Family and contextual factors associated with licit drug use in adolescence

OBJECTIVE: TO evaluate the family and contextual factors associated with licit drug use among 15 to 19-year-old adolescents in the school context. METHODS: This is a representative, school-based, cross-sectional study conducted with 746 adolescents from 15 to 19 years old enrolled in public and private schools. Parents/guardians reported on the sociodemographic variables, while adolescents answered questionnaires on drug use, family cohesion and adaptability, oral health literacy and visits to the dentist. Information on school context was obtained at the institution and via municipal publications. Associations between variables were analyzed using unadjusted and adjusted multilevel Poisson regression models. RESULTS: Prevalence of licit drug use at least once and a pattern indicative of harmful drug use were 39.8% and 15.1%, respectively. After the adjusted analysis of licit drug use at least once, the variables gender (PR = 1.26; 95% CI: 1.01–1.59), family cohesion (PR = 9.81; 95% CI: 1.23–72.54), and average income of the school district (PR = 0.72; 95% CI: 0.57–0.91) remained in the final model. As for drug abuse, only the detached type (PR = 23.01; 95% CI: 2.46–214.87) and separated type (PR = 13.54; 95% CI: 1.40–130.97) of family cohesion remained in the final model. CONCLUSION: Experience with licit drug use was associated with family and contextual factors among the adolescents, while family cohesion was the main factor related to harmful drug use

Contributions of school context to caries on anterior teeth: a multilevel analysis

OBJECTIVE To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents. METHODS A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05). RESULTS The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24–2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13–1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05–3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07–1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78–3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05–0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98–0.99) were associated with the outcome. CONCLUSIONS Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19

Socioeconomic status and family functioning influence oral health literacy among adolescents

OBJECTIVE: Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS: Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87–0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS: The following variables remained associated with better OHL: high mother’s schooling level (RR = 1.07; 95%CI: 1.03–1.12), high income (RR = 1.04; 95%CI: 1.01–1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01–1.10), married parents (RR = 1.04; 95%CI: 1.01–1.09), “enmeshed” family cohesion (RR = 1.21; 95%CI: 1.12–1.30), “structured” (RR = 1.06; 95%CI: 1.01–1.12) or “rigid” (RR = 1.11; 95%CI: 1.04–1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01–1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03–1.13). CONCLUSION: Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents

Psychometric properties of BREALD-30 for assessing adolescents’ oral health literacy

OBJECTIVE: To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents. METHODS: The study included 750 adolescents: 375 aged 12 years and 375 aged 15–19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%. RESULTS: BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach’s alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48–3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24–3.11]. CONCLUSIONS: BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy

LESÕES DENTÁRIAS ORIUNDAS DA OCLUSÃOhttp://dx.doi.org/10.5892/ruvrd.v14i1.2522

Descrever as lesões dentárias geradas por de agentes físicos, como a abrasão dentária, abfração, bruxismo e apertamento. Realizou-se a pesquisa nas bases de dados eletrônicos Scielo, Pubmed, Lilacs, BBO. Foram encontrados artigos específicos sobre o assunto utilizando os seguintes descritores: abrasão dentária, desgaste dos dentes, bruxismo, colo do dente, oclusão dentária. Apresentando-se com aspecto arredondado ou em forma de valas, a lesão de abrasão é encontrada nas superfícies vestibulares na região da junção cementoesmalte, sendo a cavidade assintomática e com superfície polida, possuindo como causa mais comum a escovação traumática. A lesão de abfração se apresenta em forma de cunha, com bordas vivas e término cavitário nítido, geradas por forças oclusais aplicadas excentricamente, mal dirigidas no elemento dentário, em que a tensão de tração é concentrada no fulcro cervical, ocasionando a ruptura da união química dos cristais de hidroxiapatita do esmalte. O bruxismo cêntrico (apertamento) produz facetas com aspecto irregular e superfícies rugosas, geralmente não coincidentes e sem brilho. O bruxismo excêntrico (ranger de dentes) apresenta desgastes com superfície achatada, polida, lisa e localizam-se em pontos bem definidos de dentes antagonistas. Os bruxismos cêntrico e excêntrico possuem etiologia multifatorial. O conhecimento sobre a etiologia, os aspectos clínicos e as consequências destas lesões quando não tratadas, resultarão em um prognóstico positivo, proporcionando um correto planejamento do tratamento odontológico

Lesões dentárias oriundas da oclusão

Descrever as lesões dentárias geradas por de agentes físicos, como a abrasão dentária, abfração, bruxismo e apertamento. Realizou-se a pesquisa nas bases de dados eletrônicos Scielo, Pubmed, Lilacs, BBO. Foram encontrados artigos específicos sobre o assunto utilizando os seguintes descritores: abrasão dentária, desgaste dos dentes, bruxismo, colo do dente, oclusão dentária. Apresentando-se com aspecto arredondado ou em forma de valas, a lesão de abrasão é encontrada nas superfícies vestibulares na região da junção cementoesmalte, sendo a cavidade assintomática e com superfície polida, possuindo como causa mais comum a escovação traumática. A lesão de abfração se apresenta em forma de cunha, com bordas vivas e término cavitário nítido, geradas por forças oclusais aplicadas excentricamente, mal dirigidas no elemento dentário, em que a tensão de tração é concentrada no fulcro cervical, ocasionando a ruptura da união química dos cristais de hidroxiapatita do esmalte. O bruxismo cêntrico (apertamento) produz facetas com aspecto irregular e superfícies rugosas, geralmente não coincidentes e sem brilho. O bruxismo excêntrico (ranger de dentes) apresenta desgastes com superfície achatada, polida, lisa e localizam-se em pontos bem definidos de dentes antagonistas. Os bruxismos cêntrico e excêntrico possuem etiologia multifatorial. O conhecimento sobre a etiologia, os aspectos clínicos e as consequências destas lesões quando não tratadas, resultarão em um prognóstico positivo, proporcionando um correto planejamento do tratamento odontológico

POLÍTICAS PÚBLICAS DE SAÚDE NA ODONTOLOGIA: RESGATE HISTÓRICO E SUA RELAÇÃO COM A DISFUNÇÃO TEMPOROMANDIBULARdoi: http://dx.doi.org/10.5892/ruvrd.v12i2.1592

RESUMO: O objetivo deste estudo é através uma revisão de literatura, analisar e abordar os aspectos sociais, econômicos, políticos e culturais durante a história da odontologia e sua relação com as políticas e práticas de saúde bucal no Brasil, assim como apresentar uma das consequências da prática desenvolvida até os dias atuais. Foram utilizadas as bases de dados eletrônicos Bireme, Pubmed, como também livros, dissertações, teses e referências legislativas. Foram criadas várias políticas de saúde bucal ao longo dos anos para proporcionar um melhor atendimento odontológico à população. Contudo, dentro das consequências destas ações destacam-se as várias perdas dentárias ao longo do tempo. Como resultado, pode-se ocorrer o surgimento de situações danosas à população, dentre elas quadros de disfunção temporomandibular. Esta associação necessita de estudos, pois é pouco relatada nas bases de dados eletrônicos e em outros meios de publicação literária, assim há uma carência de estudos sobre este assunto

Políticas públicas de saúde na odontologia: Resgate histórico e sua relação com a disfunção temporomandibular

O objetivo deste estudo é através uma revisão de literatura, analisar e abordar os aspectos sociais, econômicos, políticos e culturais durante a história da odontologia e sua relação com as políticas e práticas de saúde bucal no Brasil, assim como apresentar uma das consequências da prática desenvolvida até os dias atuais. Foram utilizadas as bases de dados eletrônicos Bireme, Pubmed, como também livros, dissertações, teses e referências legislativas. Foram criadas várias políticas de saúde bucal ao longo dos anos para proporcionar um melhor atendimento odontológico à população. Contudo, dentro das consequências destas ações destacam-se as várias perdas dentárias ao longo do tempo. Como resultado, pode-se ocorrer o surgimento de situações danosas à população, dentre elas quadros de disfunção temporomandibular. Esta associação necessita de estudos, pois é pouco relatada nas bases de dados eletrônicos e em outros meios de publicação literária, assim há uma carência de estudos sobre este assunto

Adolescents with worse levels of oral health literacy have more cavitated carious lesions.

The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18-2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01-1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39-2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist