The association between maternal fears about their infant/toddler during the COVID-19 pandemic and depression and anxiety: a birth cohort study

Objective: To assess the association between maternal fears about their infant/toddler and depression and anxiety during the COVID-19 pandemic. Methods: In 2019, all mothers who gave birth in hospitals in Rio Grande, RS, Brazil were asked to respond to a standardized questionnaire (baseline). We followed them between May-June 2020 (first follow-up point), August-December 2020 (second follow-up point), and from October 2021 to March 2022 (third follow-up point), and asked them if they were: (1) afraid that their infant/toddler would become infected with COVID or get sick (yes/no), (2) afraid that they would contaminate their own child with COVID, and/or (3) worried about the pandemic's effects on their child's future. At baseline and at all follow-up points, we assessed depressive symptoms using the Edinburgh Postnatal Depression Scale and anxiety symptoms using the Generalized Anxiety Disorder Scale, creating symptom trajectories using group-based trajectory modelling. We used multinomial logistic regression to calculate adjusted relative risk ratios (RRR). Results: A total of 1,296 mothers participated. Worrying about the pandemic's effects on their child's future and the fear of contaminating their own child with COVID-19 increased the risk of raising depressive symptoms to a clinical level (RRR = 4.97, 95%CI 2.32-10.64 and RRR = 3.87, 95%CI 1.58-9.47, respectively) and anxiety to a moderate level (RRR = 2.91, 95%CI 1.69-5.01 and RRR = 1.86, 95%CI 1.03-3.35, respectively). Conclusion: Fear for their children increased maternal depressive and anxiety symptoms during the pandemic.

Association among oral health and academic performance: a longitudinal study in a university in Southern Brazil

Abstract This longitudinal study aimed to investigate the association between self-perceived oral health, oral-health-related quality-of-life (OHRQoL), toothache, and university students' academic performance or dropout. A cohort of 2,089 students from 64 different courses at a public university in southern Brazil was interviewed in 2016 regarding their self-perceived oral health (Locker instrument; dichotomized into good/poor), OHRQoL (Oral Impacts on Daily Performances instrument, OIDP) and having had any toothache over the last 6 months (yes/no). After three years (2020), the academic records of 1,870 of these students were assessed, their average grade over all courses evaluated, and their dropout status was determined. Multivariable linear or logistic regression adjusting for gender, skin color, age, family income and maternal education was used to associate oral health variables (self-perceived oral health, OIDP, toothache) and academic performance or dropout. In 2016, 28.6% reported negative self-perceived oral health through the Locker instrument and 31.4% had toothache in the last 6 months. Over the next three years, 36.2% had dropped out. In multivariable regression, toothache in the last 6 months had a decrease of 0.32 (β -0.32, CI95% -0.59; -0.04) points in the final grade and were 35% (OR 1.35 CI95% 1.08; 1.69) more likely to dropout than students without toothache. In conclusion, this study showed that worse oral health conditions may be associated with worse academic performance or dropping out.

Dental students' self-perception of security and biosafety measures in times of pandemic by COVID-19: a cross-sectional study in private Universities in Southern Brazil

The study investigated the factors associated with the self-perception safety of dental students in clinical activities during the COVID-19 pandemic. This cross-sectional study was based on a semi-structured online (google forms) self-applied questionnaire, sent by e-mail to three private Dental Schools in Brazil. The variables were: 1) sociodemographic information; 2) questions about the measures adopted by dental schools before returning to clinical activities; 3) dental students' self-perception of security; 4) the General Health Questionnaire. Data were submitted to Fisher's exact test (p<0.05). Of the 294 eligible students, 97% were evaluated and 100% received previous specific biosafety training predominantly theoretical (72.16%) longer than one hour (51.55%). Most students (81.44%) felt secure performing clinical care during the COVID-19 pandemic. Students undergoing specific biosafety training for longer than one hour felt safer than those perfoming training for up to 1 hour (p=0.004). Students from schools where the aerosol-producing restriction was applied felt safer than those without restrictions (p=0.016). Women reported feeling less secure than men (p=0.046), and students who submitted to COVID-19 Specific Biosafety Training felt safer in clinical activities than those submitted to theoretical training only (p=0.011). Students from private universities presenting psychosomatic changes felt less secure in practicing clinical dental care activities (p=0.006). In conclusion, time-spent training in biosafety, restriction of the use of aerosol-producing procedures, and the gender of students were associated with the self-perception safety of students. Students with practical training felt safer in clinical activities for patients with COVID-19 than those who had only theoretical training

Mediating effect of eating pattern on the relationship between television exposure and caries in children

Abstract Behavioral characteristics may also take part in the etiology of dental caries. Sedentary behavior, especially watching television, is associated with increased intake of foods high in fat or free sugar, which could influence the occurrence of dental caries. The aim of this study was to assess the mediating effect of eating pattern on the relationship between television exposure time and the presence of dental caries in children. A cross-sectional study was conducted with a representative sample of 580 parent-child dyads with children aged 7 to 8 years in 20 public schools in Pelotas, Brazil. Parents or legal guardians were interviewed and provided information on demographic/socioeconomic data, children's daily television exposure time, and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-eating pattern domain). Caries was evaluated through clinical examination. The mediating effect of eating pattern on the relationship between television exposure and presence of dental caries was estimated using the parametric g-formula. Prevalence of dental caries was 63%, and 22% of children watched TV 4 or more hours per day. Television exposure had no direct effect on the dental caries experience [odds ratio (OR): 1.05 (95% confidence interval (95%CI): 0.92-1.19)]. Nevertheless, difficulty maintaining regular eating pattern mediated the natural indirect effect of television exposure time (≥ 4 hours/day) on dental caries experience [OR: 1.07 (95%CI): 1.01-1.14)]. The results of this study confirm the indirect pathway between television viewing and dental caries and the role of disordered eating patterns in this association.

Number of erupted teeth at the age of 12 and 24 months: a maternal report validation study

Aim: To verify the validity of maternal reports on the number of deciduous teeth erupted in their children. Methods: This cross-sectional study was performed with children enrolled in a Birth Cohort at the age of 12 months in the first stage and 24 months in the second stage. At both stages, children were clinically examined, and mothers reported the number of teeth of their children. Comparison between groups was performed using the Mann-Whitney non-paired Wilcoxon test. Level of agreement between two methods were estimated by the Observed Agreement, Weighted Kappa and Intraclass Correlation coefficients. Results: A total of 125 children were examined in the first stage, with mean number of reported teeth of 6.2. In the second stage, 149 children were examined, with mean number of reported teeth of 15.9. High level of agreement, kappa values and intraclass correlation coefficients were observed for both arches in both periods (p<0.001). Conclusions: Maternal report on the number of teeth erupted in children was reliable and valid. Thus, it seems to be a useful instrument for collecting data in population-based epidemiological studies targeting young children

Flipped classroom and the use of role-play in the COVID-19 pandemic: challenges and learning

Aim In Brazil, COVID-19 remains one of the epicenters of the pandemic, thus, presential educational activities are suspended. The study aimed to describe the approach of flipped classroom performed to provide social distancing and to maintain teaching activities during COVID-19-pandemic. Methods Flipped Classroom was chosen to be associated with the role-play technique as a central methodology. To bring students closer to activities performed in the non-pandemic period, some actions and assessments were also role-played by Professor simulating patients in virtual meetings. Results Although the changes in the format of the lessons, our approaches stimulated the students maintained the high frequency of students in the activities (almost 100%) providing continuity activities. Conclusions This report can reinforce that meaningful learning can be taught by using a virtual/remote approach. However, the potential positive results observed cannot be used as an excuse to maintain remote teaching activities with the objective of cost-cutting by the institutions.

Are stress and symptoms of depression associated with halitosis? A cross-sectional study

Mood disorders such as stress and depression can promote alterations of several hormones Aim: The present study aimed to evaluate if symptoms of depression and stress are associated with halitosis. The hypothesis is that halitosis is associated with stress and depression symptoms. Methods: All university students' entrants in the Federal University of Pelotas (UFPel) were invited to participate. Self-reported halitosis was measured using a visual analog scale. Students were also asked about the presence of halitosis perceived by close individuals. The stress level was measured using a modified version of the Perceived Stress Scale and symptoms of depression were screened by Patient Health Questionnaire-2. Poisson Regression Models were performed. Results: Of a total of 2,058 students who participated in the study, only 16% of them have reported not having any degree of halitosis and 17.6% were informed of closed individuals having halitosis. After adjustments, stress and depression symptoms remained associated with halitosis selfreported. Individuals from the higher stressed quartile presented higher scores of halitosis (RR 1.37 CI95% [1.24­1.53]). Students who presented depressive symptoms showed higher scores of self-perceived halitosis (RR 1.20 CI95% [1.10­1.32]). When the association of stress and halitosis reported by close individuals was tested, symptoms of depression lost the association in the adjusted model, while individuals from the highest quartile from stress remained associated (PR 1.36 CI95% [1.02­1.81]). Conclusion: Halitosis was associated with stress even after control for oral health and socioeconomic variables

Use of Health Services and Family Health Strategy Households Population Coverage in Brazil / Utilização dos Serviços de Saúde e Estratégia Saúde da Família Cobertura da População Domiciliar no Brasil

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis ​​sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis ​​dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis ​​dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Impact of the COVID-19 pandemic on prenatal, diabetes and medical appointments in the Brazilian National Health System / Impacto da pandemia COVID-19 no Pré-natal, Diabetes e consulta médica no Sistema Único de Saúde Brasileiro

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 - 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 - 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 - 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 - 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

COVID-19 Pandemic impact on Brazil's Public Dental System

Abstract: The present study aimed to estimate the impact of the COVID-19 pandemic on dental care procedures in the Public Health System in Brazil. A retrospective, ecological study was carried out, comprising 5,564 Brazilian municipalities. The number of dental procedures (per 100,000 inhabitants) performed in the Brazilian Public Health System (SUS) was the outcome. The impact of the pandemic was estimated by comparing the rate of procedures for each month of 2020 with the rates observed in the equivalent months in 2019, considering the period from March to August. Regulatory legislation regarding restrictions on dental care, issued by the state governments of 27 Brazilian federative units, was used for mediation analysis. A 55% reduction was observed in March for all procedures (IRR = 0.45, 95%CI 0.39-0.51), while in the other months, the rate of reduction remained ≥ 88%. The biggest decrease was observed in collective preventive procedures (reduction ≥99%) between April and August. Procedures that were less likely to generate aerosols (tooth extraction and prosthetic) and emergencies showed the smallest reduction. The reduction was not mediated by the restrictions imposed by state governments (p>0.05). The impact of the COVID-19 pandemic was noteworthy in terms of the decrease in the number of dental procedures carried out in the Brazilian Public Dental Service. The lack of access, the delay of elective procedures and the lack of preventive collective procedures could result in an overburdened system, post-Pandemic.

Associação entre dor dentária, uso de serviços odontológicos e absenteísmo escolar: Pesquisa Nacional de Saúde do Escolar 2015 / Asociación entre dolor dental, uso de servicios dentales y absentismo escolar: Encuesta Nacional de Salud Estudiantil, Brasil, 2015 / Association between dental pain, use of dental services and school absenteeism: 2015 National School Health Survey, Brazil

Objetivo: Analisar a associação entre dor dentária, uso de serviços odontológicos e absenteísmo escolar em adolescentes brasileiros. Métodos: Estudo transversal, sobre dados da Pesquisa Nacional de Saúde do Escolar (PeNSE 2015). A variável dependente do estudo foi o absenteísmo escolar por motivo de saúde nos últimos 12 meses. Características socioeconômicas, dor dentária e utilização de serviços odontológicos foram as variáveis independentes avaliadas. Empregou-se regressão logística, para estimar odds ratio (OR) e respectivos intervalos de confiança de 95% (IC95%). Resultados: Foram incluídos 102.072 escolares. A prevalência de absenteísmo por motivo de saúde foi de 53,7% (IC95% 53,2;54,3). Pela análise ajustada, houve associação entre dor dentária e absenteísmo (OR=1,35 - IC95% 1,26;1,45), e aumento na ocorrência de absenteísmo conforme o maior número de consultas odontológicas. Conclusão: Os resultados sugerem que a dor dentária e a frequência de consultas odontológicas podem estar relacionadas ao absenteísmo escolar.

Objetivo: Analizar la asociación entre dolor dental, el uso de servicios dentales y el absentismo escolar en adolescentes brasileños. Métodos: Estudio transversal con datos de la Encuesta Nacional de Salud Escolar (PeNSE 2015). La variable dependiente del estudio fue el absentismo escolar por razones de salud en los últimos 12 meses. Características socioeconómicas, dolor dental y frecuencia del uso de los servicios dentales fueron las variables independientes evaluadas. La regresión logística se usó para estimar los odds ratio (OR) e intervalos de confianza del 95% (IC95%). Resultados: Se incluyeron datos de 102.072 estudiantes. La prevalencia de absentismo por razones de salud fue del 53,7% (IC95% 53,2; 54,3). En el análisis ajustado, hubo una asociación entre el dolor dental y el absentismo escolar (OR=1,35; - IC95% 1,26; 1,45), y un aumento del absentismo según el mayor número de consultas dentales. Conclusión: Los resultados sugieren que el dolor dental y la frecuencia de las visitas al dentista pueden estar relacionados con el absentismo escolar.

Objective: To analyze association between dental pain, use of dental services and school absenteeism in Brazilian adolescents. Methods: This was a cross-sectional study with data from the National School Health Survey (PeNSE 2015). The study's dependent variable was school absenteeism due to health reasons in the last 12 months. Socioeconomic characteristics, dental pain and use of dental services were the independent variables evaluated. Logistic regression was used to estimate odds ratios (OR) and respective 95% confidence intervals (95%CI). Results: Data on 102,072 schoolchildren were included. Absenteeism prevalence due to health reasons was 53.7% (95%CI 53.2;54.3). In the adjusted analysis, there was association between dental pain and school absenteeism (OR=1.35 - 95%CI 1.26;1.45), and an increase in absenteeism occurrence the greater the number of dental visits. Conclusion: The results suggest that dental pain and frequency of dental visits may be related to school absenteeism.

Is obesity associated with tooth loss due to caries? A Cross-sectional study

Aim: To investigate the association between obesity, overweight, and tooth loss due to caries among university students of (Federal University of Pelotas) in southern Brazil. Methods: A cross-sectional study with all first-year students who regularly enrolled in the first semester of 2016 who were invited to respond to a self-administered questionnaire contain socioeconomic and demographic; psychosocial; oral health; behavioral questions. The body mass index (BMI) was calculated through the self-reported data of weight and height. The main outcome of the present study was determined by the person's that answer having had at least one tooth extracted due to caries. A Poisson regression using a backward stepwise procedure was performed. Two models were tested: i) including socioeconomic and behavioral variables; ii) without behavioral variables. Results: From 3,237 eligible students, 2,089 (64.5%) participated in the present study. Almost 23% of students presented overweight and 8.4% obesity, whereas 362 individuals (17.5%) reported having had at least one tooth extracted due to caries. Regarding the final model adjusted by behavioral variables, it was observed that obese university students presented a 32.0% higher prevalence of tooth loss (PR=0.32,CI95%[1.17­1.49]). However, overweight was not associated with tooth loss in the present sample. When the model was not associated with behavioral variables, overweight was associated with tooth loss (PR=1.44; CI95%[1.15­1.81]), just as obesity (PR=2.13; CI95%[1.63 ­ 2.78]). Conclusions: Obesity and overweight were associated with tooth loss due to caries in the present sample of university students

Severe traumatic dental injuries and oral health related quality of life of preschool children / Traumatismos dentários severos e qualidade de vida relacionada à saúde bucal de crianças pré-escolares

ABSTRACT Objective: The aim of this study was to investigate the impact of severe traumatic dental injuries on the Oral Health related Quality of Life (OHRQoL) of preschool children. Methods: This cross-sectional study was conducted with children aged 2 to 5 years and their mothers, in Pelotas/ Brazil Southern. The Early Childhood Oral Health Impact Scale (ECOHIS) was applied to assess the perception of mothers about children's OHRQoL. Oral examination included dental trauma, categorized as absent/mild (enamel fracture only) or severe, the number of decayed, missing or restored primary teeth (dmft), and presence of anterior open bite. The impact of severe dental trauma on OHRQoL was evaluated using logistic regression analysis (P<0.05). Results: A total of 599 preschool children were included and 7.4% had severe dental trauma. Of these 73.3% showed negative impact on OHRQoL (p= 0.044). After adjustments, children with severe dental trauma had an impact in OHRQoL 110% higher than those without/with mild trauma (OR: 2.10, 95% CI 1.01-4.35). Severe dental injuries caused negative impact on the oral symptoms (OR: 2.13, 95% CI 1.10-4.14), psychological (OR: 2.13, 95% CI 1.10-4.13) and family function (OR: 2.79, 95% CI 1.17-6.61) domains. Conclusion: The presence of severe dental trauma impacts the OHRQoL of preschool children and their families.

RESUMO Objetivo O objetivo deste estudo foi investigar o impacto de lesões dentais traumáticas severas na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) de crianças pré-escolares. Métodos Estudo transversal realizado com crianças de 2 a 5 anos e suas mães, na cidade de Pelotas / RS. A escala Early Childhood Oral Health Impact Scale (ECOHIS) foi aplicada para avaliar a percepção das mães sobre a QVRSB das crianças. O exame de saúde bucal incluiu traumatismo dentário, classificado como ausente / leve (fratura de esmalte apenas) ou severo, o número de dentes decíduos cariados, ausentes ou restaurados (ceo-d) e a presença de mordida aberta anterior. O impacto do traumatismo dentário severo na QVRSB foi avaliado por meio de análise de regressão logística (P <0,05). Resultados Foram incluídos 599 pré-escolares e 7,4% sofreram traumatismo dentário severo. Destes, 73,3% apresentaram impacto negativo na QVRSB (p = 0,044). Após ajustes, as crianças com traumatismo dentário severo tiveram um impacto na QVRSB 110% maior do que aquelas sem trauma / com trauma leve (OR: 2,10, IC 95% 1,01-4,35). Traumas dentais graves causaram impacto negativo nos domínios sintomas orais (OR: 2,13, IC 95% 1,10-4,14), domínio psicológico (OR: 2,13, IC 95% 1,10-4,13) e função familiar (OR: 2,79, IC 95% 1,17-6,61). Conclusão A presença de traumatismo dentário severo impacta a QVRSB de crianças pré-escolares e suas famílias.

How common is dry mouth? systematic review and meta-regression analysis of prevalence estimates

Abstract The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

Resumo O objetivo do estudo é revisar sistematicamente a literatura afim de estimar a prevalência global de xerostomia/hiposalivação em estudos epidemiológicos. Uma busca eletrônica foi conduzida até Fevereiro de 2018 sem restrições de linguagem. Um total de 5760 títulos foram inicialmente identificados e somente vinte e nove artigos foram incluídos na revisão e meta-análise após dois revisores independentes aplicarem os critérios de seleção. Os artigos foram extraídos das bases de dados PubMed/Medline e Web of Science. Os critérios de elegibilidade incluíram investigações originais de estudos observacionais de base populacional os quais reportaram a prevalência de xerostomia ou dados que permitissem o cálculo da prevalência de xerostomia e/ou hiposalivação. Estudos realizados em populações com condições de saúde específicas, revisões de literatura, relato de casos e estudos antropológicos, assim como, conferências ou comentários foram excluídos. Tamanho amostral, localização geográfica aonde foi realizado o estudo, desenho do estudo, idade da população estudada, métodos de diagnóstico e o critério de avaliação para determiner xerostomia e/ou hiposalivação foram extraídos para a meta-análise e metaregressão. Análise de meta-regressão multípla foi realizada para explorar a heterogeneidade entre os estudos. A prevalência global estimada de boca seca foi de 22.0% (95%IC 17.0-26.0%). Uma maior prevalência de xerostomia foi observada em estudos realizados exclusivamente em populações idosas. Apesar de diferentes abordagens utilizadas para mensurar as condições de interesse, cerca de uma em quatro pessoas é acometida por xerostomia, com taxas mais elevadas sendo observadas na população idosa. Além disso, os métodos de mensuração podem ter super- ou subestimado os valores de xerostomia. Os achados do presente estudo salientam a necessidade de mais estudos acerca das existentes e novas formas de avaliação clínica, os quais serão úteis para determinar qual é a mais confiável para as perspectivas clínicas e epidemiológicas.

Simultaneidade de comportamentos de risco para infecções sexualmente transmissíveis em adolescentes brasileiros, 2012 / Simultaneidad de comportamientos de riesgo para infecciones de transmisión sexual en adolescentes brasileños, 2012 / Simultaneity of risk behaviors for sexually transmitted infections in Brazilian adolescents, 2012

OBJETIVO: analisar a simultaneidade de dois grupos de comportamentos de risco para infecções sexualmente transmissíveis em adolescentes brasileiros. MÉTODOS: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar 2012; os desfechos foram (1) simultaneidade de consumo de álcool, fumo e drogas (pelo menos dois) e (2) não uso de camisinha e relação sexual com dois ou mais parceiros. RESULTADOS: a simultaneidade de consumo de álcool, fumo e drogas foi de 14,7% nos meninos e 21,5% nas meninas, mais prevalente em brancos, com mães mais escolarizadas, que não moravam com os pais; aproximadamente 12,0% dos adolescentes apresentaram simultaneidade de não uso de camisinha e dois ou mais parceiros, sendo mais frequente nos meninos mais novos, não brancos (RP=1,22; IC95% 1,10;1,36) e que não moravam com os pais (RP=1,78; IC95% 1,48;2,16), enquanto nas meninas, esse desfecho associou-se a maior idade. CONCLUSÃO: ambos desfechos associaram-se a diferentes características, dependendo do sexo do adolescente.

OBJETIVO: analizar la simultaneidad de dos grupos de comportamientos de riesgo para infecciones de transmisión sexual, en adolescentes brasileños. MÉTODOS: estudio transversal con datos de la Investigación en Salud Escolar Nacional, 2012; las variables de desenlace fueron (1) simultaneidad de alcohol, tabaco y drogas (al menos dos) y (2) no uso de condones y relaciones sexuales con dos o más compañeros. RESULTADOS: 14,7% de los niños y 21,5% de las niñas presentaron simultaneidad de alcohol, tabaco y drogas, fue más frecuente entre blancos, con madres más educadas, y que no viven con sus padres; aproximadamente 12,0% de los adolescentes mostraron simultaneidad de no usar condón y dos o más compañeros sexuales, más común entre más jóvenes, no blancos [RP=1,22 (IC95% 1,10;1,36) ] y que no viven con sus padres [RP=1,78 (IC95% 1,48;2,16) ], en las niñas, este resultado se asoció con un aumento de la edad. CONCLUSIÓN: ambos resultados se asociaron con diferentes características, en función del sexo de los adolescentes.

OBJECTIVE: to analyze the simultaneity of two groups of risk behaviors for sexually transmitted infections in Brazilian adolescents. METHODS: cross-sectional study with data from the National Adolescent School-based Health Survey 2012; the outcomes were (1) simultaneous consumption of alcohol, tobacco and drugs (at least two), and (2) no use of condom and having two or more sexual partners. RESULTS: simultaneity of consumption of alcohol, tobacco and drugs was present in 14.7% of the boys and 21.5% of the girls, and was more prevalent among white individuals, with more educated mothers, and who did not live with their parents; approximately 12.0% of the adolescents presented simultaneity of no use of condom and having two or more sexual partners; this was more common among younger boys, not white (PR=1.22; 95%CI 1.10;1.36), and who did not live with their parents (PR=1.78; 95%CI 1.48;2.16), whilst among girls, this outcome was associated with higher age. CONCLUSION: both outcomes were associated with different characteristics, depending on the sex of the adolescent.

Experience of Dental Caries and Use of Continuous Medication in Children with Neuropsychomotor Disorders

Objective: To identify the relation between the use of continuous medication by children with neuropsychomotor disorders and the development of the dental caries disease. Material and Methods: The data were obtained from medical and dental records of children, who were assisted in an extension project of the Dentistry School of the Federal University of Pelotas. Socio-economic variables, the disability diagnosis, the type and frequency of the continuous medication, and the dental caries experience registered in the dental record were collected. The data were evaluated by double typing, analyzed by descriptive statistics, and the associations were tested by the Qui-squared, Fisher exact, Mann-Whitney, and Kruskal-Wallis tests. The Stata Statistical Software, version 12.0, was utilized considering the level of significance of 5%. Results: 119 records were evaluated, and the results were distributed by age bracket due to the high age range. Undoubtedly, the cerebral palsy was the most prevalent (33.9%). From the total of the children, 68.8% were using continuous medication, and the majority (56%) uses medication there are more than 24 months. The anticonvulsants were the most used medications (33.8%), and 96.5% of the children used medication during the nocturnal period. Half of the utilized medications presented sucrose in its composition. Conclusion: A statistically significant association between the use of continuous medication, containing sucrose, and the dental caries experience were not observed, what suggests that other risk factors contribute to the disease installation.

Avaliação da percepção e da experiência dos cirurgiões-dentistas da rede municipal de Pelotas/RS no atendimento aos portadores de fissuras labiopalatais / Evaluation of perception and experience of dentists in the municipal network of Pelotas/RS in attendance of cleft lip and palate patients

Objetivo: investigar a percepção e a experiência dos cirurgiões-dentistas da rede municipal de saúde de Pelotas no atendimento a portadores de fissuras labiopalatais. Métodos: participaram do censo 43 profissionais de Unidades Básicas de Saúde do município de Pelotas - RS, os quais responderam a um questionário sobre atuação profissional, experiência no atendimento a pacientes portadores de fissura labiopalatal e conhecimento específico sobre a malformação. Resultados: constatou-se que 37,2% dos profissionais atenderam pacientes portadores de fissura e 67,4% fariam o tratamento odontológico adequado, porém 32,6% dos pesquisados os encaminhariam a profissionais especializados por falta de conhecimento no assunto. A maioria dos profissionais respondeu adequadamente às questões de conhecimento específico, mas 74,4% desconheciam o padrão alimentar cariogênico no primeiro ano de vida. Foi relatado que 60,5% dos profissionais conheciam algum centro de atenção multidisciplinar para reabilitação de portadores de fissuras no Brasil, e 11,6% no Rio Grande do Sul. Conclusão: parcela importante dos profissionais envolvidos neste estudo (87,5%) teve experiência no atendimento a pacientes com necessidades especiais, entre eles, pacientes portadores de fissuras labiopalatais. A malformação congênita não foi impedimento para a realização de pro-cedimentos clínicos básicos, porém, constatou-se falta de informação sobre o tema. Sugere-se que os serviços disponibilizem capacitações aos cirurgiões-dentistas da rede pública, tendo em vista que orientações aos pais sobre os cuidados com a higiene bucal na região da fissura, aconselhamento alimentar e informações sobre o processo de reabilitação são importantes na atenção primária em saúde.

Efetividade de uma estratégia educacional em saúde bucal aplicada a crianças deficientes visuais / Effectiveness of an educational strategy on oral health of visually impaired children

Objetivo: o objetivo deste estudo foi avaliar a efetividade de uma estratégia educacional em saúde bucal direcionada a crianças deficientes visuais, matriculadas em uma escola da cidade de Pelotas - RS. Métodos: a estratégia foi empregada semanalmente, durante um mês. Utilizaram-se material lúdico-pedagógico, orientação através do tato e escovação supervisionada. A higiene bucal e o estado de saúde gengival dos 15 alunos com idades entre 7 e 16 anos foram avaliados através do índice de placa (IP) e índice de sangramento gengival (ISG), antes da intervenção, trinta e noventa dias após. Para avaliar a percepção, atitude e conhecimento quanto à saúde bucal, foi aplicado um questionário semiestruturado às crianças e aos seus cuidadores. Os dados foram analisados por meio de estatística descritiva e teste T pareado. Resultados: após trinta dias, houve redução significativa do IP e ISG (p = 0,001), 80% reduziram o IP e 100%, o ISG. Após noventa dias, houve um aumento do ISG e do IP, porém sem diferença estatisticamente significativa, quando comparado ao exame de trinta dias. Conclusão: a proposta educativa e preventiva utilizada neste estudo pode ser efetiva se pautada nos sentidos remanescentes destes pacientes, devendo ser regular e contínua.