Padrões de aleitamento e hábitos de sucção não nutritiva em crianças, na fase de dentição decídua, com e sem más-oclusões /

Dissertação (Mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde.Foram examinadas 495 crianças, de ambos os sexos, matriculadas em creches de Florianópolis-SC, e selecionadas 180 delas para esta pesquisa . Os dados sobre forma e tempo de aleitamento e presença de hábitos de sucção não nutritiva (HSNN) foram obtidos através de um questionários enviado aos pais. Os resultados sugerem que o aleitamento natural exclusivo por períodos maiores de quatro meses, deve ser enfatizado, por favorecer o correto crescimento e desenvolvimento da face, a harmonia da oclusão e a não instalação de HSNN

Maxillofacial trauma due to traffic accidents and falls:an exploratory study of associated factors

This study aimed to determine the pattern of Maxillofacial trauma (MFT) due to traffic accidents and falls in a reference hospital in a rural region of northeastern Brazil between December 2011 and December 2018 and to identify associated factors. This was a cross-sectional study using 585 medical records of patients with MFT. The data were subjected to a Poisson-Tweedie multiple regression analysis to estimate the Prevalence ratio (PR), with a 95% confidence interval (95% CI) and a significance level of p<0.05. MFT due to traffic accidents was more prevalent among patients 21 to 40 years old (PR=2.30; 95% CI=1.20-4.41; p<0.001) diagnosed with zygomatic-orbital complex fractures (PR=1.80; 95% CI=1.08-2.98; p=0.023). Falls were more frequent among older groups of 41 to 60 years (PR=1.83; 95% CI=1.09-3.06; p=0.022) and over 61 years (PR=2.23; 95% CI=1.09-3.06; p=0.022). In traffic accidents, alcohol consumption increased the length of stay (PR=2.081; 95% CI=1.553-2.787; p<0.001), and patients who did not use personal protective equipment (PPE) had higher hospital costs (PR=179.964; 95% CI=1.485-1.994; p<0.001) for this etiology. Traffic accidents and falls are two of the main etiologies of MFT, especially for males in the young adult age group (traffic accidents) and those above 41 years (falls). Alcohol consumption and the nonuse of PPE influenced the length of the hospital stay and hospital costs. Strategies to confront this problem, such as road and highway improvements, effective enforcement of laws and intersectoral coordination involving the entire community to implement policies and prevention programs targeted at these populations, can be implemented

Impact on the Quality of Life of Older Adults Who Use Inadequate Dental Prostheses: A Cross-Sectional Study

Objective: To investigate the impact of inadequate prostheses on older adult’s quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher’s exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p&lt;0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85- 4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual

Tooth loss in middle-aged adults with diabetes and hypertension : social determinants, health perceptions, oral impact on daily performance (OIDP) and treatment need

This study aimed to explore the association between tooth loss and social determinants, health self-perceptions, OIDP and self-concept of dental treatment need in middle-aged adults with diabetes and hypertension. A cross-sectional study was developed with 212 hypertensive and diabetic middle-aged adults (50-65 years). Data were collected from clinical examinations (DMFT) and a questionnaire regarding socioeconomic status, dental health assistance, self-perceptions of oral and general health, OIDP, and the self-concept of dental treatment need. Tooth loss was dichotomized considering the cutoff point of 12 (Model I) or 24 missing teeth (Model II). Data were analyzed using Chi-square, Fisher?s exact test and logistic regression (p?0.05). Tooth loss was significantly associated with variables such as last dental visit, reason for dental visit, OIDP, perception of dental treatment need, and general self-perception (Model I). Schooling, last dental visit, oral health self-perception and perception of dental treatment need were significantly associated with tooth loss in the Model II. When Model 1 and 2 were adjusted, they demonstrated that last dental visit and perception of dental treatment need were predictor variables. The annual dental visit and the self-concept of dental treatment need were associated with tooth loss, demonstrating that these variables reduce the tooth loss prevalence

Fluoride in Bottled Waters Consumed in Northeastern Brazil

Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels

Inequalities in access to HIV and syphilis tests in prenatal care in Brazil

This study aims to evaluate the social determinants of access to HIV and VDRL tests during pregnancy in Brazil. The dependent variables were based on prenatal care access: prenatal care appointments, no HIV and syphilis tests. The independent variables at the first level were formal education level, age, race, work and participation in the Family Income program conditional cash transfer program. The city-level variables were the human development index (HDI), Gini index, and indicators related to health services. An exploratory analysis was performed assessing the effect of each level through prevalence ratios (PR) calculation. A multilevel mixed-effect Poisson regression model was constructed for all outcomes to verify the effect of individual level and with both the individual and contextual levels. Regarding prenatal appointments, the main implicated factors were related to individual socioeconomic position (education level and participation in the Family Income Program conditional cash transfer program), however only HDI maintained significance for the city-level context. The city-level variance dropped from 0.049 to 0.042, indicating an important between-city effect. Regarding the outcomes performing tests in prenatal care, the worst conditions such as contextual (HDI > 0.694, p 8 years of schooling, p < 0.001) showed a risk effect in the final model. Variables related to health services did not show significant effects. They were associated with individual socioeconomic position and a city-level contextual effect. These findings indicate the importance of strengthening HIV and syphilis infection control programs during pregnancy.publishersversionpublishe

Dental fluorosis in children from Princesa Isabel, Paraíba

Diversas localidades da Paraíba possuem níveis moderados ou elevados de fluoreto in natura nas águas de abastecimento. Nas áreas onde os níveis de fluoretos são considerados "ótimos" para a região (0,6 ppm), já constatou-se uma moderada prevalência de fluorose dentária (30-40%). O presente trabalho teve por objetivo observar a prevalência de fluorose dentária na cidade de Princesa Isabel, com níveis "subótimos" de fluoretos (0,4 ppm). Foram selecionados aleatoriamente 142 escolares de 10 a 15 anos para o levantamento de fluorose dentária pelo índice TF (de Thylstrup e Fejerskov). Os exames foram realizados por três examinadores previamente calibrados, sob luz natural indireta e após escovação supervisionada e secagem dos elementos dentários. Cerca de 20% dos escolares examinados apresentaram fluorose dentária, sendo que 70% com TF 1 e outros 30% distribuídos em diversos graus (TF 2 a 5). Fluorose foi mais prevalente no sexo masculino e em dentes pré-molares. Embora a fluorose dentária observada esteja dentro dos níveis esperados para o teor de fluoretos (0,4 ppm), outras fontes sistêmicas de fluoretos devem ser controladas. A prevalência de fluorose dentária observada não é problema de saúde pública nesta localidade.Several communities in Paraíba have moderate or high levels of fluoride naturally present in the drinking water. A moderate prevalence of dental fluorosis (30-40%) has been observed in some areas where the levels of fluoride are regarded as "optimal" for the region (0.6 ppm). The aim of the present study was to determine the prevalence of dental fluorosis in Princesa Isabel, a city with "sub-optimal" fluoride levels (0.4 ppm). The sample comprised 142 schoolchildren (10- to 15-year-old subjects) randomly selected and examined by means of the TF (Thylstrup & Fejerskov) index. The clinical exams were carried out under indirect natural light by three calibrated examiners. Prior to the examination the teeth were cleaned and dried. Approximately 20% of the subjects examined presented with some degree of fluorosis. Seventy per cent were classified as TF 1 while 30% were classified as TF 2 to 5. The prevalence of fluorosis was higher in male subjects and in premolars. Although the observed prevalence of dental fluorosis was within the expected levels, other sources of systemic fluoride must be controlled. The observed prevalence of dental fluorosis is not a public health problem in this community

Morar perto de áreas verdes é benéfico para a saúde mental? Resultados do Estudo Pró-Saúde

OBJETIVO: Investigar a associação entre a exposição às áreas verdes no entorno da residência e a presença de transtornos mentais comuns entre adultos, segundo diferentes estratos de renda. MÉTODOS: Estudo seccional com 2.584 participantes do Estudo Pró-Saúde (2006), residentes na cidade do Rio de Janeiro. Os transtornos mentais comuns foram aferidos por meio do General Health Questionnaire (GHQ-12) e a exposição às áreas verdes pelo índice de vegetação por diferença normalizada, em buffers com raios entre 100 e 1.500 metros em torno da residência. Foram utilizados o índice de vegetação por diferença normalizada médio e máximo categorizado em quartis. A população do estudo foi dividida em três subgrupos, de acordo com a renda: baixa, intermediária e alta. Foram estimadas razões de chances e seus intervalos de 95% de confiança com modelos de regressão logística. Os modelos foram ajustados por sexo e idade, com e sem inclusão da prática de atividade física. RESULTADOS: A proporção de transtornos mentais comuns foi de 30% e 39% entre homens e mulheres, respectivamente. Os resultados dos modelos ajustados mostraram associação inversa entre a presença de áreas verdes no entorno do domicílio e a ocorrência de transtornos mentais comuns, no buffer de 200 metros no grupo de renda intermediária e nos buffers de 400 e 1.500 metros no grupo de baixa renda. A razão de chances variou de 0,52 (buffer de 1.500 metros) a 0,68 (buffer de 200 metros). A associação encontrada foi independente da prática de atividade física. CONCLUSÕES: As evidências encontradas sugerem a existência de um efeito benéfico de áreas verdes urbanas na saúde mental dos indivíduos de renda mais baixa. Tais achados podem ajudar na compreensão de como o meio ambiente urbano pode afetar a saúde mental da população.OBJECTIVE: To evaluate the factors associated with HIV and syphilis testing during pregnancy in Brazil. METHODS: This was an ecological study covering all Brazilian municipalities evaluated by the second cycle of the National Program for Access and Quality Improvement in Primary Care, 2013-2014. The dependent variables were based on prenatal care access: prenatal care appointments, and HIV and syphilis tests during prenatal care. The independent variables were compared with demographic and social characteristics. Bivariate analysis was performed assessing the three outcomes with the independent variables. Variables with significant associations in this bivariate analysis were fit in a Poisson multiple regression analysis with robust variance to obtain adjusted estimates. RESULTS: Poisson regression analysis showed a statistically significant association with the variables “less than eight years of study” [prevalence ratio (PR) = 1.31; 95%CI 1.19–1.45; p &lt; 0.001] and “participants of the cash transfer program” (PR = 0.80; 95%CI 0.72–0.88; p &lt; 0.001) for the outcome of “having less than six prenatal care appointments” and individual variables. A statistically significant association was found for “participants of the cash transfer program” (PR = 1.43; 95%CI 1.19–1.72; p &lt; 0.001) regarding the outcome from the comparison between HIV testing absence during prenatal care and demographic and social characteristics. The absence of syphilis testing during prenatal care, and demographic and social characteristics presented a statistically significant association for the education level variable “less than eight years of study” (PR =1.75; 95%CI 1.56–1.96; p &lt; 0.001) and “participants of the cash transfer program” (PR = 1.21, 95%CI 1.07–1.36; p &lt; 0.001). CONCLUSIONS: The individual factors were associated with prenatal care appointments and HIV and syphilis tests in Brazilian pregnant women. They show missed opportunities for diagnosing HIV and syphilis infection during prenatal care and indicate weaknesses in the quality of maternal health care services to eliminate mother-to-child transmission

Dental pain associated with untreated dental caries and sociodemographic factors in 5-year-old children

The aim of this study was to assess the prevalence of dental pain and to examine its association with untreated dental caries in 5-year-old children. This was a cross-sectional study of 261 5-year-old children in Northeast Brazil. Parents answered ques

Influence of the dental prosthetic status on self-perceptions of health and treatment needs : a cross-sectional study of middle-aged adults with chronic disease

Background: Subjective aspects of dental prosthesis need in middle-aged adults are poorly explored, especially when the population presents chronic diseases. Objectives: To investigate if the use and necessity of dental prosthesis influence the self-perceptions of health and dental treatment need in middle-aged adults with chronic diseases. Material and Methods: A cross-sectional study was performed in 210 middle-aged adults. Socio-demographic aspects, dental services use, oral and general perceptions of health, dental treatment need and OIDP were assessed using a standardized questionnaire. One trained dentist evaluated the use and necessity of dental prosthesis. Data were analyzed using Chi-square and multivariate logistic regression ( p <0.05). Results: The use of dental prosthesis showed a proportion of 2.2:1 for upper to lower arch. Dental prosthesis need was largely prevalent (90 and 95% in upper and lower arch, respectively). The self-perceptions of dental treatment need and oral health were associated with the use and necessity of dental prosthesis ( p <0.05), which could not be observed in relation to the general self-perception. The adjusted model demonstrated that the subjective necessity of dental treatment was 16.04 (1.92-133.7) fold higher in individuals with necessity of rehabilitation in the lower arch. Besides, a positive self-perception of oral health (satisfied) was 2.59 (1.38-4.85) more expressive in individuals that used a dental prosthesis in upper arch. Conclusions: The self-perception of oral health was influenced by the use of maxillary dental prosthesis in individuals with chronic disease. Moreover, individuals were more likely able to perceive treatment need when the lower jaw was affected by tooth loss