Anxiety/depression And Orofacial Myofacial Disorders As Factors Associated With Tmd In Children.

The purpose of this study was to evaluate factors associated with temporomandibular disorder (TMD) in children. TMD clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD; axis I), and subjective symptoms were evaluated using a structured questionnaire. Eighty-two children were selected, 40 with TMD (19 boys and 21 girls, mean age 9.84 ± 1.53 and 9.71 ± 1.30 years, respectively) and 42 without TMD (21 boys and 21 girls, mean age 10.27 ± 1.63 and 9.9 ± 1.37 years, respectively). Intra- and extra-oral examinations were carried out to determine the myofunctional characteristics of the masticatory system. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Data were analyzed using descriptive statistics and bivariate analysis followed by multiple logistic regression (α = 0.05). In bivariate analysis, the variables of open lips, anxiety, and depression had a p value < 0.15 and were entered into the multivariate logistic regression model. The most significant predictor factors were the presence of open lips (odds ratio = 5.42, p = 0.034) and anxiety (odds ratio = 18.59, p < 0.001). Thus, anxiety levels and open lips were associated with TMD in children. Owing to the cross-sectional design of the present study, the associations observed may have a bidirectional relationship.27156-6

Reasons related to tooth loss among adolescents in São Paulo, Brazil

AIM:To estimate tooth loss prevalence among adolescents in S&#227;o Paulo, considering socioeconomic and demographic factors, dental service use and pain.METHODS:Data were obtained from the S&#227;o Paulo Oral Health Survey 2008. The sample comprised 2858 adolescents from 15 to 19 years old from public and private schools, who underwent through an oral examination. In addition, a questionnaire was applied regarding the characterization of factors related to socioeconomics, demographics, use of dental services and pain in the last six months. At least one tooth lost was the outcome. The independent variables included gender, ethnicity, parents' schooling, type of school, number of rooms, people and cars per home, family income, dental service use, decayed teeth, toothache. A multivariate logistic regression model was used.RESULTS:The prevalence of tooth loss was 7%. The independent variables decayed tooth (RP=1.71), toothache (RP=2.04), father's schooling - elementary (RP=1.40) and per capita family income - less than 1/2 a minimum salary (RP=1.45) were associated with the outcome.CONCLUSIONS:The results suggest that socioeconomic factors may contribute to the increase of early tooth loss among adolescents.374

Practices and perceptions of teachers, after the voice experience

 Objetivo: implementar um programa educacional para professores em treinamento de voz, bem como avaliar os benefícios deste programa. Metodologia: participaram deste estudo piloto, seis professores sendo cinco mulheres e um homem com idade entre 29 e 55 anos, de uma escola pública de Piracicaba, em São Paulo, Brasil, foram incluídos no estudo. Este programa educacional consistiu de cinco reuniões semanais, incluindo palestras sobre saúde vocal, exercícios de aquecimento, postura corporal, relaxamento corporal e respiração adequada. Para analisar a eficácia do programa educativo, foram coletadas respostas dos participantes sobre o programa após cada encontro, comumente relatadas e submetidas à abordagem da análise do conteúdo. Resultados: os participantes relataram que os exercícios de aquecimento para a voz melhorou o desempenho na articulação das palavras, necessitando de menos esforço para falar.  Entre as mudanças como forma de hábitos saudáveis, beber água e comer maçã foram as mais relatadas. Conclusão: o programa educativo para o treinamento da voz trouxe benefícios para os professores no que diz respeito à melhoria do desempenho profissional e na qualidade de vida no trabalho. Aim:  was to implement an educational program for teachers in voice training, as well to assess the benefits of this program. Methodology: Six teachers participated, being five women and one man, aged from 29 to 55 years, living in Piracicaba, São Paulo/ Brazil.  This educational program consisted of five weekly meetings, including lectures on vocal health, warm-up exercises, body posture, relaxation of the neck, and proper breathing. To analyze the effectiveness of the educational program, data concerning participants’ responsiveness to the program were collected after each appointment and submitted to the content analysis. Results: The participants reported that voice warm-up exercises improved their ability to articulate words, and they required less effort to speak. Among the changes in healthy voice habits, drinking water and eating apples were the most reported. Conclusions: the educational program for voice training brought benefits to teachers as regards improvement in professional performance and the quality of work life.

Evaluation of risk factors for voice disorders in teachers and vocal acoustic analysis as an instrument of epidemiological assessment

PURPOSE: conduct a prospective study to analyze risk factors for dysphonia in teachers, associated with presence of vocal alterations. METHOD: one-hundred-and-two teachers (81 women and 21 men) were randomly selected from 11 schools in Piracicaba/SP, with mean age 42.48 years. A questionnaire covering aspects of the work environment and organization, vocal behavior, lifestyle and signs and symptoms of vocal alterations was applied. Acoustic analysis was performed and the dependent variables assessed were Fundamental Frequency and mean Vocal Intensity. There were associations between questionnaire variables and Fundamental Frequency, and mean Intensity. The following statistical tests were used: Chi-square, Fisher's Exact Test and Odds Ratio calculation. RESULTS: individuals of the male gender had less chance of presenting altered fundamental frequency of the voice than the female gender (p<0.0001). Teachers who had been teaching elementary II and middle school had less chance of presenting alteration in fundamental frequency of the voice than those who taught in (first grade) primary schools I (p=0.04). The environmental noise was significantly associated with alteration in mean voice intensity (p=0.02). CONCLUSION: factors such as female gender, teaching in primary school and exposure to work environment noise are considered risk indicators for voice disorders.OBJETIVO: avaliar fatores de risco para disfonia em professores e associá-los compresença de alteração vocal. MÉTODO: 102 professores(81 mulheres e 21 homens) selecionados aleatoriamente de 11 escolas do município de Piracicaba/SP, com média de idade de 42,48 anos. Um questionário sobre aspectos do ambiente e organização do trabalho, comportamento vocal, estilo de vida e sinais e sintomas de alterações vocais foi aplicado.Uma análise acústica da voz foi realizada e as variáveis avaliadas dependentes foram Frequência Fundamental e a Intensidade média vocal. Foram realizadas associações entre as variáveis do questionário com a frequência fundamental e a intensidade média e utilizaram-se os testes estatísticos: Qui-quadrado, Exato de Fisher e cálculo do OddsRatio e este é um estudo clínico prospectivo. RESULTADOS: os indivíduos do sexo masculino tiveram menos chance de apresentarem frequência fundamental da voz alterada do que o gênero feminino (p<0,0001). As professoras que lecionavam para o ensino fundamental II e médio tiveram menos chance de apresentar alteração da frequência fundamental da voz do que aquelas que lecionavam para o ensino fundamental (p=0,04). O ruído ambiente teve associação significante com a alteração da intensidade média da voz (p=0,02). CONCLUSÃO: fatores como o sexo feminino lecionar para o ensino primário e estar exposto ao ruído do ambiente de trabalho foram considerados indicadores de risco para distúrbios da voz em professores.957966Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Program of vocal health for the teacher : assessment, self-perception vocal and educational activities of the voice

Orientador: Antonio Carlos PereiraTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Profissionais da voz, especificamente os professores, têm alto risco de desenvolver distúrbios da voz. Programas educativos de saúde vocal podem auxiliar o professor a cuidar melhor da voz e consequentemente na prevenção contra as disfonias. O objetivo deste trabalho foi desenvolver um programa educativo, que inclui treinamento de exercícios vocais e higiene vocal, e analisar os efeitos do treinamento dos exercícios e prática de hábitos vocais de forma transversal e longitudinalmente. Participaram do estudo 102 professores de 11 escolas da rede pública de ensino do município de Piracicaba, SP, selecionadas aleatoriamente. A amostra foi dividida em grupo controle (52 mulheres e 14 homens) e grupo experimental (29 mulheres e 7 homens) com média de idade 42,55±7,84 anos. O programa oferecido ao grupo controle baseou-se em 2 palestras educativas sobre hábitos de higiene vocal e mecanismo da produção da voz. Para o grupo experimental foi proferida uma palestra sobre hábitos de higiene vocal e mecanismo de produção da voz e 4 sessões de treinamento de exercícios específicos para a voz. Estes exercícios abordaram: postura e relaxamento cervical; respiração; fonação, intensidade e freqüência; ressonância e articulação. Os sujeitos de ambos os grupos responderam 2 questionários: um sobre queixas vocais, hábitos bons e ruins para a voz e organização do trabalho e outro referente a qualidade de vida e voz (QVV). Uma da coleta da emissão da vogal [i] em tom habitual da fala foi realizada no início do programa e após 3 meses de finalização deste. A cada sessão de exercícios no grupo experimental foi realizado a coleta da vogal [i] em situação pré e pós treino. Após 3 meses da finalização do programa educativo, 73 sujeitos de ambos os grupos participaram da reavaliação da qualidade da voz e 70 responderam o questionário qualidade de vida vocal. O teste t de Student (pareado) foi utilizado para comparar medidas repetidas dentro do mesmo grupo e para comparar o efeito de interação do tratamento com o tempo, intra e inter-grupos, foi aplicado o teste Proc Mixed (medidas repetidas), utilizando-se o nível de significância (p<0,05). Os testes Qui-quadrado e exato de Fisher foram utilizados para testar a associação das variáveis independentes do questionário geral com as dependentes "Frequência Fundamental" e "Intensidade Média Vocal". Os resultados mostraram que os exercícios de postura e relaxamento cervical proporcionaram diminuição da média da freqüência fundamental masculina e os exercícios de fonação, intensidade e freqüência proporcionaram aumento da média da freqüência fundamental feminina, após o treino. Não houve diferença estatisticamente significativa para as variáveis da análise acústica da voz, quando comparadas as avaliações inicial e final após 3 meses do programa educativo, entre os grupos. Nas avaliações iniciais e finais dos escores (físico, psicoemocional e total) do QVV houve diferenças estatisticamente significantes para todos os escores, para o grupo controle e experimental, e não houve diferença da análise intergrupos. Pode-se concluir que o programa educativo teve efeitos benéficos para os professores, refletindo na melhora da qualidade de vida e vozAbstract: Professional voice users, specifically teachers, are at high risk for developing voice disorders. Therefore, educational programs for vocal health may help teachers take better care of their voice and consequently, to prevent dysphonia. The aim of this study was to develop an educational program with vocal training exercises and vocal hygiene, analyze the pre- and post-training effects of exercises and the effectiveness of the program after 3 months. One-hundred-and-two teachers from 11 public schools, randomly selected in the municipality of Piracicaba, State of São Paulo-Brazil, participated of this study. The sample was divided into a control group (52 women and 14 men) and experimental group (29 women and 7 men), mean age 42.55±7.84 years. The program offered to the control group was based on 2 educational lectures on vocal hygiene habits and the mechanism of voice production. For the experimental group, a lecture was presented on vocal hygiene habits and the mechanism of voice production, and 4 meetings about specific training exercises for the voice. This exercises comprised: Cervical posture and relaxation; respiration; phonation, intensity and frequency; resonance and articulation. The subjects of both groups answered two questionnaires: one about signs and symptoms of vocal problems, habits that are good and bad for the voice and organization of work, , and another about the Voice-Related Quality of Life (V-RQOL). A collection of vowel [i] emission in habitual tone of speech was made at the beginning of the program and after 3 months of completion. In each exercise session in the experimental group, vowel [i] emission was collected in the pre- and post-training situation. Three months after conclusion of the educational program, 73 subjects of both groups participated in re-evaluation of voice quality and 70 responded the questionnaire (V-RQOL). The paired Student's test was used to compare the repeated measures within the same group and Proc Mixed (repeated measures) were used to compare the effect of the interaction of treatment in the groups over time. For the analyses the level of significance (p<0.05) was considered. The Chi-square and Exact Fisher test were used to test the association of independent variables of the general questionnaire, considering the dependent variables Fundamental Frequency and Mean Vocal Intensity. The results showed that the cervical posture and relaxation exercises provided a mean reduction in fundamental frequency in men, and the phonation, intensity and frequency provided an increase in the mean value of fundamental frequency in women after training. There was no statistically significant difference between the groups for the variables acoustic analysis of the voice, when the initial and final evaluation after 3 months of the educational program were compared. In the initial and final evaluations of the scores (physical, psycho-emotional and total) of the V-RQOL there were statistically significant differences in all the scores, for both the control and experimental groups, and there was no difference in the inter-group analysis. It could be concluded that the educational program had beneficial effects for the teachers, reflected in improved quality of lifeDoutoradoSaude ColetivaDoutora em Odontologi

Set-Out

ABSTRACT Purpose: to analyze the knowledge and practices of nurses, doctors and dentists working in Primary Care for the development of the child&apos;s language early in life Methods: it is a qualitative research with 30 professionals from a network of Primary Care, among them doctors, nurses and dentists. An individual consultation was carried out through a semi-structured questionnaire. The technique of thematic speech analysis was used using three methodological approaches: The Central Idea, Expressions-Keys and the Collective Subject Discourse. Results: the knowledge that professionals have about the development of children&apos;s language were anchored to the core ideas to meet some milestones of development, the child&apos;s language depends on the middle stimulus, the family and normal hearing to know little or know nothing about the subject. The professionals reported that they would like to get more information on the subject in relation to the milestones of the child&apos;s language development, normal deviations and guidelines for parents in order to improve the care of children&apos;s health. Conclusion: the knowledge of professionals on the subject has been limited, and there is a need to expand educational practices in health through speech therapy, in partnership with the institutions of educatio

Reasons Related To Tooth Loss Among Adolescents In São Paulo Brazil

Aim: To estimate tooth loss prevalence among adolescents in São Paulo, considering socioeconomic and demographic factors, dental service use and pain. Methods: Data were obtained from the São Paulo Oral Health Survey 2008. The sample comprised 2858 adolescents from 15 to 19 years old from public and private schools, who underwent through an oral examination. In addition, a questionnaire was applied regarding the characterization of factors related to socioeconomics, demographics, use of dental services and pain in the last six months. At least one tooth lost was the outcome. The independent variables included gender, ethnicity, parents’ schooling, type of school, number of rooms, people and cars per home, family income, dental service use, decayed teeth, toothache. A multivariate logistic regression model was used. Results: The prevalence of tooth loss was 7%. The independent variables decayed tooth (RP=1.71), toothache (RP=2.04), father’s schooling - elementary (RP=1.40) and per capita family income - less than 1/ 2 a minimum salary (RP=1.45) were associated with the outcome. Conclusions: The results suggest that socioeconomic factors may contribute to the increase of early tooth loss among adolescents.13137-4