Maria Eneide Leitão de Almeida

Perfil epidemiológico da cárie dentária, doença periodontal, uso e necessidade de prótese em idosos residentes em uma instituição na cidade de Fortaleza, Ceará

In Brazil, the elderly population has been growing continuously, leading to a higher demand for long-term institutions for the elderly. In spite of that, studies on the oral health of institutionalized elderly in northeast Brazil are virtually non-existent. The objective of the present study was to analyze the dental and periodontal conditions and the use and need for prostheses in the institutionalized elderly in a northeastern Brazilian city. A cross-sectional study was conducted with 160 individuals (95.2% of the target population), 65 years old or older, living in a nursing home in the city of Fortaleza/CE - Brazil, consisting of the analysis of patient records and oral examination. Their mean age was 76.6 years. The DMFT index of the institutionalized elderly was high: 29.73. Lost teeth represented the highest proportion (28.42); 109 (68.1%) elderly did not have any healthy teeth. Of the 160 elderly, 93 (58.1%) were total edentates and 56 (35.0%) had teeth with exposed roots. Of the exposed roots, 16% were decayed or filled. Of the 67 dentate elderly, 54 (80.6%) required dental extraction. Of the total 573 teeth present, 256 (44.6%) required some kind of treatment, and 194 (75.8%) of them dental extraction. Of the study population, 112 (70%) did not use any upper prosthesis, and 130 (81.3%) did not use any lower prosthesis. The need of an upper prosthesis was detected in 135 elderly (84.4%), and 142 (88.7%) elderly needed a lower prosthesis. Of 117 sextants present in 160 elderly, the majority (838%) had dental calculus. These data show that most of the elderly had poor oral health. Interventional measures focused on these populations, such as health education and preventive treatment, are, therefore, necessary.No Brasil, a populacao de idosos esta em crescimento continuo, causando um aumento da demanda por instituicoes de longa permanencia para idosos. Porem, estudos no nordeste brasileiro sobre a saude bucal em idosos institucionalizados sao praticamente inexistentes. Esse estudo objetivou analisar a condicao dentaria, a condicao periodontal, o uso e necessidade de protese em idosos institucionalizados em um municipio do nordeste brasileiro. Foi realizado um estudo transversal em 160 idosos (95,2% da populacao-alvo) idosos de 65 anos e mais, residentes em um asilo na cidade de Fortaleza/CE - Brasil, consistindo de consulta aos prontuarios e exame bucal. A idade media foi de 76,6 anos. O indice CPO-D dos idosos asilados foi elevado com valor de 29,73. O componente dente perdido foi o que mais contribuiu para o alto valor do CPO-D, com 28,42 dentes; 109 (68,1%) idosos nao possuiam nenhum dente higido na boca. Dos 160 idosos, 93 (58,1%) eram totalmente desdentados e 56 (35,0%) apresentavam dentes com raizes expostas. Das raizes expostas, 16% estavam cariadas ou obturadas. Dos 573 dentes presentes, 256 (44,6%) necessitavam de algum tipo de tratamento, sendo 194 (75,8%) para extracao dentaria. Do total dos idosos investigados, 112 (70%) nao usavam nenhum tipo de protese superior (total e removivel) e 130 (81,3%) de protese inferior. Quanto a necessidade de protese (total e removivel) detectada, 135 (84,4%) necessitavam de algum tipo de protese superior e 142 (88,7%) de protese inferior. Dos 117 sextantes presentes nos 160 individuos, a maioria (83,8%) apresentava calculo dentario. Os dados mostram que a maioria dos idosos apresenta saude bucal precaria. Assim, sao indispensaveis medidas intervencionais focalizadas nessas populacoes como educacao em saude e tratamento precoce.

Análise dos fatores de risco ou de proteção para fluorose dentária em crianças de 6 a 8 anos em Fortaleza, Brasil

OBJETIVO: Investigar os fatores de risco ou de protecao para a fluorose dentaria na denticao permanente de criancas de 6 a 8 anos em um bairro no Municipio de Fortaleza, Brasil. METODOS: Este estudo de caso-controle incluiu 67 criancas com fluorose nos incisivos superiores e inferiores permanentes erupcionados, conforme o indice de Dean, e 57 controles. A presenca de fluorose foi determinada como variavel dependente. Os dados acerca das variaveis independentes foram obtidos atraves de entrevistas com os pais das criancas. O teste exato de Fisher foi utilizado para verificar a existencia de associacao entre fluorose e as variaveis independentes. Foi calculada a razao de chances (odds ratio, OR) para verificar a associacao e a probabilidade de fluorose no grupo-caso, ambos com significância de 95%. RESULTADOS: Houve associacao significativa da fluorose com tipo de moradia (propria, alugada ou ocupada), mas nao com fonte de agua para consumo ou uso de dentifricios fluoretados e suplementos de fluor. Na analise univariada, o risco de fluorose foi maior em criancas que iniciaram o consumo de leite em po reconstituido com agua antes dos 2 anos de idade (OR = 4,53; IC95%: 1,07 a 26,74) e nas que nao mamaram (OR = 6,66; IC95%: 1,61 a 38,62). Na analise multivariada, somente a amamentacao apresentou associacao com a fluorose (4,54; IC95%: 1,21 a 16,66). CONCLUSOES: A amamentacao se configurou como fator de protecao contra a fluorose. E preciso estabelecer criterios de classificacao mais especificos para permitir a investigacao de relacoes entre fluorose e classe socioeconomica

Poor Dental Status and Oral Hygiene Practices in Institutionalized Older People in Northeast Brazil

In this study we describe the dental status and oral hygiene practices in institutionalized older people and identify factors associated with poor dental status. A cross-sectional study was performed in a nursing home in Fortaleza, the capital of Ceará State (northeast Brazil). The number of decayed, missing, and filled teeth (DMFT) was assessed in the residents of the nursing home (n = 167; mean age = 76.6 years). The mean DMFT value was 29.7; the mean number of missing teeth was 28.4. Ninety-three (58.1%) were edentulous. Almost 90% practiced oral hygiene, but only about half used a toothbrush. Only 8% had visited a dentist in the preceding three months. Most of the variables regarding oral hygiene habits (such as the use of toothbrush, frequency of oral hygiene per day, regular tooth brushing after meals) did not show any significant association with the DMFT. In multivariate regression analysis, age, general literacy level, and practice of oral hygiene were independently associated with the DMFT (R2 = 0.13). Institutionalized older people in northeast Brazil have poor dental status, and oral hygiene practices are insufficient. Dental health education is needed focusing on the special needs of this neglected and socioeconomically deprived population to improve their quality of life.

Autopercepção de pessoas acometidas pela hanseníase sobre sua saúde bucal e necessidade de tratamento

A hanseniase e uma doenca infecciosa que produz impacto do ponto de vista fisico, social e psicologico. O proposito deste estudo foi avaliar a autopercepcao sobre saude bucal e a necessidade de tratamento em pacientes com hanseniase no Municipio de Fortaleza (CE), Brasil. Trata-se de um estudo transversal e descritivo, onde 100 pacientes com hanseniase foram submetidos a questionario semiestruturado. Os resultados da analise bivariada entre necessidade de tratamento e caracteristicas socioeconomicas mostrou que apenas a escolaridade apresentou associacao estatistica (p = 0,000). Verificou-se associacao entre a classificacao da saude bucal e autopercepcao da necessidade de tratamento (p = 0,05). Com relacao a autopercepcao em saude bucal, 36% dos sujeitos pesquisados classificaram sua saude bucal como boa. A autopercepcao do paciente com hanseniase quanto a sua saude bucal e necessidade de tratamento deve, juntamente com uma avaliacao clinica, servir de guia para a execucao de politicas publicas que visem a favorecer um tratamento odontologico mais efetivo para esses pacientes.Trata-se de caracterizar a evolucao da serie historica quanto ao tipo de parto, normal, cesarea e forceps, no periodo de 1960 a 2001, nas tres maternidades mais antigas e conveniadas ao Sistema Unico de Saude (SUS) de Juiz de Fora. O metodo utilizado denomina-se historia serial e permite a comparabilidade entre eventos historicos em determinado periodo de tempo. Foi identificado o aumento de incorporacao tecnologica nesta trajetoria e o crescente uso da cesariana ate 1998, quando se identifica o impacto da portaria no 2816, proposta pelo Ministerio da Saude, atraves de inversao dessa tendencia com elevacao do numero de partos normais. A diferenciacao constatada do tipo de parto de acordo com a categoria de internacao aponta para uma discussao marcadamente politica, que diz respeito as relacoes sociais em que se entrelacam desigualdades de diversas ordens, entre elas as de genero e de classe social. Conhecer as desigualdades e problematizar sua existencia, traduzida em perfis de morbimortalidade e padroes desiguais de assistencia, e precondicao para obter o encaminhamento da solucao.

Self-perception of people afflicted with leprosy regarding their oral health and the need for treatment

Leprosy is an infectious disease that has an impact from a physical, social and psychological standpoint. The scope of this study was to assess the self-perception on oral health and need for treatment in leprosy patients in the city of Fortaleza, State of Ceará, Brazil. This is a cross-sectional and descriptive study, where 100 leprosy patients were given a semi-structured questionnaire to fill out. The results of the bivariate analysis between need for treatment and socio-economic characteristics showed that only education revealed a statistical association (p=0.000). An association was verified between the classification of oral health and self-perception of need for treatment (p=0.05). With respect to the self-perception of oral health, 36% of the researched subjects classified their oral health as good. The self-perception of leprosy patients regarding their oral health and need for treatment, together with a clinical evaluation, should serve as a guide for the drafting of public policies that aim to foment more effective dental treatment for these patients.

Agreement between parents and adolescents on dental fluorosis: a population-based study.

This study evaluated the prevalence and severity of dental fluorosis and compared the reports from adolescents aged 12 to 18 years with those of their parents regarding the perceptions and concerns arising from this disease. The study was conducted in the cities of Viçosa and Sobral and the District of Rafael Arruda (Sobral), Ceará. A cross-sectional study was conducted from October 2010 to March 2011, with 891 students examined and 780 parents or guardians interviewed. Dental fluorosis was measured using the Deans Index, and the Childs and Parents Questionnaire about Teeth Appearance was used to assess the reports from parents and adolescents. A chi-squared test for trends was used to compare the opinions of parents and adolescents about fluorosis, and the agreement was measured using the weighted kappa. For the dichotomous variables, we used the unweighted kappa coefficient. The prevalence of fluorosis was 29.7%, but in the District of Rafael Arruda, evidence of very mild and mild fluorosis was found in 32.5% of the subjects, and moderate and severe fluorosis was found in 28.7%. There was poor agreement between the data reported by the adolescents and their parents or guardians regarding areas of concern and their perceived satisfaction with the appearance and color of their teeth. The prevalence of dental fluorosis was high in one of the communities studied, but the clinical diagnosis of this condition should not necessarily equate with concern and dissatisfaction with aesthetic appearances among teenagers and their parents.

Desnutrição energético-protéica e cárie dentária na primeira infância

Este estudo tem por objetivo investigar a relacao existente entre a desnutricao energetico-proteica e a cariedentaria precoce na primeira infância. Trata-se de uma comunicacao, para a qual foi realizada uma revisao daliteratura, a partir de analise documental de producao bibliografica, baseada em levantamentos de periodicose consultas a livros. Verificou-se que a carie precoce na infância e altamente prevalente nas comunidades debaixa renda, nas quais a desnutricao e um fator comum e de grande relevância. Estudos mostram que criancasdesnutridas tendem a apresentar defeitos estruturais no esmalte do dente, como tambem estao predispostasa um maior risco a carie dentaria. Portanto, uma deficiencia energetico-proteica durante a fase de desen-volvimento dentario (odontogenese) tem demonstrado uma maior suscetibilidade a carie dentaria, atraso nacronologia de erupcao e defeitos estruturais do esmalte (hipoplasia de esmalte), hipofuncao das glândulassalivares e mudanca na composicao da saliva. Estes fatores podem ser os mecanismos pelos quais a desnutricaoassocia-se a carie. Em conclusao, os estudos sugerem que a deficiencia energetico-proteica durante aodontogenese gera atraso na cronologia de erupcao e defeitos estruturais no esmalte (hipoplasia), alem depoder afetar as glândulas salivares, aumentando o risco de ocorrencia da doenca carie. Estudos investigandoassociacoes entre desnutricao e carie na primeira infância sao de grande relevância para ampliar o conhecimentodesta doenca e o desenvolvimento de acoes de promocao e de prevencao desse problema de saude publicacom aplicacoes nas areas de nutricao e odontologia.

Quality of life of postgraduate students stricto sensu in dentistry and sociodemographic factors

Introduction: Quality of life (QL) is subjective and must be based on a multidimensional construct and on positive and negative factors in the individual’s life. Objective: The objective of this study was to evaluate the QL of the students of the Postgraduate Program in Dentistry (PPGO) of the Federal University of Ceará. Material and method: Cross-sectional study with a quantitative approach, conducted with 88 students regularly enrolled in PPGO. The QL was measured by the World Health Organization Questionnaire for Quality of Life-bref (WHOQOL-bref). For a better analysis of the QL scores, they were categorized into three levels: dissatisfaction, uncertainty and satisfaction. A multinomial logistic regression model was used. Result: The majority of the respondents (55.7%) was classified in the area of satisfaction with QL, with 14,05 total average scores, corresponding to 62.8% of the total. By associating the socio-demographic data with the categories of analysis of QL, it was observed relevant in single students (p=0.005), those who considered themselves religious (p=0.041) and those who did not have a postgraduate scholarship (p=0.025), being evaluated in the area of dissatisfaction/uncertainty about the QL. Conclusion: It was concluded that marital status, religion and scholarship in postgraduate school were relevant in the QL of stricto sensu postgraduate students in Dentistry. Descriptors: Quality of life; students, dental; education.

Analysis of fluoride concentration in commercial bottled waters

Objective: Evaluate fluoride concentration in 500ml commercial brands of bottled water and compare it to the amount ​​printed on the label. Methods: A descriptive, cross-sectional epidemiological study was conducted. Samples of nine different commercial brands of 500ml bottled water were collected at authorized distribution points in the city of Fortaleza, CE, Brazil, in 2013. Fluoride concentration was determined in duplicate using a fluoride ion-selective electrode. The results were obtained from linear regression of the calibration curve. Results: Fluoride concentrations ranged between 0.07 and 0.63 ppm F- or mg F/L. There were significant differences between the values ​​​​printed on the labels and those found in the analysis. The fluoride concentration levels determined were not in compliance with the recommended levels by the National Health Surveillance Agency. Conclusions: The results obtained confirm the need for more careful monitoring of fluoride levels in bottled water and closer sanitary inspections.

Oral health indicators in primary health care: the understanding and the information recorded by dentist-surgeons

OBJECTIVE: This study aimed to know the understanding of Oral health indicators recommended by the Ministry of Health by dentists in the family health strategy of the state of Ceara in 2008.METHODS: It is a descriptive, cross-sectional study in which it was used a questionnaire to obtain the data concerning the way information on oral health actions performed in Family Health Care Units and other social spaces are registered, as well as investigate their knowledge about oral health indicators. The calculation of the sample of dentist-surgeons adopted an absolute sampling error of 6.8% and a significance level of 5%, resulting in an initial sample of 175 dentists; however, only 159 participated in this study according to the inclusion criteria. For instance, they should have been working in the service in the period from 2001 to 2007. In all, 32 cities participated in the research, distributed in 18 Regional Health Cells selected by drawing lots. The data were processed in the program SPSS version 17.0 and considered statistically significant the inferential analyses with p < 0.05.RESULTS: it was observed that there are differences between the interpretation of the indicators objectives and the data relating to oral health actions recorded by dentist-surgeons from the Family Health Strategy. They also differ from the guidelines of the Ministry of Health.CONCLUSION: The pregnant present some knowledge about oral health that can be improved by means of educational, preventive and healing programs. This group exert big it influences in the family ambit, could act as agents multipliers and avoiding the childs precocious contamination.