Dental care in social programs for socially vulnerable populations on the perspective of the Uruguay Trabaja program

This paper discusses the characteristics of the oral health subprogram ‘Uruguay Trabaja’ (UT), in Montevideo, and identifies finished, unfinished, and abandoned dental treatments from 2008 to 2015. The implementation of the UT, its characteristics, and the subprogram aimed at oral health are described through documentary analysis. The Program is conceptually discussed according to two categorical levels. The first refers to the macro-social context, related to the expansion of dental care coverage integrated into social protection systems, while the second one is based on the systematic observation of the dental care included in social programs. The UT is a nine-month social program which occurs every year for people between 18 and 65 years old, in social and economic vulnerability situations and unemployed for a long term. It aims at improving employment chances and the participants’ social integration. Comprehensive dental care is one of the benefits of the program, as it is not available at the National Integrated Health System. Of the 2.592 dental treatments initiated, 941 (36,3%) were completed. Focused programs such as the UT should be articulated to universal social policies, which must adequately meet the needs of the entire population. Comprehensive dental care should be included into the National Integrated Health System, to ensure the right to oral health.Este trabalho discute características do subprograma da saúde bucal do programa Uruguai Trabaja (UT), em Montevidéu, e identifica os tratamentos odontológicos iniciados, completados e abandonados de 2008 a 2015. Por meio de análise documental, o UT é discutido a partir de dois níveis categóricos. O primeiro refere-se ao contexto macrossocial, relacionando-se à expansão da cobertura da assistência odontológica integrada nos sistemas de proteção social, enquanto o segundo se origina da observação sistemática da assistência odontológica inserida em programas de acompanhamento social. UT é um programa social anual de nove meses de duração dirigido a pessoas de 18 a 65 anos em situação de vulnerabilidade socioeconômica e desempregadas há muito tempo. Seu propósito é melhorar a empregabilidade e a integração social dos participantes. Assistência odontológica integral é um dos benefícios do programa, a qual não é disponibilizada pelo Sistema Nacional Integrado de Saúde. Dos 2.592 tratamentos odontológicos iniciados, 941 (36,3%) não chegaram ao final. Programas focalizados como o UT, enquanto dispositivos de proteção social, devem estar articulados funcionalmente a políticas sociais universais que devem responder adequadamente as necessidades da população. A saúde bucal, nesse contexto, deve ser incluída no Sistema Nacional Integrado de Saúde do Uruguai, garantindo o direito à saúde

Associação entre os fatores sociodemográficos e bucais com o bem-estar psicológico em adolescentes escolares

Objective: To investigate the relationship between sociodemographic factors and the performance of activities related to oral function, with psychological well-being in school adolescents. Materials and Methods: School-based, cross-sectional study, conducted in 36 municipalities up to 50 thousand inhabitants from Southern Brazil. The sample was composed of 1,760 scholars, selected thorough systematic sampling. Data were collected by means of a structured questionnaire, containing information on socioeconomic status, oral impact on daily activities (OIDP) and Well-Being (Andrews Scale). Poisson Regression was used to conduct the data analyses. Results: Difficulty to smile was almost twice as high for students who did not present well-being, PR = 1.9 (95%CI = 1.30-2.80). In addition, difficulty to speak, PR = 1,57 (95%CI CI = 1,02-2,40), and disconfort to brush the teeth, PR = 1,93 (CI= 1,29-2,91), were also associated to well-being. Difficulty to eat PR = 1,1 (95% CI= 0,75-1,65), was not associated to it. The family average income was the only sociodemographic variable associated to adolescents well-being, PR = 0,65 (95% CI = 0,45-0,96). Conclusion: The results of this study showed the influence of oral health related activities, smile, speak and teeth brush on the well-being of school adolescentes in Rio Grande do Sul state. In addition, they pointed out the Family average income as a protection factor for the well-being of this population.Objetivo: Investigar a relação entre fatores sociodemográficos e o desempenho de atividades relacionadas à função oral, com o bem-estar psicológico em adolescentes escolares. Materiais e Métodos: Estudo transversal, de base escolar, realizado em 36 municípios de até 50 mil habitantes da região sul do Brasil. A amostra foi composta por 1.760 acadêmicos, selecionados por amostragem sistemática completa. Os dados foram coletados por meio de um questionário estruturado, contendo informações sobre situação socioeconômica, impacto oral nas atividades diárias (OIDP) e Bem-Estar (Escala de Andrews). Regressão de Poisson foi usada para conduzir as análises de dados. Resultados: A dificuldade para sorrir foi quase duas vezes maior para os estudantes que não apresentaram bem-estar, RP = 1,9 (IC95% = 1,30-2,80). Além disso, dificuldade para falar, RP = 1,57 (IC95% IC = 1,02-2,40) e desconforto para escovar os dentes, RP = 1,93 (IC = 1,29-2,91), também foram associados ao bem-estar. A dificuldade para comer PR = 1,1 (IC 95% = 0,75-1,65), não foi associada a ele. A renda familiar média foi a única variável sociodemográfica associada ao bem-estar dos adolescentes, RP = 0,65 (IC95% = 0,45-0,96). Conclusão: Os resultados deste estudo mostraram a influência das atividades relacionadas à saúde bucal, sorriso, fala e dentes no bem-estar de adolescentes escolares no estado do Rio Grande do Sul. Além disso, apontaram a renda média da família como fator de proteção para o bem-estar dessa população

Factors affecting tooth cleaning pattern, structure and performance in Brazilian adults

Tooth cleaning behaviour can be divided into pattern (frequency of tooth cleaning), performance (relative effectiveness of tooth cleaning), and structure (range of items used in tooth cleaning). The main aim of this programme of research was to assess whether those three dimensions were associated with routines of daily activities, flexibility of daily activities and flexibility of working time schedule (job personal schedule freedom). The hypothesis is that tooth cleaning behaviour is affected by the level of routines and flexibility of daily activities, as well as the level of flexibility of the working time schedule. It is hypothesized that subjects who enjoy higher rather than lower levels of routines in daily activities are more likely to clean their teeth less frequently and have worse cleaning performance, use fewer oral hygiene aids, and have more bleeding gums. In addition, subjects who have higher levels of flexibility in daily activities, compared to those with lower levels of flexibility, tend to clean their teeth more frequently, have better cleaning performance, make use of more oral hygiene aids, and have fewer teeth with gums bleeding after probing. Furthermore, it is also hypothesised that subjects who have higher levels of flexibility of working time schedule are predisposed to have higher tooth cleaning frequency, better cleaning performance and less gums bleeding after probing, as well as employ more oral hygiene items, as opposed to those who have lower levels of flexibility of working time schedule. The study was conducted on a sample of 471 Brazilian adults, 234 women and 237 men, from two social classes. The age range was 24 to 44 years. Behavioural socio-economic and clinical data was collected through structured interviews and clinical examinations. Data were analysed by means of logistic regression analysis. There was a highly significant relationship between routines of daily activities and pattern of tooth cleaning behaviour. There was no significant association between routines of daily activities and tooth cleaning performance, structure and gums bleeding. A significant relationship was observed between pattern, performance and less gums bleeding after probing, and flexibility of daily activities. Flexibility of working time schedule was significantly associated with tooth cleaning pattern, performance and structure. It was concluded that routines of daily activities was strongly associated with tooth cleaning pattern and that flexibility of daily activities is an important correlate of tooth cleaning pattern, performance and gums bleeding. In addition, flexibility of working time schedule influences tooth cleaning pattern, performance and structure

Suportes teóricos para educação em saúde bucal nas escolas: uma abordagem qualitativa.

This research aimed to identify the principal aspects of dental health education in official documents, which would give theoretical support to teachers of primary schools. The research used a qualitative approach. The results showed that official documents offer support to the teaching of dental health education in primary schools.Este estudo objetivou identificar, descrever e interpretar aspectos da legislação e outros documentos oficias em vigor que se relacionam com educação e ou saúde e que servem de suporte às ações de Educação em Saúde Bucal que se desenvolvem em escolas de ensino fundamental de Porto Alegre. Os propósitos, a natureza e os objetivos da investigação encaminharam para a análise qualitativa de conteúdo do tipo temática como forma de tratamento do material escolhido. Os resultados deste estudo permitem que se afirme que documentos estudados oferecem apoios importantes e diversificados para o desenvolvimento da Educação em Saúde Bucal no ensino fundamental

Original research Community Dental Health

Dental pain, use of dental services and oral health-related quality of life in southern Brazil Abstract: This study aimed at assessing the relationship between dental pain and the reason for using dental services and oral health quality of life in people aged 50 to 74 years in southern Brazil. A cross-sectional population-based study was conducted with 720 individuals aged 50 to 74 years, living in three health districts in the city of Porto Alegre. Dental impacts on daily life and sociodemographic data were assessed using structured interviews. The Oral Impacts on Daily Performance -OIDP instrument was used to measure oral impacts. The information was analyzed by Poisson regression with robust variance adjustment, taking into account cluster sampling. Dental pain was present in 32.5% of those reporting an oral impact on their daily activities. Dental pain most frequently affected talking (37.6%), cleaning teeth and gums (37.0%) and enjoying the companionship of people (36.5%). After adjustments to the multivariate analysis, the reason for dental visits due to dental pain was found to have a high impact on daily activities ]