Aline Araújo Sampaio

Socioeconomic inequalities in the use of dental care services during early childhood: an epidemiological survey

BACKGROUND The use of dental care services contributes to the improvement of childrens healthy behaviors, reducing the prevalence of future dental problems. In this way, the purpose of this study was to describe the use of dental care service during early childhood and the possible socioeconomic inequalities in this use. DESIGN Data from the Brazilian Oral Health Survey (SB Brasil, 2010) were used. Interviews with the childrens parents and clinical examinations with the children were conducted in a 5-year-old representative sample. Descriptive, bivariate and multiple hierarchical statistical analyses were applied. RESULTS Of the 7241 children included, 3812 (53.2%) had used dental care services at least once in their lifetimes, and 1872 (48.8%) had used services for check-up/prevention. The use of dental services was greater among children with a higher family income (P < 0.05). The use of check-ups was lower among children with non-White skin color (Black and Browns) and among those who did not live in state capitals (P < 0.05). Clinical conditions and self-perception were also associated with the use (P < 0.05). CONCLUSION Socioeconomic differences in the general use of dental care and in its use for check-ups were identified during early childhood, indicating the presence of inequalities.

The Role of Prosthesis Spacer for Ocular Prostheses

Eye defects can lead to emotional, psychological, and social changes, impacting negatively the quality of life of the patient. When these structures cannot be satisfactorily repaired by reconstructive surgery, the prosthetic rehabilitation is the better treatment option to restore lost ocular anatomy and promote the social integration of the individual. The aim of this clinical report is to report and discuss a case of ocular prosthesis confection eviscerated patient with opening limitation eyelid and shortening of the distance between palpebral commissure, to obtain a more natural and comfortable to the patient ocular rehabilitation.

Assistive technologies for improving the oral hygiene of leprosy patients residing in a former leprosy colony in Betim, Minas Gerais, Brazil

Background This study deals with management of a group of elderly patients with a history of leprosy and hand deformities by a multidisciplinary team of dentists and occupational therapists. Assistive technology devices have been developed to allow such patients to obtain independence in oral self-care and can be a cost-effective approach to improving oral care in this population. The objective of this study was to describe the development of assistive devices to facilitate daily oral hygiene in older people with enduring leprosy-related impairments. Methodology Case study realized among elders with a history of leprosy residents in a former isolation colony in Betim, Minas Gerais, Brazil. The elders were evaluated for dependence on others for denture hygiene and mouthwash using the Daily Oral Hygiene Activity Index (ADOH). Those deemed partially or completely dependent on others were eligible for an intervention based on assistive technology. We adopted a personalized approach to each case, taking into account medical history, physical impairment and living environment. Six months after the intervention, the participants were assessed again using the ADOH and an unstructured interview about use of the devices. Principal findings Assistive devices for denture hygiene and mouthwash were developed for 16 elders. These devices facilitated oral hygiene in most patients and there was no worsening in any of the cases. Patients’ report suggested they were satisfied with the devices provided. Conclusions This study demonstrated that assistive devices can facilitate oral hygiene activities in leprosy patients. It also reinforces the importance of using a multidisciplinary team for the rehabilitation of these patients.

Contextual and Individual Determinants of Root Caries in Older People

The aim of this study was to identify the association of the presence of root caries in older people with contextual and individual determinants using a multilevel model. Data from the National Survey of Oral Health collected in Brazil were used. A sample of older Brazilians (aged 65-74 years) was included and selected through multistage probability cluster sampling, using probability proportional to size. Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate, and multilevel analyses were conducted. Of the 3,926 older people included in the study, 934 (21.8%) had at least 1 tooth with root caries. There seemed to be no pattern of involvement between the anterior and posterior teeth in the dental arches. Multilevel analysis showed a higher presence of root caries among older people resident in municipalities that were noncapital cities (OR = 1.50), who were over 70 years of age (odds ratio, OR = 1.22), had nonwhite skin color (OR 1.35), had coronal caries (OR = 5.58), were dissatisfied with their teeth and mouth (OR = 1.47), and had self-perceived dental treatment needs (OR = 1.33). Contextual and individual determinants were associated with the occurrence of root caries in older people. Lesion presence demonstrated a profile of social inequality.

Starch Combined with Sucrose Provokes Greater Root Dentine Demineralization than Sucrose Alone

Since there is no consensus about whether starch increases the cariogenic potential of sucrose, we used a validated 3-species biofilm model to evaluate if starch combined with sucrose provokes higher root dentine demineralization than sucrose alone. Biofilms (n = 18) composed by Streptococcus mutans (the most cariogenic bacteria), Actinomces naeslundii (which has amylolytic activity), and Streptococcus gordonii (which binds salivary amylase) were formed on root dentine slabs under exposure 8 ×/day to one of the following treatments: 0.9% NaCl, 1% starch, 10% sucrose, or a combination of 1% starch and 10% sucrose. Before each treatment, biofilms were pretreated with human whole saliva for 1 min. The pH of the culture medium was measured daily as an indicator of biofilm acidogenicity. After 96 h of growth, the biofilms were collected, and the biomass, bacteria viability, and polysaccharides were analyzed. Dentine demineralization was assessed by surface hardness loss (% SHL). Biofilm bioarchitecture was analyzed using confocal laser scanning microscopy. Treatment with a starch and sucrose combination provoked higher (p = 0.01) dentine demineralization than sucrose alone (% SHL = 53.2 ± 7.0 vs. 43.2 ± 8.7). This was supported by lower pH values (p = 0.007) of the culture medium after daily exposure to the starch and sucrose combination compared with sucrose (4.89 ± 0.29 vs. 5.19 ± 0.32). Microbiological and biochemical findings did not differ between biofilms treated with the combination of starch and sucrose and sucrose alone (p > 0.05). Our findings give support to the hypothesis that a starch and sucrose combination is more cariogenic for root dentine than sucrose alone.

Autopercepção da necessidade de prótese dentária total entre idosos brasileiros desdentados

The objective is to estimate the prevalence of self-perception of the need for a full dental prosthesis among toothless elderly Brazilians aged 65 to 74, as well as identify the associated factors. It is a cross-sectional study based on the national survey of oral health conditions of the Brazilian population, called SB Brazil - 2010. The dependent variable was the self-perceived need for full dental prosthesis, considering the purchase of new or replacement of the existing prosthesis. Descriptive bivariate and multiple analyses were conducted on 3514 elderly people, of which 2039 (55%) elderly self-perceived the need for a full denture. The self-perception of the need for a full denture was higher among those who needed dental prosthesis and who were dissatisfied with their oral health conditions. In addition to the high prevalence of self-perception of the need for prosthesis identified, the results identified that normative and subjective conditions of oral health remained associated with this self-perception among elderly Brazilians.Resumo Propoe-se estimar a prevalencia da autopercepcao da necessidade de protese dentaria total entre idosos (65 a 74 anos) brasileiros desdentados, assim como identificar seus fatores associados. Trata-se de estudo transversal com base no inquerito nacional das condicoes de Saude Bucal da populacao brasileira, denominado SB Brasil – 2010. A variavel dependente foi a autopercepcao da necessidade de protese dentaria total, considerando a aquisicao de protese nova ou substituicao da existente. Foram conduzidas analises descritivas, bivariadas e multiplas. Foram incluidos 3514 idosos, destes, 2039 (55,0%) perceberam a necessidade de protese total. A autopercepcao da necessidade de protese total foi maior entre os que necessitavam de protese dentaria inferior e que estavam insatisfeitos com as suas condicoes de saude bucal. Alem da alta prevalencia da autopercepcao da necessidade de protese identificada, os resultados permitiram identificar que condicoes normativas e subjetivas de saude bucal se mantiveram associadas a esta autopercepcao entre idosos brasileiros.