João Gabriel Silva Souza

Associação entre impactos funcionais e psicossociais das desordens bucais e qualidade de vida entre idosos

This study sought to evaluate the association between the impact of oral disorders in terms of physical/psychosocial dimensions and quality of life among the elderly. It involved a cross-sectional study conducted among the elderly (65-74 years) in 2008/2009. The social impact was assessed using the Oral Health Impact Profile (OHIP 14) and the quality of life using the SF 12 Short-Form Health Survey. Descriptive, univariate and multivariate (logistic regression) analysis was conducted with correction for the design effect, using SPSS(r)18.0 software. Of the 800 individuals approached, 736 elderly individuals participated (TR = 92%), with a mean age of 67.77 years, the majority of whom showed no impact based on the measurement of the prevalence of OHIP. The functional limitation dimension of the OHIP was associated with the physical domain of the SF12, irrespective of the other variables investigated. However, the seriousness of OHIP and its psychological discomfort and disability dimensions was associated with the mental domain of the SF12. The conclusion reached is that some impacts of oral disorders were associated with unsatisfactory quality of life in the physical and mental domains.

Is the negative evaluation of dental services among the Brazilian elderly population associated with the type of service

This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.

Uso de serviços odontológicos entre pré-escolares: estudo de base populacional

Estimou-se a prevalencia e fatores associados ao uso de servicos odontologicos, em uma amostra probabilistica, complexa, por conglomerados em dois estagios de pre-escolares com 18 a 36 meses de idade. Questionarios estruturados foram aplicados aos pais/responsaveis, os pre-escolares foram avaliados por cirurgioes-dentistas treinados e calibrados. Nas analises foram consideradas as correcoes pelo efeito de desenho e estimaram-se as magnitudes das associacoes a partir de regressao logistica (OR/ IC95%). Foram avaliados 809 pre-escolares, 15,5% havia usado servico odontologico. Ser mais velho (3,27/1,71-6,24), ter maior renda per capita (2,65/1,50-4,65), ter moradia propria (1,83/1,04-3,23), ter acesso a informacoes preventivas de saude bucal (5,44/3,00-9,86), usar fio dental (2,75/1,50-5,02) ocasionaram chances mais elevadas de uso desses servicos. Nao possuir experiencia de carie (0,22/0,13-0,38) e nao apresentar lesoes fundamentais em tecidos moles (0,10/0,01-0,77) ocasionaram menores chances. A prevalencia do uso de servicos odontologicos foi baixa, indicando a necessidade de maior oferta desses servicos e a ampliacao de acoes preventivas e de promocao de saude. A maior chance de usos entre aqueles com melhores condicoes socioeconomicas sugere iniquidade.

Impact of oral clinical problems on oral health-related quality of life in brazilian children: a hierarchical approach

BACKGROUND Oral health-related quality of life may be influenced by a series of characteristics. Considering the multidimensional character of quality of life, these impacts should be evaluated in the context of the physical, psychological, and social domains. AIM To evaluate the impact of clinical and perceived oral health problems on oral health-related quality of life in its different domains. DESIGN Clinical exams were conducted on a representative cross-sectional sample of 12-year-old children in Brazil. The instrument Oral Impacts on Daily Performance (OIDP) was used to evaluate the quality of life in relation to oral health. Descriptive, bivariate, and multiple hierarchical analyses were conducted. RESULTS Of the 7328 children studied, 2577 (33.5%) presented oral health-related impacts on quality of life. Clinical and perceived conditions of oral health were associated with the presence of overall impacts in the physical, psychological, and social dimensions of oral health-related quality of life. Furthermore, Family income was associated with overall impacts and the level of motivation to use dental health services was associated with the physical dimension. CONCLUSIONS The clinical and perceived conditions of oral health in Brazilian 12-year-olds were associated with a negative impact on oral health-related quality of life.

O idoso com comprometimento cognitivo apresenta pior condição de saúde bucal

A comparison of the oral health of elderly people with and without a cognitive handicap was assessed. The cognitive condition, the indices of decayed, missing, filled teeth (DMFT), decayed, filled roots (DFR), the need for dental treatment, the presence of plaque (P), calculus (C), the community periodontal index (CPI), the rate of periodontal attachment loss (PAL), edentulism, prosthetic use and the need for prosthetics were evaluated in a complex probabilistic sample by conglomerates of the elderly (65-74 years). PASW(r) 17.0 was used for the statistical analyses with correction for the design effect, applying the Mann Whitney and chi-square test with 95% reliability. A total of 736 elderly individuals were interviewed and examined. Those with cognitive impairment had higher average DMFT, DFR and lower average healthy sextant CPI, a lower prevalence of sextants without plaque/calculus, use of prosthetics and higher prevalence of edentulism and need for prosthetics. Elderly individuals with a cognitive handicap had poorer oral health.

Calcium Prerinse before Fluoride Rinse Reduces Enamel Demineralization: An in situ Caries Study

A calcium (Ca) prerinse before a fluoride (F) rinse has been shown to increase oral F levels. We tested the anticaries effect of this combination in a dose-response in situ caries model. In a double-blind, crossover experiment, 10 volunteers carried enamel slabs in palatal appliances for 14 days, during which they rinsed twice/day with one of four rinse combinations: (1) a placebo prerinse (150 mM sodium lactate) followed by a distilled water rinse (negative control); (2) a placebo prerinse followed by a 250 ppm F rinse; (3) a placebo prerinse followed by a 1,000 ppm F rinse, or (4) a Ca prerinse (150 mM Ca, as calcium lactate) followed by a 250 ppm F rinse. Sucrose solution was dripped onto the slabs 8×/day to simulate a high cariogenic challenge. The percent surface hardness loss (%SHL) was significantly lower in the Ca prerinse used with the 250 ppm F rinse group (%SHL = 38.0 ± 21.0) when compared with the F rinse alone (%SHL = 59.5 ± 24.1) and similar to the 1,000 ppm F rinse group (%SHL = 42.0 ± 18.3). Compared with the 250 ppm F rinse, the Ca prerinse increased biofilm fluid F only twice (nonsignificant). However, it greatly increased F in biofilm solids (∼22×). The Ca prerinse had little effect on loosely or firmly bound enamel F. The results showed an increased level of protection against demineralization by the use of a Ca prerinse, which seems to be caused by the enhancement of F concentration in the biofilm.

Acesso a informações sobre como evitar problemas bucais entre escolares da Rede Pública de Ensino

The scope of this study is to identify the prevalence of access to information about how to prevent oral problems among schoolchildren in the public school network, as well as the factors associated with such access. This is a cross-sectional and analytical study conducted among 12-year-old schoolchildren in a Brazilian municipality with a large population. The examinations were performed by 24 trained dentists and calibrated with the aid of 24 recorders. Data collection occurred in 36 public schools selected from the 89 public schools of the city. Descriptive, univariate and multiple analyses were conducted. Of the 2510 schoolchildren included in the study, 2211 reported having received information about how to prevent oral problems. Access to such information was greater among those who used private dental services; and lower among those who used the service for treatment, who evaluated the service as regular or bad/awful. The latter use toothbrush only or toothbrush and tongue scrubbing as a means of oral hygiene and who reported not being satisfied with the appearance of their teeth. The conclusion drawn is that the majority of schoolchildren had access to information about how to prevent oral problems, though access was associated with the characteristics of health services, health behavior and outcomes.

Equidade no uso de serviços odontológicos provenientes do SUS entre idosos: estudo de base populacional

The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.

Users’ dissatisfaction with dental care: a population-based household study

OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users’ dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users’ dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units.

Prevalence of oral cancer self-examination among elderly people treated under Brazil's Unified Health System: household health survey

The aim of this study was to examine the prevalence of oral cancer self-examinationamong the elderly and confirm whether prevalence was higher among users of the dental services provided by Brazils Unified Health System (SUS, acronym in Portuguese). A transversal study of elderly people aged between 65 and 74 years living in a large-sized Brazilian municipality was conducted using simple random sampling. Logistic regression was conducted and results were corrected for sample design and unequal weighting using the SPSS(r) software. The study assessed 740 individuals. A total of 492 met the inclusion criteria, of which 101 (22.4%) reported having performed an oral cancer self-examination. Prevalence was higher among users of the dental services provided by the SUS, higher-income individuals, people with higher levels of education, individuals that used a removable dental prosthesis, and people who had not experienced discomfort attributed to oral condition, and lower among people who sought regular and periodic dental treatment and individuals who did not have a drinking habit. This type of self-care should be encouraged by public health policies which respond to the needs of the elderly, with emphasis on users of private and philanthropic services, and other services outside the public health network.