Promotion of bucal health and the elderly / Promoção da saúde bucal e o idoso

Introdução: Há uma estimativa, para o ano de 2050, de mais de dois bilhões de pessoas acima de 60 anos no mundo. Essa projeção do envelhecimento da população ressalta a importância de avaliar a saúde bucal do idoso e, consequentemente, evidenciar qual o papel das políticas públicas e do cirurgião dentista na promoção de saúde neste contexto. Objetivo: O objetivo deste artigo é abordar as principais alterações bucais que ocorrem no idoso e a importância dada a isso pelas políticas públicas. Discussão: A literatura enfatiza a política nacional de saúde da pessoa idosa e o dever do profissional em promover a qualidade de vida preservando a autonomia e a independência funcional do paciente. Conclusão: Várias políticas públicas garantem os direitos assegurados às pessoas com idade igual ou superior a 60 anos, no que se refere à atenção integral à saúde, porém muito se tem a fazer para que os idosos sejam beneficiados e tenham pleno acesso a ela. Cabe ao cirurgião dentista o despertar para essa realidade e necessidade.

Introduction: For the year 2050, the estimate is to have more than two billion people over the age of 60 worldwide. This projection of population aging highlights the importance of assessing the oral health of the elderly and, consequently, highlighting the role of public policies and the dental surgeon in health promotion in this context. Objective: The purpose of this paper is to approach the main oral changes that occur in the elderly and the importance given to this by public policies. Discussion: The literature emphasizes the national health policy of the elderly and the duty of the professional to promote the quality of life while preserving the autonomy and functional independence of the patient. Conclusion: Several public policies ensure the rights guaranteed to people aged 60 years or older regarding whole health care for the elderly. However, much needs to be done for them to benefit and have full access to this service. Therefore, it's the dental surgeon's responsibility to bring awareness to this reality and need.

Inequalities in the workforce distribution in the Brazilian Dentistry / Desigualdades na distribuição da força de trabalho na Odontologia brasileira

ABSTRACT This article aimed to describe the distribution of dental professionals in Brazil, through a narrative review. The approach is based on the assumptions which lead the individual in choosing such career and as well as their fragmented current practices due to the university educational curriculum process. Furthermore, data are revised on the geographical distribution of these individuals and the potential impacts, among others, in the epidemiological profile of the population oral health problems. It was evident that the workforce shifts as presented in different ways in society and influenced by social needs, public policy and market, play special roles. It discusses the urgency of socio-spatial redistribution of dentists, a role to be played collaboratively among different States in Brazil, regulatory and social control agencies. Finally, the role of dental courses in forming active subjects was highlighted, in the process of health improvement, aiming to build a more equitable and just society.

RESUMO O presente artigo teve por objetivo descrever a distribuição dos profissionais da área odontológica no Brasil, por meio de uma revisão narrativa. A abordagem parte dos pressupostos que levam o indivíduo a optar por essa carreira e passa à observação das práticas atuais fragmentadas em virtude do processo de formação universitária. Ainda, são revistos dados relativos à distribuição geográfica destes indivíduos e os possíveis impactos, dentre outros, no perfil epidemiológico de problemas bucais da população do país. Evidenciou-se que a força de trabalho se desloca/fixa de formas diferentes na sociedade e sofre influência das necessidades sociais, das políticas públicas e do mercado. Discute-se a premência da redistribuição socioespacial dos cirurgiões-dentistas, papel a ser desempenhado de modo colaborativo entre Estado, órgãos fiscalizadores e instâncias de controle social. Por fim, destacou-se a função dos cursos de Odontologia em formar sujeitos atuantes no processo de melhorias no setor da saúde, com vistas a uma sociedade mais equânime e justa.

Lesiones de la mucosa bucal en pacientes de Mérida, Venezuela / Oral mucosal lesions in patients of Mérida, Venezuela

Existen muy pocos estudios sobre lesiones de la mucosa bucal en Venezuela y ningún estudio de la epidemiología de estas lesiones en el estado de Mérida. El objetivo de este estudio fue determinar la prevalencia de lesiones de la mucosa bucal en una población atendida en centros odontológicos de Mérida, describir las características de las mismas y analizar la influencia de otros parámetros tales como los hábitos de higiene buco-dental, los hábitos nocivos o los hábitos parafuncionales. De los 8640 pacientes atendidos en centros odontológicos públicos y privados durante un año, 120 (el 1,39%) presentaron lesiones de la mucosa bucal. Las lesiones bucales más frecuentemente encontradas fueron úlceras traumáticas (17,5%), herpes recurrente labial (11,7%), estomatitis por prótesis (10%), candidiasis eritematosa (10%) y estomatitis aftosa recurrente (9,2%). Las lesiones de la mucosa bucal fueron más frecuentes en el sexo femenino y su principal localización fue la gingival. La mayoría eran lesiones agudas (< 7 días), no recurrentes, con sintomatología dolorosa y sin factor etiológico atribuible por parte del paciente. Ni los hábitos nocivos, ni los hábitos parafuncionales tuvieron influencia sobre las características clínicas de las lesiones.

There are very few epidemiological studies of oral mucosal lesions in Venezuela. None of these studies has been conducted in the state of Merida. The aim of this study was to determine the prevalence of oral mucosal lesions in a population from Merida, Venezuela, describe their oral lesions' characteristics and analyze the influence of parameters such as oral hygiene habits, harmful habits or parafunctional habits. Of the 8640 patients seen in public and private dental centers from Merida during one year, 120 (1.39%) had oral mucosal lesions. The oral mucosal lesions most frequently found were: traumatic ulcers (17.5%), recurrent herpes labialis (11.7%), denture stomatitis (10%), erythematous candidiasis (10%) and recurrent aphthous stomatitis (9.2%). The main features of these oral mucosal lesions were: more frequent in females and, main location on the gingiva. Moreover, most of them were acute lesions (< 7 days), non-recurring and painful lesions. Neither harmful habits nor parafunctional habits had influence on the clinical features of the lesions.

Oral Lesions in Elderly Patients in Referral Centers for Oral Lesions of Bahia

Introduction The aging population phenomenon is occurring on a global scale; aging affects all of the structures of organisms, including the oral cavity. Objective To estimate the frequency of oral lesions, according to the clinical and histopathologic diagnoses, and to describe the sociodemographic profile of the elderly treated at the referral centers of oral lesions of public universities in Bahia, Brazil. Methods A descriptive epidemiologic study with transverse characteristics was conducted with elderly patients between August 2010 and January 2012. A form was used to collect data. The descriptive analysis consisted of calculating the simple and relative frequencies of sociodemographic variables and oral lesions. Results The population was predominantly black women, and the minority of elderly people were retired. Fibroid (13%) and squamous cell carcinoma (145%) were more prevalent clinical diagnoses, with squamous cell carcinoma (30.7%) and fibrous hyperplasia more prevalent histopathologic diagnoses. Conclusion A prevention policy needs to be implemented to reduce new cases of oral lesions in Bahia, Brazil and to aid in early diagnosis and appropriate treatment of oral lesions.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2

BACKGROUND: Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES: To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS: A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fisher's exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS: The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS: The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2. .

Alterações bucais de idosos institucionalizados: revisão de literatura / Oral problems in elderly people in a nursing home: literatura review

A população brasileira tem aumentado rapidamente e a faixa etária acima dos 60 anos de idade é a que mais cresce. E na medida em que a população envelhece devido a diversos fatores, aumenta a demanda por instituições de longa permanência. O aumento da expectativa de vida dos indivíduos nem sempre se faz acompanhado de saúde, pois, com o processo de envelhecimento, ocorrem alterações funcionais que acarretam maior predisposição ao surgimento de agravos crônicos. Indivíduos idosos, geralmente, consomem maior número de medicamentos, o que pode provocar alterações sistêmicas e também causar efeitos adversos na cavidade bucal. Diante disso, o presente artigo teve como objetivo realizar uma revisão de literatura sobre alterações bucais associadas ao uso de medicamentos em idosos institucionalizados

Brazilian population has increased rapidly lately, specially ages 60 and up and as the population gets older due to one reason or another, the demand for nursing homes increases as well. The increase on life expectancy for elders does not mean any increase in the attention payed on their health. With aging comes some changes that would generate a predisposition to some chronic problems. Elderly people, generally, take a large amount of medication and in some cases its side effects cause some changes in their mouth as well. With that being said, the following article aims to review what has been said about changes occurred in mouths of elderly people who live in nursing homes

Factors associated with prevalence of oral lesions and oral self-examination in young adults from a birth cohort in Southern Brazil / Fatores associados à prevalência de lesões bucais e à realização do autoexame bucal em adultos jovens de uma coorte de nascidos vivos do Sul do Brasil / Factores asociados a la prevalencia de lesiones bucales y a la realización del autoexamen bucal en adultos jóvenes de una cohorte de nacidos vivos del sur de Brasil

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.

O objetivo foi determinar a prevalência e características de lesões bucais, autoexame bucal e suas associações com determinantes ao longo da vida em uma população de adultos jovens. Uma amostra representativa (n = 720) dos nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1982, foi investigada, e a presença de lesões bucais e a realização do autoexame, verificadas aos 24 anos. As variáveis independentes foram obtidas de outros seguimentos dessa coorte. A prevalência de lesões bucais foi de 23,3% (IC95%: 20,3-26,6), e 31% dos indivíduos (IC95%: 27,6-34,4) relataram nunca ter realizado o autoexame da boca. A análise multivariável mostrou que o baixo nível socioeconômico ao nascimento, não ter recebido instrução de higiene oral até os 15 anos de idade e fumar aos 22 anos foram associados à presença de lesões. A realização do autoexame bucal esteve associada à maior escolaridade materna ao nascimento e a ter recebido orientação de higiene bucal pelo dentista aos 15 anos. Fatores socioeconômicos e comportamentais estão associados tanto à presença de lesões bucais quanto à realização do autoexame bucal.

El objetivo fue determinar la prevalencia y características de lesiones bucales, autoexamen bucal, y sus asociaciones con determinantes a lo largo de la vida, en una población de adultos jóvenes. Fue investigada una muestra representativa (n = 720) de los nacidos en Pelotas, Río Grande do Sul, Brasil, 1982, y la presencia de lesiones bucales y realización del autoexamen fueron verificadas a los 24 años. Las variables independientes se obtuvieron de otros seguimientos de esta cohorte. La prevalencia de lesiones bucales fue de un 23,3% (IC95%: 20,3-26,6) y un 31% de los individuos (IC95%: 27,6-34,4) relató no haber realizado nunca el autoexamen de la boca. El análisis multivariable mostró que el bajo nivel socioeconómico en el momento del nacimiento, el no haber recibido instrucción de higiene oral hasta los 15 años de edad, y fumar a los 22 años, se asociaron a la presencia de lesiones. La realización del autoexamen bucal se asoció a una mayor escolaridad materna en el nacimiento y al haber recibido orientación de higiene bucal por el dentista a los 15 años. Factores socioeconómicos y de comportamiento están asociados, tanto la presencia de lesiones bucales, como a la realización del autoexamen bucal.

Oral mucosa alterations in a socioeconomically deprived region: prevalence and associated factors

This study aimed to evaluate the prevalence and factors associated with oral mucosa alterations in patients from Vale do Jequiti-nhonha, Brazil. The sample consisted of 511 patients of both genders. Questionnaires were used to obtain information about patient gender, age, race, systemic disease state, medication use, cigarette use and alcohol consumption. Physical examinations were then performed to identify lesions of the oral mucosa. Descriptive analyses, Chi-squared tests and logistic regressions were then used to analyze the results (p < 0.05, 95 percent CI). In this population, 84.9 percent (434/511) of patients were found to have alterations in their oral mucosa. The most common alterations were melanotic maculae (36.0 percent), linea alba (33.9 percent), traumatic ulcers (21.5 percent), Fordyce's granules (20.4 percent), coated tongue (12.5 percent) and fissured tongue (10.0 percent). Melanotic maculae were more frequently observed in black patients, with an odds ration (OR) of 7.51. Being female was a statistically significant predictive factor for having a visible linea alba (OR: 1.90) and a fissured tongue (OR: 2.11). No statistically significant association was found between the presence of oral lesions and systemic disease, medication use, alcohol use and smoking. The high observed prevalence of melanotic maculae and Fordyce's granules suggests that these alterations could be considered typical characteristics of the population of the Vale do Jequitinhonha. Coated tongue may be related to the socioeconomic deprivation in the region. Furthermore, the high prevalence of traumatic ulcers may be associated with the traumatic agents that caused patients to seek dental care.