Daniel Demétrio Faustino-Silva

Saúde Bucal na Ação Programática da Criança: indicadores e metas de um Serviço de Atenção Primária à Saúde

The objective of this study is to assess fulfillment of the oral health goals of the Childrens Preventive Health Care Initiative in 12 Health Units (HU) of a Primary Health Care Service, in Porto Alegre, in the state of Rio Grande do Sul, through a cross-sectional analytical study on the annual dental visit coverage in early childhood. The study was comprised of 660 children born in 2010. In relation to the coverage of dental visits for each year of life of children, the health units did not achieve the set targets (100%). However, a considerable number of children (35%) had their first dental visit during the first year of life. In relation to the total number of visits, 22% of the children had never gone to the dentist and only 8% did the recommended four visits. There was a positive correlation between the ratio of the total population and children from ages 0 to 4 years in the area enrolled in the initiative, on the one hand, and the number of dental professionals and coverage in the first year of life in each health unit, on the other. Although few children had adequate follow-up visits in relation to the set targets, the percentage of coverage was higher than that found in the literature.The objective of this study is to assess fulfillment of the oral health goals of the Childrens Preventive Health Care Initiative in 12 Health Units (HU) of a Primary Health Care Service, in Porto Alegre, in the state of Rio Grande do Sul, through a cross-sectional analytical study on the annual dental visit coverage in early childhood. The study was comprised of 660 children born in 2010. In relation to the coverage of dental visits for each year of life of children, the health units did not achieve the set targets (100%). However, a considerable number of children (35%) had their first dental visit during the first year of life. In relation to the total number of visits, 22% of the children had never gone to the dentist and only 8% did the recommended four visits. There was a positive correlation between the ratio of the total population and children from ages 0 to 4 years in the area enrolled in the initiative, on the one hand, and the number of dental professionals and coverage in the first year of life in each health unit, on the other. Although few children had adequate follow-up visits in relation to the set targets, the percentage of coverage was higher than that found in the literature.

Motivational Interviewing in Preventing Early Childhood Caries in Primary Healthcare: A Community-based Randomized Cluster Trial

Objective To assess the effectiveness of motivational interviewing in preventing early childhood caries compared with conventional oral health education. Study design Twelve health care units in southern Brazil were randomly allocated in 2 groups of 6 and professionals in 1 group were trained in motivational interviewing. The mothers/children and external examiners were blinded to the intervention. The data were collected by calibrated examiners using questionnaires and a clinical examination based on modified International Caries Detection and Assessment System criteria. Of the 674 children born in the catchment area in the year 2013, 469 received the intervention (224 in the conventional oral health education group, 245 in the motivational interviewing group), and 320 were examined by the end of the study (145 in the conventional oral health education group, 175 in the motivational interviewing group), with mean age of 30 months. The final follow‐up was 68%, after 3 years. Results Mean of decayed, missing, and filled surfaces at the end of the study period for the whole sample was 1.34 (95% CI 0.97‐1.71). The caries rate per 100 surface‐year in the conventional oral health education group was 1.74 (95% CI 1.14‐2.34) and in the motivational interviewing group, it was 0.92 (95% CI 0.63‐1.20). To correct for clustering effect and unbalanced factors, multilevel Poisson regression was fitted and the effect of motivational interviewing on the incidence rate ratio was 0.40 (95% CI 0.21‐0.79). Conclusions An intervention based on the principles of motivational interviewing style was more effective in reducing the number of surfaces affected by early childhood caries compared with conventional oral health education intervention. Trial registration ClinicalTrials.gov NCT02578966, Brazilian Registry of Clinical Trials RBR‐8fvwxq.

Relationship between Asthma, Malocclusion and Mouth Breathing in Primary Health Care Children

Objective: To assess the relationship between asthma, malocclusion and mouth breathing. Material and Methods: This investigation was a cross-sectional study of 228 children between 6 and 12 years of age, of whom 112 were asthmatic and 116 were not, performed in two Primary Health Units of Porto Alegre, Brazil. The assessment consisted of a mouth exam performed by two calibrated dentists, an interview with parents/caregivers and medical chart data. Mouth breathing was determined through oral-facial changes related to Mouth Breathing Syndrome. Occlusion was assessed according to Angle’s Classification for permanent or mixed teeth and regarding primary teeth were based on the canine relationships. The data were assessed by the Chi-square test and Poisson regression, with robust variation, at a p<0.05 significant level. Results: Asthma [PR = 2.12 (95% CI: 1.46-3.08), p<0.001] and the use of pacifiers [PR = 1.98 (95% CI: 1.27-3.07), p<0.001] were associated with mouth breathing, in the final multivariate model. Age [PR = 1.02 (95% CI: 1.00-1.03), p=0.039] and thumb sucking [PR = 1.08 (95% CI: 1.03-1.13), p=0.001] were associated with malocclusion in the final multivariate model, while there was no relationship between asthma and malocclusion (PR = 1.00; 95% CI: 0.94-1.07). Conclusion: This study provides evidence of the relationship between asthma and mouth breathing in children, demonstrating that knowledge regarding the oral health of populations with chronic diseases is fundamental for developing health programmes suitable to their needs and risks.

Resistência de união do adesivo à dentina de dentes decíduos submetidos a dois métodos de remoção químico-mecânica da cárie

The aim of this study was to evaluate the bond strength to dentin of deciduous teeth after caries removal.with PapacarieTM and CarisolvTM and then compare it with the conventional method of caries removal. It is an in vitro essay which sample consisted of 15 deciduous decayed exfoliated teeth and divided into three groups: PapacarieTM – caries removal with PapacarieTM; CarisolvTM – caries removal with CarisolvTM gel multimix; Control – caries removal with low speed burs. All teeth were restored with composite resin Z 100TM and stored in distilled water at 37 oC for 24 hours. Microtensile tests were achieved with sticks of 0.5 mm2 of adhesive area in universal testing machine Emic DL-2000TM, at the speed of 1 mm/min. the results were submitted to analysis of variance (Anova) and the Tukey test, with a significance level of 5%. The mean values of the bond strength of groups PapacarieTM and CarisolvTM did not show significant statistical difference (p = 0.98). Therefore, in the control group, in which the conventional caries removal was accomplished, the statistical values were higher when compared to group PapacarieTM (p < 0.001) and CarisolvTM (p < 0.001). it It is concluded that chemomechanical methods of caries removal had similar PapacarieTM and CarisolvTM performance and both showed less bond strength to dentin than with the methods with low speed burs.

Pacientes com fissura labiopalatina – acompanhamento de casos clínicos DOI:10.5585/conssaude.v9i2.2256

Introducao: Fissura labiopalatina e considerada um problema de saude publica, tendo os portadores de passar por diversas etapas para sua cura. Objetivo: Relatar casos clinicos de pacientes com fissura labiopalatina, mostrando o processo de reabilitacao e as consequencias psicologicas. Metodo: Foi realizado estudo longitudinal com quatro pacientes fissurados, submetidos a tratamento de reabilitacao multidisciplinar. Resultados: A fissura de labio-palato interfere na vida de pacientes tanto no aspecto funcional quanto no psicologico, por isso individuos com tal patologia precisam receber cuidados multidisciplinares, e o tratamento deve comecar com a maior antecedencia possivel. Conclusao: Sugere-se que o paciente fissurado tenha um fator genetico predisponente a essa doenca, podendo apresentar um menor desenvolvimento fisico e ate mental. Ele pode sofrer preconceito e abandono ou ser negligenciado pela sociedade que nao sabe lidar com essa situacao, nem que um tratamento correto, na epoca adequada, pode proporcionar ao doente melhores chances de reabilitacao.