Concentração de flúor nas águas de abastecimento público de municípios da região noroeste do estado de São Paulo, Brasil

It may be difficult for small and medium cities to obtain information about the fluoride content of public water, because of the lack of equipments and technicians. This study aimed to analyze the fluoride levels of the water supplied by the public treatment stations of 40 cities situated in the northwest region of São Paulo State, during a period of 6 months, to verify if fluoridation occurs in a continuous manner and if the fluoride levels are within the recommended. Maps of the water distribution system were obtained from the water treatment companies and utilized to randomize the addresses of the collection sites, so that they included all regions with treated water sources. One water sample by month was collected and analyzed in duplicate using an ion-specific-electrode. Samples with 0.6 to 0.8 mgF/L were considered acceptable. In the 38 cities that regularly provided the samples in the 6 months of the study, water from 144 collection sites was collected and a total of 864 samples were analyzed, of which 61.81 percent were classified as unacceptable. It was observed that 33 cities performed fluoridation but in 78.79 percent of these cities there were variations in the fluoride level among the sites and in the same site during the period of study. One can conclude that most of these cities do not control the fluoride levels in the public water, since fluoridation occurs in a discontinuous manner and in most of the situations not within the recommended concentrations.Municípios de pequeno e médio porte podem ter dificuldades em realizar o controle da adição de flúor nas águas de abastecimento público em função da falta de infra-estrutura laboratorial e técnica. Este estudo realizou análises do teor de flúor das águas de abastecimento de 40 municípios situados na região noroeste do estado de São Paulo, durante 6 meses, para verificar se a adição ocorre de forma contínua e se os teores adicionados encontram-se dentro dos parâmetros recomendados. Mapas com a rede de distribuição de água dos municípios foram solicitados e utilizados para definir as regiões de coleta e sortear os endereços dos pontos, de forma que abrangessem todas as fontes de água tratada. Uma amostra de água de cada ponto foi coletada por mês e analisada em duplicata pelo método íon-eletrodo específico. Amostras com 0,6 a 0,8 mg F/L foram consideradas aceitáveis. Nos 38 municípios que enviaram as amostras regularmente nos 6 meses de estudo, a água de 144 pontos foi coletada, perfazendo um total de 864 amostras analisadas, das quais 61,81% foram classificadas como inaceitáveis. Constatou-se que 33 destes municípios realizavam a fluoretação, sendo que em 78,79% deles as concentrações de flúor variavam entre os pontos e no mesmo ponto ao longo do período. Pode-se concluir que a maioria destes municípios não mantém controle adequado sobre os níveis de flúor em sua água, pois a adição de flúor ocorre de forma descontínua e na maioria das vezes em teores fora dos parâmetros recomendados

Concentração de flúor nas refeições e saúde bucal de crianças matriculadas em creches públicas

A primeira infância é uma fase importante para instituição de hábitos alimentares saudáveis que irão influenciar a qualidade da saúde bucal dos futuros adultos. Nessa fase a ingestão excessiva de flúor pode resultar no desenvolvimento de fluorose dentária e o consumo descontrolado de açúcares aumenta o risco de desenvolvimento de cárie precoce de infância. Nesta pesquisa os objetivos foram estudar a ingestão de flúor por crianças com até 36 meses de vida, matriculadas em duas creches públicas de municípios com diferentes concentrações de flúor na água de abastecimento, no período de permanência na creche, e a prevalência de cárie e sua relação com algumas variáveis. Amostras das refeições servidas para 80 crianças foram coletadas durante uma semana. As concentrações de flúor das amostras de alimentos sólidos e leite foram determinadas por eletrodo específico (Orion 9409BN) combinado a eletrodo de referência (Accumet 1362079) após difusão facilitada por hexametildisiloxano. Os alimentos líquidos adicionados com igual volume de total ionic strenght adjustment buffer (TISAB II) foram analisados por um eletrodo combinado (Orion 9609BN). Os resultados foram comparados por meio do teste Mann-Whitney. Para se determinar a prevalência de lesões de cárie dentária com cavidade (LCC) e cárie precoce de infância (CPI), e a contribuição de algumas variáveis, um total de 68 crianças foram examinadas, utilizando-se os códigos e critérios preconizados pela OMS e pela ADA (American Dental Association). Os pais das crianças foram entrevistados. O teste exato de Fisher (p<0,05) foi aplicado. Quanto à concentração de flúor, as refeições continham em média 0,204 ± 0,179 e 0,322 ± 0,242 μgF/mL (p<0,05), respectivamente nos municípios com teor reduzido...The early childhood is an important phase to establish healthy eating habits that will influence the quality of the oral health for the future adults. At this phase, excessive fluoride intake may result in dental fluorosis development and uncontrolled consumption of sugar increases the risk of developing early childhood caries. This survey aimed to study the fluoride ingestion by children up to 36 months of life, registered in two public daycare centers from municipalities with different fluoride concentrations in the water supply, during the period of stay in daycare, and the caries prevalence and its relationship with some variables. Samples of meals served to 80 children were collected during one week. The fluoride concentrations of solid foods and milk were determined by a specific electrode (Orion 9409BN) combined with a reference electrode (Accumet 1362079) after diffusion facilitated by hexamethyldisiloxane. The beverages added with an equal volume of total ionic strength adjustment buffer (TISAB II) were analyzed by a combined electrode (Orion 9609BN). The results were compared using the Mann-Whitney test. In order to determine the prevalence of cavitated caries lesions (CCL) and early childhood caries (ECC), and the contribution of some variables, a total of 68 children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and ADA (American Dental Association). Their parents were interviewed. Fisher’s exact test (p<0.05) was applied. Mean fluoride concentrations of the meals were of 0.204 ± 0.179 and 0.322 ± 0.242 μgF/mL (p<0.05) in the municipality with low fluoride content (LFC) and in the municipality with adequate fluoride content (AFC), respectively. Daily fluoride intake in the former was 0.013 ± 0.003 mg/kg body weight/day and 0.012 ± 0.001 mg/kg body weight/day in the... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Dental caries prevalence in children up to 36 months of age attending daycare centers in municipalities with different water fluoride content

This study determined the prevalence of cavitated caries lesions (CCL) and early childhood caries (ECC), and the contribution of some variables in children up to 36 months of age attending daycare centers in municipalities with different fluoride levels in the water supply: AFC (adequate fluoride content) and LFC (low fluoride content). After approval of the Ethics Committee, the parents were interviewed. The children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and the ADA (American Dental Association). Fisher's exact test (p<0.05) was applied for statistical analysis of data. The dmft indices calculated in the LFC and AFC municipalities were 0.57 and 0.68, respectively. Considering all children examined, 17.6% presented CCL and 33.8% ECC. The economic classification, mother's education level and duration of breastfeeding were considered statistically significant with regards to CCL prevalence. The age group, duration of the habit of drinking milk before bedtime and age at which oral hygiene started were considered statistically significant with regards to ECC prevalence

Prevalence of enamel white spots and risk factors in children up to 36 months old

The aim of this study was to determine the prevalence of enamel white spots and the quality of oral hygiene in children up to 36 months old, in municipalities with different fluoride levels in the water supply, analyzing the contribution of several variables. After approval of the Ethics Committee, the parents signed an informed consent form and were interviewed about their educational level, economic classification of the family, nursing habits, use of toothpaste, access to dental service and other information. The children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and ADA (American Dental Association). The data were processed and analyzed with the Epi-info software program, version 3.2, and Microsoft Excel. Fisher's exact test (p<0.05) was applied to assess the association among the variables. The enamel white spot prevalence was 30.8% and the age group, duration of the bedtime milk feeding habit, age of initial practice of oral hygiene and presence of caries lesions with cavitation were considered statistically significant with regard to enamel white spot prevalence (p < 0.05). No association was found between oral hygiene quality and the study variables. © 2009 Sociedade Brasileira de Pesquisa Odontológica

Cconselhos de saúde: análise do funcionamento dos espaços de participação social

The Health Councils appears in the Brazilian scene, after innumerable attempts of improvement in the political and administrational’s decentralization and regionalization, like subsystems of the social security’s in the health, whose main function is to improve the social control in this area. In this perspective, this article has as objective to analyze the legal basis and functioning of the Health Councils in five municipalities from 2nd Regional Health in the state of São Paulo. The methodological approach was descriptive exploratory, sustained from desk research conducted by analysis of municipal legislation in force, the minutes of the meetings hel over a period of two years, and semi-structured interviews with the Presidents of Municipal Councils Health. The results show the figurative character of the studied councils’ members in their functions, revealing only the physical presence of the representative segments’ in the resolution 333/03, without their effective participation.Os Conselhos de Saúde surgem no cenário brasileiro, após inúmeras tentativas de conquista da descentralização e municipalização político-administrativa, como importante instrumento de controle social na saúde. Nesta perspectiva, objetivou-se neste estudo analisar as bases legais e o funcionamento dos Conselhos de Saúde de cinco municípios adstritos à 2ª Regional de Saúde do Estado de São Paulo. A abordagem metodológica foi descritiva exploratória, sustentada a partir de pesquisa documental realizada por meio de análise da legislação municipal em vigor, das atas referentes às reuniões ocorridas em um período de dois anos, além de entrevistas semiestruturadas com os presidentes dos Conselhos Municipais de Saúde. Os resultados evidenciaram o caráter figurativo dos membros dos conselhos estudados no exercício de suas funções, revelando a presença apenas física de representantes dos segmentos previstos na resolução 333/03, sem, portanto, a efetiva participação dos mesmos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Dentistry and HIV: university professors&apos; role in establishing a basis for judgment

The aim of this study was to determine whether there are differences in the attitudes of Dentistry School Professors from two universities, one private and one public, concerning HIV-positive patients or HIVpositive health care professionals. A questionnaire was handled to all professors at the Araçatuba Dental School of São Paulo State University - FOA-UNESP (public) and Lins Dental School of the Piracicaba Methodist University - FOL-UNIMEP (private). When asked if they would be willing to be treated by an HIV-infected health care professional, 38.9% of the 77 professors at FOA-UNESP replied that they would accept only non-invasive treatments and 13% would not accept any kind of treatment; the same applied to 42.4% and 15.2% of the 33 FOL-UNIMEP professors. Among the 54 professors at FOA-UNESP and 27 at FOL-UNIMEP providing clinical service, only 31.5% and 18.5% stated that they treat HIV-infected persons like any other patient. The results were very similar in both schools. Although they reported that they taught their students not to act in a discriminatory manner towards HIV-positive patients, the professors themselves showed prejudice towards infected patients and professionals. Consequently, this topic must be further debated in the academic milieu

Dentistry and HIV: university professors role in establishing a basis for judgment

of this study was to determine whether there are differences in the attitudes of Dentistry School Professors from two universities, one private and one public, concerning HIV-positive patients or HIVpositive health care professionals. A questionnaire was handled to all professors at the Araçatuba Dental School of São Paulo State University - FOA-UNESP (public) and Lins Dental School of the Piracicaba Methodist University - FOL-UNIMEP (private). When asked if they would be willing to be treated by an HIV-infected health care professional, 38.9% of the 77 professors at FOA-UNESP replied that they would accept only non-invasive treatments and 13% would not accept any kind of treatment; the same applied to 42.4% and 15.2% of the 33 FOL-UNIMEP professors. Among the 54 professors at FOA-UNESP and 27 at FOL-UNIMEP providing clinical service, only 31.5% and 18.5% stated that they treat HIV-infected persons like any other patient. The results were very similar in both schools. Although they reported that they taught their students not to act in a discriminatory manner towards HIV-positive patients, the professors themselves showed prejudice towards infected patients and professionals. Consequently, this topic must be further debated in the academic milieu