Level of Satisfaction and Quality of Life of Caregivers of People with Disabilities in Secondary Dental Care

Objective: To assess the level of satisfaction and quality of life (QOL) of caregivers of Patients with Special Needs seen at the Dental Specialties Center in Aracaju, Brazil. Material and Methods: The Program for Primary Care Access and Quality Improvement (PMAQ – DSC) and the World Health Organization's Quality of Life - Brief (WHOQOL-BREF) questionnaires were applied to PSN and caregivers. Results: The PMAQ questionnaire was applied to 31 patients or caregivers; 97% had no paid work and 61% used public transportation to reach the Dental Specialties Center. The WHOQOL-BREF questionnaire was applied to 20 caregivers; 60% considered their life to be good; however, 60% had practically no leisure time. Correlation tests (Pearson’s coefficient) showed a statistically significant correlation between the physical and psychological domain (p=0.02; r=0.64), the psychological and social domain (p=0.033; r=0.48), and the psychological and environment domain (p<0.001; r=0.80). Conclusion: The caregivers and patients with special needs felt satisfied with the specialized oral health service offered by the municipality. Concerning the quality of life of caregivers, the majority stated they had a good quality of life, despite not having the opportunity to participate in leisure-oriented activities and often having negative feelings

Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food

Objective: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h). Method: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels. Results: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%). Conclusion: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives

Barreiras no acesso dos pacientes com necessidades especiais aos serviços odontológicos especializados / Barriers in the access of patients with special needs to specialized dental services

Avaliar o acesso dos Pacientes com Necessidades Especiais (PNE) aos Centros de Especialidades Odontológicas (CEO) Estaduais de Sergipe. Foram coletados dados de 2017 a 2019 do Sistema de Informação Ambulatorial, Cadastro Nacional de Estabelecimentos de Saúde e da Fundação Estadual de Saúde. Analisou-se dados de consultas agendadas, absenteísmos, procedimentos, referenciamentos, profissionaiss cadastrados, carga-horária e metas definidas. Foi aplicado um questionário aos 70 gestores municipais de saúde do Estado sobre disponibilização de transporte, conhecimento e percepção dos serviços e atendimento.  Houve CEO com 50% de falta dos pacientes às consultas.  Em 57,15% dos CEO no ano 2018 houve falta de profissionais. Em 100% dos serviços, não se atingiu a meta para procedimentos restauradores.  Os maiores encaminhamentos foram dos municípios sedes dos serviços. Foram observadas dificuldades no acesso dos PNE aos CEO quanto a ausência de profissionais, baixa carga-horária e baixo referenciamento

Mortality profile of myeloid and lymphoid leukemias in Brazil: 2000 to 2018 / Perfil de mortalidade por leucemias mieloide e linfoide no Brasil: 2000 a 2018

Introduction: Leukemias, despite their declining mortality over the years, continue to be a major public health problem in Brazil. Objective: to analyze trends in mortality from myeloid leukemia (LM) and lymphoid leukemia (LL) in Brazil from 2000 to 2018, correlating with health services and municipal human development index (MHDI). Methods: Data were collected from DATASUS databases for the year 2000 to 2018, regarding mortality rate, number of specialized hospitals, MDHI, primary care coverage and population by state. Correlation analyzes were performed between the studied variables and time series analysis to measure trends over the years (VPA – annual percentage change). Results: Approximately 50% of the Brazilian states showed a tendency to increase mortality from LL and LM. The North and Northeast regions have higher APC and lower MDHI. There is a statistically significant difference between MHDI and referral hospitals (p = 0.000; r = 0.64) and MHDI with primary care (p = 0.034; r = -0.41). For LL, mortality is higher in men (p < 0.001). There was a statistically significant correlation for LL mortality rate in women with primary care coverage (p=0.049; r=-0.38). Conclusions: Approximately 50% of Brazilian states showed increasing mortality. Mortality is higher in men with LL. Mortality of women with LL is lower where there are more primary and referral centers

Dental caries trends among preschool children in Indaiatuba, SP, Brazil

AIM:To evaluate caries experience and associated factors in 5-year-old preschool children in the city of Indaiatuba, SP, Brazil.METHODS:This was a cross-sectional, representative study, conducted from an epidemiological oral health survey (2010) with 303 children. The sample was established by the systematic probabilistic method, in public and private schools, in accordance with WHO criteria. The sample was checked for caries experience (dmft) by four trained and calibrated dentists, reaching acceptable levels of agreement for data collection. Parents or guardians answered questions related to their education and monthly income, and the children answered questions related to dental care and pain. Descriptive and bivariate analyses of independent variables were performed. Variables with p<0.20 were included in the model (Poisson regression analysis).RESULTS:The sample consisted of 151 boys and 152 girls, with a mean dmft of 1.46. The reasons for visiting a dentist due to pain or need for treatment were associated with dmft > 0 (PR=3.76, 95%CI=2.06-6.84) after adjustment of the regression model.CONCLUSIONS:Among the preschool children of this study, pain or need for treatment due to caries disease in the primary dentition and the reason to visit the dentist due pain emphasizing the importance of the professional not only in curative actions, but as a health promoter at the first contact with the child.1

Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food

Objective: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h). Method: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels. Results: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%). Conclusion: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives

Programa odontológico direcionado a crianças de familiares de baixa renda, Piracicaba, São Paulo, Brasil

A manutenção da saúde bucal em crianças de idade precoce torna-se importante devido ao fato da experiência de cárie na dentição decídua ser considerada como forte preditor da doença na dentição permanente, o que justifica a implementação de programas odontológicos voltados a esta população, assim sendo, os objetivos deste trabalho foram conhecer a saúde bucal, em relação à cárie e necessidades de tratamento em crianças com baixo poder aquisitivo no município de Piracicaba e verificar os resultados de um programa odontológico preventivo e educativo em Saúde Pública voltado a crianças (4 e 5 anos) em uma pré-escola do município. Este trabalho consta de dois grupos: grupo controle (Gl) e grupo teste (G2). Todas as crianças do grupo G2 realizaram ações de promoção e prevenção em saúde bucal, como Educação em Saúde, Atividades com uso de Flúor (de acordo com risco) e Higiene Bucal Supervisionada. Para análise estatística utilizou-se o teste / pareado(p=5%).Dentre as variáveis analisadas observa-se diferença entre os índices de placa e necessidades de tratamento pulpar. Obteve-se que ceos inicial em Gl era de 3,6 passando a 5 e em G2 era de 4,5 passando a 4,6 após um ano de análise. Ao analisar apenas os molares permanentes que erupcionaram durante o período do estudo, não foram encontradas diferenças para atividades de cárie entre os grupos Gl(p=0,08) eG2(p=0,5).Conclui-se que o programa odontológico preventivo apresentou resultados significativos no controle de placa durante o período, ressaltando que haveria necessidade de um período maior para o acompanhamento dos voluntários, a fim de verificarmos se a diminuição da quantidade de placa bacteriana refletiria na diminuição da atividade de cárie e conseqüentemente na história natural da cárie.Early maintenance of the oral health in children plays an important role in caries prevention; the experience of caries in the deciduous dentition is considered a caries predictor in the permanent dentition. Therefore, the aim of this study was to assess the oral health (caries and need for treatment) in children with low purchasing power living in Piracicaba, Sao Paulo, Brazil, as well as to evaluate the results of an educative and preventive public health program focusing on preschool children aged 4-5 years. Children were assigned to two groups; control (Gl) and experimental (G2). All children in G2 participated in an educational and preventive program, involving activities with fluorine use (considering risk) and supervised oral hygiene. Statistically significant difference (T-paired test) was observed between dental plaque index and need for root treatment The dmft values ranging from 3,6 to 5 were observed for GI and 4,5 and 4,6 tor G2, after one year old of program. When analyzing molar only the permanent ones, had not been differences for activities of caries between the groups Gl(p=0,08) and G2(p=0,5). In conclusion, the preventive program evaluated was efficient in controlling dental plaque; however, a longer follow-up period would be needed to verify this reduction in dental plaque formation would reduce activity caries

Relative validity of a scale with eight food items to measure frequency of sucrose intake

Orientadores: Paulo Frazão São Pedro, Jaime Aparecido CuryTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Objetivos: Comparar as medidas indiretas de consumo de açúcares extrínseco, por meio de um instrumento autorreferido e por meio de três R24h (recordatório de dieta de 24 h), utilizando como método de referência a média de 3 R24h e comparar as medidas diretas (por meio de medidas bioquímicas) e medidas indiretas (por meio do R24h) de consumo de açucares a fim de verificar possível correlação entre tais medidas. Materiais e métodos: Foi conduzido um estudo observacional transversal, em uma amostra intencional composta por 87 adolescentes (13 a 16 anos), residentes no município de Piracicaba em 2011. Os adolescentes foram identificados conforme os tercis de ingestão de açúcar e os mesmos responderam a três R24h (com intervalo de 15 dias entre cada aplicação) e um instrumento autorreferido contendo questões sobre a frequência e ingestão de açúcar ao qual foram expostos, além do momento em que ingeriram. Os alimentos descritos nos R24h foram convertidos em energia (Kcal), como energia e carboidratos pelo programa Dietwin e a quantidade em gramas de açucares foram convertidas pelo programa USDA. Foram ainda coletados saliva dos voluntários a fim de que fosse realizada análise bioquímica da enzima sacarase saliva e biofilme dental para analises dos íons Ca, Pi e F presentes neste biofilme.Os adolescentes foram ainda pesados e medidos a fim de se verificar o Índice de Massa Corpórea (IMC) dos voluntários. Resultados: Ao se comparar os R24h com o instrumento autorreferido verfica-se que os valores médios obtidos por meio do instrumento são sempre superiores aos relatados na média de ingestão dos R24h, com diferença estatisticamente significativa para maioria dos itens (teste de Wilcoxon p<0,05). Em relação ao momento de ingestão, não houve uma tendência clara de superestimação, sendo que para 6 dos 11 itens avaliados, as estimativas produzidas pelos métodos não foram significativamente diferentes (teste de McNemar). Ao se comparar os R24 com as medidas bioquímicas, verifica-se que foram encontradas correlações estatisticamente significativas entre frequência/quantidade e Energia; frequência/quantidade e Carboidrato. Contudo, não foram encontradas diferenças estatisticamente significativas entre a frequência e a quantidade de consumo de açúcar e as medidas bioquímicas (teste de correlação de Kendall). Conclusões: As estimativas relativas ao comportamento alimentar referidas por adolescentes devem por meio de instrumento autorreferido ser consideradas com cautela. Ao se comparar as medidas indiretas (R24h) e diretas (medidas bioquímicas), observa-se que em nível populacional as medidas bioquímicas não refletem a variação da ingestão de açúcares estimada pelos R24hAbstract: Objective: To compare the use of indirect measures of extrinsic sugars consumption, through an instrument of self-reported and through three R24h (diet recall 24 h), using as a reference method the R24h and to compare the direct measures (by measures biochemical ) and indirect measure (by R24h) of consumption of sugars in order to verify a possible correlation between these measures. Materials and methods: An cross-sectional observational study was conducted in a purposive sample of 87 adolescents (13-16 years) residing in the city of Piracicaba in 2011. The adolescents were identified according to tertiles of sugar intake and they answered three R24h (with an interval of 15 days between each application), and a self-reported instrument containing questions about intake, frequency of sugar and moment with which they were exposed. The foods described in the R24h were converted into energy (Kcal), with carbohydrates and energy using the Dietwin program and the amount of the sugar consumed was converted by the USDA program. Were collected saliva of volunteers to analysis of sucrase enzyme and biofilm to analysis of Ca, Pi and F present in this biofilm. Results: Comparing the R24h with the self-reported instrument in mean the values obtained from the instrument are always higher than those reported in the average intake of R24h, with a statistically significant difference for most items (Wilcoxon test p < 0 05). Regarding the time of intake, there was not a clear trend of overestimation, being that 6 of the 11 items assessed, the estimates produced by the methods were not significantly different (McNemar test). Comparing the R24h with biochemical measures, statistically significant correlations between frequency / quantity and Energy were found; frequency / quantity and Carbohydrate. However, no statistically significant differences between the frequency and the amount of sugar intake and biochemical measures (Kendall¿s correlation test) were found. Conclusions: The estimates of feeding behavior reported by the adolescent in a self-reported instrument should be considered with caution. Comparing indirect measures (R24h) and direct measure (biochemical measures), it is observed that the biochemical measures in the population level do not reflect the variation in intake of sugars estimated by R24hDoutoradoSaude ColetivaDoutora em Odontologi

Low fluoride dentifrice and deciduous enamel demineralization under different cariogenic challeng and sucrose exposure

Orientador: Jaime Aparecido CuryDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O uso de dentifrício fluoretado com menor concentração de flúor (500 ppm F) tem sido recomendado para crianças devido ao risco de fluorose, entretanto sua eficácia anticárie em relação ao dentifrício com concentração convencional de fluoreto (1100 ppm F) é desconhecida quando de acúmulo de biofilme dental e diferentes exposições à sacarose. Assim, um estudo in situ, cruzado e duplo cego relativo aos dentifrícios e boca dividida quanto à freqüência de exposição à sacarose foi conduzido em 4 fases de 14 dias cada. Em cada fase, 14 voluntários utilizaram dispositivos intra-orais palatinos contendo 8 blocos de esmalte decíduo, de dureza de superfície pré-determinada, os quais foram submetidos a acúmulo de biofilme dental e expostos à sacarose 20% nas freqüências de 2 a 8x/dia. Três vezes por dia os voluntários usaram formulações de dentifrício com 500 ou 1.100 ppm F (NaF, base sílica). No 14º dia, o biofilme formado sobre os blocos de esmalte foi coletado antes e 15 min após a escovação com o respectivo dentifrício para a determinação da concentração de flúor no fluido e parte sólida do biofilme. A desmineralização do esmalte foi avaliada pela porcentagem de perda de dureza de superfície (%PDS) e área de lesão de cárie (_S). Também foi avaliada a concentração de F no esmalte. A concentração de F no fluido e parte sólida do biofilme foi significativamente maior quando o dentifrício de 1.100 ppm F foi utilizado(p 0,05), entretanto somente o dentifrício com concentração convencional de F reduziu a área da lesão de cárie de acordo com a freqüência de exposição de sacarose (p 0.05), but only the conventional F dentifrice significantly reduced caries lesion progression according to the frequency of sucrose exposure (p<0.05). The findings suggest that the high F availability in biofilm, resulting from the use of conventional compared to low F dentifrice, is important to reduce caries lesion progression under a high frequency of sucrose exposure.MestradoSaude ColetivaMestre em Odontologi