Efigênia e Ferreira

Prevalence and factors associated to dental trauma in infants 1–3 years of age

The aims of this study were to assess the epidemiology of traumatic dental injuries (TDI) to primary teeth in infants and toddlers between 1 and 3 years of age and investigate whether TDI was related to biological and social factors. A representative sample of infants and toddlers in the city of Belo Horizonte, Minas Gerais, Brazil (n = 519) was examined during a vaccination campaign. The evaluation of clinical signs of previous dental trauma was performed by nine previously calibrated examiners (intra-examiner Kappa = 0.95%; inter-examiner Kappa = 0.88%). Data were analysed through descriptive analysis, the chi-squared test (P < 0.050) and logistic regression. The prevalence of dental trauma was 41.6%. Among the 519 children examined, 193 (37.2%) had enamel fractures, 30 (5.7%) had enamel-dentin fractures and only three (0.6%) had enamel-dentin fractures involving the pulp. Dental care had been performed within the first 24 h in 4.1% of the sample and after 36 h in 0.8% of the sample. There was no statistically significant difference between genders. The most reported aetiologies were falls (28.8%) and collisions (6.8%). There were no statistically significant associations between the prevalence of dental trauma and non-nutritive sucking habits, dental caries or lip incompetence (P > 0.050). Children of mothers with low levels of schooling (0-6 years of study) had a greater prevalence of TDI (P = 0.001). The results of the logistic regression also demonstrated a significant association between dental injury and the Social Vulnerability Index (P = 0.045). Children from families with high social vulnerability (worse living conditions) had a 1.51 (95% confidence interval 1.0-2.2) greater chance of exhibiting TDI. These results can help guide the implementation of health promotion policies.

Relationship between the use of full dentures and mucosal alterations among elderly Brazilians

The objective of the present study was to evaluate the prevalence of oral mucosal lesions associated with the use of full dentures (FD) among non-institutionalized individuals of 60 or more years of age in a rural Brazilian population. The sample consisted of 344 individuals aged 60 or more from two rural communities of Brazil. Of this total, 146 were FD users and 198 FD, non-users. Angular cheilitis, denture stomatitis and inflammatory fibrous hyperplasia were statistically associated with prosthesis use. Hygiene and integrity of the prosthesis were related to the presence of oral lesions. While inflammatory fibrous hyperplasia was positively related to FD integrity, denture stomatitis was associated with time of use, hygiene status and integrity of FD. The results indicate the need for oral health care programmes for the elderly and show a relationship between time of use, quality and hygiene of oral prostheses with the presence of mucosal lesions.

Implications of edentulism on quality of life among elderly.

This study aimed was to test the association between quality of life and edentulism among elderly individuals in a city in southeastern Brazil. This cross-sectional study was carried out with 163 individuals aged 60 years or older, functionally independent and non-institutionalized. Data were collected with a questionnaire and oral examination. The edentulism was the dependent variable. The independent variables were sex, age, household income and quality of life (WHOQOL-Old) and their scores. To assess the association between the dependent variable and independent variables was used bivariate analysis (p < 0.10). Poisson regression model was performed, adjusting for age and sex. The average age of participants was 69 years (± 6.1), 68.7% were female and 52.8% were diagnosed as completely edentulous (90% CI: 0.33–1.24). When the independent variables were associated to the prevalence of edentulism, statistically significant associations were found for age (p = 0.03) and social participation dimension of the WHOQOL-Old (p = 0.08). In the Poisson regression, social participation remained statistically associated to edentulism {RP = 2.12 [90% CI (1.10–4.00)]}. The social participation proved to have a significant association to edentulism, thereby attesting to the negative effect of this condition on social aspects.

Impacto da perda dentária na qualidade de vida

In order to evaluate the impact of tooth loss in patients quality of life, 50 volunteers were selected among patients who use the Public Health Services in treatment for their complete dentures placement or replacement. The Oral Health Impact Profile (OHIP-14) and a socio-demographic data collection were applied before treatment. The values were founded through the weight of each question in association with Likerts Scale. As higher was the score, higher was the impact in the quality of life. In this survey 82% were female, 52% of patients between 41 and 60 years old (average: 59.1), and 34% married. The higher values of OHIP-14 dimensions in patients quality of life were: Psychological Discomfort (122), Physical Pain (121), Psychological Disability (113), Physical Disability (109), Functional Limitation (93), Handicap (82) and Social Disability (76). As it could be observed, the lost of teeth or the use of inadequate prosthesis could bring negative impacts in lifes quality, especially regarding preoccupation, stress with mouth problems and shame, although people perceive minor impacts in social relationships and development of their daily activities. This information can be relevant to prepare dentists to raise their knowledge about edentulous people and how to work with them.

Social capital and self-rated health among adolescents in Brazil: an exploratory study

BackgroundSocial capital may influence health and the patterns of association differ according its dimension such as cognitive, behavioral, bridging or bonding. There is a few numbers of studies in Latin America which comprise these aspects of social capital and health. The aim of this study was to examine the association between social capital and self-rated health among youth, and distinguish between the different forms of social capital - cognitive versus behavioral, and bonding versus bridging.FindingsA cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample comprised 363 individuals and data were collected using a validated structured questionnaire. The outcome, self-rated health, was measured as a dichotomous variable (poor/good health) and fourteen social capital indicators were investigated (cognitive, behavioral and bonding/bridging). Data were analyzed using multivariate logistic regression. Cognitive (social support and trust), behavioral (civic participation) and bridging social capital were associated with good self-rated health after adjustment of all the other social capital indicators and confounders (sex, age, skin color and educational background).ConclusionsSocial capital was associated with self-rated health and the patterns of association differed according its specific dimensions. Cognitive, behavioral and bridging social capitals were protective for adolescents health living in a developing country context..

Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults

BackgroundIn Brazil, a rapidly aging country suffering from large inequalities, the study of the quality of life (QOL) of aged people is important for the future health. The aim of this study was to examine the associations among QOL, gender, and physical and psychosocial health in older Brazilian community-dwelling adults to identify factors that are associated with better QOL.MethodsThe “Aging, Gender and Quality of Life (AGEQOL)” study, which included 2,052 respondents aged 60 or older, was conducted in Sete Lagoas, Brazil between January and July 2012. The respondents answered questions regarding their socioeconomic and demographic information, health and social situations, cognitive impairment, depressive symptoms and family satisfaction. The authors also applied the Brazilian version the World Health Organization Quality of Life QOL Assessment-Brief Instrument (WHOQOL-BREF) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Ordinal logistic regression with the Proportional-Odds and Logit function was used to test the association between QOL and physical and psychosocial health according to age and socioeconomic status.ResultsOlder adults of both genders with five or more years of education, good self-rated health, an absence of depressive symptoms, and no family dysfunction reported better QOL. Retired men had a better QOL compared to non-retired men (OR = 2.2; 95% CI = 1.4–3.2), but this association was not observed in females. Men living in mixed arrangements (OR = 0.5; p = 0.033) and women who did not practice physical activity (OR = 0.7; p = 0.022) tended to have poorer QOL.ConclusionsWe conclude that there are gender differences related to better QOL in this sample. Women with good physical and psychosocial health are more likely to have a better QOL. For men, the best QOL was associated with high socioeconomic conditions and good physical and psychosocial health.

The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies

The present study assesses the validity and reproducibility of two occlusal indices for epidemiological studies—the Dental Aesthetic Index (DAI) and the Dental Health Component of the Index of Orthodontic Treatment Need (DHC-IOTN) for the identification of orthodontic treatment needs. The total of 131 study models was examined by an examiner (orthodontic specialist) for the determination of the DAI and DHC-IOTN. Thirty days later, further assessment was performed to determine the reproducibility. The duration of each exam was measured in seconds with a stopwatch. The indices were compared by a panel of three experts in orthodontics to evaluate validity. The intra-examiner reliability evaluation resulted in an intraclass correlation coefficient of 0.89 for the DAI (95% CI = 0.64 to 1.0) and 0.87 for the DHC-IOTN (95% CI = 0.56 to 0.96). The time spent on the evaluation of the DHC-IOTN was less than the time spent on that of the DAI (P < 0.001). The accuracy of the indices, as reflected by the area under the receiver-operating characteristic curve, was 61% for the DAI (95% CI = 51 to 70; p = 0.037) and 67% for the DHC-IOTN (95% CI = 58 to 77; p = 0.001). Both indices presented good reproducibility and validity.

Perfil dos cuidadores de idosos nas instituições de longa permanência de Belo Horizonte, MG

The purpose of this cross-sectional study was to determine the profile of caregivers of elderly in long-term care facilities. The studied population included 181 randomly selected caregivers, 98 from philanthropic and 83 from private institutions in the city of Belo Horizonte. Data were collected applying structured questionnaires. The variables evaluated were sex, age group, educational level, marital status, income, economic condition, time of work in the facility, and professional experience. The data were compared using Chi-square and Fishers exact tests. There was no statistically significant difference between caregivers from the two facilities with regard to sex (p=0.62) and income (0.77). In the philanthropic facilities we observed more caregivers aged 50 years or more, widowers, with less than 4 years of study, socio-economic level D and who were working as caregivers in the facility for more than two years (p<0,05). The results of this study are relevant for discussing developing and implementing public policies aimed at qualifying the caregivers in long-term care institutions for elderly in Belo Horizonte.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

BackgroundWorkers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.MethodsThis cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression.ResultsPoor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions.ConclusionsThere is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.ResumoIntroduçãoOs trabalhadores da Atenção Primária à Saúde estão frequentemente expostos a estresse no trabalho. Esse estudo avaliou a associação entre condições estressantes no trabalho e qualidade de vida ruim entre trabalhadores da Atenção Primária à Saúde, Minas Gerais, Brasil.MétodosTrata-se de um estudo transversal analítico, que incluiu os 797 trabalhadores da Atenção Primária à Saúde. A qualidade de vida foi medida pelo WHOQOL-bref; considerou-se a questão de ordem geral e os domínios físico, psicológico, social e ambiente, com escores de 0 a 100, quanto maior o escore melhor a qualidade de vida. Os trabalhadores foram considerados com qualidade de vida ruim quando apresentaram escores no menor quartil de cada um dos domínios. O modelo Effort-reward Imbalance foi empregado para avaliação de condições estressantes no trabalho; composto pelo componente extrínseco (esforço e recompensa) e intrínseco (comprometimento excessivo no trabalho). As associações foram verificadas por meio de regressão logística múltipla.ResultadosQualidade de vida ruim foi observada em 15.4% dos trabalhadores. Trabalhadores com desequilíbrio esforço/recompensa (alto esforço/baixa recompensa) apresentaram maior chance de qualidade de vida ruim geral (OR = 1.91; 1.07-3.42), nos domínios físico (OR = 1.62; 1.02-2.66) e ambiente (OR = 2.39; 1.37-4.16); aqueles com baixo esforço/baixa recompensa apresentaram maior chance de qualidade de vida ruim no domínio social (OR = 1.82; 1.00-3.30). Trabalhadores com alto comprometimento no trabalho apresentaram maior chance de qualidade de vida ruim nos domínios físico (OR = 1.55; 1.06-2.26) e ambiente (OR = 1.69; 1.08-2.65). Essas associações foram independentes de características individuais, relacionadas ao trabalho, do estilo de vida, da percepção de saúde geral, das funções psicológica e biológica.ConclusõesHá uma associação entre estresse no trabalho e a qualidade de vida entre os trabalhadores da Atenção Primária à Saúde.

Perda dentária e expectativa da reposição protética: estudo qualitativo

This qualitative research analyses the repercussions of total dental loss on peoples quality of life. The Oral Health Impact Profile short-form (OHIP14) was applied to 50 volunteers, and after analyzing the results, 13 out of those 50, were selected to be individually interviewed in an opened questions script. The criteria to select these 13 people were: perception of the impact of mouth condition on quality of life measured by the score reached on OHIP. We tried to comprise the sample with a good variety, according to the profile of the initial sample. After analyzing peoples statements, it was possible to verify that dental loss had strong negative consequences on peoples life, like shame, difficulty to eat, impact on social relationship and feeling of not being complete. The possibility of having their teeth replaced generates some anxiety. Although being aware that wearing total prosthesis represents some sacrifices, people considered it worthwhile because the possibility of regaining the social pattern and the self-image is renewed.