The role of dental pain and psychosocial factors on the relationship between dental caries and oral health‑related quality of life in children

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Socio-economic status, psychosocial factors, health behaviours and incidence of dental caries in 12-year-old children living in deprived communities in Manaus, Brazil

Objectives This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries amongst 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. Methods A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents’ schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. Results The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (β = 0.103) and sedentary behaviour (β = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (β = -0.243) and higher sedentary behaviour (β = 0.227). Higher social support directly predicted lower sugar consumption (β = -0.114). Lower socio-economic status (β = -0.046) and lower social support (β = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. Conclusions In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries amongst schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries amongst children living in deprivation. Clinical significance Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.acceptedVersionPaid open accessUNIT agreemen

The influence of change on sense of coherence on dental services use among adolescents: a two‑year prospective follow‑up study

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Subjective oral health measures in caregivers of patients with autism spectrum disorder and down syndrome: a preliminary study

This study aimed to address the subjective oral health measures of caregivers of individuals with autism spectrum disorder (ASD) and Down syndrome. This cross-sectional study included 15 caregivers of individuals with ASD (n = 7) and Down syndrome (n = 8). Sociodemographic data, sense of coherence (SOC) (SOC-13 scale), social support (Social Support Scale [MOS-SSS]), oral health-related quality of life (OHRQoL) (OHIP-14), and self-rated oral health assessed on a 5-point Likert scale were collected. A descriptive analysis was performed in addition to correlation analyses (Spearman correlation coefficient). Most primary caregivers were parents of the individual (86.6%). The age of the caregivers ranged between 40 and 59 years (60%). Most caregivers have had 9 to 11 years of education (53.3%). Monthly family income was less than USD 186,28 for ASD caregivers (57.2%) and between USD 327,56 and USD 931,40 for Down syndrome caregivers (50%). Of the caregivers, 33.3% reported good oral health and 33.3% reported neither good nor bad. The average SOC score, social support and OHRQoL was 48.9, 69.3 and 10.9, respectively. The higher the family income, the better the OHRQoL (rs = -0.62, p = 0.014). SOC was correlated with the score of the emotional support domain (rs = 0.54, p = 0.039). It was concluded that caregivers had a strong SOC and high perceived support. Moreover, caregivers did not report a high impact on OHRQoL A better understanding of the caregivers’ protective and coping factors in caring for individuals with disabilities may better promote their quality of life

Fluxo de internação por COVID-19 nas regiões de saúde do Brasil

Objective: To investigate the flows of hospitalizations for COVID-19 in the 450 regions and 117 Brazilian health macro-regions between March and October 2020. Method: Descriptive study, comprising all hospitalizations due to COVID-19 registered in the Flu Epidemiological Surveillance Information System (SIVEP-Gripe) between the 8th and 44th epidemiological weeks of 2020. The proportion of hospitalizations for COVID-19 occurred within same health region of residency was calculated, stratified according to periods of greater and lesser demand for health care, according to the population size of health regions. The indicator of migratory efficacy was calculated, which takes into account the evasion and invasion of patients, by crossing the data of origin of the patients (health region of residence) with the data of the place of hospitalization (health region of attendance). Results: 397,830 admissions were identified for COVID-19 in the period. Evasion was 11.9% of residents in health regions and 6.8% in macro-regions, pattern that was maintained during the peak period of hospitalizations for COVID-19. There was an average of 17.6% of evasion of residents of health regions in the Northeast and of 8.8% in health regions of the South. Evasion was more accentuated in health regions with up to 100 thousand / inhabitants (36.9%), which was 7 times greater than that observed in health regions with more than 2 million / inhabitants (5.2%). The negative migratory efficacy indicator (-0.39) indicated a predominance of evasion. Of the 450 Brazilian health regions, 117 (39.3%) had a coefficient of migratory efficacy between -1 and -0.75 and 113 (25.1%) between -0.75 and -0.25. Conclusion: The results indicate that the regionalization of the health system proved to be adequate in the organization of care in the territory, however the long distances traveled are still worrying.Objetivo: Investigar os fluxos de internações por COVID-19 nas 450 regiões e 117 macrorregiões de saúde brasileiras no período de março a outubro de 2020. Método: Estudo descritivo, compreendendo todas as internações por COVID-19 registradas no Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) entre a 8ª e a 44ª semanas epidemiológicas de 2020. Foi calculada a proporção das internações por COVID-19 realizadas pelos residentes que ocorreram dentro da sua respectiva região de saúde, estratificado segundo períodos de maior e menor demanda de internações e segundo o porte populacional das regiões de saúde. Foi calculado o indicador de eficácia migratória, que leva em consideração a evasão e invasão de pacientes, por meio do cruzamento dos dados de origem dos pacientes (região de saúde de residência) com os dados do local da realização das internações (região de saúde de atendimento). Resultados: Foram identificadas 397.830 internações por COVID-19 no Brasil. A evasão foi de 11,9% dos residentes nas regiões de saúde e de 6,8% nas macrorregiões; o padrão que se manteve também no período de pico das internações por COVID-19. Houve em média 17,6% de evasão dos residentes das regiões de saúde do Nordeste e de 8,8% nas regiões de saúde do Sul. A evasão foi mais acentuada nas regiões de saúde com até 100 mil/hab. (36,9%), a qual foi 7 vezes maior que a verificada nas regiões de saúde com mais de 2 milhões/habitantes (5,2%). O indicador de eficácia migratória negativo (-0,39) indicou predomínio da evasão. Das 450 regiões de saúde brasileiras, 117 (39,3%) apresentaram coeficiente de eficácia migratória entre -1 e -0,75 e 113 (25,1%) entre -0,75 e -0,25. Conclusão: Os resultados indicam que a regionalização do sistema de saúde mostrou-se adequada na organização do atendimento no território, porém as longas distâncias percorridas ainda são preocupante

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis

BACKGROUND: Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. METHODS: Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. RESULTS: Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. CONCLUSIONS: Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services

Abordagem sociodental na caracterização da necessidade de tratamento ortodôntico em escolares de 12 anos de idade na cidade de Manaus-AM

Made available in DSpace on 2017-11-16T17:57:50Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Dissertacao_ID_198.pdf: 1327969 bytes, checksum: 4edb24ec4019887e8aec0015708ef00b (MD5) Previous issue date: 20110617Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane, Manaus, AM, Brasil.A necessidade normativa (NN) definida pelo profissional têm sido amplamente utilizada para indicação de tratamento ortodôntico. Devido às limitações deste método foi proposta a avaliação sociodental de necessidade de tratamento, um método que incorpora à NN medidas subjetivas autorreferidas e comportamentos relacionados à saúde bucal. O objetivo deste estudo foi testar a avaliação sociodental de necessidade de tratamento ortodôntico em adolescentes. Um estudo seccional envolveu 201 escolares de 12 anos de idade na cidade de Manaus, Amazonas, em 2010-2011. A NN de tratamento ortodôntico foi determinada através de exame clínico bucal e o emprego do Índice de Necessidade de Tratamento Ortodôntico (IOTN) e do Índice de Estética Dental (DAI). A abordagem sociodental combinou medidas normativas (IOTN e DAI), impacto da má oclusão nas atividades diárias (instrumento Child- OIDP) e avaliação da propensão ao tratamento ortodôntico. Os métodos de avaliação de necessidade de tratamento foram comparados entre si com o teste de McNemar. A associação entre o impacto da má oclusão nas atividades diárias e a NN foi testada com o teste Qui- quadrado e teste de Kruskal-Wallis. A frequência de indivíduos com NN de tratamento (IOTN e DAI) foi estatisticamente maior em comparação com a abordagem sociodental (p<0,001). A abordagem sociodental mostrou resultados distintos utilizando-se o DAI e o IOTN (p<0,001). A magnitude da NN foi associada ao impacto da má oclusão nas atividades diárias dos adolescentes. Observou-se uma grande redução nas estimativas de necessidade de tratamento ortodôntico em adolescentes com o emprego da abordagem sociodental. O uso da avaliação sociodental de necessidade de tratamento ortodôntico pode otimizar o emprego dos recursos nos serviços públicos odontológicos.The normative needs (NN) professionally defined have been widely used for recommending orthodontic treatment. The socio-dental approach for treatment needs is a method that embodies to NN self-reported subjective measures and oral health related behaviors. It was proposed because of the limitations of the NN methods. The aim of this study was to test the socio-dental approach of orthodontic treatment needs in adolescents. A cross-sectional study was conducted in the city of Manaus, Amazonas, Brazil in 2010-2011 and included 201 scholars of 12 years-old. The orthodontic treatment NN was determined by oral clinical examination using two occlusal indexes, Index of Orthodontic Treatment Need (IOTN) and Dental Aesthetics Index (DAI). The socio-dental approach has combined normative measures (IOTN and DAI), impact of malocclusion on daily activities (Child-OIDP), and propensityrelated orthodontic treatment assessment. The methods of treatment needs assessment were compared using McNemar test. The association between the impact of malocclusion on daily activities and NN was tested by Qui-square test and Kruskal-Wallis test. The frequency of individuals with NN treatment (IOTN and DAI) was statistically higher comparing to socio- dental approach (p<0.001). The socio-dental approach showed different results when using IOTN and DAI (p<0.001). The magnitude of NN was associated with the impact of malocclusion on the adolescents daily activities. Large reductions in normative needs estimates for orthodontic treatment were apparent using socio-dental approach. The socio- dental approach for orthodontic treatment needs can optimize the use of resources in oral health services

Desempenho dos Centros de Especialidades Odontológicas frente ao quadro sociodemográfico dos municípios do Amazonas, Brasil, 2009

O estudo avaliou o cumprimento das metas de desempenho dos Centros de Especialidades Odontológicas (CEO) do estado do Amazonas, utilizando dados secundários do SIA-SUS, considerando as variáveis estruturais dos estabelecimentos, cobertura da atenção básica e indicadores sociodemográficos dos municípios. Treze CEO foram avaliados. Um estabelecimento de Manaus e os de Maués e Parintins apresentaram melhor desempenho em relação ao Cumprimento Global das Metas. A cobertura das Equipes de Saúde Bucal na atenção básica parece não acompanhar o desempenho dos estabelecimentos. Os resultados sugerem que o desempenho dos CEO está relacionado às características sociodemográficas dos municípios