Lúcia Maria Fantinel

Factors associated to endemic dental fluorosis in Brazilian rural communities.

The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9) or absence (TF = 0) of any degree of dental fluorosis; and presence (TF ≥ 5—with loss of enamel structure) or absence of severe dental fluorosis (TF ≤ 4—with no loss of enamel structure). Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073) and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060) in the water of deep wells. No other variable was associated with this prevalence (p > 0.05). More severe dental fluorosis (TF ≥ 5) was only associated with age group (p < 0.05). No other variable was associated to the severe dental fluorosis (p > 0.05). Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05) to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value.

Beliefs and attitudes about endemic dental fluorosis among adolescents in rural Brazil

OBJETIVO: Compreender crencas e atitudes em relacao a fluorose dentaria de jovens residentes em regiao rural do Brasil. PROCEDIMENTOS METODOLOGICOS: Estudo qualitativo em que foram realizadas entrevistas semi-estruturadas com 23 adolescentes com fluorose dentaria, 14 professores e tres gestores publicos no municipio de Sao Francisco, MG, em 2002. Foram empregadas a tecnica de analise de conteudo e a teoria das representacoes sociais. ANALISE DOS RESULTADOS: Pelas caracteristicas organolepticas que imprime a agua (sabor salgado, coloracao esbranquicada e turbidez) e sua associacao com aspectos negativos relacionados ao uso domestico, o carbonato e considerado a causa da fluorose por adolescentes e professores. Mesmo apos o contato com pesquisadores que investigaram o fenomeno e que participaram da sua solucao, a populacao continua a resistir em aceitar o fluor como causa do problema e nao concorda plenamente com o uso de agua de outras fontes por duvidar de sua qualidade. CONCLUSOES: Percepcoes equivocadas em relacao as causas da fluorose dentaria e a dificuldade em custear o tratamento da agua comprometem a implantacao de suprimento de agua de superficie nao contaminada. Estrategias de educacao em saude devem ser implementadas paralelamente a solucoes para captacao de agua de fontes alternativas nao contaminadas em localidades afetadas pela seca.OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.

Crenças e atitudes em relação à fluorose dentária de jovens em região rural do Brasil

OBJETIVO: Compreender crencas e atitudes em relacao a fluorose dentaria de jovens residentes em regiao rural do Brasil. PROCEDIMENTOS METODOLOGICOS: Estudo qualitativo em que foram realizadas entrevistas semi-estruturadas com 23 adolescentes com fluorose dentaria, 14 professores e tres gestores publicos no municipio de Sao Francisco, MG, em 2002. Foram empregadas a tecnica de analise de conteudo e a teoria das representacoes sociais. ANALISE DOS RESULTADOS: Pelas caracteristicas organolepticas que imprime a agua (sabor salgado, coloracao esbranquicada e turbidez) e sua associacao com aspectos negativos relacionados ao uso domestico, o carbonato e considerado a causa da fluorose por adolescentes e professores. Mesmo apos o contato com pesquisadores que investigaram o fenomeno e que participaram da sua solucao, a populacao continua a resistir em aceitar o fluor como causa do problema e nao concorda plenamente com o uso de agua de outras fontes por duvidar de sua qualidade. CONCLUSOES: Percepcoes equivocadas em relacao as causas da fluorose dentaria e a dificuldade em custear o tratamento da agua comprometem a implantacao de suprimento de agua de superficie nao contaminada. Estrategias de educacao em saude devem ser implementadas paralelamente a solucoes para captacao de agua de fontes alternativas nao contaminadas em localidades afetadas pela seca.OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.

Creencias y actitudes con relación a la fluorosis dentaria de jóvenes en región rural de Brasil

OBJETIVO: Compreender crencas e atitudes em relacao a fluorose dentaria de jovens residentes em regiao rural do Brasil. PROCEDIMENTOS METODOLOGICOS: Estudo qualitativo em que foram realizadas entrevistas semi-estruturadas com 23 adolescentes com fluorose dentaria, 14 professores e tres gestores publicos no municipio de Sao Francisco, MG, em 2002. Foram empregadas a tecnica de analise de conteudo e a teoria das representacoes sociais. ANALISE DOS RESULTADOS: Pelas caracteristicas organolepticas que imprime a agua (sabor salgado, coloracao esbranquicada e turbidez) e sua associacao com aspectos negativos relacionados ao uso domestico, o carbonato e considerado a causa da fluorose por adolescentes e professores. Mesmo apos o contato com pesquisadores que investigaram o fenomeno e que participaram da sua solucao, a populacao continua a resistir em aceitar o fluor como causa do problema e nao concorda plenamente com o uso de agua de outras fontes por duvidar de sua qualidade. CONCLUSOES: Percepcoes equivocadas em relacao as causas da fluorose dentaria e a dificuldade em custear o tratamento da agua comprometem a implantacao de suprimento de agua de superficie nao contaminada. Estrategias de educacao em saude devem ser implementadas paralelamente a solucoes para captacao de agua de fontes alternativas nao contaminadas em localidades afetadas pela seca.OBJECTIVE: To understand beliefs and attitudes about fluorosis among young people living in a rural area. METHODOLOGICAL PROCEDURES: Qualitative study consisting of semi-structured interviews with 23 adolescents with dental fluorosis, 14 teachers and three health authorities in the city of São Francisco, Southeastern Brazil, in 2002. Content analysis and social representation theory were applied. ANALYSIS OF RESULTS: The organoleptic characteristics of carbonates that affect groundwater (salty flavor, whitish coloration, and turbidity) associated with negative aspects of household use of this water are considered a cause of mottled enamel. Even after contact with researchers who investigated this phenomenon and helped find a solution for this condition, the local population is still unwilling to accept fluoride as the cause of the problem and does not fully agree to use water from other sources because they are afraid of the quality of water. CONCLUSIONS: Misperceptions of the causes of dental fluorosis and water treatment costs compromise the implementation of uncontaminated surface water supplies. Health education strategies are required in parallel with solutions for securing water supply in drought-ravaged areas.