Oral health actions in the primary health care network of northeastern brazil in relation to oral cancer / Ações de saúde frente ao câncer bucal na atenção básica do nordeste brasileiro

ABSTRACT Objective: To describe oral health actions against oral cancer promoted by Primary Health Care Teams in northeastern Brazil. Methods: This is a descriptive and inferential study based on data related to detection, referral, registration, follow-up and documents related to these actions in the External Evaluation of the 1st and 2nd Program for Improving Access and Quality of Primary Care Cycles. Results: Overall, 5,599 and 7,700 teams were evaluated, respectively, in the first and second cycles, with the highest and lowest concentrations in the states of Bahia / Maranhão and Bahia / Sergipe. In all, 58.9% / 79.7% Health Teams conducted campaigns to detect oral lesions and referred suspected cases of oral cancer, and 43.9% / 23% of them recorded and followed suspicious / confirmed cases and only 20.7% / 16.2% had documents proving these records in the respective cycles. There was statistical significance in the comparisons of actions and the evaluation cycles (p ? 0.01). Conclusion: Health teams in northeastern Brazil need to improve actions related to detection, referral, registration, follow-up and verification of oral health documents related to oral cancer.

RESUMO Objetivo: Descrever as ações em saúde bucal frente ao câncer de boca promovidas pelas Equipes de Saúde da Atenção Básica do nordeste brasileiro. Métodos: Estudo descritivo e inferencial a partir de dados referentes à detecção, encaminhamento, registro, acompanhamento e documentos comprovatórios relacionados a estas ações relativos ao 1º e 2º Ciclo de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Os dados foram analisados pelos testes Qui-Quadrado e McNemar (?=0,05). Resultados: Foram avaliadas 5.559 e 7.700 equipes, respectivamente, nos 1º e 2º ciclos, sendo, a maior e menor concentração na Bahia/Maranhão e Bahia/Sergipe. 58,9%/79,7% das Equipes realizam campanhas para detecção de lesões bucais e encaminham os casos suspeitos de câncer de boca. Além disso, 43,9%/23% delas registram e acompanham os casos suspeitos/confirmados e apenas 20,7%/16,2% possuem documentos que comprovem esses registros, nos respectivos ciclos. Houve significância estatística nas comparações das ações e os ciclos de avaliação (p ? 0,01). Conclusão: As Equipes de Saúde na região nordeste necessitam melhorar as ações referentes à detecção, encaminhamento, registro, acompanhamento e documentos comprovatórios em saúde bucal frente ao câncer de boca.

Evolução dos Índices CEO-D/CPO-D e de Cuidados Odontológicos em Crianças e Adolescentes com Base no SB Brasil 2003 e SB Brasil 2010 / Evolution of DMF-T/DMF-T and Dental Care Index in Children and Adolescents Based on SB Brasil 2003 and SB Brasil 2010

Objetivo: Analisar a evolução dos índices ceo-d/CPO-D e do Índice de Cuidados Odontológicos, em crianças e adolescentes, tendo como referência os resultados dos levantamentos epidemiológicos nacionais. Material e Métodos: Estudo ecológico, exploratório onde foi realizada análise da série histórica dos índices em crianças de 5 e 12 anos e de 15 a 19 anos, a partir dos resultados do SB Brasil 2003 e SB Brasil 2010. Os dados foram analisados descritivamente, considerando a variação, em percentagem, de indivíduos livres de cárie (ceo-d=0 e CPO-D =0), médias de ceo-d e CPO-D e do Índice de Cuidados Odontológicos. Resultados: Houve uma evolução de +6,0% do índice ceod=0 em crianças de 5 anos, de +12,4% em indivíduos de 12 anos e de +12,8% na faixa etária de 15 a 19 anos. Em relação ao índice ceo-d, aos 5 anos a evolução foi de -13,2%, aos 12 anos de -25,5% e na faixa etária de 15 a 19 anos, -31,11%. A evolução do Índice de Cuidados Odontológicos no Brasil, em crianças de 5 anos, foi de +0,7%, aos 12, foi de +2,6% e na faixa dos 15 aos 19 anos, +10,4%. No Nordeste e Sudeste houve aumento no número de crianças livres de cárie aos 5 anos. Aos 12 e dos 15 a 19 observou-se um aumento, em todas as regiões brasileiras, de indivíduos livres de cárie. Conclusão: Observou-se aumento no número de indivíduos livres de cárie em crianças e adolescentes, constatando-se declínio nos valores dos índices ceo-d/CPO-D e maior cuidado odontológico. (AU)

Objective: To analyze the evolution of dmf-t / DMF-T and Dental Care Index among children aged 5 to 12 years and 15 to 19 years, with reference to the results of national epidemiological surveys. Material and Methods: An ecological, exploratory study was performed to analyze the historical evolution of dmf-t / DMF-T and dental care index in children 5 to 12 years and aged 15 to 19 years, based on the results of the Brazilian national epidemiological surveys "SB Brazil 2003" and "SB Brazil 2010". The data were analyzed descriptively, considering the variation in percentage of caries-free individuals (dmf-t and DMF-T = 0), mean dmf-t and DMF-T and Dental Care Index. Results: There was an increase of +6.0% in dmf-t = 0 in 5-year-old children; +12.4% in 12-year-old children; and 12.8% in the age group 15 to 19 years. In relation to dmf-t, the trend was -13.2% for 5-year-olds, -25.5% for 12-year-olds, and -31.11% for the age group 15 to 19 years. The evolution of the Dental Care Index in Brazil was +0.7% among 5-year-old children, +2.6% among 12-year-olds, and +10.4% for those in the age group 15 to 19 years. In northeastern and southeastern Brazil, there was an increase in the number of 5-year-old children with caries-free status. As for 12 and 15 to 19 years of age, there was an increase in the number of caries-free individuals in all Brazilian regions. Conclusion: There was an increase in the number of caries-free children and adolescents, with a decline in the dmf-t/ DMF-T indices and an improvement in dental care. (AU)

Factors associated with oral biofilm in ICU patients with infectious diseases / Fatores associados à presença de biofilme oral em pacientes internados na UTI

Introduction: Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective: To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method: This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result: Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion: Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.

Introdução: A hospitalização pode provocar deterioração da saúde bucal, repercutindo em todo o corpo. A UTI pode ser um ambiente favorável ao acúmulo de biofilme oral em pacientes críticos. Objetivo: Identificar fatores associados à presença do biofilme em pacientes da UTI de um hospital de doenças infectocontagiosas. Método: Estudo retrospectivo, descritivo e inferencial, com abordagem quantitativa. Os dados foram obtidos em prontuários de pacientes da UTI, de janeiro de 2012 a julho de 2015. O biofilme foi avaliado de acordo com o índice de Greene e Vermillion. Os fatores influentes foram analisados por regressão logística. Resultado: Entre os pacientes da UTI, 69,1% eram homens, 60,7% pacientes com AIDS, 66,3% pacientes na enfermaria, 50,6% intubados e 50,0% sedados. Seus elementos orais eram na maioria normais. As seguintes características foram significativamente associadas a biofilmes orais: alterações orais nos lábios, gengivas, bochechas e palatos e sangramento. Pacientes da enfermaria apresentaram menor risco de apresentar biofilmes. Conclusão: o aumento do acúmulo de biofilme oral foi observado em pacientes com alterações na boca e a procedência do paciente foi associada à presença de biofilme.

Factors Associated with Toothache in Patients Affected by Hereditary Coagulopathies

Objective: To determine a probabilistic model that represents the likelihood of the event Dental Pain to occur in Brazilians patients affected by hereditary coagulopathies. Material and Methods: In this cross-sectional study, information on use and access to dental services, oral morbidity, self-perceived oral health and behavioral health habits were obtained through semi-structured questionnaire and analyzed by means of logistic regression. Results: High prevalence of dental caries was observed for children aged 1-5 years (50%) and for adolescents aged 13-19 years (66%). Cumulative pattern of dental caries in the age groups of 20-35 years and 36-59 years was observed. Most patients did not report pain in the last six months prior to the survey (24.5%). It was observed that searching for dental care for the last time in case of localized pain (OR=26.7), for feeling uncomfortable when brushing teeth (OR=7.3) and difficulty searching for health professionals, not only the dentist (OR 3.7) was considered risk factors for the determination of Dental Pain diagnosis. However, if the patient has mild hemophilia A (OR=0.21), this likelihood decreases, being thus a protective factor. Conclusion: Patients affected by hereditary coagulopathies have high prevalence of caries, indicating the cumulative nature of this disease, which suggests the symptomatic effect of Dental Pain.

Factors associated with lip and oral cavity cancer / Fatores associados ao câncer de lábio e cavidade oral

This study aimed to identify factors associated with the occurrence of primary cancer of the lip and oral cavity regions compared to other types of head and neck cancers according to demographic, socioeconomic data and lifestyle, in Brazil, from 2000 to 2011.

Objetivou-se identificar fatores associados à ocorrência de câncer primário nas regiões de lábio e cavidade oral frente aos demais tipos de cânceres de cabeça e pescoço segundo dados demográficos, socioeconômicos e de estilo de vida, no Brasil, no período de 2000 a 2011.

From diagnosis to survival of pediatric cancer: children's perspective / Do diagnóstico à sobrevivência do câncer infantil: perspectiva de crianças / Del diagnóstico a la supervivencia del cancer infantil: perspectiva de los niños

Objetivou-se compreender o processo do diagnóstico à sobrevivência do câncer a partir da perspectiva da criança. Estudo exploratório com análise qualitativa dos dados, com base em uma adaptação da técnica do desenho-estória e utilização da interpretação temática. Revelou-se uma maturidade precoce, por meio da compreensão das crianças acerca do diagnóstico, das diferentes fases do tratamento e enfrentamento das dificuldades de convívio com colegas e readaptação na escola após o término do tratamento. É papel da equipe de saúde usar estratégias para ajudar as crianças a tomar atitudes que minimizem e/ou previnam a aflição relacionada ao câncer, considerando-se para o cuidado não somente protocolos clínicos, mas também critérios referentes à dimensão existencial.

the study aimed to investigate the process from diagnosis to survival of cancer from the child's perspective. This study is exploratory with qualitative analysis of the data, based on an adaptation of story-board narrative research and use of thematic interpretation. A precocious maturity was revealed, through the children's understanding regarding the diagnosis, of the different phases of the treatment, and coping with the difficulties of co-existing with classmates and re-adapting to school after the end of treatment. The use of strategies to help the children to adopt attitudes which minimize and/or prevent the distress related to cancer is a role of the health team, considering as care not only clinical protocols but also criteria relevant to the existential dimension.

Se intentó comprender el proceso de diagnóstico a la supervivencia del cáncer a partir de la perspectiva del niño. Un estudio exploratorio utilizando el análisis de datos cualitativos, basado en una adaptación de la técnica del dibujo y la utilización de la interpretación temática. Se reveló una gran madurez precoz, por medio de la comprensión de los niños sobre el diagnóstico, de las diferentes fases del tratamiento y enfrentamiento de las dificultades de convivencia con colegas y readaptación en la escuela después del final del tratamiento. Es papel del equipo de salud usar estrategias para ayudar a los niños a tomar actitudes que minimicen o prevengan la aflicción relacionada con el cáncer, considerándose para el cuidado, no solamente los protocolos clínicos, sino también los criterios relativos a la dimensión existencial.

Tooth loss and associated factors in patients with coagulopathies in the State of Paraiba, Brazil

BACKGROUND The most common and best known hereditary coagulopathies are hemophilia A and B followed by von Willebrand Disease. OBJECTIVE This study aimed to estimate the prevalence of tooth loss and investigate its association with demographic and socioeconomic data, as well as to discuss self-reported oral morbidity and use of health services by patients with coagulopathies treated in blood centers in Paraíba, Brazil. METHODS This was a quantitative cross-sectional epidemiological survey. Data was collected in the period from October 2011 to July 2012 by clinical examination and by assessing interviews using a semi-structured questionnaire. The findings were analyzed by descriptive and inferential statistics with the level of significance (α) being set at 10%. RESULTS One hundred and six, predominantly male (88.8%), patients with coagulopathies were evaluated. The ages ranged from one to 59 years. Most patients were of mixed race (61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%), and most had not completed elementary school (37.1%). Hemophilia A was found in 76.4% of the cases. The prevalence of dental caries among individuals was 50.0% predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth loss, teeth were missing in 35.1% of the study participants. CONCLUSION Tooth loss is high in this population. Males with severe hemophilia A, those who use fluoride and have a good or very good perception about their last dental appointment have a reduced chance of losing their teeth.

Edentulismo, uso e necessidade de prótese e fatores associados em município do nordeste brasileiro / Edentulism, denture use and need and associated factors in a brazilian northeastern city

Introdução: No Brasil, a população idosa cresce com o aumento da expectativa de vida constituindo uma responsabilidade para os gestores públicos na perspectiva de uma oferta de atenção adequada com conhecimento epidemiológico para o planejamento efetivo de políticas públicas. Para a saúde bucal o mais importante indicador para essa população é o edentulismo. Objetivo: Testar a associação entre os desfechos edentulismo/uso e necessidade de prótese dentária e dados sociodemográficos e de acesso em adultos e idosos em um município no Nordeste do Brasil (Bayeux/PB). Método: Utilizou uma abordagem indutiva, com procedimento descritivo e comparativo-estatístico e técnica da observação direta intensiva, por meio de exames bucais, e extensiva, por meio de formulários. O exame das condições bucais foi realizado por uma examinadora previamente calibrada em uma amostra probabilística de adultos (n=64) e idosos (n=22), de acordo com os critérios estabelecidos pela OMS. Os dados foram analisados mediante estatística descritiva e regressão logística (p-valor menor que 0,10). Resultados: Os fatores de risco identificados para necessidade de prótese foram: idade (OR = 1.07), necessidade de tratamento dentário autorreferida (OR = 32,02) e ter procurado o dentista pelos seguintes motivos: Extração dentária (OR = 5,58) e tratamento (OR = 14,69). Conclusão: A prevalência do edentulismo em adultos e idosos no município é alta, sendo expressiva a necessidade de prótese dentária, constatando-se maior necessidade de prótese nos pacientes mais velhos, que referiram necessitar de tratamento odontológico e cujo motivo da consulta foi para realização de exodontia ou tratamento.

Introduction: In Brazil, the elderly population grows with the increase of life expectancy, representing a responsibility to the public managers in the perspective of offering adequate attention with epidemiological knowledge for an effective planing of public policies. As far as oral health is concerned, edentulism is the most important indicator for this population. Objective: To assess the association between the endpoints edentulism/denture use and need and sociodemographic and access data in adults and elderly in a Brazilian northeastern city (Bayeux - PB). Method: An inductive approach with a descriptive and comparative-statistical approach was used, as well as intensive (oral exams) and extensive (questionnaires) direct observation. Examination of oral conditions was performed by a previously calibrated examiner in a probabilistic sample of adults (n=64) and elderly (n=22), according to the criteria established by the WHO. Data were analyzed by descriptive statistics and logistic regression (p less than 0.10). Results: The risk factors identified for denture need were: age (OR = 1.07), self-referred dental care need (OR = 32.02) and seeking the dentist for dental extraction (OR = 5.58) and treatment (OR = 14.69). Conclusion: The prevalence of edentulism in adults and elderly in the evaluated city is high, being expressive the denture need. Higher need of denture was observed in the older patients who reported needing dental care for alleged tooth extraction or treatment reasons.