How much does household food insecurity explain income inequalities in untreated dental caries?

BACKGROUND: The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear. AIM: To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI). DESIGN: A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PRc ) for dental caries and this measure adjusted by HFI (PRa ). RESULTS: The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI. CONCLUSIONS: Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families.

Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis.

A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at "low," 2 at "unclear," and 4 studies at "high" risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.

Spatial distribution of molar incisor hypomineralization (mih) opacities in first permanent molars

Aim: To evaluate the spatial distribution of MIH opacities in first permanent molars (FPM). Materials and methods: an analysis of intraoral photographs of FPM with demarcated MIH opacities was conducted. The presence of opacity was computed in a digital matrix, discriminating the anatomical regions of the FPM surfaces. The frequencies of distribution of the opacities were descriptively analyzed through 227 FPM digital images of 89 children built in GIMP and Python and by Spearman correlation (= 0,05). Results: the occlusal surface was the most affected one (94% to 100%). In the upper FPM, the palatine surface was the second most affected one (84%-91%). In the lower FPM, the vestibular surface was the second most affected one (85%-80%). A similar pattern of opacity distribution was observed in the contralateral teeth. On smooth surfaces, opacities were more frequent in the regions closer to the occlusal surface than to the cervical one. Conclusion: MIH opacities were mostly present on occlusal, vestibular, and lingual/palatine surfaces, respectively. There is a possibility that the occurrences are in accordance with the chronology of dental formation.

Percepção de acadêmicos de enfermagem sobre o cuidado em saúde mental em domicílio: uma abordagem qualitativa / Percepción de alumnos de enfermería sobre el cuidado en salud mental en domicilio: un enfoque cualitativo / Perception of nursing students on mental health home-care: a qualitative approach

to understand the perceptions of Nursing students on mental health home-care, accomplished through extension activities. Method: this is an exploratory, descriptive research with a qualitative approach. There were 14 students of Nursing participating in the study. Data was collected through audio-recorded with semi-structured interviews treated according to Bardin content analysis. Results: the data led to three categories: "The University Extension in Mental Health as an Opportunity for the Personal and Academic Growth", "Reformulating Concepts of Care through the University Extension in Mental Health, "University Extension in Mental Health as a Facilitator of the Humanized Care”. Conclusion: the students apprehend the university extension as a way of acquiring knowledge and different abilities, by having the opportunity to carry out an effective approach with the family and with the quotidian of the Person with Mental Disorder (PTM)...

compreender a percepção de acadêmicos de enfermagem sobre o cuidado em saúde mental em domicílio, realizado por meio de atividades de extensão universitária. Método: trata-se de uma pesquisa descritiva exploratória com abordagem qualitativa. Participaram do estudo 14 acadêmicos de enfermagem. Os dados foram coletados através de entrevistas semiestruturadas, as quais foram áudio-gravadas, e tratados conforme análise de conteúdo de Bardin. Resultados: os dados resultaram em três categorias: “A Extensão Universitária em Saúde Mental como Oportunidade para o Crescimento Pessoal e Acadêmico”, “Reformulando Conceitos de Cuidado por meio da Extensão Universitária em Saúde Mental”, “A Extensão Universitária em Saúde Mental como Facilitadora do Cuidado Humanizado”. Conclusão: os acadêmicos compreendem a extensão universitária como uma maneira de adquirir conhecimentos e habilidades diversificadas por terem a oportunidade de operacionalizar uma aproximação eficaz com a família e com o cotidiano da Pessoa com Transtorno Mental (PTM)...

comprender la percepción de académicos de enfermería sobre el cuidado en salud mental en el domicilio, realizado por medio de actividades de extensión universitaria. Método: se trata de una investigación descriptiva exploratoria con enfoque cualitativo. Participaron del estudio 14 alumnos de enfermería. Los datos fueron recolectados a través de entrevistas semiestructuradas audio-grabadas y tratados conforme análisis de contenido de Bardin. Resultados: los datos resultaron en tres categorías: “La Extensión Universitaria en Salud Mental como Oportunidad para el Crecimiento Personal y Académico”, “Reformulando Conceptos de Cuidado por medio de la Extensión Universitaria en Salud Mental”, “La Extensión Universitaria en Salud Mental como Facilitadora del Cuidado Humanizado”. Conclusión: los alumnos comprenden la extensión universitaria como una manera de adquirir conocimientos y habilidades diversificadas, pues tienen la oportunidad de trabajar una aproximación eficaz con la familia y con el cotidiano de la Persona con Trastorno Mental (PTM)...

Abordaje conservador y mínimamente invasivo de la Hipomineralización Molar-Incisivo (HMI) -Relato de casos clínicos / Minimally invasive treatment for esthetic management of Molar-Incisor Hypomineralization (MIH) -A case report

La Hipomineralización Molar-Incisivo (HMI) es un defecto de esmalte de origen sistèmico que afecta uno o varios molares permanentes, asociado en algunos casos a los incisivos permanentes. Defectos de esmalte, como la HMI pueden influenciar negativamente la calidad de vida, percepción estètica y autoestima de niños y adolescentes. Las opciones de tratamiento para este tipo de alteración, incluye desde medidas preventivas y procedimientos restauradores hasta la extracción dental. Factores como la edad y expectativas del paciente, severidad de la alteración y materiales deben ser considerados en el plan de tratamiento del paciente con HMI. La utilización de resinas compuestas para la restauración de molares e incisivos ha mostrado buenos resultados relacionados a la durabilidad y estètica. Este artículo presenta dos casos clínicos sobre el abordaje de la HMI en dientes anteriores, realizando preparos cavitários conservadores por medio de puntas ultrasónicas adaptadas a un sistema de ultrasonido y restauración con resina compuesta, obteniendo resultados estéticos favorables con un año de acompañamiento.

Molar-Incisor Hypomineralization (MIH) is a qualitative developmental enamel defect that affects one to four permanent first molars, with or without involvement of permanent incisors. Enamel defects may produce many symptoms that have physical, social and psychological effects and influence day-to-day living or quality of life. The available treatment modalities for teeth with MIH are extensive, ranging from prevention, restoration, to extraction. Factors such as age, patient expectations, severity of the lesion and materials should be considered in the treatment of the patient with MIH. Restoration with composite resin is an alternative choice for posterior and anterior MIH defective teeth and its use has been show acceptable results. This article describes two clinical cases involving pediatric patients with MIH whose procedure of cavity preparation was based on the use of CVD ultrasound diamond tips and restored using composite resin obtaining favorable esthetics results after a 1 year follow-up.

Identificação da população atendida no centro de psicologia aplicada da universidade paranaense / Identification of the population assisted by the psychology applied center of the universidade paranaense

Este estudo teve como objetivo identificar o perfil da população atendida no Centro de Psicologia Aplicada - CPA da Universidade Paranaense - UNIPAR no período de 1993 a 2006, de acordo com as seguintes variáveis: gênero, idade, escolaridade, local de moradia, profissão, religião, nível sócioeeconomico, encaminhamento e motivo da consulta (queixa). Para tanto, utilizou-se uma metodologia retrospectiva documental, de consulta às fichas de triagens e dos prontuários dos clientes e a análise se deu por estatística descritiva, compreendendo frequências e porcentagens. A população que procura esse serviço é variada, predominando jovens adultos, do gênero feminino com escolaridade no ensino fundamental incompleto, procedentes de Umuarama/PR, sem ocupação e estudantes, católicos, com renda familiar de até três salários mínimos e encaminhados por amigos/vizinhos. As principais queixas referem-se a dificuldades nas relações familiares, depressão/tristeza, ansiedade/insegurança e dificuldades escolares. A partir do estudo realizado, os autores discutem os dados destacando a necessidade de se pensar em novos modelos de atendimento, planejando e ampliando novas modalidades mais adequadas às especificidades da clientela do CPA da UNIPAR.

The present study aimed to identify the profile of the population assisted by the Psychology Applied Center - CPA of the Universidade Paranaense ? UNIPAR between 1993 and 2006 according to the following variables: gender, age, schooling, place of residence, occupation, religion, socioeconomic status, referral and reason for psychological consultation. For such purpose, we adopted the documental retrospective methodology, verifying the triage files and patient records, and used descriptive statistics for data analysis, showing frequency and percentage. According to the results, the population that seeks the Psychological Clinic services does not have an unique profile, but there is a predominance of youngsters and adults - male and female - who have not finished middle school, live in Umuarama/PR, either without occupation or students, catholics, with a family income of up to three minimum wages, and referred by friends/neighbors. The main complaints are family conflicts, depression/sadness, anxiety/lack of self-confidence, and school problems. From this study, the authors discuss the results and highlight the need for new models of assistance, planning and broadening the services to others more appropriate to the particularities of the population who seeks the CPA at the UNIPAR.