ABSTRACT
RESUMEN De acuerdo a la literatura, los pacientes hospitalizados con trastornos mentales (TM), tienen mayor riesgo a desarrollar caries y enfermedad periodontal que la población general, asociado a la dificultad motora para hacerse una adecuada higiene oral, a los efectos adversos que ocasionan los medicamentos para el control de los síntomas psiquiátricos y a la falta de cuidado oral y atención clínica. El objetivo era realizar una revisión sistemática de la literatura sobre el estado de salud oral de pacientes hospitalizados con TM. Se hizo una búsqueda sistemática de la literatura en PubMed, de acuerdo con la metodología de la declaración PRISMA, a través de los descriptores en salud MeSh "Dental Caries" y "Mental Disorders" a febrero de 2017. De acuerdo a los diferentes filtros que fueron aplicados, se obtuvieron 14 artículos que describieron el estado de salud oral -mediante el índice COP-D (dientes con caries, dientes con restauraciones, dientes perdidos y dientes con extracción mandatoria)- de pacientes hospitalizados con TM. Se debe promover el reconocimiento de la importancia de la salud oral por parte de los profesionales de la salud, cuidadores y familiares; se debe explorar la cavidad oral para determinar el estado de salud además de instruir a los pacientes y personal de apoyo en higiene oral; las instituciones de salud mental deben establecer un programa de intervención para eliminar focos infecciosos orales y luego implementar un programa preventivo multidisciplinario para mantener la salud oral de acuerdo al diagnóstico del TM.
ABSTRACT According to the literature, hospitalized patients with mental disorders have a higher risk of developing cavities and periodontal disease than the general population, associated with the motor difficulty to perform adequate oral hygiene, to the adverse effects caused by drugs for the control of psychiatric symptoms, as well as the lack of oral care and clinical care. The aim was to carry out a systematic review of the literature on the oral health status of hospitalized patients with mental disorders (MD). A systematic search of the literature was carried out in PubMed, according to the PRISMA statement methodology, through the MeSh health descriptors "Dental Caries" and "Mental Disorders" in February 2017. According to the different filters that were applied, 14 articles describing the oral health status were obtained - through the DMF-T index (teeth with cavities, teeth with restorations, missing teeth and teeth with necessary extraction)- of hospitalized patients with MD. The recognition of the importance of oral health by health professionals, carers and family members should be promoted; the oral cavity should be explored to determine the state of health in addition to instructing patients and support personnel in oral hygiene; mental health institutions should establish an intervention programme to eliminate oral infectious sites and then implement a multidisciplinary preventive programme to maintain oral health according to the MD diagnosis.
ABSTRACT
Objetivo: O objetivo da pesquisa foi identificar os aspectos contextuais associados à ausência de cárie em escolares brasileiros de 12 anos de idade nos anos de 1986, 1996 e 2003. Método: Foi realizada uma análise multinível a partir dos dados dos três principais inquéritos epidemiológicos nacionais da saúde bucal de escolares de 12 anos de idade, sendo o primeiro nível os escolares e o segundo nível, a respectiva Unidade da Federação. Modelos de regressão logística foram utilizados para estimar a razão de chances para a ausência de cárie (CPO-D = 0) em relação a alguns indicadores contextuais estaduais demográficos e socioeconômicos. Resultado: A análise da partição da variância revelou em 1986, 1996 e 2003 uma participação, respectivamente, de 28,6, 5,8 e 4,4% do nível contextual sobre a variabilidade do desfecho ausência de cárie. A análise múltipla mostrou associação do aumento da esperança de vida ao nascer e da percentagem de indivíduos em moradias com três cômodos ou mais com a ausência de cárie, tanto no ano de 1986 quanto no ano de 2003. A percentagem de indivíduos com cobertura de rede de água encanada manteve-se associada à ausência de cárie no ano de 1996. Conclusão: O estudo alcançou o objetivo de identificar o efeito dos fatores contextuais sobre a cárie e possibilitou conhecer a importância que características coletivas de uma determinada população exercem sobre características individuais de saúde bucal.
Objective: The objective of the research was to identify the relationship between contextual aspects and the absence of caries in Brazilian 12-year-olds in the years of 1986, 1996 and 2003. Method: Multilevel analyses were carried from the data of the three main national epidemiological surveys of oral health condition among Brazilian 12-year-olds, being the first level the individuals and as the second level their respective federation unit. Logistic regression models were used to estimate the Odds Ratio for the absence of caries (DMF-T = 0) in relation to some demographic and socio-economic contextual variables. Result: The analysis of the variance partition showed in 1986, 1996 and in 2003, respectively, a participation of 28,6, 5.8 and 4.4% of the contextual level on the variability of the outcome caries absence. The multiple analysis showed association of the increase of the life expectancy at birth and the percentage of individuals in housings with three rooms or more with the absence of caries, in the years of 1986 and 2003. The percentage of individuals with covering of canalized water net was associated with the absence of caries in the year of 1996. Conclusion: The study reached the goal of identifying the effect of contextual factors on caries and made possible to know the importance of collective characteristic from determined population on oral health individual characteristics.
Subject(s)
Humans , Child , Epidemiology , Dental Caries , Multilevel Analysis , Dental Health Surveys , Oral HealthABSTRACT
OBJETIVOS: Conocer la prevalencia de caries y pérdida dental para calcular las necesidades terapéuticas en estudiantes de educación media superior que ingresan a la Universidad Nacional Autónoma de México (UNAM). MATERIAL Y MÉTODOS: Se realizó un estudio transversal descriptivo en el que se obtuvo una muestra de 77 191 estudiantes correspondientes a las generaciones de ingreso al bachillerato 2003, 2004 y 2005. Los datos de salud bucal se obtuvieron a partir del índice CPOD incluido en el Examen Médico Automatizado (EMA), instrumento de autorrespuesta estandarizado que aplica la Dirección General de Servicios Médicos (DGSM). El análisis del EMA fue univariado con la finalidad de identificar la distribución y la frecuencia de las variables. RESULTADOS: La prevalencia de caries y pérdida dental fue de 48.0 y 34.2 por ciento, respectivamente, con una cuantificación del índice CPOD de 5. Las necesidades de tratamiento para caries y pérdida dental se obtuvieron en al menos un diente por estudiante. CONCLUSIONES: Cerca de la mitad de los alumnos que ingresan al bachillerato de la UNAM requiere al menos la atención de una caries o prótesis dental. Lo anterior evidencia que las políticas en salud bucal instrumentadas no han alcanzado los índices en salud esperados en relación con los objetivos internacionales, así como la necesidad de impulsar nuevas líneas de investigación orientadas a identificar la gravedad de la enfermedad y factores vinculados con el deterioro de la salud bucal.
OBJECTIVE: To determine the prevalence of dental decay and tooth loss, and to consider the treatment needs for students at the Mexican National Autonomous University (UNAM). MATERIALS AND METHODS: A cross sectional study was designed including 77 191 students corresponding to the years of entrance to high school 2003, 2004 and 2005. Oral health data were obtained from the DMF-T index included in the Automatized Medical Exam (AME), a student self-answer instrument administered by the General Medical Services Department, UNAM. The analysis of the AME was univaried with the purpose of identifying the distribution and frequency of the variables. RESULTS: The prevalence of dental decay and tooth loss was 48.0 percent and 34.2 percent, respectively. The DMF-T index was 5. The treatment needs for dental decay and tooth loss for a student were considered as at least one lost tooth. CONCLUSIONS: Approximately half of the students from UNAM high schools need at least restorations and dental prosthesis. This suggests that oral health programs have not yet reached the expected health indexes according to international regulations, as well as the need to develop new research projects directed toward identifying disease severity and the factors that are detrimental to oral health.