Ronaldo Seichi Wada

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.

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.

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.

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.

Cárie dentária em adolescentes de 15 a 19 anos de idade no Estado de São Paulo, Brasil, 2002

Dental caries was evaluated by surveying 15-to-19-year-olds in the State of Sao Paulo, Brazil, in 2002, concerning disease prevalence and severity according to age, gender, ethnicity, and public water supply fluoridation. This cross-sectional study was based on data collected through an oral dental health epidemiological survey. Adolescents (n = 1,825) were examined at their homes by 132 dentists from 35 cities in the State of Sao Paulo. Chi-square, Kruskal-Wallis, and Mann-Whitney tests were used (a = 5%). The SiC Index was used to determine the groups having higher caries experience. DMF-T was 6.44 (sd = 4.60) and SiC Index was 11.68. Caries-free frequency was 9.6%. No statistically significant difference was observed for DMF-T in relation to public water supply fluoridation; however, there was a high percentage of caries-free individuals in cities with fluoridation. Caries conditions were worse in males. A higher prevalence of decayed and missing teeth was observed in the non-white groups. Therefore, emphasis is recommended on strategies to mitigate harm by caries progression, especially in higher-risk groups.

Dental caries experience in 12-year-old schoolchildren in southeastern Brazil.

The aim of this study was to evaluate the prevalence of caries-free children using DMFT and significant caries (SiC) indexes in different caries prevalence groups in cities of the region of Campinas, São Paulo State, Brazil. The methodology proposed by the World Health Organization (1997) was used for caries diagnosis in 2,378 individuals. According to the DMFT index obtained in each evaluated city, 3 prevalence groups with representative samples were formed, being classified as low, moderate and high. SiC index was used to classify the one third of the population with the highest caries prevalence. In the low prevalence group, 32.4% of the children were caries free (DMFT=0), with mean DMFT of 2.29 and SiC index of 4.93. In the moderate prevalence group, 21.8% of the children were caries free, with mean DMFT of 3.36 and SiC of 6.74. Only 6.9% of the children in the high prevalence group were caries free and the mean DMFT was 5.54 (SiC=9.62). There was a great heterogeneity in dental caries distribution within the studied population, as well as a high caries prevalence considering the 3 classifications. Other indexes besides DMFT could be used to improve oral health assessment during establishment of the treatment plan and intervention.

Fatores associados à experiência de cárie em escolares de um município com baixa prevalência de cárie dentária

The literature has shown that poorer levels of oral health are more frequently related to lower socio-economic status, consequently this cross-sectional and exploratory study conducted in 2003 investigated the association between caries and socio-economic factors, access to care, self-perception and habits among 266 12-year-old schoolchildren living in a community with low prevalence of dental caries. World Health Organization dental caries diagnosis methodology was used, in addition to the application of socio-economic and behavioral questionnaires. To identify the factors associated with dental caries, multivariate logistic regression was used and the dependent variable was synthesized into DMFT=0 and DMFT>0. Bearing in mind the limitations of a cross-sectional study, disliking the appearance of teeth, seeking dental care because of pain, studying at a state school and the head of the family being a manual worker were independently associated with dental caries. Even in a municipality with low prevalence of caries, the socio-economic status, dental care and self-perception were important factors in the incidence of dental caries among schoolchildren, and it is recommended that many factors in the bio-psychosocial context of multi-factorial dental caries should be investigated.

Cárie dentária e necessidades de tratamento em adolescentes do estado de São Paulo, 1998 e 2002

OBJETIVO: Avaliar indicadores de prevalencia e severidade de carie em adolescentes e as necessidades de tratamento. METODOS: Os dados foram obtidos a partir de levantamentos epidemiologicos em saude bucal realizados no Estado de Sao Paulo em 1998 e 2002, com adolescentes de 12 e 18 anos de idade. A experiencia de carie foi medida pelo indice de dentes permanentes cariados, perdidos e restaurados (CPOD) e a necessidade de tratamento foi avaliada segundo criterios da Organizacao Mundial de Saude. O significant caries index foi empregado para definir a experiencia de carie de um terco do grupo que apresentou maior experiencia da doenca. Para a idade de 12 anos, os exames ocorreram em escolas publicas e privadas, em 1998 (N=9.327) e 2002 (N=5.782), enquanto que os adolescentes de 18 anos, em 2002, foram examinados em seus domicilios (N=5195, em 1998 e N=257 em 2002). RESULTADOS: Aos 12 anos de idade, o indice CPOD foi de 3,72 em 1998 e de 2,52 em 2002, enquanto que aos 18 anos foi de 8,64 e 7,13, respectivamente. O significant caries index aos 12 anos foi de 7,40 (1998) e 5,62 (2002), aos 18 anos foi de 15,05 e 12,19, respectivamente. Aos 12 anos observou-se aumento de necessidades de restauracoes de uma superficie (p<0,0001) e de selantes aos 18 anos (p<0,0001). CONCLUSOES: Verificou-se que houve declinio da carie entre os adolescentes e a maioria das necessidades de tratamento odontologicas foram de baixa complexidade.

Saúde bucal dos pré-escolares, Piracicaba, Brasil, 1999

OBJETIVO: Verificar a prevalencia de carie, doenca gengival e fluorose e dimensionar as necessidades de tratamento dos pre-escolares. METODOS: Estudo transversal realizado a partir de um levantamento epidemiologico de saude bucal em 2.805 criancas de 5 e 6 anos, matriculadas em pre-escolas municipais de Piracicaba, SP. As criancas foram examinadas por uma equipe de dez dentistas, treinados e calibrados. Foi empregada a tecnica de consenso, aferindo-se o erro intra e inter examinadores pelo calculo de percentagem de concordância. RESULTADOS: Obteve-se 44,3% de criancas livres de carie aos 5 anos e 38,5% aos 6 anos de idade. O indice de carie para a denticao decidua (ceo-d) foi 2,64 aos cinco anos e 3,07 aos seis anos, sendo que 31,9% e 37,9%, respectivamente, apresentaram ceo-d maior que 3. O maior percentual de necessidade de tratamento (45,3%) foi a indicacao de restauracao de uma superficie dentaria. Quanto a saude gengival, 68,6% e 72,6% das criancas aos 5 e 6 anos apresentaram sangramento gengival. A prevalencia de fluorose observada foi de 2,6% aos 5 e 6,1% aos 6 anos. CONCLUSOES: Ha necessidade da implementacao de acoes e estrategias adequadas aos grupos de maior risco.

Relationship between dental caries and socio-economic factors in adolescents

Dental caries has a multifactorial etiology, including socio-economic variables and access to dental care, which were discussed in the national survey conducted in 2002. The aim of this study was to investigate the socio-economic aspects and access to dental care, associated with caries prevalence and severity in adolescents from the State of São Paulo. The study design was cross-sectional, on which data on 1,825 adolescents aged 15 to 19 years achieved from the data of an epidemiological survey conducted in the State of São Paulo in 2002 were analyzed. Epidemiological exams and interviews with previously formulated questions were used in the survey. The Significant Caries Index (SiC Index) was utilized to determine the group with higher caries experience. Frequency distribution and chi-square association tests were carried out in order to evaluate the relationship between independent variables and the dependent variable (DMFT). Confidence intervals and odds ratio (OR) were estimated. The risk factors pointed as indicators of presence of dental caries were as follows: not being a student, studying at public schools, family income lower than 5 Brazilian minimum wages. Moreover, not having an own house or a car seemed to contribute to caries experience. With regard to the access to public dental care, the adolescents assisted at public centers and looking for emergency dental care had the higher caries experience. Thus, the results showed that social deprivation is associated with caries experience in adolescents from the State of São Paulo.