Silvia Cypriano

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.

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.

Desigualdades na distribuição da cárie dentária em adolescentes de Indaiatuba (SP), 2004

The objectives of this work was to know the dental caries prevalence and treatment need, besides the distribution of the dental caries in a population of 12 year-old teenagers with high incidence of dental caries. 309 adolescents of public schools of Indaiatuba, Sao Paulo State, in 2004, were examined. They were selected by process systematic random and the exams followed the World Health Organization criteria. The percentile of school caries free was of 38.8%. Among the adolescents examined, 36.6% (n=113) presented dental caries. DMFT was of 2.50 (IC95%=2.07-2.93). The decayed component was the highest (61.0%). The coefficient of Gini was 0.602 and SiC value was of 5.97 (IC95%=5.32-6.62); in this group especially, 74.7% (n=74) presented dental caries activity in the moment of the exam. Thus, it can be concluded that the adolescents of this city presented low dental caries experience; however, their needs were not assisted, once most of DMFT was formed of the decayed component at 12 years old. In the group SiC, it was verified that this came quite high, being recommended actions addressed to this specific group of adolescents.The objectives of this work was to know the dental caries prevalence and treatment need, besides the distribution of the dental caries in a population of 12 year-old teenagers with high incidence of dental caries. 309 adolescents of public schools of Indaiatuba, São Paulo State, in 2004, were examined. They were selected by process systematic random and the exams followed the World Health Organization criteria. The percentile of school caries free was of 38.8%. Among the adolescents examined, 36.6% (n=113) presented dental caries. DMFT was of 2.50 (IC95%=2.07-2.93). The decayed component was the highest (61.0%). The coefficient of Gini was 0.602 and SiC value was of 5.97 (IC95%=5.32-6.62); in this group especially, 74.7% (n=74) presented dental caries activity in the moment of the exam. Thus, it can be concluded that the adolescents of this city presented low dental caries experience; however, their needs were not assisted, once most of DMFT was formed of the decayed component at 12 years old. In the group SiC, it was verified that this came quite high, being recommended actions addressed to this specific group of adolescents.

Polarization of dental caries among individuals aged 15 to 18 years

Objective: To evaluate the role of socioeconomic variables and self-perceived oral health in the polarization of caries among adolescents in Santa Bárbara DOeste, Brazil. Material and Methods: Cross-sectional study. Sampling was randomized and sample size was defined according to WHO criteria. Two hundred and seventy seven adolescents (15 to 18 year-old) were examined by five trained examiners that assessed DMFT index according to WHO criteria. Self-perceived oral health, access to dental services and socio-demographic variables were self-reported. Students t tests, chi-square tests, and multivariate logistic regression (with significant caries index (SiC) as the outcome), were performed. Results: Mean DMFT was 5.48 (±4.22) and the proportion of caries free subjects was 15.5%. Mean DMFT (9.71±2.85) and mean D (1.67±2.18) of SiC positive subjects were significantly higher than mean DMFT (2.88±2.17) and mean D (0.45±0.87) of SiC negative subjects (p<0.0001). Mean D of white (0.76±1.51) was significantly smaller than mean D of non-white subjects (1.32±2.01). The only variable independently associated with the SiC positive outcome was report of toothache within six months prior to the study [OR=1.83 (95%CI 1.08 to 3.12)], p<0.001. Conclusion: SiC was associated with report of toothache but not with sociodemographic variables in the studied population.

Atividade de cárie na dentição decídua, Indaiatuba, São Paulo, Brasil, 2004

Os objetivos deste trabalho foram verificar a atividade de carie, alem de conhecer a experiencia de carie (ceod), necessidades de tratamento e defeitos de esmalte em pre-escolares de cinco anos de idade. Examinaram-se 624 criancas de Indaiatuba, Sao Paulo, Brasil, em 2004, selecionadas por meio de processo amostral aleatorio sistematico. Para medir a experiencia de carie e necessidade de tratamento adotou-se os criterios da OMS. Para a atividade de carie, optou-se por uma simplificacao dos criterios de diagnostico de Nyvad et al. Na analise estatistica utilizaram-se os testes Mann Whitney e qui-quadrado com nivel de significância de 5%. 40,5% dos pre-escolares apresentaram atividade de carie. O ceod foi de 1,62 (IC95%: 1,35-1,89). Entre os doentes (ceod > 0) o ceod foi 3,81 (IC95%: 3,36-4,26), ainda neste grupo, 91,4% das criancas apresentaram atividade de carie. O indice de cuidados foi de 12,3%. Sugere-se que medidas de prevencao e tratamento direcionadas a essa populacao continuem sendo priorizadas, uma vez que as medidas de controle e paralisacao da carie em seus estagios iniciais sao bem conhecidas. Alem disso, recomenda-se cuidado direcionado aos pre-escolares com maior experiencia de caries.

FATORES ASSOCIADOS À PREVALÊNCIA E INTENSIDADE DE ODONTALGIA EM CRIANÇAS DE MUNICÍPIOS DA REGIÃO DE CAMPINAS, SÃO PAULO

ABSTRACT Objective: The aim of this study was to evaluate the prevalence and intensity of dental pain in children according to size of municipality, associated factors and absenteeism. Methods: The sample consisted of children aged 12 years old from public and private schools drawn from eight cities in the region of Campinas (SP). A questionnaire was applied to obtain dental pain, demographic, socioeconomic data, and a clinical examination was carried out to evaluate the experience of having a cavity. The outcome for the logistic regression analysis was having pain and the outcome for the negative log-binomial regression was the intensity of pain. The significance level was 5%. Results: The sample consisted of 1,233 children, and 16.7% reported pain in the last six months. Dental pain was the cause of 46.4% of school absenteeism during this period. The prevalence of pain was lower among households with high income (p=0.023) and higher among nonwhites (p=0.027). Pain intensity was lower in medium-sized cities (p=0.02) and small cities (p=0.004), and higher in children whose parents had a lower educational level (p=0.003), children who sought out a dentist for the pain (p=0.04) and who had untreated cavities (p=0.04). Conclusions: The prevalence and intensity of dental pain in children aged under 12 are related to socioeconomic aspects of the family, such as low-income and parents with a low level of education, which impact daily activities as seen through school absenteeism. Pain intensity was lower in medium and small cities. Oral health promotion strategies in this age group should be encouraged to avoid dental pain.