Angela Xavier

Dental caries related to quality of life in two Brazilian adolescent groups: a cross‐sectional randomised study

OBJECTIVES To analyse dental caries-related quality of life (QoL) in adolescent (15-19-year-old) subjects in a suburban area (SA) and a downtown area (DA) of Bauru, São Paulo, Brazil, in 2009. METHODS This was a cross-sectional, randomised study. The sample consisted of 185 and 147 adolescents from the SA and DA, respectively. The caries index used was that for decayed, missing and filled teeth (DMFT) (World Health Organization criteria). The 14-item Oral Health Impact Profile (OHIP-14) was used to assess QoL. The non-parametric Mann-Whitney test, Spearmans correlation coefficient and chi-squared test were used in the statistical analysis. RESULTS The DMFT index, Significant Caries (SiC) Index and percentage of caries-free students were similar (P > .05) between these populations, but findings on the Care Index differed (P < 0.05). There was a correlation between the DMFT index and OHIP-14 score in SA subjects (mean DMFT index = 3.01) in the dimensions of physical pain (r = 0.25; P < 0.01) and psychological disability (r = 0.17; P = 0.02). The DMFT index in DA subjects (mean DMFT index = 2.95) showed a correlation with functional limitation (r = 0.19; P = 0.02). The correlation in SA subjects between the caries component (mean = 1.22) of the DMFT index and OHIP-14 was significant only for the physical pain dimension (r = 0.16; P = 0.03). In DA subjects, correlations between the caries component (mean = 0.37) and all dimensions of OHIP-14 were statistically significant (P < 0.05). CONCLUSIONS  Despite the similarities in means in the DMFT index, the SiC Index and the caries-free percentage of subjects in both localities, access to dental treatment proved to be less effective for SA adolescents. Physical pain and psychological disability were the most frequent negative manifestations of impact on QoL. The SA adolescents were more negatively affected by dental caries in terms of QoL.

Dental caries-related quality of life and socioeconomic status of preschool children, Bauru, SP

Aim: To evaluate oral health-related quality of life of preschool children of Bauru, State of Sao Paulo, Brazil, and associate it with socioeconomic profile of households. Methods: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children’s dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman’s correlation and Kruskal-Wallis test (p <0.05). Results: A dmft of 1.65 (± 2.87) and a Sic Index 4.88 (± 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). Conclusions: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children’s families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Correlation between dental caries and nutritional status: preschool children in a Brazilian municipality

INTRODUCTION: Dental caries and nutritional status in children in preschool age are serious public health problems, with multifactorial etiology, with diet as a common risk factor. OBJECTIVE: This cross-sectional study assessed the relationship between dental caries and nutritional status of preschool children attending public schools in a city in the State of Sao Paulo. MATERIAL AND METHOD: The study population was comprised of 3-5 year-old preschool children (n = 229) attending public schools, in which dmft (decay, missing, filled, teeth) was used for dental caries assessment and Body Mass Index (BMI) was used for nutritional status in accordance with the recommendations of the World Health Organization. Statistical analysis was performed in a descriptive way through absolute and relative frequencies and Spearman Correlation test and Kruskal Wallis (P<0.05). RESULT: A dmft of 1.65 (2.87) and a SiC index (Significant Caries Index) of 4.88 (3.20) have been found, indicating polarization of dental caries. It was observed that 66.81% of children presented with nutritional status within the normal range and children with malnutrition had a mean dmft of 4.0 (3.66), which is two times higher than the other categories of nutritional status. No statistically significant correlation has been found by correlating dmft and components with Body Mass Index. CONCLUSION: This research did not identify a significant correlation between the occurrence of dental caries and nutritional status of preschool children, researches should be conducted to elucidate this relationship.

Equidade na Estratégia Saúde da Família (ESF)

Objective: To associate the implementation of the Family Health Strategy (FHS) between 2001 and 2010 with the variables of the Municipal Human Development Index (MHDI) and socioeconomic indicators. Methods: Ecological study collected information on the MHDI, socioeconomic indicators, and the FHS, regarding the number of Community Health Workers (CHW), Family Health Teams (FHT), Oral Health Teams (OHT), and population and relative (%) coverage in 645 municipalities in the state of Sao Paulo, Brazil, in the period from 2001 to 2010. Descriptive analysis was conducted by means of absolute and relative frequencies for evaluation of each indicator. Non-parametric tests were used: Spearman’s correlation coefficient for the FHS variables and the socioeconomic indicators, and Wilcoxon test (p<0.05) for comparison between the two dates. Results: There was positive correlation between the increase in FHS and OHT teams, and the MHDI (p<0.01). Social data (access to water, waste collection percentage, and average income presented positive correlation with FHS and population coverage. A negative correlation was found between population coverage (%) and all the social variables except illiteracy. Conclusion: The evolution of the FHS in the state of Sao Paulo during the studied period was positive in fighting the health inequalities.

Towards Oral Health Promotion

What is the concept of health? What is oral health? What is the concept of health and oral health promotion? Is there a prescription to follow for any individual or a population? Can this universal prescription be refined to serve both developed and developing countries as well as populations with social deprivation characteristics? Many other questions could be raised before the discussion of oral health promotion or health promotion, yet the fact is that oral health is an important part of general health (1). Previous studies have thoroughly documented the association between oral health and other health conditions as well as also oral health’s relation to quality of life (2, 3). However, health promotion cannot be targeted to only health sector efforts; intersectorial actions are necessary to make oral health more affordable. Therefore, it is not possible to improve oral health without assembling the evolution of the concept of health promotion.