Relationship between oral health status and marital quality and work stress

This study aims to investigate whether oral health status is associated with work stress and marital quality. The term stress was applied to define the stimuli themselves and not to the body reaction in response to a variety of physical or psychological stimuli. Marital quality is defined as the subjective evaluation of a married couple's relationship on a number of dimensions and evaluations (Spanier and Lewis, 1980). The hypothesis is that a given set of psychosocial factors, if favourable, will predispose family members to oral health, or alternatively, if unfavourable, will predispose to oral disease. It is hypothesised that families whose members experienced high levels of communication, companionship, and satisfaction with the partner and children are more likely to show better oral health status than families whose members experienced low levels of communication, companionship and satisfaction with the partner and children. In addition, fathers who experienced low levels of stress at work tend to have a better oral health status than fathers who experienced high levels of stress at work. The study was conducted in Belo Horizonte, Brasil. 164 families, equally distributed over four socio-economic groups, were randomly selected from children from private and state schools. The parents' age ranged from 35 to 44 years old. Each family had a child aged 13 years old. Data were analysed using multiple regression analysis (dental caries data) and logistic regression analysis (periodontal data). Age, socio-economic status, gender, dental attendance, toothbrushing frequency, sugar consumption and type of toothpaste were considered in the analysis. The results showed a highly significant linear relationship between marital quality and the father's, mother's and child's dental caries status. Work related mental demand, work control, and work variety were not significantly associated with fathers' dental caries status. A significant relationship between periodontal health status and marital quality was found for fathers and mothers and a significant relationship between work related mental demand and fathers' periodontal health status was also found. It was concluded that marital quality is an important determinant of oral health status - dental caries and periodontal disease - and that work related mental demand is an important determinant of periodontal health status

Impacto do tratamento restaurador na prevenção da perda de dentes

A cross-sectional study was carried out to analyze tooth loss resulting from caries in relation to the number of times the extracted tooth had been restored, the type of caries diagnosed (primary or secondary), and socioeconomic indicators of patients from the city of Recife, Brazil. Ten public health centres and ten centres associated with health insurance companies were randomly selected. The size of the sample was calculated using a standard error of 2.5%. A confidence interval of 95% and a 50% prevalence of reasons for extractions were used for calculating the sample. The minimum size of the sample for meeting these requirements was 381 patients. Patients were randomly selected from the list of adults registered at each centre. A total of 410 patients were invited to take part in the study. The response rate was 100%, but 6 patients were excluded due to incompleteness of data in the questionnaire applied. An assessment was made to obtain the number of decayed, missing or filled teeth (DMFT index) and the reasons for extraction. The results showed a highly significant (p < 0.001) relationship between the number of times the tooth indicated for extraction had been restored and the reason for extraction being caries. Furthermore, the majority of teeth extracted due to caries had been restored two or more times. A highly statistically significant association was also observed between one indicator of use of dental services (F/DMFT) and extraction due to caries (p < 0.001). The findings questioned the belief that tooth loss can be prevented in the general population by merely providing restorative treatment.Um estudo transversal foi conduzido com o objetivo de analisar a perda dentária, pela razão cárie, em relação ao número de vezes que o dente extraído foi restaurado, tipo de cárie diagnosticada (primária ou secundária) e indicadores socioeconômicos de pacientes na cidade de Recife, Brasil. Dez centros do Sistema Público de Saúde e dez pertencentes a empresas de convênios foram sorteados. O tamanho da amostra foi calculado utilizando-se um erro padrão de 2.5%. O intervalo de confiança de 95% e uma prevalência de razões de extração na ordem de 50% foram usados para o cálculo da amostra. Uma amostra mínima requerida de 381 pacientes foi calculada, sendo examinados um total de 410 pacientes sorteados da lista de atendimento dos postos. 100% dos pacientes concordaram em participar da pesquisa, contudo, seis pacientes foram excluídos do estudo por apresentarem dados incompletos no questionário aplicado. Os pacientes foram examinados para a obtenção do CPOD e da razão das extrações. Cárie foi a principal razão para exodontia (p < 0,001). Analisando-se a relação entre o número de vezes que o dente foi restaurado e a razão da exodontia, observou-se um valor altamente significativo (p < 0,001), indicando que a maioria dos dentes extraídos pela razão cárie foram restaurados duas ou mais vezes. Foi observada uma relação altamente significativa estatisticamente entre um indicador de uso de serviços (O/CPOD) e exodontia devido a cárie (p < 0,001). Os achados demonstraram que é errônea a crença de que a perda dentária pode ser prevenida na população simplesmente pela restauração do dente

Dental caries prevalence and mean dmf-t among schoolchildren between 1971 to 1997, Brazil

INTRODUCTION: Cross-sectional surveys carried out in Brazil during the last decade have showed a significant decrease in both prevalence and severity of dental caries. However, the validity of these studies is questioned. Different methodologies as well as diagnosis criteria were used. Thus, a study was carried out with the purpose of comparing the prevalence and severity of caries among schoolchildren aged 12 and 13 years in a region of Brazil. METHODS: Two cross-sectional surveys were carried out. All 12 and 13 year old children enrolled in a primary school were examined by a single dentist in 1971 (n=202) and 1997 (n=175), following the same protocol. The original criteria for the diagnosis of caries proposed by Klein and Palmer in 1937 were used both in 1971 and 1997. A total of 202 and 175 children were examined in 1971 and 1997 respectively. RESULTS: The response rate was 100%. Intra-examiner agreement was very high. Kappa test was performed on a tooth by tooth basis and all values were above 0.86. The prevalence of caries was 98% and 93.7% in 1971 and 1997 respectively. Comparison of the severity of caries experience expressed as changes in the mean DMF-T scores showed a reduction from 9.2 to 6.2 between 1971 and 1997 in the study group. CONCLUSIONS: There was a significant reduction in dental caries prevalence and severity between 1971 to 1997 in the study population. The observed reduction of caries was not a statistical artifact as the same methodology and diagnostic criteria were applied in both cross-sectional surveys.INTRODUÇÃO: Estudos epidemiológicos de cárie dentária, realizados no Brasil na última década, revelam uma significante redução na prevalência e na severidade da cárie dentária. Dúvidas persistem sobre a validade e a confiabilidade desses achados, em razão de diferentes metodologias e de critérios de diagnóstico utilizados. Foi realizado estudo com o objetivo de comparar a prevalência e a severidade da cárie dentária em escolares de 12 e 13 anos de idade entre 1971 e 1997. MÉTODOS: Foram realizados dois estudos transversais de prevalência, nos anos de 1971 e de 1997, em que todos os alunos de 12 e 13 anos de idade, de uma mesma escola de Florianópolis, SC, Brasil, foram examinados, utilizando-se o mesmo protocolo e os critérios de diagnóstico de cárie dentária, estes originalmente propostos por Klein e Palmer. Foram examinados 202 e 175 escolares, em 1971 e 1997, respectivamente. Todos os exames foram conduzidos pela mesma examinadora, que foi previamente treinada por meio de um exercício de calibração. RESULTADOS: A taxa de resposta foi de 100%, sendo a concordância intra-examinadora, medida dente por dente, muito alta (Kappa >; 0,86). As prevalências de cárie foram de 98% e 93,7% em 1971 e 1997, respectivamente. O valor do CPO-D médio variou de 9,17 em 1971 para 6,25 em 1997, tomando-se as idades de 12 e 13 anos em conjunto. CONCLUSÕES: Houve no período uma efetiva redução na prevalência e severidade da cárie dentária, na população estudada. Houve uma mudança real que não se deve a diferentes critérios de diagnóstico empregados

Differences between normative criteria and self-perception in the assessment of malocclusion

OBJECTIVE: To evaluate the impact of objectively defined orthodontic needs (normative criteria) on the external aspect and mastigation's satisfaction, and to compare these needs to self-perceived ones (subjective criteria) among adolescents. METHODS: A cross-sectional study was carried out among all 315 students aged 14-18 years who attended a highschool in Florianópolis, Brazil. A single dentist collected clinical data about malocclusion (Dental Aesthetic Index) and a questionnaire was applied to assess perceived aesthetic and masticatory satisfaction and need for orthodontic treatment. Data analysis included frequency distribution calculation and multiple logistic regression modeling. RESULTS: There were high participation of 95% (n=300) and intra-examiner agreement (Kappa 0.6-1.0). The prevalence of one form of malocclusion was 71.3%. Crowding in one or two incisal segments [OR=2.8 (1.6-4.9)] and overjet [OR=2,4 (1.4-4.3)] were risk factors associated with perceived aesthetic dissatisfaction. Adolescents who had anterior mandibular irregularity [OR=3.3 (1.6-6.9)], overjet [OR=1.7 (1.1-3.0)] and anterior diastema [OR=3.1 (1.4-6.9)] revealed the highest self-perceived need for orthodontic treatment. CONCLUSIONS: There are different degrees of objectively defined occlusal problems acceptable in the population which interfere with their decision to seek treatment and have a direct impact on the need of care. Subjective measures should be incorporated to clinical criteria currently used.OBJETIVO: Avaliar o impacto das necessidades ortodônticas tecnicamente definidas (critérios normativos) sobre a satisfação com a aparência e a mastigação e compará-las com as autopercebidas (critérios subjetivos) em um grupo de adolescentes. MÉTODOS: Foi realizado um estudo transversal com a totalidade dos alunos entre 14 e 18 anos de idade (n=315) de um colégio em Florianópolis, SC, Brasil, em 1999. Uma cirurgiã-dentista realizou os exames clínicos para diagnóstico das principais oclusopatias (Dental Aesthetic Index) e aplicou um questionário para conhecer a satisfação dos indivíduos quanto a aparência, mastigação e percepção das necessidades de tratamento ortodôntico. Foi utilizada análise de regressão logística múltipla para conhecer o impacto de cada oclusopatia sobre a percepção dos indivíduos a respeito dos problemas oclusais. RESULTADOS: Obtiveram-se alta taxa de resposta (95%) e alta concordância intra-examinadora (Kappa 0,6 a 1,0). A prevalência de pelo menos um tipo de oclusopatia foi de 71,3%. Presença de apinhamento incisal (OR=2,8 [1,6-4,9]) e overjet (trespasse horizontal) (OR=2,4[1,4-4,3]) foram fatores de risco para insatisfação com a aparência. Adolescentes que apresentaram irregularidade anterior da mandíbula (OR=3,3 [1,6-6,9]), overjet (OR=1,7 [1,1-3,0]) e diastema anterior (OR=3,1 [1,4-6,9]) apresentaram maior percepção para a necessidade de tratamento ortodôntico. CONCLUSÕES: Os resultados sugerem que existem graus de problemas oclusais tecnicamente definidos que são aceitáveis pela população e que devem influenciar na decisão de tratamento, interferindo diretamente na demanda para esse tipo de atendimento. Medidas subjetivas poderiam ser incorporadas aos critérios clínicos atualmente utilizados

Projeto Bambuí: avaliação de serviços odontológicos privados, públicos e de sindicato

OBJECTIVE: Since one of the goals of dental services is to reduce the effects of social inequality on dental health, it was assessed whether there are inequalities among those seeking dental care from private, public and unionized services. METHODS: The study population consisted of adults aged 18 years or more living in the city of Bambuí, Brazil. Participants were interviewed using a structured questionnaire. Data analysis was carried out using Pearson's chi-square test, odds ratio and 95% confidence intervals (Woolf's method). RESULTS: There were included 656 subjects who met the study's inclusion criteria. Adjusted results using multiple logistic regression showed that those using private services were more likely to be satisfied with their teeth's looks (OR=3.03; 95%CI =1.70-5.39) and chewing ability (OR=2.27; 95%CI=1.17-4.40) compared to those using public services. Also, they were less likely to perceive their need for dental treatment (OR=0.39; 95%CI=0.18-0.86) and were more likely to have had restorative (OR=9.57; 95%CI=4.72--19.43) and/or preventive (OR=5.57; 95%CI=2.31--13.40) treatment in their last visit to the dentist's. Those using unionized services were more likely to have had restorative (OR=8.51; 95%CI=2.80--25.92) and/or preventive treatment (OR=11.42; 95%CI=3.49--37.43) in their last visit to the dentist's when compared to those using public services. However, there were no differences regarding satisfaction with their teeth's looks, chewing ability, and perceived treatment needs. CONCLUSION: Public dental care services have not been able to reduce social inequalities related to oral health care.OBJETIVO: Partindo do princípio de que um dos objetivos dos serviços odontológicos públicos é reduzir os efeitos das desigualdades sociais sobre a saúde bucal, investigou-se se essas desigualdades estão presentes entre usuários dos serviços odontológicos públicos, privados e de sindicato. MÉTODOS: A população estudada foi constituída por uma amostra representativa de adultos residentes na cidade de Bambuí, MG. Os participantes foram entrevistados por meio de um questionário estruturado. RESULTADOS: Entre os 1.664 moradores amostrados, 1.382 (83,1%) participaram do inquérito de saúde bucal. Destes, 656 preenchiam os critérios de inclusão (idade >;18 anos, presença de pelo menos um dente natural e visita ao dentista pelo menos uma vez na vida) e participaram do trabalho. Os usuários dos serviços privados estavam mais satisfeitos com a aparência dos dentes (ORaj=3,03; IC95%=1,70-5,39) e com a mastigação (ORaj=2,27; IC95%=1,17-4,40) do que os usuários de serviços públicos. Aqueles também percebiam menos necessidade atual de tratamento odontológico (ORaj=0,39; IC95%=0,18-0,86) e receberam com mais freqüência tratamento restaurador (ORaj=9,57; IC95%=4,72-19,43) ou preventivo (ORaj=5,57; IC95%=2,31-13,40) na última visita ao dentista. Aqueles que usaram os serviços do sindicato também receberam mais tratamentos restauradores (ORaj=8,51; IC95%=2,80-25,92) e preventivos (ORaj=11,42; IC95%=3,49-37,43) na última visita ao dentista do que os usuários de serviços públicos. Nenhuma diferença foi encontrada em relação à satisfação com a aparência dos dentes, à capacidade de mastigação e à percepção de necessidade de tratamento odontológico. CONCLUSÃO: Os serviços públicos odontológicos, com base no estudo da comunidade local, aparentemente não têm conseguido reduzir as desigualdades sociais com referência à saúde bucal

Child-OIDP index in Brazil: Cross-cultural adaptation and validation

Background: Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen. Methods: For cross-cultural adaptation, a translation/back-translation method integrated with expert panel reviews was applied. A total of 342 students from four public schools took part of the study. Results: Overall, 80.7% of the sample reported at least one oral impact in the last three months. Cronbach's alpha was 0.63, the weighted kappa 0.76, and the intraclass correlation coefficient (ICC) 0.79. The index had a significant association with self-reported health measurements (self-rated oral health, satisfaction with oral health, perceived dental treatment needs, self-rated general health; all p < 0.01). Conclusion: It was concluded that the Child-OIDP index is a measure of oral health-related quality of life that can be applied to Brazilian children

Dor de origem dental como motivo de consulta odontológica em uma população adulta

OBJECTIVE: The occurrence of orofacial pain and chronic pain are frequent subjects for study today, but few studies have been made on dental pain in Brazil. The objective of the study was to assess the prevalence of dental pain and the associated factors as the reason for visiting a dentist among adults. METHODS: A cross-sectional study was carried out among 860 workers aged 18-58 years at a cooperative located in the State of Santa Catarina, in 1999. The clinical examinations and interviews were carried out by dentists who had received prior guidance. Complaints of dental pain as the reason for the last visit to a dentist were analyzed as the dependent variable, in relation to the socioeconomic and demographic conditions, access to dental services, shift pattern and caries (via the DMFT index), as the independent variables. Non-conditional multiple logistic regression analysis was utilized. RESULTS: The prevalence of dental pain as the reason for the last visit to a dentist was 18.7% (CI 95%: 15.9-20.1) and the mean DMFT index (decayed, missing and filled teeth) was 20.2 (CI 95%: 19.7-20.7), with 54% represented by the 'missing' component. The following were independently associated with the presence of dental pain: schooling of less than or equal to eight years (OR=1.9; CI 95%: 1.1-3.1); four to fifteen teeth lost due to caries (OR=2.6; CI 95%: 1.4-4.9); 16 to 32 teeth lost due to caries (OR=2.5; CI 95%: 1.1-5.8); and not having visited the company's dental service (OR=2.8; CI 95%: 1.6-5.1). CONCLUSIONS: Dental pain reflects the severity of the dental caries, expressed by the 'missing' component of the DMFT and non-usage of the company's dental services. These factors are determined by social conditions and represented by the schooling level.OBJETIVO: A ocorrência de dor orofacial e dor crônica é tema freqüente nos estudos da atualidade; porém, a dor de origem dental é pouco estudada no Brasil. O estudo tem como objetivo conhecer a prevalência de dor de dente como motivo de consulta odontológica e os fatores associados em indivíduos adultos. MÉTODOS: Realizou-se um estudo transversal com 860 funcionários de uma cooperativa localizada no Estado de Santa Catarina, com idade entre 18 e 58 anos, em 1999. Exames clínicos e entrevistas foram realizados por uma cirurgiã-dentista previamente treinada. Analisou-se a queixa de dor de origem dental como motivo da última consulta odontológica como variável dependente em relação às condições socioeconômicas, demográficas, acesso ao serviço odontológico, turno de trabalho e ataque de cárie por meio do índice CPO-D como variáveis independentes. Foi utilizada a análise de regressão logística múltipla não-condicional. RESULTADOS: A prevalência de dor de origem dental foi de 18,7% (IC 95%[15,9-20,1]) e o CPO-D médio 20,2 dentes (IC 95%[19,7-20,7]), com 54% representados pelo componente perdido. Foram associados independentes para a presença de dor de origem dental a escolaridade menor ou igual a oito anos de estudo (OR=1,9[1,1-3,1], a perda por cárie de quatro a 15 dentes (OR=2,6[1,4-4,9]) e de 16 a 32 dentes (OR=2,5[1,1-5,8]) e não ter freqüentado o serviço odontológico da empresa (OR=2,8[1,6-5,1]). CONCLUSÕES: A dor de origem dental reflete a gravidade da cárie dentária, expressa pelo componente perdido do CPO-D e o não uso de serviços odontológicos da empresa. Esses fatores são determinados pelas condições sociais, representadas pela escolaridade