Oral Health Access and Early Caries in Childhood in a Primary Care Service in Southern Brazil: A Cross-Sectional Study

Abstract Objective: To evaluate the prevalence of early childhood caries and its association with Child's Programmatic Action dental visits in a Primary Care Service. Material and Methods: A cross-sectional analytical study was carried out at the Health Centers of the Grupo HospitalarConceição Community Health Service in Porto Alegre, RS, Brazil. Mothers answered a questionnaire containing socioeconomic data, eating habits and oral care of their children. Caries examination was performed by two examiners calibrated using WHO criteria. Results: Eighty-one children with mean age of 58.8 (SD=4.8) months were evaluated, 58% were male. Caries prevalence was 43%, with mean dmft = 1.7 and mean dmfs = 3.09. In the multivariate analysis, there was a statistically significant association of caries with maternal schooling (PR=1.31, 95%CI=1.06-1.62, p=0.012), family income (PR=0.93, 95% CI=0.90-0.97, p<0.001), adequacy of the number of childcare visits (PR=0.68, 95%CI=0.54-0.86, p=0.001) and number of visits to the dentist (PR=1.04, 95%CI=1.01-1.06, p=0.001). Conclusion: Ensuring access to childcare and early dental consultation, while the family context is disregarded, does not seem to be enough to reduce caries. It is necessary to think of non-conventional oral health promotion strategies in Primary Health Care taking into account the territory and social determinants since changes to eating and oral hygiene habits and behaviors are still a challenge to the control of childhood caries.

Prevalência de má oclusão em crianças de quatro anos de idade e fatores associados na Atenção Primária à Saúde / Prevalence of malocclusion in four-year-old children and associated factors in Primary Health Care

Objetivo: avaliar a prevalência de má oclusão em crianças nascidas em 2010 e sua associação com a realização de consultas odontológicas em um serviço de Atenção Primária à Saúde. Métodos: estudo analítico transversal realizado em duas Unidades de Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar. O exame de má oclusão das crianças com 4 anos completos foi realizado por dois dentistas treinados e calibrados, seguido da aplicação do questionário sobre hábitos da criança para o responsável. Os dados de consultas odontológicas foram coletados no Sistema de Informações do GHC. As análises foram feitas no programa SPSS através do teste Qui-quadrado e da Regressão de Poisson, com significância estatística de p<0,05. Resultados: uma amostra consecutiva de 81 crianças com idade média de 58,8 (DP=4,8) meses foi avaliada, sendo 58% do sexo masculino. Do total, 28% das crianças apresentavam mordida aberta anterior, 10% de mordida cruzada posterior e selamento labial não adequado. Uso de chupeta ainda era presente em 22% das crianças. Não houve associação entre má oclusão e número de consultas odontológicas (p=0,837), assim como realização de uma consulta anual até 4 anos de idade (p=0,684). Na análise multivariada, houve associação significativa de má oclusão com uso de chupeta (RP=0,15, IC95%=0,07­0,35), bem como o seu tempo de uso (RP=1,05, IC95%=1.03-1.08). Conclusão: má oclusão na primeira infância está fortemente associada ao uso de chupeta e o acompanhamento precoce pela equipe de saúde bucal pareceu não interferir na cessação do hábito e regressão da oclusopatia aos 4 anos.

Objective: to evaluate the prevalence of malocclusion in children born in 2010 and its association with dental consultations in a primary health care service. Methods: a cross-sectional analytical study carried out in two Health Units of the Grupo Hospitalar Conceição (GHC), Porto Alegre-RS. The malocclusion test of children with 4 years of age was performed by two trained and calibrated dentists, followed by a questionnaire with the person responsible for the child's habits. Data from dental consultations were collected in the GHC Information System. The analyzes were performed in the SPSS program using the Chi-square test and the Poisson regression, with statistical significance of p <0.05. Results: a consecutive sample of 81 children with mean age of 58.8 (SD=4.8) months was evaluated, being 58% male. 28% of the children had anterior open bite, 10% posterior crossbite and inadequate lip sealing. Pacifier use was still present in 22% of children. There was no association between malocclusion and number of dental appointments (p = 0.837), as well as an annual consultation up to 4 years of age (p = 0.684). In the multivariate analysis, there was a significant association of malocclusion with pacifier use (PR = 0.15, 95% CI = 0.07-0.35) as well as its duration of use (PR = 1.05, 95% CI = 1.03- 1.08). Conclusion: malocclusion in early childhood is strongly associated with pacifier use and early follow-up by the oral health team did not seem to interfere with cessation of the habit and regression of occlusion at 4 years.

Estudio y análisis de las tecnologías de información y comunicación (TIC) en odontología en Rio Grande do Sul / Study and analysis of information and communication technology (TIC) in dentistry in Rio Grande do Sul

Objetivo: Analizar el uso de las tecnologías de información y comunicación (TIC) por odontólogos que egresaron a partir de 2002 en el estado de Rio Grande do Sul Brasil. Método: Análisis estadístico descriptivo de los datos de 217 cuestionarios on line con el software SPSS y Test Chi-Cuadrado para la obtención de los porcentajes de las variables de comparación (p<0,05). Resultados: El 61,8% son graduados en facultades públicas y 55,8% tiene, al menos, una especialidad. El consultorio particular como lugar de trabajo surge en 62,2% de las respuestas; 88,9% no utilizan la historia clínica electrónica, siendo la TIC que más desean incorporar a su práctica, constando en el 53,6% de las respuestas. El 87,2% considera que la informatización ayuda en la práctica clínica reconociendo “agilidad” el 78,9%. La mayor dificultad para la incorporación fue el alto costo (67%). Conclusión: La mayoría de los participantes posee equipamientos electrónicos, pero esa práctica no se extiende al consultorio y menos aún a servicios públicos. La informatización ayuda en la práctica clínica, brindando mayor agilidad y practicidad.

Objective: To analyze the use of Information and Communication Technologies (ICT) by dentists graduated since the year 2002 in the state of Rio Grande do Sul Brazil. Method: Descriptive statistical analysis of data from 217 on-line questionnaires with SPSS software, using the Chi-square test to obtain the percentages of variables compared (p < 0.05). Results: 61.8% graduated from public colleges and 55.8% have at least one specialty. Private practice as a workplace appeared in 62.2% of responses; 88.9% do not use electronic medical records, which is the ICT they desire most to incorporate to their practice, appearing in 53.6% of responses. 87.2% believe that computerization aids clinical practice, 78.9% reporting agility. The biggest difficulty for incorporation was the high cost (67%). Conclusion: Most participants have electronic equipment, but this practice does not extend to the office and even less to public services. Computerization aids clinical practice providing more flexibility and convenience.