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Background: This systematic review aimed to identify, describe, and analyze the global context of Atraumatic Restorative Treatment (ART) as public policy. Methods: The inclusion criteria were: studies on public oral health policies, dental caries, or ART. The exclusion criteria were: clinical studies, specific interventions unrelated to the decision making of managers or policymakers, studies that report public oral health policies that do not use ART as a strategy for caries treatment. A literature search was conducted in PubMed, BVS, Epistemonikos, Health Systems Evidence, and Rx for change. There were no language restrictions. Data extraction was performed by two authors independently according to the stages and categories of a conceptual framework and organized in spreadsheets using Microsoft Excel 365. Of the 2253 eligible articles, 139 were duplicates, and 1680 were not included after reviewing the title and abstract. After assessing the full text, 414 articles were excluded. Results: 20 articles were included in the current review. Nineteen were conducted in nine countries: South Africa (n = 3), Bolivia (n = 1), Cambodia (n = 2), Egypt (n = 2), Mexico (n = 2), Tanzania (n = 4), East Timor (n = 1), Tunisia (n = 1), and Zimbabwe (n = 3), and one in the Americas. Regarding local contexts, the studies reported a high prevalence of dental caries and a lack of access to restorative procedures in health services as common problems. Policy development processes were similar in some aspects, such as the presence of governments, conceptual use of scientific evidence, and induction by the World Health Organization. Regarding the barriers identified in the implementation stage, the lack of supplies to carry out the procedures and induction of the work process by managers were mentioned. As for the facilitators, permanent education and professional practice were mentioned. Cohort studies have shown promising results, with a survival rate greater than 80% after one year of follow up. Conclusions: The findings of this systematic review indicate that the use of ART in public policies is a promising option for tackling common problems in several countries, however, its use is still in an early stage.

AIM To investigate factors that influence the oral health-related quality of life of older people (65 years and over) in Brazil. BACKGROUND Population-based studies should be conducted to support health-planning interventions. MATERIALS AND METHODS Data from the Sao Paulo State Survey on Oral Health (SBSP-2015), which consisted of 5951 individuals, were used. A theoretical-conceptual model was built based on the impact of family socio-economic characteristics, individual social-demographic features and self-perceived and clinical oral health status on the oral impact on daily performance (OIDP). Multivariate binary logistic regression analysis was conducted at 5% significance level. Statistically significant variables included within the adjusted logistic regression model entered the multiple correspondence analysis (MCA). RESULTS Oral health impact on daily activities was observed in 34.6% of older people. Characteristics significantly related to impact on OIDP score were as follows: family income up to R$ 500 (OR = 2.73), self-perceived treatment need (OR = 1.33), self-perceived toothache (OR = 1.52), self-perception of denture replacement need (OR = 1.27), dissatisfaction (OR = 1.50) or very dissatisfied (OR = 2.57) with own oral health, partial lower denture use (OR = 1.34) and needing partial lower dentures (OR = 1.28). Increased number of people living in the same house (B = 0.05, OR = 1.06), number of bedrooms in the house (B = -0.10, OR = 0.90), age (B = -0.03, OR = 0.97) and number of teeth needing treatment (B = 0.08, OR = 1.08) contributed significantly to OIDP. CONCLUSION Prevalence of OIDP of older people in the state of Sao Paulo was related to factors other than their clinical and self-perceived oral health status.

The placenta is a remarkable organ that coordinates and regulates maternal-fetal interactions during pregnancy to optimize fetal development. A host of obstetric complications are associated with placental dysfunction, and existing methods for evaluating in vivo placental function fail to reliably detect at-risk pregnancies prior to maternal or fetal morbidity. Although routinely used as a monitoring tool, the predictive power of ultrasound for identifying compromised pregnancies is poor. Recent preclinical studies performed in our laboratory, using blood oxygen-level dependent magnetic resonance imaging (BOLD-MRI) in the pregnant nonhuman primate (NHP), established a strong correlation between placental T2* values and maternal-fetal oxygen transport. Here we extend this work to a large, longitudinal, two-site study of quantitative in vivo T2* mapping in human pregnancies across 11 to 38 weeks of gestation to characterize the evolution of placental oxygenation in uncomplicated pregnancies and to elucidate the relationship between aberrant placental T2* and adverse obstetric outcomes attributable to placental dysfunction. This methodology has high discriminatory power and strong potential diagnostic utility.

Purpose: To assess whether favourable factors related to school characteristics have a positive effect on the impact on OHRQoL related to occurrence TDI.Methods: An epidemiological survey of oral health was conducted with 12-year-old scholars from Quito, Ecuador. Children were examined regarding TDI, dental caries, and malocclusion. Individual socioeconomic data was collected. Information on the physical environment, health practices and occurrence of negative episodes in the schools were collected with the school’s coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was answered to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Results: Occurrence of severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth brushing environment for their students exhibited a lower impact on OHRQoL, even when adjusted for occurrence of TDI and other variables. Conclusion: A favourable school environment may exert a positive effect on the OHRQoL, independently of the occurrence of TDI.

Robust epidemiological data allow for logical interventions taken in the interest of public health. Dental caries is a major public health problem driven by increased sugar consumption and various biological, behavioral, and psychosocial factors, and is known to strongly affect an individual’s quality of life. This study aims to critically review epidemiological data on the prevalence of dental caries in Latin American and Caribbean countries (LACC) and its impact on the oral health-related quality of life (OHRQoL) of the population. Although the majority of national surveys did not include all age groups and several countries reported a reduction in the prevalence of cavitated carious lesions, most nations still exhibited a high burden of decayed teeth. OHRQoL evaluation was limited to children and older adults only, and was not included in any national survey. Study heterogeneity and methodological issues hindered comparison of evidence between studies and over time, and updating national level data on caries prevalence and its impact on OHRQoL should be prioritized in LACCs.

To analyze the association between the coverage by oral health teams in the Family Health Strategy (FHS-OH) and the use of dental services among 12-year-old adolescents in the state of Mato Grosso do Sul, Brazil, 2019.This is a cross-sectional study involving school-based research, which adopted the use of dental services as its outcome. Structural equation modeling was used to test the association between covariates and the outcome.Of the 615 participants, 74.0% used dental services in the last three years. ESF-SB (oral health coverage by family health strategy, acronym in Portuguese) ≥50% was associated with a greater use of public dental services [standardized coefficient (SC) = 0.10 -95%CI 0.01;0.18], a lower use of these services for prevention (SC = -0.07 -95%CI -0.17;0.01) and higher unhealthy food consumption (SC = 0.19 -95%CI 0.11;0.26).Higher ESF-SB coverage was associated with a lower use of dental services for prevention and higher unhealthy food consumption. Teams must organize the access to oral health service and qualify the work process.Analisar a associação entre a cobertura de equipes de saúde bucal na Estratégia Saúde da Família (ESF-SB) e a utilização de serviços odontológicos entre adolescentes de 12 anos, em Mato Grosso do Sul, Brasil, 2019.Trata-se de um estudo transversal, cujo desfecho foi a utilização de serviços odontológicos. Modelos de equações estruturais foram construídos para testar a associação das covariáveis com o desfecho.Dos 615 participantes, 74,0% utilizaram os serviços odontológicos nos últimos três anos. A cobertura de ESF-SB ≥50% associou-se a maior uso de serviços públicos [coeficiente padronizado (CP) = 0,10 - IC95% 0,01;0,18], menor uso para prevenção (CP = -0,07 - IC95% -0,17;0,01) e maior consumo de alimentos não saudáveis (CP = 0,19 - IC95% 0,11;0,26).Maiores coberturas de ESF-SB associaram-se a menor utilização de serviços para prevenção e maior consumo alimentar não saudável. As equipes devem organizar o acesso e qualificar o processo de trabalho.Analizar la asociación entre la cobertura de los equipos de salud bucal en la Estrategia Salud de la Familia (ESF-SB) y el uso de servicios odontológicos en 12 años en Mato Grosso do Sul, 2019.Este es un estudio transversal. El resultado fue el uso de servicios dentales. Se realizaron modelos de ecuaciones estructurales para asociación de covariables con el resultado.De los 615 participantes, el 74,0% utilizó servicios dentales en los últimos tres años. La cobertura de ESF-SB ≥50% se asoció con mayor uso público [coeficiente estandarizado (CE) = 0,10 - IC95% 0,01;0,18], menor uso para prevención (CE = -0,07 - IC95% -0,17;0,01) y mayor consumo de alimentos no saludables (CE = 0,19 - IC95% 0,11;0,26).Mayor cobertura de ESF-SB se asoció con un menor uso para la prevención y un mayor consumo de alimentos no saludables. Los equipos de salud bucal deben organizar el proceso de trabajo.

Background Population ageing in Brazil is rapid and is likely to place additional pressure over the Brazilian public health system. Objective This study aims to examine the factors associated with utilisation of dental services in the previous year among a representative sample of older adults from Sao Paulo, Brazil. Methods The sample included 5951 older adults who participated in the SBSP-15 study, an epidemiological survey conducted in 2015 in the State of Sao Paulo, Brazil. The outcome "utilisation of dental services" was defined as having visited a dentist in the previous year. Chi-square tests were employed in the bivariate analyses and Poisson regressions with robust variance in the multilevel analysis. Results Only 30.5% of the participants had their last dental appointment within the previous year. Number of teeth and dental pain presented the strongest effects on the investigated outcome. Education, income, age, ethnicity, living alone, higher Family Health Strategy coverage and the Metropolitan area were associated with having visited a dentist in the previous year. Older adults who rated their oral health as positive did not report treatment need nor prosthodontic need, presented negative oral health-related quality of life, had their last dental appointment in the public health system and sought treatment due to pain or extraction also were more likely to report the utilisation of dental services in the previous year. Conclusion Regional, sociodemographic and subjective factors are associated with utilisation of dental services in the previous year among the elders from the State of Sao Paulo, Brazil.

RESUMO: Objetivo: Verificar a associação entre impacto nas atividades de vida diária e variáveis sociodemográficas e parâmetros bucais em adolescentes no Estado de São Paulo. Métodos: Estudo transversal com dados de 5.409 adolescentes que participaram da “Pesquisa Estadual de Saúde Bucal de São Paulo - SB”, de 2015. O impacto nas atividades de vida diária foi avaliado pelo índice de impacto das condições de saúde bucal nas atividades de vida diária (em inglês: oral impacts on daily performances [OIDP]), pela prevalência (presença ou ausência de impacto) e pela severidade do impacto (escores do OIDP). Utilizou-se o modelo de regressão binomial negativa inflado de zeros, considerando os pesos amostrais. Foram calculados as razões de prevalências (RP), as razões de médias (RM) e os intervalos de confiança (IC). Resultados: A prevalência de impacto nas atividades de vida diária foi de 37,4%. Após o ajuste, pôde-se observar que o sexo feminino permaneceu com maior prevalência (RP = 1,59; IC95% 1,36 ‒ 1,81) e severidade do impacto (RM = 1,49; IC95% 1,22 ‒ 1,81). Na comparação com brancos, os demais grupos tiveram maior prevalência de impacto. A renda familiar maior que R$ 2.501 (RM = 0,79; IC95% 0,64 ‒ 0,98) e a aglomeração domiciliar (RM = 1,18; IC95% 1,00 ‒ 1,39) foram associadas com a severidade do impacto. Nas condições de saúde bucal, verificou-se que a cárie não tratada (RP = 1,46; IC95% 1,23 ‒ 1,74) e o sangramento gengival (RP = 1,35; IC95% 1,14 ‒ 1,60) permaneceram associados com maior prevalência de impacto. Conclusão: Sexo feminino, ter cor não branca, ter cárie não tratada e sangramento gengival foram associados ao maior impacto nas atividades de vida diária. Ter renda maior que R$ 2.500 e residir em domicílios menos aglomerados associaram-se com menor impacto. ABSTRACT: Objective: To assess the association between the impact of oral health on daily life and sociodemographic variables with oral parameters in adolescents living in the State of São Paulo, Brazil. Methods: A cross-sectional study was conducted with data from 5,409 adolescents who participated in the “State Oral Health Survey of São Paulo - OH”, 2015. The impact of oral health on daily life was assessed by the oral impacts on daily performances (OIDP) index, prevalence (presence or absence of impact) and severity of impact (OIDP scores). The negative binomial regression model (zeros-inflated) was used, considering the complex sampling and the sample weights. Prevalence ratio (PR), ratio of means (ROM) and confidence intervals (CI) were calculated. Results: The prevalence of impact was 37.4%. After adjusting for the model, the impact was more prevalent (PR = 1.59; 95%CI 1.22 ‒ 1.81) and more severe (RR = 1.49; 95%CI 1.22 ‒ 1.81) among females. Compared to white-skin people, all remaining groups had a higher prevalence of impact. Among socioeconomic characteristics, family income higher than R$ 2,501 (RR = 0.79; 95%CI 0.64 ‒ 0.98) and household crowding (RR = 1.18; 95%CI 1.00 ‒ 1.39) were associated with the severity of impact. In the oral health conditions, untreated caries (PR = 1.46; 95%CI 1.23 ‒ 1.74) and gingival bleeding (PR = 1.35; 95%CI 1.14 ‒ 1.60) were associated with higher prevalence of impact. Conclusion: Females, non-whites, with untreated caries and gingival bleeding were associated with higher impact of oral health on daily life. Family income higher than R$ 2,500 and living in less crowded households were factors associated with less impact.

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04–2.29), with fewer household goods (OR = 2.25; CI95%:1.50–3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27–9.35), R$1501–2500 (OR = 4.11; CI95%:1.50–11.27), R$2501–4500 (OR = 2.76; CI95%:1.10–6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08–7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06–3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06–3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06–1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71–11.60), R$501–1500 (OR = 4.01; CI95%:2.14–7.51), R$1501–2500 (OR = 2.95; CI95%:1.64–5.32), < 3 years of education (OR = 1.45; CI95%:1.13–1.85), feeling unhappy (OR = 2.74; CI95%:1.35–5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75–12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64–3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85–6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85–6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

BACKGROUND/AIM Since children spend most of their time in school, some environmental characteristics of the schools may influence the occurrence of traumatic dental injuries (TDI). Therefore, the aim of this cross-sectional study was to assess the prevalence of TDI in 12 years old children in Quito, Ecuador, and its association with some school environmental aspects. MATERIAL AND METHODS Six calibrated examiners evaluated 998 children from 31 public schools of Quito, to evaluate the occurrence of TDI in anterior teeth. School coordinators answered questionnaires on school physical conditions, promotion of health practices and the occurrence of negative episodes in school. The occlusion and socioeconomic status of the participants were also evaluated. Prevalence of TDI, unadjusted and adjusted by the design effect was calculated. Association between individual and contextual explanatory variables and presence of TDI were evaluated using multilevel Poisson regression analysis (P

Objetivo: Analisar os fatores associados ao tipo de serviço odontológico utilizado por adultos. Métodos: O estudo transversal analítico utilizou-se de dados secundários do Levantamento Epidemiológico representativo da população adulta (35-44 anos) no município de Embu das Artes-SP, Brasil, em 2008. A coleta de dados por amostragem probabilística foi realizada nos domicílios. O desfecho foi ser usuário do serviço público odontológico para tratamento regular ou atendimento de urgência. As variáveis independentes foram: agravos bucais (Índice de dentes Permanentes Cariados, Perdidos e Obturados, Índice Periodontal Comunitário, Perda de Inserção Periodontal e necessidade de prótese); condições socioeconômicas (renda familiar, aglomeração domiciliar, número de filhos, escolaridade); condições demográficas (sexo, estado civil, cor da pele); hábitos (fumo); utilização dos serviços (tempo da última consulta odontológica, informações sobre como evitar problemas bucais); percepção dos problemas bucais (dor de dente nos últimos seis meses, necessidade de tratamento e condição bucal afeta relacionamentos com outras pessoas). Houve realização de análise descritiva e bivariada, além das razões de prevalência (RP). Resultados: Houve a participação de 345 adultos, sendo 53% usuários do serviço público para tratamento regular ou urgência odontológica. O uso regular ou de urgência odontológico público foi associado ao sexo feminino (RP = 1,32; IC95%: 1,14-1,54), ter maior número de filhos (RP = 1,15; IC95%: 1,01-1,31), aglomeração domiciliar (RP = 1,88; IC95%: 1,42-2,50), menor renda familiar (RP = 2,23; IC95%: 1,33- 3,66), relato de dor nos últimos 6 meses (RP = 1,43; IC95%: 1,06-1,42), considerar que a condição bucal afeta os relacionamentos com outras pessoas (RP = 1,30; IC95%: 1,05-1,62), e ser fumante ou ex fumante (RP = 1,67; IC95%: 1,15-2,24). O uso do serviço público apenas para o tratamento de urgência foi maior entre mulheres (RP = 1,48; IC95%: 1,16-1,86), maior número de filhos (RP = 1,22; IC95%: 1,08-1,37), aglomeração domiciliar (RP: 1,54; IC95%: 1,20-1,97), menor renda familiar (RP = 1,68; IC95%: 1,07-2,62) e apresentar relato de dor nos últimos seis meses (RP = 1,37; IC95%: 1,03-1,83). Conclusão: O uso do serviço odontológico público esteve associado a fatores socioeconômicos, e isso demonstra que, mesmo há 10 anos, o município praticava o princípio da equidade na atenção à saúde bucal. Descritores: Acesso aos serviços de saúde. Odontologia em saúde pública. Serviços de saúde bucal.

OBJECTIVES The aim of the present study was to analyse the factors associated with self-perceived need for dental treatment among adolescents. METHODS A representative sample in the state of Sao Paulo, Brazil, comprising 5558 adolescents, was evaluated in 2015. The adolescents were selected by probabilistic sampling by conglomerates in two stages. The outcome evaluated was self-perceived treatment need measured via a validated questionnaire. Independent variables included sociodemographic factors, type, frequency and reason for last dental visit, and examination of oral conditions. Statistical analysis was based on the multiple hierarchical logistic regression model. RESULTS Of the total sample, 3340 (62.6%) adolescents reported needing dental treatment. After fitting the model, the self-perceived need for treatment was associated with adolescents with family income of up to $1,500 BRL (OR 1.39; [95% CI = 1.20-1.60]; P

O trabalho objetivou descrever e qualificar o acesso a computadores e à rede de internet, bem como ao ambiente virtual de aprendizagem (AVA) e suas respectivas ferramentas, por graduandos da Faculdade de Odontologia da Universidade de São Paulo. Estudo transversal, baseado em questionários aplicados em um universo de 715 estudantes, os quais estivessem presentes nas salas de aula das onze turmas dos diferentes anos e turnos. Foram feitas análises de distribuição de frequência e teste de associação no programa EPI-Info v.6.0, medidas pela Razão de Chances (OR - odds ratio). Todos os respondentes (n=400) possuem computador em casa, 98% com acesso à internet e 84,5% utilizam os computadores disponibilizados pela Instituição. Majoritariamente (89,7%), os alunos dedicaram mais de duas horas semanais para atividades virtuais. Observou-se que os alunos do noturno apresentaram duas vezes mais chances de utilização de computador que alunos do integral. Ao menos uma disciplina que utiliza o AVA (Plataforma Moodle) foi identificada por 96,5% dos estudantes. Ao acessar o AVA, os alunos declararam ter maior facilidade para acessar a página inicial e os textos disponibilizados. Fóruns e chats foram apontados como ações de menor facilidade de execução. Não houve associação entre o tempo de uso do computador e a avaliação da utilização das ferramentas. Infraestrutura computacional que acompanhe os avanços tecnológicos e a utilização de um AVA com ferramentas acessíveis podem potencializar a incorporação da educação online.

OBJECTIVE: Estimate the prevalence and gravity of coronal dental caries for populations of adolescents, adults and elderly people.METHODS: For the crossing of data of the average DMF rates by Regional Health Directorate (RHD) with the digital cartographical base, municipals were grouped by RHD, and the connection between the two bases was formed by a common code or “primary key” in the TerraView® software program (version 4.2.1).RESULTS: The distribution of the DMF average for the teen population was the worst for RHD 8, while RHDs 4, 7 and 14 had lower averages. For the adult population, RHDs 4 and 12 presented the lowest DMF averages. On the other hand, RHDs 8, 13, and 16 had the worst results. For the elderly population, the RHD 4 presented the lowest average, and RHD 9 the highest DMF rate for this population.CONCLUSION: The differences in DMF averages among the RHDs and the populations studied showed that it is necessary to plan different locoregional oral health actions to face the severe clinical state exposed, since its spatial distribution is disparate, with concentrations of cases in certain regions for all age groups studied. OBJECTIVE: Estimate the prevalence and gravity of coronal dental caries for populations of adolescents, adults and elderly people.METHODS: For the crossing of data of the average DMF rates by Regional Health Directorate (RHD) with the digital cartographical base, municipals were grouped by RHD, and the connection between the two bases was formed by a common code or “primary key” in the TerraView® software program (version 4.2.1).RESULTS: The distribution of the DMF average for the teen population was the worst for RHD 8, while RHDs 4, 7 and 14 had lower averages. For the adult population, RHDs 4 and 12 presented the lowest DMF averages. On the other hand, RHDs 8, 13, and 16 had the worst results. For the elderly population, the RHD 4 presented the lowest average, and RHD 9 the highest DMF rate for this population.CONCLUSION: The differences in DMF averages among the RHDs and the populations studied showed that it is necessary to plan different locoregional oral health actions to face the severe clinical state exposed, since its spatial distribution is disparate, with concentrations of cases in certain regions for all age groups studied. *** Análise espacial da experiência de cárie em população de adolescentes, adultos e idosos do estado de São Paulo: dados do SB SP 2015 ***OBJETIVO: Estimar a prevalência, gravidade e distribuição da cárie dentária na população de adolescentes, adultos e idosos.METODOLOGIA: Para o cruzamento dos dados foi realizada a ligação entre as duas bases por um código comum ou “chave primária” no software TerraView® (versão 4.2.1).RESULTADOS: A distribuição da média CPOD para a população adolescente foi pior para a DRS 8, enquanto as DRS 4, 7 e 14 apresentaram as menores médias. Para a população adulta, as DRS 4 e 12 apresentaram as menores médias CPOD. Em contrapartida, as DRS 8, 13 e 16 mostraram os piores resultados. Em relação à população idosa, a DRS 4 apresentou menor média, e a DRS 9 a maior média CPOD para esta população.CONCLUSÃO: As diferentes médias dos CPOD entre as DRS e entre as populações estudadas demonstram a necessidade de planejamento de ações de saúde bucal locorregionais diferentes para o enfrentamento da heterogeneidade encontrada.Palavras-chave: cárie dentária; inquéritos epidemiológicos; inquéritos de saúde bucal; índice CPO; saúde bucal.

Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far. Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous. Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs. Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth. Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

INTRODUCTION The objective of the present study was to evaluate the association of socioeconomic status (SES) as a latent variable on oral health-related quality of life (OHRQoL) using four definitions of functional dentition (FD) for elderly people. METHODS Four sets of multilevel generalised structural equation models (GSEM) were used: (i) WHO Functional Dentition (FDWHO); (ii) Well-distributed teeth (WDT); (iii) FDclass5 ; and (iv) FDclass6 . The indirect effects of SES on OHRQoL were measured in 5951 elderly participants in the Sao Paulo Oral Health 2015 (SBSP-15) survey. The latent variable (OHRQoL) was extracted from the Oral Impacts on Daily Performances questionnaire, and GSEM was used to estimate the direction of association among the variables. RESULTS SES was directly and strongly associated with FDWHO (Total effects [SC] = 0.56, P

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador – CEREST (Worker’s Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

The objective of this research was to estimate the perception of dental fluorosis in children with 12 years old and associated variables. A cross-sectional study was conducted on 12 year old school children (393) from all of 10 public schools of Rio Grande da Serra town of Sao Paulo district. Only one dental surgeon, previously calibrated (Kappa = 0.84), performed all clinical examinations. A structured questionnaire was answered by the children themselves and also for their parents. The prevalence of dental fluorosis (Dean Index) found was 57%, restricted to the very mild and mild levels, but higher than expected for Brazilian standards. Significant associations between dental fluorosis stains and perception by children or guardians weren’t found. Dental fluorosis in the degree of severity found, had no adverse effect on the health of these children, but warns of the need for constant monitoring of these changes and rational use of fluoride.

Background Oral disorders may negatively affect the quality of life (QoL) of adolescents. To investigate how social vulnerability and oral-health status factors affect QoL in 15–19 years olds who participated in the “SB São Paulo 2015” state survey. Methods The relationship of several independent variables, namely Paulista Social Vulnerability Index (PSVI) score, gender, skin color, family income, age, untreated caries, tooth loss [determined by the Decayed, Missing, Filled-Teeth (DMF-T) index], toothache, periodontal condition [determined by the Community Periodontal Index (CPI)], and malocclusion (maxillary overjet, cross bite, or open bite) affect daily life, measured by the Oral Impacts on Daily Performance (OIDP) instrument. Logistic regression analyses were carried out based on a hierarchical model. Results The final sample consisted of 5402 adolescents. The prevalence of at least one negative impact of oral health on QoL was 37.3%. After adjustment, demographic factors that were found to influence this impact significantly (p

The objective of the present study was to analyze individual, contextual and social support factors associated with periodontal condition among 2332 dentate elderly Brazilian participants from the Sao Paulo State Oral Health Survey 2015 (SBSP-15). Methods This study used the database compiled by the SBSP-15, conducted from January to December in 2015. The associations were made by relative risk (RR), with Multilevel Poisson Regressions, among individual, contextual and social support variables, and had periodontal diseases as outcomes. Results The mean age of elders was 70.13 years (SD 5.67). The risk factors for all outcomes of periodontal diseases were male gender and self-perceived color of non-white skin. Regarding social support, feeling unhappy was a risk factor for the presence of shallow periodontal pockets (3-5mm) RR 1.43(CI 95% 1.10-1.86). The coverage of the Family Health Strategy (FHS) was a protective factor for gingival bleeding RR = 0.7(CI 95% 0.44-0.99) and calculus RR = 0.75(CI 95% 0.60-0.95), and a risk factor for the number of lost sextants (sextants with only one tooth or without any teeth) RR = 1.12(CI 95% 1.00-1.28). Living in municipalities with more than 90% fluoridation coverage was a protective factor for the number of lost sextants RR = 0.89(CI 95% 0.78-0.99). Conclusions The study showed evidence that individual (gender and self-perceived skin color), contextual (coverage of the family health strategy and water fluoridation) and social support factors (feeling unhappy) are associated with the clinical outcomes of periodontal diseases in Brazilian elders. This reinforces the need for transdisciplinary actions in the FHS, stimulating work together and intersectoral collaboration between FHS and NASF (Family Health Support Center).

Resumen pt: Objetivo: Analisar a interferencia da saude bucal em funcoes biologicas e sociais, segundo a percepcao de adolescentes brasileiros de 15 a 19 anos. Metod...

A educação a distância é uma modalidade de ensino que permite eliminar a separação geográfica entre educador e educando para atender a um número ilimitado de alunos que estejam em busca de formação, capacitação ou atualização profissional. Esta pesquisa teve por objetivo conhecer e explanar a vivência dos alunos da Especialização em Saúde da Família/Unasus/Unifesp, do município de Amparo, no processo de ensino-aprendizagem através do ensino a distância mediado por tecnologia, bem como avaliar o impacto da educação permanente na organização dos serviços. Através de um modelo de pesquisa qualitativa, buscou-se estabelecer a percepção dos alunos com relação a metodologia, técnica, estratégias de aprendizagem e mudanças ocorridas nos serviços em que estão inseridos os profissionais capacitados. As respostas foram classificadas segundo os eixos estabelecidos, buscando contextualizar o relato dos atores pesquisados. Após análise e avaliação desses discursos, foram estabelecidas relações e sínteses inerentes ao processo de ensino a distância e avaliação do impacto do curso de capacitação na organização e implementa- ção dos serviços. Observou-se que todas as narrativas referem a importância da educação permanente em Saúde como eixo propulsor de mudanças nos serviços e que a especialização foi exímia em qualidade e excelência. Mas, oportunamente, tais relatos destacaram que nem sempre as transformações desejadas aconteciam na mesma velocidade do proposto e assimilado pelo curso. A conclusão deste artigo destaca a importância do reconhecimento da educação permanente em saúde, devendo ser sempre incentivada e oferecida para grupos de profissionais, para possibilitar que seus cenários de prática sejam reorganizados e fortalecidos. Essa proposta de incentivo deve ter como intuito desenvolver práticas qualificadas socialmente e tecnicamente com aplicabilidade oportunizada por gestores e representantes municipais, estaduais e federais.

A Secretaria Municipal de Saúde de São Paulo desenvolveu o Índice de Necessidades em Saúde (INS) para identificar áreas prioritárias para a oferta de serviços. Em 2008 realizou um Levantamento das Condições de Saúde Bucal. Pretende-se, neste estudo ecológico, analisar o perfil de saúde bucal em relação ao INS. As variáveis, estratificadas para as idades de 5, 12 e 15 anos, foram: porcentagem de indivíduos com dificuldade no acesso ao serviço odontológico; média do ceod e CPOD; prevalência da necessidade de extração e de livres de cárie. As informações foram analisadas para as 25 Supervisões Técnicas de Saúde (STS). Empregou-se o teste estatístico de covariância, o coeficiente de correlação de Pearson e o modelo de regressão linear. Observou-se uma correlação positiva entre maiores INS e a dificuldade de acesso aos serviços. Nas STS com maiores INS houve maior experiência de cárie, maior necessidade de exodontias e menor prevalência de livres de cárie. Reforça-se a necessidade de priorizar as áreas de privação social para melhorar a condição de saúde da população. The Health Department of São Paulo, Brazil, has developed a Health Necessities Index (HNI) to identify priority areas for providing health assistance. In 2008, a survey of the status of oral health was conducted. The objective of this ecological study was to analyze the status of oral health in relation to the HNI. The variables, stratified by the age of 5, 12 and 15 years old were: percentage of individuals with difficulty of access to dental care services; DMFT and DMFS; prevalence of the need for tooth extraction and treatment of dental caries. Data were analyzed for the 25 Health Technical Supervision Units (HTS). The Statistical Covariance Test was used as well as the Pearson correlation coefficient and linear regression model. A positive correlation was observed between high scores of the HNI and difficulty of access to services. In the HTS with high scores of HNI a higher incidence of dental caries was observed, a greater need for tooth extractions and low caries-free incidence. In order to improve health conditions of the population it is mandatory to prioritize actions in areas of social deprivation.

This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p

The aim of this study was to describe the incidence of caries among children and adolescents who have cerebral palsy. The authors conducted baseline and follow-up dental examinations of 118 children and adolescents with cerebral palsy in a specialized healthcare unit in São Paulo, Brazil. Family care-givers completed a questionnaire that provided socioeconomic and behavioral information. The analysis used multivari-ate Poisson regression models adjusted for age. More than half (52.5%) of the subjects had at least one permanent or deciduous tooth affected by new caries during the longitudinal assessment (2004-2008). The incidence of caries was associated with the baseline prevalence of caries (incidence ratio = 1.92), a higher frequency of sugar intake (IR = 1.56), and having at least one sibling (IR = 1.64). Participants whose family care-givers had more education had a significantly lower incidence (IR = 0.68). The factors associated with a higher incidence of caries are similar to those in the general population. This evidence can potentially be used to develop an effective oral health promotion program for these patients.

OBJETIVO: Este estudo descreveu a prevalência de condições periodontais e sua associação com variáveis demográficas, socioeconômicas e comportamentais em adultos de 35 a 44 anos residentes no município de Guarulhos, São Paulo, 2006. MÉTODOS: Foi realizado estudo transversal de base populacional com delineamento amostral por conglomerados. Os inquéritos e os exames foram realizados nos domicílios sorteados. Para avaliação da condição periodontal foi utilizado o índice Community Periodontal Index (CPI). Os dados foram apurados pelo programas EPIINFO 6 e STATA 10. Para o modelo de associação empregou-se a razão de prevalências (RP), calculada por meio de análise de regressão de Poisson, com correção para delineamento de amostras complexas e ponderação pelo peso populacional. RESULTADOS: Foram examinadas 263 pessoas em 237 domicílios. No estudo multivariado, com modelo ajustado para amostras complexas e ponderação populacional, a prevalência de sangramento gengival e cálculo dentário esteve associada significativamente ao fato de ser homem (RP=1,12, p=0,04), fumante (RP=1,11, p=0,01), ter menos de oito anos de estudo (RP=1,14, p=0,01) e não visitar o cirurgião-dentista (CD) há mais de dois anos (RP=1,19, p=0,00). Para a presença de bolsa periodontal, houve associação com adultos que relataram o hábito de fumar (RP=1,71, p=0,02) e apresentavam mais de dois anos sem frequentar o CD (RP=1,97, p=0,03). CONCLUSÃO: Houve maior prevalência (62,7%) de indivíduos com sangramento gengival e cálculo dentário em relação à presença de bolsas periodontais rasas ou profundas (26,6%); as primeiras, reversíveis, têm possibilidades de resolução por meio de procedimentos de atenção básica em saúde bucal. OBJECTIVE: This study described the prevalence of periodontal conditions and assessed its association with social, economical and behavioral variables in adults aged 35 to 44 years old, residents in the city of Guarulhos, State of Sao Paulo, 2006. METHODS: This study was a population based survey with cluster sampling. Data collecting and exams were done at houses drew at random. The Community Periodontal Index was used to assess the periodontal condition. Data analysis used EPIINFO 6 and STATA 10 softwares. The assessment of association used the prevalence ratio (PR), as calculated by Poisson regression models with complex sampling and weighted sample adjustments. RESULTS: The total number of people was 263 in 237 domiciles. In the multivariate model, the prevalence of gingival bleeding and dental calculus was significantly associated to being male (PR=1.12, p=0.04), smoking (PR=1.11, p=0.01), school level of less than eight years of study (PR=1.14, p=0.01), and who have not received dental care for more than two years (PR=1.19, p

Trata-se de um relato de experiência sobre a introdução de conteúdos e estratégias pedagógicas na disciplina de Saúde Coletiva em Odontologia da Faculdade de Odontologia da Universidade de São Paulo (FOUSP) que, seguindo as orientações das Diretrizes Curriculares Nacionais para cursos de Odontologia, utiliza o Sistema Único de Saúde (SUS) como cenário pedagógico, permitindo ao aluno vivenciar e dialogar com a realidade in loco, ampliando o olhar e a escuta. Por meio de módulos de conteúdo aplicados com uma pedagogia baseada em problemas, a construção da teoria é complementada com visitas técnicas ao SUS do município de Embu das Artes, além da elaboração, ao longo do ano e em grupo, de uma política municipal de saúde bucal de outro município do estado de São Paulo. A experiência propõe fornecer ao aluno instrumentos de análise críticoreflexiva, inserindo sua prática num contexto social que visa a atender as necessidades em saúde da população.

This study assessed oral health outcomes (perceived dental treatment need, untreated dental caries, gingival bleeding, periodontal pockets, and pain in teeth and gums), in relation to color/race inequalities among adolescents in each Brazilian region. The database included dental examination and interview of 16,833 15-19-year-old adolescents, surveyed by the Brazilian health authority, from May 2002 to October 2003, in accordance with international diagnostic criteria standardized by the World Health Organization. Prevalence ratios estimated by Poisson regression, and controlled by socioeconomic status and access to fluoridated piped water, assessed oral health differentials among color/race groups and country's regions. Except for periodontal pockets, prevalence figures were higher in the North and Northeast: perceived dental treatment needs, untreated dental caries, gingival bleeding at probing and pain in teeth and gums varied between 80-83%, 75-76%, 38-43%, and 17-18%, respectively, in these regions. Adolescents living in the Southeast - the richest Brazilian region - presented a better general profile of oral health than their counterparts living in the remaining regions; they had a lower prevalence of untreated dental caries (54%) and unfavorable gingival status (29%). However, the Southeast presented color/race inequalities in all oral health outcomes, with a poorer profile systematically affecting browns or blacks, depending on the oral health condition under consideration. These results reinforce the need for expanding the amplitude of health initiatives aimed at adolescent oral health. Socially appropriate health programs should concurrently aim at the reduction of levels of oral disease and its inequalities. O presente estudo avaliou desfechos de saúde bucal (necessidade de tratamento dentário autopercebida, cárie dentária não tratada, sangramento gengival, bolsa periodontal e dor nos dentes e gengivas) com o intuito de identificar desigualdades por cor/raça entre adolescentes em cada uma das macro-regiões brasileiras. O banco de dados incluiu informações sociodemográficas e de exames bucais de 16.833 adolescentes entre 15-19 anos de idade, investigados pelo Ministério de Saúde entre maio de 2002 e outubro de 2003, conforme critérios diagnósticos preconizados pela Organização Mundial da Saúde. Foram utilizadas razões de prevalência, calculadas por regressão de Poisson e ajustadas para variáveis socioeconômicas e acesso a água fluoretada, para estimar desigualdades nos desfechos de saúde bucal entre os grupos de cor/raça e as macro-regiões brasileiras. Exceto para bolsa periodontal, as estimativas de prevalência foram mais altas no Norte e no Nordeste: necessidade de tratamento dentário autopercebida, cárie dentária não tratada, sangramento gengival e dor nos dentes e gengivas variaram entre 80-83%, 75-76%, 38-43% e 17-18%, respectivamente, nestas regiões. Os adolescentes do Sudeste - a macro-região mais rica do país - apresentaram, em geral, melhores condições de saúde bucal, quando comparados com seus pares das demais macro-regiões; os adolescentes do Sudeste apresentaram menores prevalências de cárie dentária não tratada (54%) e de sangramento gengival (29%). Entretanto, o Sudeste demonstrou desigualdades por cor/raça em todos os desfechos investigados, com piores condições afetando sistematicamente pardos ou pretos, a depender da condição de saúde bucal investigada. Estes resultados reforçam a necessidade de expandir as ações dirigidas à saúde bucal dos adolescentes brasileiros. Programas/intervenções em saúde socialmente sensíveis devem visar a redução de níveis de morbidades bucais, bem como de suas desigualdades.