Adaptación y validación en adultos peruanos del instrumento Perfil de impacto de la salud oral / Adaptation and validation of the tool Oral Health Impact Profile in Peruvian adults

Introducción: La calidad de vida relacionada con la salud oral es un indicador relevante de salud pública; por lo tanto, es necesario contar con instrumentos para su medición, contextualizados y con adecuadas propiedades métricas. Objetivo: Adaptar y validar el instrumento Perfil de impacto de la salud oral en la calidad de vida en una muestra de adultos peruanos. Métodos: Estudio de tipo instrumental, participaron 415 adultos de la provincia de Ica, Perú. Se realizó un análisis factorial exploratorio para valorar la estructura interna de la escala y un análisis factorial confirmatorio que incluyó el método de estimación de máxima verosimilitud robusta. Luego se evaluó la confiabilidad del instrumento y, finalmente, se comparó el impacto de la salud bucal en la calidad de vida, según variables de caracterización. Resultados: Se obtuvo una versión de 14 ítems agrupados en siete factores que explicaron el 88,50 por ciento de la varianza total y un ajuste aceptable, x2/gl = 3,72; NNFI = 0,98; CFI = 0,99; SRMR = 0,031; RMSEA =0,081 (IC 90 por ciento: 0,070-0,093). La consistencia interna de la escala global mostró un índice satisfactorio (α = 0,95) y las subescalas valores que oscilaron entre α = 0,88 y α=0,78; con excepción de la dimensión malestar psicológico (α = 0,66). La validez discriminante fue demostrada al encontrar diferencias significativas entre las variables sociodemográficas y los puntajes de severidad. Conclusiones: La nueva versión del instrumento presenta propiedades métricas aceptables, por lo tanto, puede ser usado en futuras investigaciones y estudios de validación(AU)

ABSTRACT Introduction: Oral health-related quality of life is a relevant public health indicator. Therefore, its measurement should be performed with contextualized tools and appropriate metric techniques. Objective: Adapt and validate the tool Oral Health Impact Profile in the quality of life of a sample of Peruvian adults. Methods: An instrumental study was conducted of 415 adults from the province of Ica, Peru. The internal structure of the scale was evaluated by exploratory factor analysis. Confirmatory factor analysis was also performed, which included robust maximum likelihood estimation. The reliability of the tool was then tested, and a comparison was finally made of the impact of oral health on quality of life, according to characterization variables. Results: The version obtained consists of 14 items grouped into seven factors explaining 88.50 percent of the total variance and an acceptable fit, x2/gl = 3.72; NNFI = 0.98; CFI = 0.99; SRMR = 0.031; RMSEA = 0.081 (CI 90 percent: 0.070-0.093). Internal consistency of the overall scale exhibited a satisfactory index (α = 0.95), whereas the subscales showed values of α = 0.88-0.78, except for the dimension of psychological distress (α = 0.66). Discriminant validity was demonstrated by finding significant differences between sociodemographic variables and severity scores. Conclusions: The new version of the tool has acceptable metric properties. Therefore, it may be used in future research and validation studies(AU)

Prevalência de dificuldade na mastigação e fatores associados em adultos / Prevalence of chewing difficulty among adults and associated factors

Resumo O objetivo deste estudo foi estimar a prevalência de dificuldade na mastigação e fatores associados em adultos de 20 a 59 anos em Patos, PB, Nordeste, Brasil. Foi realizado um estudo transversal com uma amostra aleatória de 532 indivíduos. A dificuldade na mastigação foi avaliada por meio de pergunta sobre dificuldade causada por problemas com dentes ou dentadura. Foram realizadas análises descritiva, bivariada e multivariada por meio de regressão de Poisson. A prevalência de dificuldade na mastigação foi de 30,5%. Na análise multivariada, os fatores associados à dificuldade na mastigação foram: faixa etária, escolaridade, tempo desde a última consulta, perda dentária severa, ausência de dentição funcional, uso e necessidade de prótese dentária, dor de origem dental e sinais e sintomas de alterações na ATM. A magnitude das associações entre as variáveis, com destaque para perda dentária e necessidade de prótese dentária, reforça a importância deste indicador subjetivo na avaliação da condição de saúde bucal dos indivíduos adultos e mostra que a dificuldade na mastigação está associada a uma estrutura multidimensional de fatores.

Abstract The aim of this study was to estimate the prevalence of chewing difficulty and associated factors in adults aged 20 to 59 years in Patos, in the State of Paraiba in the Northeast Region of Brazil. A cross-sectional study was conducted with a random sample of 532 participants. The outcome chewing impairment was assessed using the question "How often do you have difficulty eating due to problems with your teeth or dentures?". Crude and adjusted prevalence ratios were estimated using Poisson regression. The prevalence of chewing difficulty was 30.5%. An association remained between the following variables and chewing difficulty in the final multivariate models: age group, schooling, being a smoker/non-smoker, length of time since last visit to the dentist, severe tooth loss, absence of functional dentitions, dental prosthesis use, need for a dental prosthesis, oral pain, and signs and symptoms of TMJ dysfunction. The magnitude of the associations between the variables and chewing difficulty, notably tooth loss and the need for a dental prosthesis, emphasize the importance of subjective indicators for assessing the oral health status of adults and shows that chewing difficulty is associated with a range of multi-dimensional factors.

Signos y síntomas de trastornos temporo-mandibulares en la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia) / Signs and symptoms of temporomandibular joint disorders in elderly population treated within the public hospital network of Medellin (Colombia)

Resumen: Objetivo: Determinar la prevalencia de signos y síntomas de trastornos temporomandibulares en adultos mayores de Medellín y sus factores relacionados. Material y métodos: Estudio transversal en la red hospitalaria «Metrosalud¼. Participaron 342 adultos ≥ 65 años (57.8% mujeres). Variables: sociodemográficas y apoyo social (Duke-11); estrés autopercibido, salud mental, salud general autopercibida, satisfacción estado dental, salud bucal autopercibida, problemas bucales (últimos 30 días), número de dientes presentes, presencia de prótesis (superior/inferior); índice anamnésico de Helkimo y evaluación clínica. Se calculó la prevalencia de trastornos temporomandibulares-índice anamnésico de Helkimo según variables sociodemográficas y de salud y de trastornos temporomandibulares según evaluación clínica. Se estimó la asociación entre trastornos temporomandibulares-índice anamnésico de Helkimo e indicadores de salud y trastornos temporomandibulares clínicos mediante regresión logística calculando Odds Ratio crudas y ajustadas con intervalos de confianza al 95% (IC95%). Resultados: La prevalencia de síntomas severos fue mayor en hombres (32%) y de síntomas leves en mujeres (18%), con diferencias según factores sociodemográficos. Las personas que reportan síntomas tienden a reportar mayores prevalencias de malos indicadores de salud general y bucal. La mayor asociación se encontró para los problemas dentales en los últimos 30 días (ORa 3.57; IC95% 1.80-7.08) en el caso de las mujeres y para los hombres en mala salud mental (ORa 2.83; IC95% 1.31-6.09). Aunque las mujeres presentaron mayor riesgo de reportar problemas relacionados con la ATM (excepto para la presencia de ruidos articulares), no se encontraron asociaciones estadísticamente significativas. Conclusiones: Se requieren sistemas de vigilancia epidemiológica que permitan establecer con mayor claridad las asociaciones encontradas.

Abstract: Objective: To determine prevalence of temporomandibular joint disorders signs and symptoms of elderly adults in Medellin as well as related factors. Material and methods: The present was a crosssectional study conducted at the «Metrosalud¼ hospital network. The study was composed of 342 adult patients ≥ 65 years, (57.8% females) Variables: Socio-demographical and social support (Duke- 11); Self-perceived stress, mental health, self-perceived general health, satisfaction with respect to dental circumstances, self-perceived oral health, oral problems (previous 30 days), number of teeth present, presence of prostheses (upper/lower), Helkimo Anamnestic Index and clinical assessment. Prevalence of temporomandibular joint disorders- Helkimo Anamnestic Index was assessed with respect to health and socio-demographic variables, temporomandibular joint disorders was assessed according to clinical evaluation. Association between temporomandibular joint disorders-Helkimo Anamnestic Index and health indicators was evaluated as well as clinical temporomandibular joint disorders by means of logistic regression calculating crude and adjusted Odds Ratio with 95% (CI95%) confidence intervals. Results: Prevalence of severe symptoms was higher in males (32%), females exhibited higher prevalence of mild symptoms (18.8%); differences were found according to socio-demographic factors. Subjects reporting symptoms tended to report higher prevalence of poor oral and general health indicators. Higher association was found for patients with dental problems in the previous 30 days. (aOR 3.57; CI95% 1.80-7.08) in the case of women and, for men, the indicator was poor mental health (aOR 2.83; CI95% 1.31-6.09) Even though females exhibited greater risk of reporting TMJ related problems (except for the presence of articular noises) no statistical significant associations were found. Conclusions: Further epidemiological surveillance systems are required in order to suitably and clearly establish associations found in the present study.

Fatores associados à perda dentária em adultos em uma capital do nordeste no Brasil: estudo de caso-controle

A perda dentária persiste como problema de saúde pública no Brasil. O objetivo deste estudo foi identificar os fatores associados à perda dentária em adultos em Recife/PE. Trata-se de estudo de caso-controle. Os casos foram indivíduos de 18 a 59 anos, com vinte ou mais dentes, que realizaram exodontia pelo SUS. Os controles fizerem outros procedimentos odontológicos. A amostra foi de 325 casos e 664 controles. A variável dependente foi a exodontia de um ou mais dentes permanentes. As variáveis independentes agregaram-se em sete domínios: socioeconômico e demográfico, hábitos comportamentais, perfil autorreferido de doenças crônicas, rejeição ao tratamento dentário, autopercepção e impactos em saúde bucal, necessidade autorreferida de tratamento odontológico e acesso a serviços de saúde bucal. Estimou-se medidas de efeito por Odds Ratio mediante modelos de regressão logística simples (elegeu-se as variáveis com p-valor maior o igual a 0,25) e múltipla (permaneceram as de p<0,05) com base em um modelo teórico hierarquizado. Fez-se georreferenciamento e estimou-se as superfícies de risco por meio de diagramas de Voronoi. Há maiores chances de perda dentária associadas aos fatores: renda familiar até 250 reais (OR=3,13), sexo masculino (OR=1,61), escolaridade abaixo da mediana de dez anos de estudo (OR=1,47). Não se consultar por medo de dentista (OR=1,46). Insatisfação com a boca/dentes (OR=1,62). Necessidade autorreferida de extração dentária (OR= 4,8) ou prótese total superior (OR=2,08), ou prótese para substituir um ou mais dentes (OR=1,14). Motivo da última consulta odontológica ter sido extração dentária (OR=1,69) ou tratamento (OR=1,49)...

Dental loss persists as a public health problem in Brazil. The objective of this study was to identify the factors associated with dental loss in adults in Recife / PE. This is a case-control study. The cases were individuals from 18 to 59 years old, with twenty or more teeth, who underwent exodontia by SUS. The controls do other dental procedures. The sample consisted of 325 cases and 664 controls. The dependent variable was the extraction of one or more permanent teeth. The independent variables were aggregated into seven domains: socioeconomic and demographic, behavioral habits, self-reported profile of chronic diseases, rejection of dental treatment, self-perception and impacts on oral health, self-reported need for dental treatment and access to oral health services. Odds Ratio effect measures were estimated using simple logistic regression models (variables with p-value greater than or equal to 0.25) and multiple (remaining at p <0.05) were chosen based on a model theoretical hierarchy. Georeferencing was performed and the surfaces of risk were estimated by means of Voronoi diagrams. There are higher odds of dental loss associated with factors: family income up to 250 reais (OR = 3.13), male (OR = 1.61), schooling below the median of ten years of study (OR = 1.47). Do not consult for fear of dentist (OR = 1.46). Mouth / teeth dissatisfaction (OR = 1.62). Self-referential tooth extraction (OR = 4.8) or superior total prosthesis (OR = 2.08), or prosthesis to replace one or more teeth (OR = 1.14). The reason for the last dental appointment was dental extraction (OR = 1.69) or treatment (OR = 1.49)...

Factors associated with the prevalence of anterior open bite among preschool children: A population-based study in Brazil

INTRODUCTION: The aim of this study was to identify factors associated with the prevalence of anterior open bite among five-year-old Brazilian children. METHODS: A cross-sectional study was undertaken using data from the National Survey of Oral Health (SB Brazil 2010). The outcome variable was anterior open bite classified as present or absent. The independent variables were classified by individual, sociodemographic and clinical factors. Data were analyzed through bivariate and multivariate analysis using SPSS statistical software (version 18.0) with a 95% level of significance. RESULTS: The prevalence of anterior open bite was 12.1%. Multivariate analysis showed that preschool children living in Southern Brazil had an increased chance of 1.8 more times of having anterior open bite (CI 95%: 1.16 - 3.02). Children identified with alterations in overjet had 14.6 times greater chances of having anterior open bite (CI 95%: 8.98 - 24.03). CONCLUSION: There was a significant association between anterior open bite and the region of Brazil where the children lived, the presence of altered overjet and the prevalence of posterior crossbite. .

INTRODUÇÃO: este estudo objetivou identificar os fatores associados à prevalência de mordida aberta anterior em crianças brasileiras com cinco anos de idade. MÉTODOS: foi realizado um estudo transversal analítico com dados do inquérito epidemiológico nacional de saúde bucal SB Brasil 2010. O desfecho estudado foi a mordida aberta, classificada em presente ou ausente. As variáveis independentes foram classificadas em individuais, sociodemográficas e clínicas. Os dados foram analisados por meio das análises bivariada e multivariada por meio do programa estatístico SPSS (versão 18.0), com nível de significância de 5%. RESULTADOS: a prevalência de mordida aberta anterior foi de 12,1% entre as crianças investigadas. Aqueles pré-escolares residentes na região Sul do Brasil apresentaram uma chance 1,8 vezes maior de serem diagnosticados com a mordida aberta anterior (IC 95%: 1,16 - 3,02). As crianças identificadas com alguma alteração de sobressaliência tiveram 14,6 vezes mais chance de pertencer ao grupo de crianças com mordida aberta (IC 95%: 8,98 - 24,03). CONCLUSÃO: verificou-se que mordida aberta anterior apresentou associação significativa com a região brasileira em que as crianças viviam, com a presença de alguma alteração de sobressaliência e com a prevalência de mordida cruzada posterior. .

Oral health status of children in a community in northeastern Brazil

Objective: To assess the oral health status of public school students of São Francisco do Conde, Bahia. Material and Methods: Cross-sectional, descriptive and analytical?comparative study with 350 children aged 7-12 years of both sexes. Oral health was analyzed using indicators recommended by WHO: soft tissue condition, DMFT, dmft, CPI, dental fluorosis, and DAI, and analysis of dental care, salivary examinations, chronology of eruption of permanent teeth, frequency of tooth brushing and visits to the dentist. The results were analyzed using descriptive statistics and statistical tests ?t-Student, ?2, Fisher exact test, ANOVA, Tamhane and F Levene. Results: dmft and DMFT values of 1.45 and 0.53 were found, respectively. Among black (49.4%) and brown students (49.1%), 72.5 % had mixed dentition, 0.3% deciduous, and expected chronology of eruption of permanent teeth in 70.6 %, 56.3 % reported experiencing caries, 38.3% of children had fluorosis, 96.9% of individuals with normal saliva buffer capacity, while 23.2% had reduced salivary flow. CPI in children aged 12 years found that 79 % had healthy periodontium, no bleeding or presence of calculus. In relation to DAI, 21.1 % of children had normal or slightly altered occlusion and 71.5 % had some degree of malocclusion. Only 14.6 % of the sample reported not having had any contact with dentist and 38.6 % reported brushing their teeth three times a day or more. Conclusion: The oral health pattern of schoolchildren is satisfactory, requiring particular care with occlusion. The effectiveness of the results of this epidemiological survey allowed the adequacy of public policy actions on oral health in the municipality in which orthodontics service in the public network will be established...

Cárie dentária em crianças menores de cinco anos na cidade de Teresina - PI / Dental caries in children under five years old in Teresina-PI

Este estudo teve por objetivo avaliar a prevalência, severidade da cárie dentária e seus determinantes biológicos em crianças piauienses naturais de Teresina (PI), menores de cinco anos. Delineado como transversal ou de prevalência constituído por 1.536 crianças, de ambos os gêneros, na faixa etária de 5 a 60 meses e que buscaram multivacinação no dia 10 de junho de 2006. Foi aplicado questionário ao responsável e realizado exame clínico da cavidade bucal das crianças. O questionário continha informações relativas ao conhecimento dos pais ou responsáveis sobre a situação de saúde bucal das crianças, consumo diário de alimentos açucarados, tempo de amamentação noturna, inicio da higiene bucal e número de escovações diárias. As crianças foram examinadas nas dependências dos centros de vacinação, na posição joelho a joelho, sob luz natural. Observou-se que 1.157 (75,32%) crianças não apresentaram cárie dentária. Não houve diferença entre os gêneros com relação à prevalência ou severidade da doença. A prevalência de cárie variou de 0% em crianças menores de um ano a 52% nas de cinco anos, e a severidade, medida pelo índice ceo-d variou de 0 em menores de um ano a 2,13 dentes acometidos pela doença aos cinco anos. Não se observou diferença estatisticamente significante entre os grupos com e sem manifestação da doença quando analisados tempo de amamentação noturna, consumo de sacarose, número de escovações diárias e início da escovação. É necessário que os dados do presente estudo sirvam como referencia para a implementação de programas educativas destinados à essa faixa etária.

The aim of this study to assess the prevalence and severity of dental caries and its biological determinants in children under five years old in Teresina(PI) metropolitan area (PI). The study was designed as cross-sectional or a prevalence study. The sample consisted of 1,536 children of both genders, who were born in Teresina (PI), ranging from 5 to 60 months of age and who took part in a multivaccination campaign on 10 June 2006. A questionnaire was answered by the adult accompanying the child and a clinical examination of the children's oral cavity was carried out. The questionnaire was designed to collect information on the knowledge of the parent or caretaker about the children's oral health status, their daily consumption of sugary foods, night breast feeding length of time, when oral hygiene started and number of daily tooth-brushing. The children were examined at the premises of the vaccination centers in the knee-to-knee position, under natural lighting. It was found that 1,157 (75.32%) children were caries-free. There was no difference in the prevalence or severity of the disease between genders. The prevalence of caries ranged from 0% in children under one year old to 52% in the five year old ones; and severity, which was measured by dmf-t index, ranged from 0 in the less than one year old, to 2.13 on the five years old. There was no statistical difference between children with and without signs of the disease regarding night breast feeding length of time, sucrose consumption, number of daily tooth-brushing or when oral hygiene started. It is necessary that the data of this study are used as reference for the implementation of educational programs targeting this age group.