Luciane Zanin

Comparação entre medidas de reprodutibilidade para a calibração em levantamentos epidemiológicos da cárie dentária

This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.

Oral health conditions and self-perception among edentulous individuals with different prosthetic status

Aim: To evaluate the objective oral health conditions and self-perception of edentulous individuals wearing functional complete dentures (FCD) and non-functional complete dentures (NFCD) and completely edentulous non-denture wearers, and identify the factors that influence self-evaluation and the impact on quality of life. Methods: The convenience sample was selected at the integrated clinic of a Dentistry Course (n=193) and was divided into 3 groups: FCD wearers (n= 54); NFCD wearers (n= 65); 3- edentulous non-denture wearers (n= 74). Data collection was performed by means of interviews, application of the Geriatric Oral Health Assessment Index (GOHAI) and clinical exams. Data were submitted to univariate analysis and logistic regression, considering dichotomization of the sample by the median value of GOHAI (=30). Results: Individuals with NFCD are 4.5 times more likely to show a low GOHAI score than individuals with FCD; edentulous individuals are 7.5 times more likely to show a low GOHAI score than individuals with FCD; individuals that consider their oral health as regular, poor or bad are 3.1 times more likely to show a low GOHAI score than individuals who consider their oral health as good or excellent. Conclusions: Being completely edentulous or wearing NFCD, and having oral health classified as regular, poor or extremely bad were important features for a negative self-perception of oral health, with impact on quality of life.

Association between preference for sweet foods and dental caries

OBJECTIVE: To assess the relationship between caries prevalence and sugar preference in schoolchildren.METHODS: The sample has consisted of 96 schoolchildren of both genders and age ranging from 5 to 12, enrolled at the Maria Aparecida de Jesus Segura Rural School in Sumare, Sao Paulo, Brazil. The inclusions criteria were: enrolled schoolchildren; with an authorization to participate in the research, from the parents or guardians; cooperative and not having orthodontic appliances, difficulty with mouth opening and no restriction on sugar consumption. The history of caries was performed by calibrated examiners (Kappa= 0,85) according the World Health Organization criteria. The preference for sugar was assessed using a modified version of the Sweet Preference Inventory. Each schoolchild tasted five grape juice solutions, in which the sugar concentration varied from 0 to 40g/liter. The association between the variables, DMFT and dmft was dichotomized into DMFT=0 and DMFT≥1; dmft=0 e dmft ≥1 and the sugar preference as low (A, B, C, D) and high (E).RESULTS: There was no significant association between the genders as regards preference for sugar in the solutions (Fisher Exact Test, p= 0.2150), and as regards the DMFT (Chi-Square Test, p=0.2789). In both caries history situations, the majority of the children preferred a high sugar concentration (Chi-Square Test, p=0.2463).CONCLUSION: There were no association between history of caries and preference of sugar. There no was association between gender and preference for sugar.

Prevalence of dental fractures and associated factors in students of Valinhos, SP, Brazil

AIM: To investigate the prevalence of dental fractures and their association with risk factors in the permanent dentition of adolescents in Valinhos, SP, Brazil. METHODS: The study population was obtained using the probability sampling method and comprised 379 students between 13 and 19 years old enrolled in the eight State schools of the city, who were examined by nine pairs of calibrated dentists (Kappa>0.80). The presence of dental fractures in permanent anterior incisors, as well as the presence of considerable overjet (> 5mm) and lip seal was evaluated in a clinical-epidemiological examination. RESULTS: The prevalence of dental trauma was 27.1%. The most frequent lesions were enamel fractures (72.6%) of which falls were the main cause (45.7%). No association was found between the presence of considerable overjet and deficient lip seal (chi-square test; p>0.05). CONCLUSIONS: The prevalence of dental trauma in the studied population was expressive when compared with the literature, but the analyzed oral aspects did not contribute to its occurrence.

Violence against children and adolescents: profile and tendencies resulting from Law 13.010

OBJECTIVE Describing the profile of reported violence against children and adolescents and draw an essay on the initial effects of Law 13.010 on report patterns. METHOD Analytic study of reported cases on SINAN - Information System on Reportable Harms (from 2013 to 2015) of violence to individuals under 19, in 53 cities of Minas Gerais. RESULTS 1,481 cases were reported, 49.2% before and 50.8% after Law 13.010 came to force (p = 0.5501). There was a 7% decrease on female reports and a 27.2% in male reports (p = 0.0055). It was noticed a change in report patterns (p = 0.0023), with a 130.7% increase to neglect/abandonment reports and a 33% decrease to sexual abuse report. Higher rates of violence from the parents happens at the 1 to 9-year-old age group (p < 0.0001). CONCLUSION Main victims were women, individuals from 15 to 19 years, with aggression happening within the household; after Law 13.010, changes to patterns of victim and offender profiles and of kind of violence were noticed.

Risk behaviors related to eating disorders in adolescents and its association with dental erosion

Introducao A supervalorizacao da magreza como padrao de beleza vem contribuindo para o desenvolvimento de disturbios alimentares e tem acometido, sobretudo, adolescentes e adultos jovens. Objetivo Avaliar a prevalencia do comportamento de risco para disturbios alimentares e a sua associacao com a erosao dentaria em adolescentes. Material e metodo Trata-se de estudo epidemiologico observacional transversal. A amostra foi composta por 278 adolescentes de 12 a 18 anos, residentes em Campinas - SP, provenientes de escola publica. Foram utilizados para coleta dos dados 02 questionarios para investigacao dos disturbios alimentares: o Teste de Investigacao Bulimica de Edimburgo e o Teste de Atitudes Alimentares. Logo apos, foram realizados exames bucais por examinadores calibrados para a avaliacao da erosao dentaria. Resultado A idade media da amostra foi de 14,8 anos. A prevalencia de medio risco de bulimia na amostra foi de 43,2% (IC95%: 37,3%-49,0%) e a prevalencia de adolescentes com possibilidade de bulimia foi de 53,2% (IC95%: 47,4%-59,1%). Do total 11,9% (IC95%: 8,1%-15,7%) apresentou resultado sugestivo para anorexia. Entre as mulheres 66,9% foram classificadas com possibilidade de apresentar bulimia, ja nos homens essa prevalencia foi de 39,0%. Com relacao a erosao, apenas 1,1% da amostra apresentou erosao dentaria. Conclusao O estudo apontou para grande numero de adolescentes com comportamento de risco para disturbios alimentares sem que tenha sido evidenciada associacao com a erosao dentaria, visto a sua baixa prevalencia.

Pregnant women's oral health: knowledge, practices and their relationship with periodontal disease

Objective To evaluate pregnant womens knowledge and perception of oral practices as well as their relationship with periodontal disease. Methods The project was developed in 27 units of the Family Health Strategy in the city of Picos, State of Piaui, Brazil, whose service prioritized providing the first dental appointment for pregnant women. A questionnaire was applied to 302 pregnant women, and a calibrated examiner (Kappa=0.96) performed the intraoral exam (CPI). Results the disease was present in 90.7% of them, although 96.4% had been to the dentist once, the majority have not seen a dentist during pregnancy, either because they feared the treatment would harm the baby, or lack of perceiving the need for doing so. Among those that had seen a dentist, did so because of pain or due to routine dental appointments. (19.9%). The belief that pregnancy could cause oral problems was mentioned by 39.7%, however, the majority (98.3%) stated they had received no guidance in this period, a fact which was shown to be associated with periodontal disease (p=0.0003). Conclusion It was concluded that there had been disease prevalence in the group, becoming persistent throughout pregnancy and also that the women presented many oral health care doubts during their gestational period.

Evaluation of the use of services provided by emergency care units in a Brazilian municipality

ABSTRACT ObjectiveTo characterize the users and to analyze the factors that determine their choice in using the emergency services.MethodsThe study was carried out in the two Emergency Care Units in Serra (Espirito Santo, Brazil). With regard to those users seeking the services of these Emergency Care Units, a trained interviewer approached 1 out of every 4 adults classified in the nursing consultation as not relevant to the Service (“false demand”), amounting to a total of 390 interviews. Using a validated questionnaire, the interview was conducted in accordance with the policies set out in the Health Service Action Plan. 80% of the demand was classified as not relevant.ResultsThe “false demand” was chiefly composed of women (55.1%), educated to a level between high school and incomplete higher education (69.4%) and 14.6% were enrolled in private health plans. 78.5% had not previously sought any health service, in view of the ostensible guarantee of same-day care (43.1%) or the difficulty in receiving care in the basic health units (37.9%).ConclusionThe majority of consultations performed in the Emergency Care Units should be resolved in basic healthcare facilities. The “false demand” is related to the reported difficulties the basic health units have in providing the necessary care and their ability to resolve the problem.Indexing terms: Accessibility to health services. Emergency medical services. Unified Health System.

Influence of Soft Drink Intake on the Salivary pH of Schoolchildren

Objective: To evaluate the influence of Coca-Cola ® consumption on the salivary pH of 12-year old children. Material and Methods: The convenience sample was composed of forty-five 12-year old students of both genders from public schools of Itatiba, state of Sao Paulo, Brazil. Salivary pH was measured with pH colorimetric tape indicator (Merck). The reading of the colorimetric method was made by an experienced evaluator under uniform lighting conditions. The colorimetric tape was positioned in the back of the student’s tongue, which remained with the mouth shut for 30 Seconds. For control, the first measurement (T 0 ) was performed before the intake of the soft drink (baseline pH). Subsequently, students were instructed to slowly drink 100 ml of Coca-Cola ® using a plastic disposable cup. Immediately after ingestion, the pH was measured again with the colorimetric tape (t 1 ). The oral pH values were also measured 5 minutes (t 2 ), 10 minutes (t 3 ) and 15 minutes (t 4 ) after the soft drink intake, keeping the tape positioning always the same in all measurements. The statistical SAS software was used for data analysis. Comparisons of oral pH values at different times were performed by the Tukey-Kramer test adopting 5% significance level. Results: Immediately after soft drink intake, the salivary pH significantly decreased (pH = 6.26) (p <0.05) compared to baseline (pH = 7.23) (p <0.05). Fifteen minutes after ingestion, although an increase in the pH was observed (pH = 6.64), it had not yet returned to baseline (T 0 ) (p <0.05). Conclusion: Coca-Cola ® intake caused a significant reduction in salivary pH, without, however, reaching critical pH for enamel demineralization.

Absenteísmo por causa médica e odontológica em empresa de serviços gráficos e de informação

O absenteismo no trabalho tem sido considerado um obstaculo no mundo corporativo, incidindo negativamente sobre a produtividade das empresas e na saude do trabalhador. Objetivo: Determinar o absenteismo por causas medicas e odontologicas e suas associacoes com variaveis demogra- ficas e trabalhistas. Metodos: Foram analisados 387 prontuarios de saude dos funcionarios de uma empresa de servicos graficos e de informacao, no periodo 24 meses, associando variaveis demograficas: genero, idade e trabalhistas: tempo de admissao e categoria profissional, com a presenca de atestados e declaracoes medicas e odontologicas, caracterizando respectivamente o absenteismo doenca e o absenteismo saude. Resultados: Foram identificados 749 documentos que justificavam a ausencia no ambiente laboral, em 194 prontuarios (50,1%), totalizando 1.604 dias de afastamento, sendo, 48,3% representados pelos atestados me- dicos, 2,8% pelos atestados odontologicos, 37,7% declaracoes medicas e 11,2% declaracoes odontologicas. As principais causas de absenteismo doenca foram as relacionadas ao olho e seus anexos (16,2%) e ao sistema osteomuscular e tecido conjuntivo (14,1%). As morbidades de causa odontologica mais frequentes foram as exodontias (23,8%), pulpites (19,1%) e carie dentaria (19,1%). Observou-se associacao entre o numero de atestados medicos e o tempo de admissao e a categoria profissional e entre o numero de declaracoes medicas e odontologicas com o genero feminino e tempo de admissao. Conclusao: O absenteismo medico foi superior ao odontologico, porem este ultimo representou a 11a causa de afastamento dos trabalhadores do seu ambiente laboral. O impacto dos problemas bucais causa limitacoes no desempenho funcional que pode ser mensurado atraves dos indices de absenteismo saude e doenca...(AU)