Prevalência de doenças periodontais em gestantes e associação com prematuridade e baixo peso de recém-nascidos

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Pública.OBJETIVOS: estimar a prevalência da doença periodontal em gestantes e testar a hipótese de associação desta doença e baixo peso ou prematuridade dos recém-nascidos. MÉTODOS: foi realizado um estudo transversal, de base populacional, em Itajaí, SC. A amostra foi constituída por 449 parturientes que foram entrevistadas e examinadas até 48 horas após o parto. Dois foram os desfechos investigados: o baixo peso e a prematuridade. Doença periodontal foi definida como i) a existência de pelo menos um sítio com presença de bolsa periodontal; ii) presença de bolsa em 4 ou mais sítios. Informações sócio-demográficas, relativas a saúde e hábitos maternos foram coletados através de um questionário específico e complementados pelos prontuários. Análise de regressão simples e múltipla foram realizadas para cada um dos desfechos. RESULTADOS: 449 parturientes foram efetivamente estudadas. Não houve associação estatisticamente significante entre doença periodontal e baixo peso ao nascer. Bolsa periodontal em pelo menos um sítio foi associada com prematuridade (OR=2,6 IC95% 1,0-6,9) mesmo após o ajuste pela escolaridade da mãe, paridade, números de filhos anteriores com baixo peso, número de consultas de pré-natal e índice de massa corporal. Após a introdução de variáveis relativas à saúde materna durante a gravidez esta associação não se manteve. CONCLUSÃO: não foi constatada associação entre doença periodontal da gestante e nascimentos de recém nascidos com baixo peso e nem com a prematuridade após ajuste por variáveis confundiroras relacionadas à saúde materna

The Influence of the First Thousand Days of Life on Establishing Determinant Behaviors for Dental Caries in Childhood

Objective: To study the influence of the first thousand days of life on establishing determinant behaviors for dental caries in childhood. Material and Methods: Longitudinal retrospective study involving 664 children born in 2009 living in a southern Brazilian municipality was carried out. Data was collected through interviews with mothers and through child’s health card. Dependent variables were 1) tooth brushing onset after two years of age; 2) absent tooth brushing or once a day; 3) tooth brushing without adult supervision; 4) not having gone to the dentist until the age of 6; and 5) seek for dental services due to toothache at 6 years of age, over the last 30 days. Bivariate and multivariate analyses were performed using Poisson Regression to estimate relative risks (RR) and respective confidence intervals at the 95% accuracy level. Results: Mothers with lower schooling at child’s birth presented a higher risk of “child’s tooth brushing onset only after two years of age”, “brushing the teeth once a day only or not brushing” and with “child not having gone to the dentist until the age of 6”. Mothers who did not have a job when the child was born were associated with “not having gone to the dentist until the age 6”. Children with gastroesophageal reflux who underwent hospitalization for more than 2 days under age 2 were associated with “seeking dental services because of pain at 6 years of age over the last 30 days”. Conclusion: Higher risks of some determinant behaviors related to dental caries were associated with variables of the period of the first thousand days of life

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

Prevalence and Associated Factors of Dental Trauma in Six-Year-Old School-Children

Objective: To estimate the prevalence and associated factors of dental trauma in 6-year-old school children in the city of Palhoça, Brazil. Material and Methods: Cross-sectional study nested in a cohort study. It involved a representative sample of school children born in 2009, residing in the municipality and regularly enrolled in public and private schools (n = 1,102). Clinical data were obtained through oral exams. To evaluate the incisal overjet, the distance in millimeters was measured horizontally from the labial surface of the lower central incisor to the labial surface of the upper incisor. Bivariate analyses were performed using the Chi-square test, with a p-value <0.05 considered statistically significant. Multivariate analyses using Poisson Regression were performed to identify independent associations between the prevalence and the independent variables studied. Results: Prevalence of dental trauma was 4.2% (95% CI 3.0-5.4). Dental trauma was statistically associated with studying in a private school (PR = 1.03; 95% CI 1.01-1.06) (p=0.016) and with inadequate lip coverage (PR = 1.08; 95% CI 1.01-1.14) (p=0.016). Conclusion: The prevalence of 4.2% of dental trauma in six-year-old children, associated with inadequate and greater lip coverage in children from private schools should be taken into account, since most teeth at this stage are newly erupted

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child\u27s life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions

First Thousand Days of Child Life and the Development of Risk Factors for Malocclusions

Objective: To identify the association between individual and socioeconomic factors during the first thousand days of the child's life and the occurrence of risk behaviors for the development of malocclusions. Material and Methods: Cross-sectional study. A sample of 655 6-year-old schoolchildren and families was included. Interviews with mothers were performed at home. The dependent variables were risk behaviors to the development of malocclusions. Independent variables were socioeconomic conditions, aspects of gestation, birth and health of the child up to two years of age. Bivariate and multivariate analyzes were performed through Poisson regression. Results: Maternal education of less than eight years was independently associated with the interruption of exclusive breastfeeding until the fourth month (PR=1.58 CI 95%; 1.07; 2.37). Occupation of the mother with income [PR=1.26; 1.02; 1.56)], occupation of the father without income [PR=1.46 (1.01; 2.14)] were associated fwith interruption of breastfeeding until the sixth month. Pregnancy in adolescence [PR=0.83 (0.70; 0.98)] and nursery attendance [PR=1.15 (1.02; 1.28)] were associated with bottle use. Nursery attendance [PR=1.27 (1.01; 1.59)], hospitalization in the first 29 days of life [PR=1.34 (1.01; 1.80)], occurrence of reflux [PR=1.30 (1.01; 1.70)] were associated with pacifier using. Conclusion: Variables related to the period of the first thousand days of life are associated with higher risk behaviors for the occurrence of malocclusions

Adverse birth outcomes and oral health

It is vital to improve the understandingof early child’s oral health determinants and conse-quent identification of interventions and behaviorsthat can be modified with health promotion activi-ties since birth. Authors have suggested that proper fetal growth and adequate development in the first two years of life are determinants ofhealth, not only at childhood but also in later life.David Barker’s studies conducted in the 1980s have suggested that the events of the intrauterineperiod or during early childhood have long-termeffects on morbidity and mortality from chronicdiseases.On the other hand, the Life-Course Theory emphasizes the infancy period, based on the accu-mulation of environmental, social, and behavioralrisks in life, without disregarding Barker’s pre-mises, to strengthen the interaction between bio-logical and social factors of the different stages of life, more than the current adult lifestyle. However, little research has been carried outfocusing on these ideas to determine children’s oralhealth. There is a scarcity of longitudinal studies,such as population-based cohort studies, that aimto understand the determination of the oral health-disease process and the complex interactionbetween social environment and biological and behavioral aspects. The study published by thisimportant journal has contributed to bring thisissue to the agenda

Self-esteem and dental caries in adolescents: a cross sectional study

Introduction: Dental caries in adolescents remains an important public health problem, but its relationship with psychological factors are poorly studied. Objective: To study the possible association between aspects of self-esteem and dental caries in adolescents. Material and method: A cross-sectional study involving a sample of 409 adolescents from 13 Southern Brazilian municipalities was carried out. Dental caries status was assessed through the World Health Organization criteria. For questions related to self-esteem the Rosenberg Self-Esteem Scale was used. The outcomes were each question of the scale. The chi-square test was used to determine statistical significance of associations. To adjust for confounding variables, the Poisson loglinear with robust estimator was used. Result: Positive associations were observed for the presence of decayed teeth and “At times, I think I am no good at all” (p<0.001), “I wish I could have more respect for myself ” (p= 0.016), “I certainly feel useless at times” (p= 0.022) and negative association with “On the whole, I am satisfied with myself ” (p= 0.022). In the adjusted analysis, adolescents with decayed teeth had a higher prevalence of positive responses to “At times, I think I am no good at all” [(PR= 1.23 (CI 95% 1.05; 1.44)], and negative responses for “On the whole, I am satisfied with myself ” [(PR= 1.12 (CI 95% 1.02; 1.24)]. Conclusion: Aspects of self-esteem were significantly and independently associated with the presence of decayed teeth.Introdução: A cárie dentária na adolescência continua sendo um importante problema de saúde pública; entretanto, a sua relação com os fatores psicológicos é pouco estudada. Objetivo: Estudar a possível associação entre aspectos de autoestima e cárie dentária em adolescentes. Material e método: Estudo transversal envolvendo amostra de 409 adolescentes de 13 municípios do sul do Brasil. A cárie foi avaliada segundo critérios da Organização Mundial da Saúde e a autoestima, pela Escala de Rosenberg. O teste do qui-quadrado foi utilizado para determinar a significância estatística das associações. Para ajustar para variáveis de confusão, foi utilizada a regressão loglinear de Poisson com estimativa robusta. Resultado: Foram observadas associações positivas entre presença de dentes cariados e alguns aspectos da escala de autoestima: “Às vezes, eu acho que não presto para nada” (p <0,001); “Eu gostaria de poder ter mais respeito comigo mesmo” (p=0,016), e “Eu, com certeza, me sinto inútil, às vezes” (p=0,022). Associação negativa foi observada com: “No conjunto, eu estou satisfeito comigo” (p=0,022). Na análise ajustada, os adolescentes com dentes cariados apresentaram maior prevalência de respostas positivas para a questão “Às vezes, eu acho que não presto para nada” [RP= 1,23 (IC 95% 1,05; 1,44)] e maior prevalência de respostas negativas para a questão “No conjunto, eu estou satisfeito comigo” [RP= 1,12 (IC 95% 1,02; 1,24)]. Conclusão: Aspectos da autoestima foram, independente e significativamente, associados com a presença de dentes cariados

Autoestima e cárie dentária em adolescentes: um estudo seccional

Resumo Introdução A cárie dentária na adolescência continua sendo um importante problema de saúde pública; entretanto, a sua relação com os fatores psicológicos é pouco estudada. Objetivo Estudar a possível associação entre aspectos de autoestima e cárie dentária em adolescentes. Material e método Estudo transversal envolvendo amostra de 409 adolescentes de 13 municípios do sul do Brasil. A cárie foi avaliada segundo critérios da Organização Mundial da Saúde e a autoestima, pela Escala de Rosenberg. O teste do qui-quadrado foi utilizado para determinar a significância estatística das associações. Para ajustar para variáveis de confusão, foi utilizada a regressão loglinear de Poisson com estimativa robusta. Resultado Foram observadas associações positivas entre presença de dentes cariados e alguns aspectos da escala de autoestima: “Às vezes, eu acho que não presto para nada” (p <0,001); “Eu gostaria de poder ter mais respeito comigo mesmo” (p=0,016), e “Eu, com certeza, me sinto inútil, às vezes” (p=0,022). Associação negativa foi observada com: “No conjunto, eu estou satisfeito comigo” (p=0,022). Na análise ajustada, os adolescentes com dentes cariados apresentaram maior prevalência de respostas positivas para a questão “Às vezes, eu acho que não presto para nada” [RP= 1,23 (IC 95% 1,05; 1,44)] e maior prevalência de respostas negativas para a questão “No conjunto, eu estou satisfeito comigo” [RP= 1,12 (IC 95% 1,02; 1,24)]. Conclusão Aspectos da autoestima foram, independente e significativamente, associados com a presença de dentes cariados