Maria da Luz Rosário de Sousa

Oral status and its association with general quality of life in older independent‐living south‐Brazilians

BACKGROUND There are few studies assessing the importance of oral status, particularly tooth loss, edentulism and satisfaction with mastication, on the perception of quality of life (qol) in general. The objective of this study was to evaluate if oral status was associated with lower ratings in the WHO Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) domains. METHODS In this cross-sectional study, a random sample of 872 Southern-Brazilians aged 60 years or more was evaluated using a structured questionnaire to assess sociodemographic data, qol (WHOQOL-BREF), and depressive symptoms (Geriatric Depression Scale). Oral examinations assessing the number of teeth and saliva flow were performed. Additionally, participants were asked to rate their satisfaction with the ability to chew. Correlates of poorer qol (i.e. values of the WHOQOL-BREF < or = median) were assessed by means of multivariate logistic regressions. RESULTS Poorer qol in the physical domain was associated with increasing age, income, living in rural areas, >2 chronic conditions, intake of medications, depressive symptoms, edentulism, and reporting difficulty for chewing food. Poorer qol in the psychological domain was associated with income, schooling, >2 chronic conditions, intake of medications, depressive symptoms, and difficulty for chewing. Poorer qol in the environment domain was associated with income, living in urban areas, depressive symptoms, and difficulty for chewing. Poorer qol in the social relations domain was associated with living in urban areas, depressive symptoms, and difficulty for chewing. CONCLUSION In the studied population, oral status was associated with the perception of quality of life in general.

Oral status and its association with obesity in Southern Brazilian older people.

BACKGROUND AND OBJECTIVE The loss of a functional dentition imposes eating difficulties and food avoidance, which may be detrimental in terms of nutritional status and health. The objective of this study was to investigate whether tooth loss and edentulism that were not rehabilitated with dental prostheses were associated with obesity among elderly in Southern Brazil. MATERIALS AND METHODS A random sample of 872 independently living elderly was evaluated by means of a cross-sectional study. Socio-demographic, medical history and behaviour data were assessed using a standardised questionnaire. Two trained dentists assessed the number of teeth and use of prostheses in accordance with the WHO criteria. Height and weight were assessed and used to generate body mass index (BMI = weight (kilos)/height (cm)(2)) data. Participants were categorised into non-obese (BMI <or= 30) or obese (BMI > 30). Multivariate logistic regression was used to model the relationship between number of teeth and use of dental prostheses with obesity adjusting for confounders. RESULTS Multivariate logistic regression revealed that edentulous persons wearing only upper dentures (OR = 2.34, 95% CI 1.18-4.27) and dentate participants with one to eight teeth wearing 0-to-1 prosthesis (OR = 2.96, 95% CI 1.68-5.19) were more likely to be obese. CONCLUSION The results show that a poorer oral status, represented by having fewer teeth that were not replaced by dental prostheses, was associated with obesity in Southern Brazil older people, suggesting a close relationship between poor oral status and systemic conditions that may have important clinical implications.

Autopercepção e condições de saúde bucal em uma população de idosos

This study assessed oral health conditions through clinical examination and self-perception. The sample consisted of 112 subjects 60 years of age or older in Rio Claro, Sao Paulo, Brazil, divided into two groups: G1, with dental insurance (n = 55) and G2, without dental insurance (n = 57). Clinical examinations were conducted according to WHO guidelines. Data on self-perceived oral health were collected using the GOHAI (Geriatric Oral Health Assessment Index). DMFT was 29.13, higher in G1 (p = 0.0091). Mean number of teeth currently present in both groups was 7.63, higher in G2 (p = 0.0131). Periodontal conditions showed a high percentage of null sextants (70.3%), where CPI revealed higher prevalence for calculus and PIP for pockets up to 3mm. The percentage of edentulous subjects was 45.5%, higher in G1 (p = 0.0142). Among edentulous subjects, 69.6% wore complete upper dentures and 42.9% complete lower dentures. Mean GOHAI was 33.61, qualifying self-perceived oral health status as positive, and the only difference was in the physical dimension, where G2 showed higher values (p = 0.0154). Self-perceived oral health was considered satisfactory, but this was not confirmed by clinical data from the two groups.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

Problematiza-se a afirmacao de que nao sao validas as estimativas sobre as condicoes de saude bucal da populacao brasileira geradas pelo SB Brasil 2003. Criticam-se os elementos que pretendem sustentar esse ponto de vista com base apenas em conceitos estatisticos, sem prova empirica. Identificam-se reducoes decorrentes da abordagem epistemocentrica que recusa peremptoriamente outras formas de conhecimento e nao reconhece o carater multidisciplinar da epidemiologia. Reconstituem-se informacoes sobre a realizacao do levantamento e seu impacto na producao de conhecimento. Faz-se uma analogia entre ciencia e arte, argumentando-se que, nas imagens obtidas por ambas, os saberes gerados a partir do objeto cognoscivel assumem feicoes variadas e, portanto, o reconhecimento de sua validade requer amplo dominio do objeto e operacoes com adequados criterios de valor. Conclui-se pela cientificidade, validade e relevância da producao academica desenvolvida a partir da base de dados do levantamento SB Brasil 2003.

Experiência de cárie dentária em crianças de escolas públicas e privadas de um município com água fluoretada

The aim of this study was to verify the relationship between type of school as a measure of socioeconomic conditions and caries prevalence among preschoolers and schoolchildren in Rio Claro, São Paulo State, Brazil, a city with fluoridated water supply. The data were secondary, from a sample of 888 children 5 to 12 years old enrolled in private and public schools. Caries was measured by the dmft and DMFT indices as well as the Care index. Qui-square and Mann-Whitney tests were utilized with 5% significance. In 5-year-old children, mean dmft was 2.50, and 42.20% were caries-free. At age 12, mean DMFT was 2.70 and 28.90% were caries-free. Caries prevalence rates in public schoolchildren as compared to private were 74.50% and 61.20%, respectively (p < 0.0001), and the dmft and DMFT scores were the highest in public schoolchildren (p < 0.05). The Care Index was higher in private schoolchildren (71.20%) as compared to public (52.80%). Highest caries rates were found among public schoolchildren, so the variable type of school proved sensitive for discriminating different oral health conditions; however limitations need to be recognized, suggesting that other variables should be assessed.

Paulínia, São Paulo, Brasil: situação da cárie dentária com relação às metas OMS 2000 e 2010

An epidemiological survey was conducted in Paulinia, Sao Paulo State, Brazil, in 2000, aimed at verifying the prevalence of principal oral health problems, using the DMFT index and WHO diagnostic criteria. The sample (1,151) was randomly selected. The dmft was 1.90 in 5-year-olds, with 54.2% caries-free. DMFT was 1.00 in 12-year-olds, with 46.4% caries-free in the permanent dentition. Fluorosis prevalence in 7 to 12-year-olds was 30.5%, mostly the very mild form (22.9%). Prevalence of opacities and hypoplasias was 9.1%. In adults, the dental care index was 55.4% and an average of 21.30 teeth presented caries experience. In the elderly, DMFT was 29.50, consisting predominantly of extracted teeth (93.0%).

A saúde bucal de escolares residentes em locais com ou sem fluoretação nas águas de abastecimento público na região de Sorocaba, São Paulo, Brasil

Este estudo apresenta dados de carie dentaria e fluorose em sete municipios representativos da regiao de Sorocaba, Sao Paulo, Brasil, que possuem ou nao fluor nas aguas de abastecimento publico. A metodologia utilizada foi proposta pela Organizacao Mundial da Saude (WHO, 1997), adaptada pela Faculdade de Saude Publica da Universidade de Sao Paulo. A amostra foi probabilistica, admitindo um erro de desenho de 2 e perda amostral de 20,0% (n = 96 por idade). Foram calibrados seis examinadores, com porcentagem de concordância acima de 89% para as variaveis pesquisadas. Obteve-se o resultado de 37,6% de criancas livres de carie aos 5 anos (ceod = 0) e o indice ceod foi de 3,1. Aos 12 anos, 32,3% dos escolares tinham CPOD = 0 e o indice CPOD foi de 2,6, sendo a regiao considerada de baixa prevalencia de carie. Nos municipios com agua fluoretada a proporcao de criancas livres de carie aos 12 anos foi maior (p = 0,019), e o indice ceod foi menor (p = 0,001). A prevalencia de fluorose nas criancas examinadas foi de 12,7%, estando dentro de limites aceitaveis segundo o indice de fluorose dentaria da comunidade.

Relação entre níveis de fluoreto na água de abastecimento público e fluorose dental

OBJETIVO: Avaliar a prevalencia da fluorose dentaria em escolares sujeitos a diferentes concentracoes de fluoreto na agua de abastecimento publico das suas cidades. METODOS: A amostra foi composta de 386 escolares de sete anos de idade, moradores de dois municipios do estado de Sao Paulo que realizaram heterocontrole da fluoretacao da agua de 1998 a 2002, um deles apresentando concentracao homogenea de fluoreto e o outro oscilante. Fluorose dental foi determinada examinando os incisivos superiores permanentes (secos) pelo indice de Dean, o grau de fluorose classificado como questionavel foi considerado como fluorose. Variaveis sociodemograficas e questoes sobre saude bucal foram avaliadas com questionario estruturado enviado aos pais/responsaveis. Associacoes foram verificadas por meio de regressao logistica multipla (p<0,05). RESULTADOS: Ambos os municipios apresentaram grau leve de fluorose. A prevalencia de fluorose no municipio com teores oscilantes de fluor na agua foi de 31,4% e no municipio com teores homogeneos foi de 79,9%. A prevalencia de fluorose foi associada com o municipio com teores de fluor homogeneos na agua (OR=8,33, IC 95%: 5,15;13,45) e nao possuir automovel (OR=2,10, IC 95%: 1,27;3,49) CONCLUSOES: Embora a prevalencia de fluorose tenha sido maior nas criancas do municipio que possuia melhor controle da concentracao otima de fluoreto na agua, esta nao afetou a estetica dental dos comprometidos.

Saúde bucal em adultos e idosos na cidade de Rio Claro, São Paulo, Brasil

The aim of this study was to verify the prevalence of dental caries, edentulism, and use of and need for complete dental prostheses in adults and the elderly in Rio Claro, São Paulo State, Brazil. The total sample included 202 subjects, 101 elderly (64 to 75 year-olds) and 101 adults (35 to 44 year-olds), who were examined by four examiners according to who criteria. Edentulism was 74.25% in the elderly and 8.91% in adults, and present teeth rates were 3.19 and 22.10, respectively. In the elderly and adults, DMFT was 31.09 and 22.86, respectively. MT was the major component of the DMFT index in the elderly group (92.64%), as compared to FT in the adult group (57%), followed by MT (40.54%). complete upper and lower dental prostheses were needed by only 1% of the adults; however, 48.5% of the elderly required complete upper prostheses and 45.5% complete lower prostheses. the data suggest that preventive and educational programs are needed for both the elderly group and adults in order for adults to enjoy good oral health when they reach old age.

Prevalência de defeitos de esmalte e sua relação com cárie dentária nas dentições decídua e permanente, Indaiatuba, São Paulo, Brasil

The aim of this study was to determine the prevalence of hypoplasia, demarcated opacity and dental fluorosis among schoolchildren with deciduous and permanent dentition. The association between enamel defects and dental caries was also verified. The sample consisted of 624 schoolchildren aged 5 and 309 aged 12. The dmft and DMFT indexes were used to assess dental caries prevalence, DDE to assess enamel defects, and Dean to assess fluorosis. Chi-squared test was used to test significance (p < 0.05) and odds ratio to analyze prevalence of dental caries and enamel defects. A positive association between dental caries and enamel defects (hypoplasia, demarcated opacity and dental fluorosis) was observed for schoolchildren aged 5. However, only hypoplasia and demarcated opacity were associated with caries experience in permanent dentition. The results of this study indicated that children had increased odds of dental caries when enamel defect was present, both in deciduous and permanent dentition; further studies are needed to give evidence to this association.