diamantina-MG. Os participantes preencheram o Alcohol Use Disorders Identification Test-C (AUDIT-C) e um questionário sobre o consumo de álcool por familiares e amigos. Questionários com perguntas sobre condições socioeconômicas foram enviados aos pais/responsáveis. Foram realizadas análises descritivas e bivariadas (p < 0,05). O modelo log-binomial foi usado para calcular RP e 95% IC. A prevalência de consumo excessivo de álcool foi de 23,1%. A idade média de início do consumo de álcool foi de 10,8 anos. O "binge drinking" foi mais prevalente entre adolescentes cujo melhor amigo [OR = 4,72 (95% IC 2,78-8,03)] e irmão [RP = 01.46 (IC 95% 1,10-1,92)] consumiam álcool. A religiosidade [RP = 0,40 (IC 95% 0,27-0,62)] apareceu como um possível fator de proteção. Os efeitos de pares são importantes determinantes do consumo de álcool e poderiam ser utilizados como um alvo potencial em intervenções para reduzir as taxas deste.

Incidence of dental caries in primary dentition and risk factors: a longitudinal study

Abstract The objectives of this prospective, longitudinal, population-based study were to estimate the incidence of dental caries in the primary dentition, identify risk factors and determine the proportion of children receiving dental treatment, through a two-year follow up. The first dental exam was conducted with 381 children aged one to five years, at health centers during immunization campaigns; 184 of them had dental caries and 197 had no caries experience. The second exam was carried out two years later at a nursery or at home with the same individuals who participated in the first exam. The diagnosis of dental caries was performed using the dmft criteria. Parents were interviewed regarding socioeconomic indicators. Descriptive, bivariate and adjusted Poisson regression analyses were performed. Among the 381 children, 234 were reexamined after two years (non-exposed: 139; exposed: 95). The overall incidence of dental caries was 46.6%. The greatest incidence of dental caries was found in the group of children with previous caries experience (61.1%). Among the children without dental caries in the first exam, 36.7% exhibited caries in the second exam. The majority of children (72.6%) received no treatment for carious lesions in the two-year interval between examinations. Children with previous dental caries (RR: 1.52, 95%CI: 1.12-2.05) had a greater risk of developing new lesions, compared with the children without previous dental caries. The incidence of dental caries was high and most of children's caries were untreated. Previous caries experience is a risk factor for developing new carious lesions in children.

Access to information on how to avoid oral health problems among elderly persons registered with the Family Health Strategy / Acesso a informações sobre como evitar problemas bucais entre idosos cadastrados na Estratégia de Saúde da Família

Objectives : To identify the level of access to information regarding how to prevent oral health problems among the elderly, and verify if such levels were higher among members of households registered with the Family Health Strategy Program. Methods : An analytic cross-sectional study was conducted of a probabilistic complex sample of elderly (65-74 years old) members of the population of a large city. The level of access was estimated with adjustment for the design effect, as well as the magnitudes of association. Descriptive, bivariate and logistic regression (OR/CI95%) analysis was performed. Variables related to personal determinants, health services, health-related behavior and health outcomes were considered. Results : Of the 490 participants, 53.4% reported they had access to information about how to prevent oral health problems. This access was higher among elderly persons living in a household registered with the Family Health Strategy Program (2.04/1.14-3.67), and who had at least five years of schooling (2.53/1.67-3.83), regularly used dental services (1.84/1.07-3.17), did not smoke either now or in the past (1.79/1.13-2.82), did not suffer from chronic diseases (2.14/1.34-3.42) and had not suffered social impacts because of their oral health conditions (1.77/1.08-2.91). Conclusion : Most of the elderly persons had access to information about how to prevent oral health problems, with such access being greater among those registered with the Family Health Strategy Program.

Objetivos: Identificar a prevalência do acesso a informações sobre como evitar problemas bucais entre idosos e verificar se esse acesso foi maior entre os residentes em domicílios cadastrados na Estratégia de Saúde da Família (ESF). Método: Estudo transversal analítico conduzido a partir de amostra probabilística complexa por conglomerado de idosos (65-74 anos) de um município de grande porte populacional. Foi estimada a prevalência do acesso com correções pelo efeito de desenho, além das magnitudes das associações, sendo conduzidas análises descritivas, bivariadas e regressão logística (OR/IC95%). Considerou-se variáveis referentes aos determinantes pessoais, serviços de saúde, comportamentos relacionados à saúde e desfechos de saúde. Resultados: Dentre os 490 participantes, 53,4% relataram o acesso a informações sobre como evitar problemas bucais. Esse acesso foi maior entre os idosos que residiam em domicílio cadastrado na ESF (2,04/1,14-3,67), tinham maior escolaridade (2,53/1,67-3,83), utilizaram os serviços odontológicos por rotina (1,84/1,07-3,17), não relataram hábito tabagista atual ou passado (1,79/1,13-2,82), não possuíam doença crônica (2,14/1,34-3,42) e não tiveram impacto social das suas condições de saúde bucal (1,77/1,08-2,91). Conclusão: Conclui-se que a maioria dos idosos teve acesso a informações sobre como evitar problemas bucais, sendo o acesso maior entre aqueles cadastrados na Estratégia de Saúde da Família.

Maior acesso à informação sobre como prevenir o câncer bucal entre idosos assistidos na atenção primária à saúde / Greater access to information on how to prevent oral cancer among elderly using primary health care

Resumo Na promoção de saúde, as ações educativas são prioridade na Estratégia de Saúde da Família (ESF). Evidencia-se a eficácia dessas ações na adesão a comportamentos saudáveis e na redução nas taxas de morbimortalidade por câncer bucal. Objetivou-se identificar se o acesso a informações sobre como prevenir o câncer bucal é maior entre idosos residentes em domicílios cadastrados na ESF. Utilizou-se o SPSS® na obtenção de estimativas corrigidas pelo efeito do desenho amostral, considerando as magnitudes das associações do acesso a tais informações com os determinantes pessoais, uso dos serviços/custos com a saúde, comportamentos relacionados à saúde e desfechos da saúde. Dentre os 492 idosos, 58,9% relataram ter tido acesso a tais informações. Verificaramse maiores chances de acesso entre residentes em domicílios cadastrados na ESF; com maior renda per capita (2,01/1,18-3,43); não tabagistas (2,00/1,16-3,46); que realizaram autoexame bucal (6,35/3,46-11,64); e que não autoperceberam incômodo na boca, cabeça ou pescoço (2,06/1,024,17). O acesso foi maior entre os residentes em domicílios cadastrados na ESF. Determinantes pessoais, comportamentos relacionados à saúde e desfechos de saúde sofrem influência ou influenciam a oferta e o acesso a essas informações.

Abstract Educative actions are an important component of health promotion in Brazil's primary healthcare program, the Family Health Strategy (FHS). The efficacy of these actions is evidenced by compliance with healthy behaviors and in the reduction of rates of mortality and morbidity. The objective of this study was to identify whether access to information regarding the prevention of oral cancer is greater among elders whose residences are registered with the FHS. SPSS® was utilized to obtain estimates that were corrected for sample design, considering the magnitude of the associations between access to such information with personal determinants, the use and cost of healthcare, health-related behaviors and health outcomes. 58.9% of the 492 participating elders reported having access to such information. We verified that there was a greater chance for access among residents of houses registered by the FHS; those with greater per capita income (2.01/1.183.43); non-smokers (2.00/1.16-3.46); those that realized oral self-examination (6.35/3.46-11.64); and those that did not perceive discomfort in the mouth, head or neck (2.06/1.02-4.17). Access was greater among residents of homes registered by the FHS. Personal determinants of health, health-related behaviors and health outcomes are influenced or influence access to information regarding the prevention and management of oral diseases.

Prevalence of oral cancer self-examination among elderly people treated under Brazil's Unified Health System: household health survey / Prevalência de autoexame bucal é maior entre idosos assistidos no Sistema Único de Saúde: inquérito domiciliar

The aim of this study was to examine the prevalence of oral cancer self-examinationamong the elderly and confirm whether prevalence was higher among users of the dental services provided by Brazil's Unified Health System (SUS, acronym in Portuguese). A transversal study of elderly people aged between 65 and 74 years living in a large-sized Brazilian municipality was conducted using simple random sampling. Logistic regression was conducted and results were corrected for sample design and unequal weighting using the SPSS(r) software. The study assessed 740 individuals. A total of 492 met the inclusion criteria, of which 101 (22.4%) reported having performed an oral cancer self-examination. Prevalence was higher among users of the dental services provided by the SUS, higher-income individuals, people with higher levels of education, individuals that used a removable dental prosthesis, and people who had not experienced discomfort attributed to oral condition, and lower among people who sought regular and periodic dental treatment and individuals who did not have a drinking habit. This type of self-care should be encouraged by public health policies which respond to the needs of the elderly, with emphasis on users of private and philanthropic services, and other services outside the public health network.

Este estudo objetivou identificar a prevalência do autoexame bucal entre idosos e constatar se essa prevalência foi maior entre usuários de serviços odontológicos prestados pelo Sistema Único de Saúde (SUS). Estudo transversal conduzido a partir de amostragem probabilística complexa por conglomerados, entre idosos (65-74 anos) de um município brasileiro de grande porte populacional. Foi realizada regressão logística binária, as estimativas foram corrigidas pelo efeito de desenho e por ponderações, utilizando-se o SPSS(r). Dentre os 740 avaliados, atenderam aos critérios de inclusão 492 idosos e, destes, 101 (22,4%) relataram a prática do autoexame bucal. Esta prática foi maior entre idosos usuários dos serviços odontológicos prestados no SUS, entre aqueles com maior renda per capita, os com maior escolaridade, aqueles que utilizavam prótese dentária removível e entre os que não tiveram impactos decorrentes das desordens bucais; foi menor entre os que usaram serviços odontológicos por rotina e os que não possuíam hábito etilista. A prevalência do autoexame bucal entre idosos foi baixa e maior entre aqueles usuários do SUS. O estímulo à adesão a este autocuidado deve ser considerado nas políticas de saúde do idoso vigentes, especialmente entre usuários de serviços particulares, supletivos e filantrópicos.

Dental caries and social factors: impact on quality of life in Brazilian children

The objective of this study was to evaluate the impact of dental caries and social determinants in the Oral Health Related Quality of Life (OHRQoL) of children in Belo Horizonte, Brazil. This is a population-based cross-sectional study with a representative sample of 1,204 children aged 8 to 10 years randomly selected from 19 public and private schools. The children were clinically examined at school by two trained and calibrated examiners (Kappa = 0.78 - 1.00). The Decayed, Missing and Filled Teeth Index (DMF-T and dmf-t) was used for the diagnosis of dental caries. The social factors were determined by parents’/caregivers’ schooling, household income, number of people in the household, type of school, and by the Social Vulnerability Index. The Brazilian version of the Child Perceptions Questionnaire for ages 8 to 10 years was used to assess the impact on quality of life. A total of 278 (23.1%) out of 1,204 children had at least one cavitated carious lesion and 47.0% presented a negative impact on OHRQoL. In the final multivariate Poisson’s regression model, household income and presence of untreated dental caries were statistically associated with a negative impact on OHRQoL (p < 0.001).Children with dental caries and from low-income families had a higher negative impact on OHRQoL.

Influence of clinical and socioeconomic indicators on dental trauma in preschool children

The aim of the present study was to determine the prevalence of traumatic dental injury (TDI) in the primary dentition and investigate associations with clinical and socioeconomic indicators. A population-based, cross-sectional study was carried out with a randomly selected sample of 301 children aged one to five years. Data were collected through clinical oral examinations and interviews with parents/guardians during immunization campaigns. Statistical analysis involved Pearson’s Chi-squared test and Poisson regression with robust variance. The prevalence of TDI was 33.9%. TDI was more prevalent in children with overjet > 3 mm (p < 0.001) and those with inadequate lip coverage (p < 0.001). A statistically significant association was also found between TDI and household income (p = 0.024). According to the adjusted Poisson regression model, greater prevalence rates of TDI were found for children from families with a monthly income ≥ twice the Brazilian minimum monthly wage (PR: 1.52; 95%CI: 1.10-2.12), those with accentuated overjet (PR: 1.53; 95%CI: 1.05-2.22) and those with inadequate lip coverage (PR: 2.00; 95%CI: 1.41-2.84). The prevalence of TDI was high in the present study and was associated with a higher family income, accentuated overjet and inadequate lip coverage.

Associação entre impactos funcionais e psicossociais das desordens bucais e qualidade de vida entre idosos / Association between physical and psychosocial impacts of oral disorders and quality of life among the elderly

Objetivou-se avaliar a associação entre o impacto das desordens bucais em suas dimensões física/psicossocial e a qualidade de vida entre idosos. Estudo transversal conduzido entre idosos (65-74 anos), em 2008/2009. O impacto foi avaliado através do Oral Health Impact Profile (OHIP 14) e a qualidade de vida, através do Short-Form Health Survey SF 12. Foram realizadas análises descritivas, univariadas e múltiplas (regressões logísticas), com correção pelo efeito de desenho, utilizando-se o PASW(r) 18.0. Dos 800 convidados, participaram 736 idosos (TR = 92%), com a média de idade de 67,77 anos, a maioria não apresentou impacto, a partir da medida da prevalência do OHIP. A dimensão limitação funcional do OHIP foi associada ao domínio físico do SF12, independentemente de outras variáveis investigadas. Já a gravidade do OHIP, as suas dimensões de desconforto psicológico e deficiência, foram associadas ao domínio mental do SF12. Conclui-se que alguns impactos das desordens bucais estiveram associados a uma qualidade de vida insatisfatória em seus domínios físico e mental.

This study sought to evaluate the association between the impact of oral disorders in terms of physical/psychosocial dimensions and quality of life among the elderly. It involved a cross-sectional study conducted among the elderly (65-74 years) in 2008/2009. The social impact was assessed using the Oral Health Impact Profile (OHIP 14) and the quality of life using the SF 12 Short-Form Health Survey. Descriptive, univariate and multivariate (logistic regression) analysis was conducted with correction for the design effect, using SPSS(r)18.0 software. Of the 800 individuals approached, 736 elderly individuals participated (TR = 92%), with a mean age of 67.77 years, the majority of whom showed no impact based on the measurement of the prevalence of OHIP. The functional limitation dimension of the OHIP was associated with the physical domain of the SF12, irrespective of the other variables investigated. However, the seriousness of OHIP and its psychological discomfort and disability dimensions was associated with the mental domain of the SF12. The conclusion reached is that some impacts of oral disorders were associated with unsatisfactory quality of life in the physical and mental domains.

Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service? / A avaliação negativa dos serviços odontológicos entre idosos brasileiros está associada ao tipo de serviço utilizado?

This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

Objetivou-se avaliar a prevalência de avaliação negativa dos serviços odontológicos e constatar se ela foi maior entre usuários de serviços públicos ou filantrópicos do que entre idosos brasileiros usuários de serviços particulares ou de planos de saúde. Além disso, foram identificados os fatores associados a tal avaliação negativa. Foram utilizados dados do levantamento epidemiológico das condições de saúde bucal da população brasileira de 2002/2003, obtidos por meio de entrevistas e exames conduzidos nos domicílios por examinadores treinados e calibrados. A variável dependente foi obtida a partir das respostas sequenciais às perguntas: "Já foi ao dentista alguma vez na vida?; Há quanto tempo? e Como avalia o atendimento?", categorizadas em péssimo/ruim; regular e bom/ótimo. A principal variável independente foi o "Sistema de atenção à saúde utilizado (plano de saúde/particular; público/filantrópico)". Foram conduzidas análises descritivas, univariadas (prova de tendência linear do χ2) e múltiplas, utilizou-se a regressão logística ordinal de Odds proporcionais parciais. Dentre os idosos, 196 (3,7%) avaliaram negativamente (péssimo/ruim) os serviços odontológicos. A avaliação negativa foi superior entre aqueles que usaram serviços públicos/filantrópicos; homens; com maior escolaridade; que não receberam informações sobre como evitar problemas bucais; que autoperceberam dor nos dentes e gengivas nos últimos seis meses, a saúde bucal e a fala como ruim/péssima. Conclui-se que a avaliação negativa foi maior entre usuários de serviços públicos e filantrópicos independentemente das demais variáveis investigadas.

Impact of Malocclusion on Oral Health-Related Quality of Life among Brazilian Preschool Children: a Population-Based Study

The purpose of the present study was to evaluate the impact of malocclusion on Oral Health-Related Quality of Life (OHRQoL) of children and their families. A population-based cross-sectional study was carried out in Belo Horizonte, MG, Brazil. A representative sample of 1069 male and female preschoolers aged 60 to 71 months was randomly selected from public and private preschools and daycare centers. Data were collected using the B-ECOHIS. In addition, a questionnaire addressing socioeconomic and demographic data was self-administered by the parents/guardians. The criteria used to diagnose malocclusion were based on Foster and Hamilton (1969), Graboswki et al. (2007) and Oliveira et al. (2008). Descriptive, univariate and multiple Poison logistic regression analyses were carried out. The prevalence of malocclusion was observed in 46.2% of the children and deep overbite was the most prevalent type of malocclusion (19.7%), followed by posterior crossbite (13.1%), accentuated overjet (10.5%), anterior open bite (7.9%) and anterior crossbite (6.7%). The impact of malocclusion on OHRQoL was 32.7% among the children and 27.1% among the families. In Poisson multiple regression model adjusted for socioeconomic status, no significant association was found between malocclusion and OHRQoL of the children (PR=1.09, 95% CI: 0.96-1.24) and their families (PR=1.11, 95% CI: 0.94-1.31). It is concluded that children with malocclusion in this sample did not have a negative impact on their OHRQoL and of their families.

O objetivo do presente estudo foi avaliar o impacto da maloclusão na OHRQoL de crianças e suas famílias. Um estudo transversal de base populacional foi conduzido em Belo Horizonte, Brasil. Uma amostra representativa contendo 1069 crianças dos gêneros masculino e feminino foi randomicamente selecionada, em creches e pré-escolas públicas e privadas. Os dados foram coletados através do questionário B-ECOHIS. Ademais, um questionário contendo dados socioeconômicos e demográficos foi respondido pelos pais/responsáveis das crianças. Os critérios utilizados para o diagnóstico de maloclusão foram baseados nos estudos de Foster e Hamilton (1969), Graboswki et al. (2007) e Oliveira et al. (2008). Análises descritivas, univariadas e regressão logística múltipla de Poisson foram realizadas. A prevalência de maloclusão foi observada em 46,2% das crianças, sendo a mordida profunda o tipo de maloclusão mais frequente (19,7%), seguido de mordida cruzada posterior (13,1%), sobressaliência acentuada (10,5%), mordida aberta anterior (7,9%) e mordida cruzada anterior (6,7%). A prevalência do impacto da maloclusão na OHRQoL foi de 32,7% nas crianças e 27,1% nas famílias. No modelo de regressão múltipla ajustado para o status socioeconômico, não se observou associação significante entre maloclusão e OHRQoL das crianças (PR=1.09, 95% CI: 0,96-1,24) e de suas famílias (PR=1,11, 95% CI: 0,94-1,31). Conclui-se que as crianças que apresentaram maloclusão nesta amostra, não apresentaram impacto negativo na sua OHRQoL e nem de suas famílias.

Fatores associados à satisfação com serviços odontológicos entre idosos / Factors associated with satisfaction with dental services among the elderly / Factores asociados a la satisfacción con servicios odontológicos entre ancianos

OBJETIVO: Analisar a prevalência da satisfação de idosos com o atendimento odontológico e os fatores associados. MÉTODOS: Estudo transversal com 495 idosos de 65 a 74 anos, sem déficit cognitivo, conforme miniexame do estado mental, que usaram serviços odontológicos de Montes Claros, MG, de 2008 a 2009. A amostra foi probabilística complexa por conglomerado em dois estágios. Profissionais e estudantes treinados/calibrados conduziram exames e entrevistas domiciliares usando computadores de mão com programa desenvolvido para esse fim. Nas análises estatísticas, com correção pelo efeito de desenho, empregou-se o PASW® Statistics 18.0. Regressão de Poisson foi conduzida para identificar as associações entre a satisfação e os fatores de interesse, estimando-se a razão de prevalência e o intervalo de 95% de confiança (RP/IC95%). RESULTADOS: No geral, 91,4% dos idosos estavam satisfeitos. Constatou-se maior satisfação entre usuários de serviços do Sistema Único de Saúde (SUS) (1,07/1,01;1,12); que tiveram acesso a informações sobre como evitar problemas bucais (1,09/1,02;1,16); que não faziam uso de medicamentos (1,05/1,00;1,10) e que classificaram a aparência de seus dentes e gengivas como ótimas ou boas (1,13/1,00;1,28). CONCLUSÕES: O idoso que acessa o serviço ofertado pelo Sistema Único de Saúde tem maior satisfação com o tratamento odontológico, assim como aqueles que não fazem o uso de medicamentos, os com melhor autopercepção da estética dos dentes e gengivas e aqueles que possuem mais acesso a informações sobre como evitar problemas bucais. Logo, as políticas de saúde no SUS apresentam resultados positivos.

OBJECTIVE: To analyze the prevalence of elderly users' satisfaction with dental care and associated factors. METHODS: Cross-sectional study conducted with 495 elderly individuals aged 65-74 years, without cognitive impairment according to the Mini-Mental State Examination, who used dental services of the municipality of Montes Claros (Southeastern Brazil) from 2008 to 2009. A two-stage cluster, complex probability sample was used. Trained/ calibrated professionals and students conducted tests and household interviews using handheld computers with software developed for this purpose. In the statistical analysis, with correction by design effect, PASW® Statistics 18.0 was utilized. To identify associations between satisfaction and the factors of interest, Poisson regression was conducted, estimating the prevalence ratio and the 95% confidence interval (PR / 95%CI). RESULTS: Overall, 91.4% of the elderly were satisfied. Greater satisfaction was found among users of services of the Sistema Único de Saúde (SUS - Brazil's National Health Service) (PR = 1.07; 95%CI 1.01;1.12); those who had access to information on how to avoid oral problems (PR = 1.09; 95%CI 1.02;1.16); those who did not use medicines (PR = 1.05; 95%CI 1.00;1.10); and those who rated the appearance of their teeth and gums as excellent or good (PR = 1.13; 95%CI 1.00;1.28). CONCLUSIONS: The elderly who access the service offered by SUS have greater satisfaction with dental treatment, as well as those who do not use medicines, those with better self-perception of the aesthetics of teeth and gums and those who have more access to information about how to prevent oral problems. Therefore, health care policies in the SUS have been presenting positive results.

OBJETIVO: Analizar la prevalencia de la satisfacción de ancianos con la atención odontológica y los factores asociados. MÉTODOS: Estudio transversal con 495 ancianos de 65 a 74 años, sin déficit cognitivo, conforme mini-examen del estado mental, que usaron servicios odontológicos de Montes Claros, MG, Brasil, de 2008 a 2009. La muestra fue probabilística compleja por conglomerado en dos fases, estratificada por edades-índice o grupos etarios. Profesionales y estudiantes entrenados/calibrados condujeron exámenes y entrevistas domiciliares usando computadores de mano con programa desarrollado para ese fin. En los análisis estadísticos, con corrección por el efecto de diseño, se empleó el PASW® Statistics 18.0. Se realizó regresión de Poisson para identificar las asociaciones entre la satisfacción y los factores de interés, estimándose la tasa de prevalencia y el intervalo de 95% de confianza (RP/IC95%). RESULTADOS: En general, 91,4% de los ancianos estaban satisfechos. Se constató mayor satisfacción entre usuarios de servicios del Sistema Único de Salud Brasileño (1,07/1,01;1,12); que tuvieron acceso a informaciones sobre como evitar problemas bucales (1,09//1,02;1,16); que no hacían uso de medicamentos (1,05/1,00;1,10) y que clasificaron la apariencia de sus dientes y encías como óptimas o buenas (1,13/1,00;1,28). CONCLUSIONES: El anciano que tiene acceso al servicio ofertado por el Sistema Único de Salud Brasileño tienen mayor satisfacción con el tratamiento odontológico, así como aquellos que no hacen uso de los medicamentos, los que presentaron mejor autopercepción de la estética de los dientes y encías y aquellos que poseen más acceso a informaciones sobre como evitar problemas bucales. Luego, las políticas de salud en el SUS presentan resultados positivos.

Signs, symptoms, parafunctions and associated factors of parent-reported sleep bruxism in children: a case-control study

Bruxism is the non-functional clenching or grinding of the teeth that may occur during sleep or less commonly in daytime. The aim of this study was to investigate the association between clinical signs and symptoms, parafunctions and associated factors of sleep bruxism in children. A population-based case-control study was carried out involving 120 children, 8 years of age, with sleep bruxism and 240 children without sleep bruxism. The sample was randomly selected from public and private schools in the city of Belo Horizonte, MG, Brazil. Groups were matched by gender and social class. The Social Vulnerability Index (SVI) drawn up by the city of Belo Horizonte was employed for social classification. Data collection instruments included clinical forms and pre-tested questionnaires. The diagnosis of sleep bruxism was supported by the American Association of Sleep Medicine (AASM) criteria. The McNemar test, binary and multivariate logistic regression models were used for statistical analysis. The risk factors associated with sleep bruxism included: primary canine wear (OR=2.3 IC 95% 1.2-4.3), biting of objects like pencils or pens (OR=2.0 IC 95% 1.2-3.3) and wake-time bruxism (tooth clenching) (OR=2.3 IC 95% 1.2-4.3). Children that present the parafunctions of object biting and wake-time bruxism were more susceptible to sleep bruxism.

Bruxismo é o ato não funcional de ranger os dentes enquanto se dorme ou apertar os dentes em vigília. O objetivo deste estudo foi investigar a associação entre sinais e sintomas clínicos associados ao bruxismo noturno em crianças. Foi desenvolvido um estudo de base populacional com desenho caso-controle, envolvendo 120 crianças, de 8 anos de idade, com bruxismo e 240 crianças sem bruxismo. A amostra foi selecionada de forma randomizada em escolas públicas e particulares da cidade de Belo Horizonte, Brasil. Os grupos caso e controle foram pareados por gênero e classe social. O Índice de Vulnerabilidade Social (IVS) desenvolvido pela prefeitura da cidade de Belo Horizonte foi utilizado para a classificação social. Como instrumentos de coleta foram utilizados: uma ficha clínica e um questionário pré-testados. O diagnóstico de bruxismo noturno foi baseado nos critérios da American Association of Sleep Medicine (AASM). Os testes estatísticos de McNemar, regressão logística binária e multivariada com modelo de regressão foram utilizados para análise dos dados. Foram considerados fatores de risco para o bruxismo noturno: desgaste em caninos decíduos (OR=2,3 IC 95% 1,2-4,3), morder objetos como lápis e canetas (OR=2,0 IC 95% 1,2-3,3) e apertar os dentes em vigília (OR=2,3 IC 95% 1,2-4,3). Crianças que apresentam outras parafunções tais como: morder objetos e apertar os dentes em vigília são mais susceptíveis ao bruxismo noturno.

Hepatites virais na prática odontológica: riscos e prevenção / Viral hepatites in dental practice: risks and prevention

Objetivo: Discuti r os aspectos epidemiologicos das hepatites virais em profissionais de Odontologia, com enfase nas formas de transmissao e prevencao. Metodo: Revisao narrativa da literatura sobre riscos e prevencao das hepatites na pratica odontologica. Resultados: As hepatites constituem um grupo de doencas inflamatorias do figado de diversas etiologias, sendo mais comuns aquelas causadas pelos virus hepatotropicos de A a E. As hepatites A e E apresentam forma clinica aguda e autolimitada. As hepatites B e C podem cronificar e evoluir para a cirrose. Os sinais e sintomas das hepatites sao semelhantes e a evolucao da forma cronica e silenciosa ou oligossintomatica, sendo a doenca descoberta por acaso, muitas vezes em estagios avancados. O diagnostico precoce favorece maiores chances de cura. Os trabalhadores da area da saude tem maior risco de adquirirem hepatites principalmente pelos virus B e C. Conclusao: Os cirurgioes-dentistas, em sua pratica diaria, estao expostos a maior risco de acidentes com instrumentos perfuro-cortantes constituindo assim, um grupo de alto risco de contaminacao. E possivel que outros agentes causadores de diferentes formas de hepatites ou outras doencas, sejam identificados no futuro. A adocao de normas de precaucao universal no controle de infeccao e, e continuara sendo, fundamental para o controle das doencas transmissiveis no ambiente odontologico.

Objective: To discuss the epidemiological aspects of viral hepatites in dental professionals, with emphasis of the forms of transmission and prevention. Method: Narrative review of the literature on risks and prevention of the hepatites types in dental practice. Results: Hepatites are a group of inflammatory liver diseases with several etiologies, among which the most common are those caused by the A-E hepatotropic viruses. Hepatites A and E have acute and self-limited clinical presentation. Hepatites B and C may become chronic and progress to cirrhoses. The signs and symptoms of hepatites are similar and their evolution to the chronic form is silent or oligosymptomatic, which makes the disease being diagnosed incidentally, frequently at an advance stage. The early diagnosis increases the chances of chances of cure. Health professionals are at higher risk of having hepatites, especially those causes by the B and C viruses. Conclusion: Dentists, in their daily practice, are more exposed to accidents with cutting and perforating instruments, being thus a group with high risk of contamination. It is possible that other agents causing different forms of hepatitis or other diseases are identified in the future. The adoption of the universal infection control measures is and will always be essential for controlling transmissible diseases in dental facilities.

Auto-avaliação de saúde bucal em idosos: análise com base em modelo multidimensional / Objective and subjective factors related to self-rated oral health among the elderly

Propôs-se investigar fatores associados à auto-avaliação negativa da saúde bucal. Idosos, participantes do inquérito de saúde bucal do Ministério da Saúde, 2002-2003, que auto-avaliaram sua saúde bucal como ruim/péssima foram comparados aos que a auto-avaliaram como ótima/boa/regular usando-se razões de prevalências (RP) com base na regressão de Poisson. A minoria (870 - 17 por cento) auto-avaliou sua saúde bucal negativamente. A auto-avaliação negativa foi menor entre aqueles com 1-9 dentes e edentados, maior entre pardos/negros/índios, que nunca usaram serviços, que apresentavam alterações de tecidos moles, que relataram pouca e média/muita dor, que auto-avaliaram sua aparência e mastigação como regular ou ruim/péssima, entre os que relataram seus relacionamentos sociais pouco ou muito afetados pelas condições bucais e entre os que avaliavam necessitar de tratamento bucal. Apesar das precárias condições bucais, a maioria auto-avaliou positivamente sua saúde bucal. Condições subjetivas estiveram mais fortemente associadas do que as objetivas. Os resultados sugerem iniqüidade e permitem orientar políticas públicas que objetivem saúde bucal e qualidade de vida.

The aim of this study was to investigate factors associated with negative self-rated oral health. Elderly subjects from the Brazilian Ministry of Health's oral health survey (2002-2003) who rated their own oral health as bad or very bad were compared to those who rated their oral health as excellent, good, or fair, using prevalence ratios based on Poisson regression. The minority (870; 17 percent) gave their own oral health a negative rating. Negative self-rated oral health was less prevalent among those with 1-9 teeth and the edentulous, and more prevalent among blacks, mixed-race, and indigenous, those who had never used dental service, with soft tissue alterations, who reported little pain or medium to intense pain, rated their own appearance and chewing as fair or bad or very bad, reported that their oral health limited their social interaction a little or considerably, and reported needing dental treatment (PR = 1,47; 95 percentCI: 1.20-1.79). Despite their precarious oral conditions, the majority gave their oral health a positive rating. Subjective conditions were more heavily associated with self-rated oral health than were objective conditions. The findings suggest unequal oral health conditions and allow orienting public policies aimed at oral health and quality of life.