Prevalência de cárie em dentes permanentes de escolares do Município de São Paulo, SP, 1970-1996

OBJETIVO: Estudar a evolução da prevalência de cárie em dentes permanentes da população infantil do Município de São Paulo, SP, no período 1970-1996, com base em levantamento epidemiológico em escolares das redes pública e privada de ensino. MÉTODOS: Utilizando metodologia recomendada pela Organização Mundial da Saúde, foram examinados 2.491 escolares de 103 unidades das redes de ensino público e privado. Foi obtida amostra probabilística, com base no cadastro das escolas do município. Os elementos amostrais foram identificados ao acaso. RESULTADOS: Observou-se que de uma situação de prevalência "muito alta" de cárie dentária nos anos 60 e 70, a população de referência evoluiu positivamente, na idade-índice de 12 anos, para um quadro de "baixa" prevalência. CONCLUSÃO: Entre 1986 e 1996 o declínio na cárie dentária, aos 12 anos de idade, foi da ordem de 68,2% entre escolares do Município de São Paulo.OBJECTIVE: To assess the evolution of dental caries in permanent teeth of schoolchildren in S. Paulo City, Brazil, during the period of 1970-1996. METHODS: The World Health Organization methodology for oral health surveys was applied in 2,491 shoolchildren, both male and female from 103 public and private schools. A probabilistic sample stratified by age, school category, and city zones was obtained by the Education State Service data system. Computational resources were used. RESULTS: Data from the 1996 S.Paulo survey were compared with others data provided by studies such as the one conducted in the same city and the reference-population in the second half of the 20th century. In the 60s and 70s the DMF-T Index among 12-year-old schoolchildren was around 7.0. In 1986 it was 6.5 and in 1996 it was registered 2.1, a decline of 68%. CONCLUSION: Dental caries in permanent teeth among S. Paulo City 12-year-old schoolchildren changed from a "very high" to "low" prevalence

Prevalência de cárie dentária em crianças aos doze anos de idade, em localidades do Estado de São Paulo, Brasil, período 1990-1995

INTRODUCTION: Dental caries is the most prevalent disease of the oral cavity, leding to serious economic and social consequences. Studies on the prevalentce of dental caries should be undertaken periodically for the adequat planning of oral health services and action. This research project sought to discover the prevalence of dental caries in the counties of S. Paulo State, Brazil, measured by means of the DMF-T rate on the 12 year-old bracket from 1990-1995. MATERIAL AND METHOD: Data originally produced by Municipal Health Departments, collected by means of an instrument devised for this purpose, sent to 625 counties in the state, were used. The counties concerned were grouped according to their size and geographical region. RESULTS: The total of 625 counties of S. Paulo State, 237 (37.9%) provided the information requested, and 125 (20.0%) had data on DMF-T corresponding to about 5,000 12 year-old children available examined. The study revealed that the prevalence of dental caries is low in only 4.0% of the counties, and is hight or very hight in approximately 80% of them . The DMF-T index values varied from1.3 to 13.6, and the estimated average for all the counties was 4.8. Further, it was discovered that "large" counties recorded 54.6% of their population classified in the categories of low or moderate prevalence of caries; while in "small" counties 87.8% of the population corresponded to the high or very high caries prevalence range. CONCLUSIONS: This research project has shown that the county services for oral health in S. Paulo State have made little use of the basic resources that epidemiology can provide. This indicates the need for an appropriate professional background for oral health in epidemiology, especially for those who fulfil duties in the coordination of the services.INTRODUÇÃO: A cárie dentária é a doença de maior prevalência da cavidade bucal gerando graves conseqüências econômicas e sociais. Estudos de prevalência de cárie dentária devem ser realizados periodicamente para o adequado planejamento das ações e serviços de saúde bucal. Assim, objetivou-se realizar estudo para conhecer a prevalência da cárie dentária em municípios do Estado de São Paulo, Brasil, medida através do índice CPO-D, na idade-índice de 12 anos, no período 1990-1995. MATERIAL E MÉTODO: Foram utilizados dados produzidos originalmente por secretarias ou departamentos municipais de saúde, obtidos através de instrumento concebido para essa finalidade, encaminhado aos 625 municípios do Estado de São Paulo, agrupados segundo o seu tipo e a região geográfica a que pertencem. RESULTADOS: Do total de 625 municípios, 237 (37,9%) atenderam à solicitação de informações e 125 (20,0%) dispunham de dados sobre o CPO-D, correspondendo a cerca de 5 mil crianças de 12 anos examinadas. O estudo revelou que em apenas 4,0% dos municípios a prevalência de cárie dentária é baixa, sendo alta ou muito alta em cerca de 80,0%. A variação nos valores do índice CPO-D ficou entre 1,3 e 13,6 e a média estimada para o Estado de São Paulo foi 4,8. Constatou-se ainda que os "grandes" municípios registraram 54,6% das suas populações enquadrando-se nas categorias de baixa ou moderada prevalência de cárie enquanto nos "pequenos" municípios 87,8% da população correspondiam às faixas de alta ou muito alta prevalência de cárie. CONCLUSÕES: A pesquisa evidenciou que os serviços municipais de saúde bucal, no estado de São Paulo, pouco tem se utilizado dos recursos básicos que a epidemiologia pode oferecer, indicando a necessidade de uma adequada formação de profissionais de saúde bucal na área de epidemiologia, em especial aqueles que exercem atividades de coordenação de serviços

Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial

Abstract Background Supervised toothbrushing programs using fluoride dentifrice have reduced caries increment. However there is no information about the effectiveness of the professional cross-brushing technique within a community intervention. The aim was to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries. Methods A randomized double-blinded controlled community intervention trial to be analyzed at an individual level was conducted in a Brazilian low-income fluoridated area. Six preschools were randomly assigned to the test and control groups and 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice supervised directly by a dental assistant, was developed four times per year. At the remaining school days the children brushed their teeth under indirect supervising of the teachers. In test group, children also underwent a professional cross-brushing on surfaces of first permanent molar rendered by a specially trained dental assistant five times per year. Enamel and dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars during 18-month follow-up. Exposure time of surfaces was calculated and incidence density ratio was estimated using Poisson regression model. Results Difference of 21.6 lesions per 1,000 children between control and test groups was observed. Among boys whose caries risk was higher compared to girls, incidence density was 50% lower in test group (p = 0.016). Conclusion Modified program was effective among the boys. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs. Trial registration ISRCTN18548869