Luiz Fernando Lolli

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. Objective Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and methods This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis. Results The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001). Conclusions The results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.

Prevalência de oclusopatias e comparação entre a Classificação de Angle e o Índice de Estética Dentária em escolares do interior do estado de São Paulo - Brasil

INTRODUCTION: The malocclusions are among the main buccal health problems all over the world, together with dental cavity and periodontal disease. Several indexes are being used for malocclusion registration. The present study verified the prevalence of this condition, using the Angle classification and the Dental Aesthetic Index (DAI), the severity and the necessity of orthodontic treatment registered with the DAI and the results of both indexes were compared, seeking to correlate collected data pattern and the viability of using them together. METHODS: The sample consisted of 734 schoolchildren with 12 years of age, both male and female from the public municipal schools in Lins-SP, Brazil. The exams were performed at the schools playgrounds with the use of IPC probes with a naked eye. RESULTS: For the Angle classification, it was found that 33.24% of the children presented normal occlusion and 66.76% presented malocclusions. It was observed, with the DAI, that 65.26% of the children had no abnormalities or had slight malocclusions. The defined malocclusion was present in 12.81%, severe malocclusion was observed in 10.90% and very severe or disabling malocclusion in 11.03%. Most of the children (70.57%) presented normal molar relationship and the anterior maxillary overjet was the most frequently observed alteration. When the indexes were compared there were similarities and divergences. CONCLUSION: DAI was not sensitive for some occlusion problems detected by the Angle classification, and vice-versa, demonstrating that both indexes have different points in malocclusions detection, so they could be used mutually in a complementary way.

Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa

The scope of this study was to discuss the administrative sustainability of Brazils Vocational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public administration. It was a qualitative study using case study methodology. The research involved a semi-structured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core activities. The majority did not have administrative autonomy and relied heavily on funding from the federal government. According to ETSUS managers, the lack of regulation of teaching activities by civil servants weakens the management of ETSUS. The ETSUS have managerial problems related to teaching-service integration, which has to be regulated in order to guarantee the sustainability of these schools and avoid conflicts with Brazilian legislation.

Harmful oral suction habits in children: association with breastfeeding and family social profile

Purpose: To record the prevalence of nonnutritive sucking habits (thumb and pacifier sucking) in children at 6 and 12 months of age and test its association with family social profile and breastfeeding pattern. Method: The sample consisted of 80 pairs of mother-child living in the Northwest region of the state of Sao Paulo, Brazil. A semi-structured questionnaire was used to collect data on the presence of nonnutritive sucking habits, family social profile and breastfeeding pattern when the children had 6 and 12 months of age. Data were analyzed by using qui-square tests. Results: Pacifier sucking was more frequent than thumb sucking. Exclusive breast feeding was not reported for children either in the 6th or 12th month of age, and approximately 70% were already receiving artificial feeding. There was no association between family social profile and sucking habits, but lower rates of breastfeeding was associated with pacifier sucking in the 12-month old children. Thumb sucking was not associated with breastfeeding. Conclusion: The frequency of breastfeeding was lower than that recommended by WHO for children in the age groups assessed. Pacifier sucking was more prevalent than thumb sucking and was associated with a lower rate of breastfeeding in the 12th-month old children. Family social profile does not seem to be related with nonnutritive sucking habits.