Iniquidade de gênero e atenção à saúde no Brasil: em busca de equidade, diversidade e liderança

A equidade de gênero é reconhecida como direito fundamental do ser humano pela Organização das Nações Unidas (ONU) desde 1948. Em 2015, a sua importância foi novamente destacada através da Agenda 2030 da ONU para o desenvolvimento sustentável em seu objetivo número 5: “atingir a equidade de gênero e empoderar todas as mulheres e meninas”. Nesse ponto, vale destacar a definição do termo “Equidade”, definido pelo Dicionário Cambridge como a “a situação em que todos são tratados de forma justa de acordo com suas necessidades e nenhum grupo de pessoas recebe tratamento especial”. A equidade é um dos princípios fundamentais do Sistema Único de Saúde (SUS) do Brasil, buscando atender de maneira universal às diferentes necessidades de saúde da população brasileira

Desempenho de cimentos de ionômero de vidro nacionais e importados utilizados no Tratamento Restaurador Atraumático (ART) frente à microinfiltração em molares decíduos

Buscando comparar o desempenho de 2 cimentos de ionômero de vidro (CIV) restauradores convencionais nacionais, mais acessíveis tanto financeiramente quanto por disponibilidade no mercado, ao desempenho de 2 CIV importados frente à microinfiltração, confeccionou-se preparos classe II com término cervical em esmalte em 40 molares decíduos hígidos. Vinte cavidades foram restauradas com os CIV nacionais (Vidrion® R e Vidrion® R Caps) e as demais com os importados (Fuji® IX e Fuji® IX GPFast), por um único operador. Os dentes foram impermeabilizados, imersos em azul de metileno 0,5% e seccionados mesio-distalmente. A microinfiltração foi avaliada por 3 examinadores calibrados, em microscópio estereoscópico, através de escores (0-3). Foram utilizados os testes estatísticos de Kruskall-Wallis e de Wilcoxon. Verificou-se altos índices de microinfiltração para todos os CIV: 59,5% das amostras restauradas com Vidrion® R ou Vidrion® R Caps e 83,4% das amostras restauradas com Fuji® IX ou Fuji® IX GPFast obtiveram o escore máximo (3). Os CIV nacionais apresentaram menos microinfiltração que os CIV importados, embora essa diferença só tenha sido significativa (p=0,003) entre os materiais encapsulados.With the aim of assessing the performance of Brazilian and imported glass ionomer cements (GIC) with regard to microleakage, 40 primary molars received two standard class II cavity preparations with margins in enamel. Twenty cavities were filled with Brazilian materials (Vidrion® R and Vidrion® R Caps) and the other 20 cavities were filled with imported materials (Fuji® IX and Fuji® IX GPFast capsule). All fillings were performed by a single operator according to the manufacturer's instructions. Teeth were immersed in 0.5% methylene blue and half-sectioned. Three independent calibrated examiners assessed microleakage using scores (0-3). Data were submitted to the Kruskal-Wallis statistical test and Wilcoxon analysis. High microleakage indexes were verified for all ionomer cements: 59.5% of the samples restored with Vidrion® R or Vidrion® R Caps and 83.4% of the samples restored with Fuji® IX or Fuji® IX GPFast capsule obtained the maximum score (3). The Brazilian ionomer cements presented less microleakage than imported cements, although this difference was only significant (p=0.003) among the encapsulated materials

Temporomandibular Disorders are Associated with Sociodemographic Factors, Health-Related and Oral Conditions in Adolescents: A Cross-Sectional Study

Objective: To assess the association between temporomandibular disorder (TMD) with sociodemographic factors, health-related factors, and oral conditions in adolescents. Material and Methods: This cross-sectional study was developed with 89 adolescents between 13 to 18 years. TMD diagnosis was obtained by the Research Diagnostic Criteria for Temporomandibular Disease (RDC/TMD) Axis I. Diagnoses of chronic pain, depression, presence of non-specific physical symptoms, including pain and anxiety, were obtained by the RDC/TMD Axis II. The feeling of happiness was measured by the Subjective Happiness Scale. Socio-economic and demographic characteristics were collected through self-administered questionnaires. Patients were examined for dental caries, dental trauma, malocclusion, and tooth wear. Parents answered a sociodemographic, economic, and general health questionnaire. Data were submitted to descriptive statistics, and a logistic regression model was used to assess the association between TMD and the socio-economic, demographic, health-related, and clinical variables. Results: TMD prevalence was 42%. TMD was associated to skin color (p=0.040), use of medications in the past year (p = 0.020) and previous dental trauma (p=0.030). Also, it tended to be associated with the presence of probable awake bruxism (p=0.053). Conclusion: Sociodemographic factors, health-related factors, and oral conditions play a role in TMD, with nonwhite adolescents, those who had used medications in the past year and/or had previous dental trauma having a greater chance of present this disorder

Shame from Smiling and Speaking Due to Oral Health Problems in Brazilian Adolescents: A Nationwide Population-Based Study

Objective: To investigate the association between oral health problems and being ashamed of smiling or speaking among Brazilian adolescents. Material and Methods: This was a population-based cross-sectional study carried out with secondary data from 7,328 12-year-old Brazilian adolescents from the latest Brazilian national oral health survey (SB Brasil 2010). The question “In the previous 6 months, have you been ashamed of smiling or speaking due to your teeth?” was the outcome variable. Calibrated examiners performed clinical examinations on adolescents for the diagnosis of dental caries (DMF-T), dental trauma, dental fluorosis and occlusal alterations. Data were analyzed descriptively and by Poisson unadjusted and adjusted Poisson regression analysis (p<0.05). The final model was controlled by family income. Results: The prevalence of being ashamed of smiling or speaking was 13.6%. The following variables were associated with the outcome: female sex (PR=1.33; 95% CI: 1.17-1.53), cavitated dental caries on upper incisors (PR=1.81; 95% CI: 1.51-2.15), dental trauma (PR=1.36; 95% CI:1.16-1.60), increased maxillary overjet (PR=1.36; 95% CI:1.18-1.57), dental crowding (PR=1.60; 95% CI:1.40-1.83), midline diastema (PR=1.30; 95% CI:1.11-1.44), tooth loss (PR=1.45; 95% CI:1.16-1.80), mild/questionable dental fluorosis (PR=1.23; 95% CI:1.06-1.44) and moderate/severe dental fluorosis (PR=1.67; 95% CI:1.15-2.44). Conclusion: Oral health problems that impact dental aesthetics were predisposing factors for being ashamed of smiling or speaking in Brazilian adolescents

Association Between Socioeconomic Factors and the Choice of Dentifrice and Fluoride Intake by Children

It is questionable whether socioeconomic factors influence the choice of marketed children’s dentifrices and whether these products are associated with greater fluoride (F) intake in children. The present cross-sectional study involving 197 children (mean age: 40.98 ± 6.62 months) was carried out in Montes Claros, Brazil. Parents completed a questionnaire on socioeconomic status and the tooth brushing habits of their children. The children brushed their teeth and saliva residues were collected for F analysis. F intake from dentifrice was determined with an ion-specific electrode. Univariate analysis and logistic regression were used to test whether the type of dentifrice (children’s or family) and F dose (<0.05 and ≥0.05 mg F/Kg of body weight/day) were associated with the independent variables (p < 0.05). No differences were found between children’s and family dentifrices regarding daily F intake (0.046 and 0.040 mg F/Kg/day, respectively; p = 0.513). The following were strong predictors for the use of a children’s dentifrice: studying at a private kindergarten (OR: 6.89; p < 0.001); age that the child begun to tooth brush <2 years (OR: 2.93; p = 0.041), and the interaction between the variables “use of the same dentifrice as parents” and “type of tooth brush used” (OR: 27.20; p < 0.001). “The amount of dentifrice used” and “frequency of tooth brushing” (p ≤ 0.004) had a statistically and synergistic effect over the daily F dose. The present study found a social influence over the choice of dentifrice: children with a high socioeconomic status tend to use a children’s dentifrice. The amount of dentifrice used can strongly increase the risk of exposure to higher doses of F, regardless of the type of dentifrice

Impact of Wearing Palatal Expanders on the Quality of Life of Children Aged 8 to 10 Years

Objective: To assess the impact of wearing palatal expanders on the oral health-related quality of life (OHRQoL) of children aged 8 to 10 years. Material and Methods: The sample consisted of 35 children aged 8 to 10 years treated at the orthodontics and pediatric dentistry outpatient clinics affiliated with the Dental School. Children were divided in two groups: 17 were submitted to palatal expansion treatment (Group 1), while 18 just received coronal polishing and topical fluoride application (Group 2). The Brazilian version of the Child Perceptions Questionnaire (CPQ8-10) was used to assess children’s OHRQoL. The questionnaire was administered before the expander was placed, at the end of its activation, and before its removal. Intervals between the interviews were similar in the two groups. Descriptive statistics and ANOVA were used for data analyses. Results: The overall CPQ8-10 score was not significantly different between the groups. The results show statistically significant differences between the two groups only for the functional limitations domain after activation of the appliance (p=0.001). Conclusion: Palatal expanders may negatively affect children's functions only during the initial wearing period