Cárie dentária em população ribeirinha do Estado de Rondônia, Região Amazônica, Brasil, 2005/2006 Dental caries in a riverine community in Rondônia State, Amazon Region, Brazil, 2005-2006

O objetivo foi analisar experiência de cárie dentária na população ribeirinha residente às margens dos rios Machado e Preto (Rondônia, Brasil), em 2005 e 2006. Foram examinados 469 indivíduos com formulário preconizado pela Organização Mundial da Saúde, sob luz natural e utilização de espátulas de madeira e sonda CPI. Na faixa etária de 4-5 anos de idade, ceod = 4,30 e 19,64% livres de cárie; 6-10 anos, CPOD = 1,04, ceod = 3,52, 17,05% livres de cárie; aos 12 anos, CPOD = 2,65 e 30,76% livres de cárie; aos 18 anos, CPOD = 5,41 e 19,51% livres de cárie; 35-44 anos, CPOD = 17,74 e 2,98% livres de cárie; 65-74 anos, CPOD = 21,56 e 4,34% livres de cárie. Na análise por componentes, constatou-se que o componente cariado tem maior prevalência nas idades de 0-3, 4-5, 6-10, 12 e 18 anos. Em adultos e idosos, o componente que mais contribui é o perdido. Conclui-se que a população apresenta índices de cárie dentária elevados, sendo necessária a atuação em âmbito educativo, preventivo e curativo.<br>This study aimed to analyze dental caries patterns among riverine people from Rondônia State, Brazil (Machado and Preto rivers) in 2005 and 2006. A total of 469 subjects were examined, using the World Health Organization form, under natural light, using a wooden tongue depressor and CPI probe in cases of doubts about the presence of dental caries. The results were: 4-5-year age bracket, dmtf = 4.30 and 19.64% caries-free; 6-10 years, DMTF = 1.04, dmtf = 3.52 and 17.05% caries-free; 12 years, DMTF = 2.65 and 30.76% caries-free; 18 years, DMTF = 5.41 and 19.51% caries-free; 35-44 years, DMTF = 17.74 and 2.98% caries-free; 65-74 years, DMTF = 21.56 and 4.34% caries-free. When each component was analyzed separately in the dmtf and DMTF indices, decay was most prevalent in the 0-3, 4-5, 6-10, 12, and 18-year brackets. However, in young and older adults, the most prevalent component was missing teeth. In conclusion, the study population showed a high dental caries index, thus highlighting the need for educational, preventive, and curative measures

Oral Health in Brazil - Part I: public oral health policies

This paper reviews the historical development of public health policies in Brazil and the insertion of oral health in this context. Since 1988, Brazil established a Unified National Health System ("Sistema Único de Saúde" - SUS), which was conceived to assure access to health actions and services, including oral health. However, a history of lack of access to health services and the health problems faced by the Brazilian population make the process of building and consolidating the SUS extremely challenging. Since 2004, the Oral Health National Policy has proposed a reorientation of the health care model, supported by an adaptation of the working system of Oral Health teams so that they include actions of health promotion, protection and recovery. Human resources should be prepared to act in this system. The qualifying process must take in consideration knowledge evolution, changes in the work process and changes in demographical and epidemiological aspects, according to a perspective of maintaining a balance between technique and social relevance

Salud bucal: representaciones sociales en madres gestantes de una población urbana. Medellín, Colombia Oral health: social representations among pregnant mothers. Medellin, Colombia

A partir de la teoría de las representaciones sociales, se realizó una investigación cualitativa con el propósito de comprender las representaciones sociales del proceso salud-enfermedad bucal en madres gestantes de una población urbana. Se entrevistaron 28 mujeres adultas asistentes al programa prenatal en una institución de salud de la ciudad de Medellín. Las entrevistas fueron grabadas y transcritas y se analizaron mediante codificación abierta, axial y selectiva, de acuerdo con la teoría fundada. Los hallazgos revelaron que si bien para las madres gestantes la boca del hijo no ocupa un lugar preponderante al inicio del ciclo vital, gana importancia con el proceso de crecimiento y desarrollo del niño, cuando además de su papel en la masticación y alimentación, adquiere una carga social relevante. El análisis dio cuenta de cómo confluyen en las madres de una población urbana representaciones arraigadas en la tradición, con nuevas visiones en cuya construcción hay elementos de los discursos profesionales y de los medios de comunicación; entre ellas, la estrecha relación salud bucal-dientes, la salud atada a prácticas saludables y a la utilización de servicios de salud y salud bucal como ventaja social, relacionada con la estética.<br>Based on the theory of social representations, a qualitative investigation was conducted in order to assess social representations in oral heath in pregnant mothers living in an urban environment. Twenty-eight pregnant adult women attending a prenatal program at a health institution in the city of Medellín, Colombia, were interviewed. The interviews were recorded and transcribed; analysis was performed through open, axial and selective coding, in line with grounded theory. Findings revealed that although pregnant mothers are not greatly concerned about oral health after birth and in early childhood, it increases in importance during growth and development of the child when, besides chewing and feeding aspects, it acquires a socially important role. Analysis revealed how social representations anchored in tradition, with new elements from health professional discourses as well as mass media influences coexist in mothers in an urban environment. These include the close relationship between oral health and teeth, health linked to healthy practices as well as recourse to health services and oral health as a social advantage, related to esthetic aspects

Representações sociais de saúde bucal entre mães no meio rural de Itaúna (MG), 2002 A social representation study of oral health among mothers in rural areas, Itaúna (MG), 2002

Análise das representações sociais sobre o processo saúde-doença bucal entre 29 mães de escolares residentes no meio rural de Itaúna, em 2002. As entrevistas semi-estruturadas foram transcritas e a análise de conteúdo foi desenvolvida. A análise mostra que as representações sociais sobre saúde-doença estão vinculadas à alimentação e utilização de serviços médicos. Em relação ao processo saúde-doença bucal, identifica-se um discurso associado às normas odontológicas de higiene e dieta. A cárie dentária é vista como uma experiência inevitável, mas a perda dentária, não. Apesar de as condições materiais de vida no meio rural dificultarem a adoção de práticas consideradas favoráveis à saúde bucal, essas mulheres são cobradas em relação ao trabalho de cuidar dos filhos. Essa vivência contraditória causa sentimentos negativos (culpa) e, como conseqüência, queda na qualidade de vida nessa população. Na realidade de vida das entrevistadas, verifica-se que, apesar de as mesmas apresentarem informações sobre o cuidado bucal e desejarem "cuidar dos filhos direito", uma complexa rede de fatores sociais, econômicos, culturais etc., não favorece a promoção de saúde. O planejamento das ações de saúde bucal coletiva deveria levar em consideração não somente dados epidemiológicos quantitativos, mas também as representações sociais sobre saúde bucal.<br>The study evaluated social representation on oral health-illness process between 29 scholarship's mothers in rural areas from Itaúna, in 2002. Semi-structured interviews were transcripted and content analysis was developed. The results have showed that social representation of health-illness was associated with food intake and medical service utilization. Discourse on oral health-illness process was related to dental hygiene and diet rules. Dental caries were an inevitable experience, but tooth loss was not. Despite material conditions of life in rural area have not enabled favorable oral health practices, these mothers were considered responsible for their children oral health care. This contradicted life has caused negative feelings (as guilty) and, consequently, bad quality of life. Respondents have had information about oral home care and they desired to "take care of children well". However, a complex net of social, economic and cultural factors has not favored health promotion. Planning public oral health actions should take in account not only quantitative epidemiological data but social representation of oral health