Factors associated with feeding practices among Brazilian children aged 12 to 23 months old / Fatores associados à prática alimentar de crianças brasileiras de 12 a 23 meses de vida

Abstract Objectives: a quantitative analytical cross-sectional study aimed to identify demographic characteristics to access health services and housing conditions in relation to inadequate feeding practices among Brazilian children from 12 to 23 months of age. Methods: the analysis of the feeding practices (consumption of recommended food groups) of 2541 Brazilian children (aged 12-23 months old) was performed using data from the Pesquisa Nacional de Saúde 2013 (National Health Survey). Descriptive and multivariate statistics used the Decision Tree Analysis based on CHAID (Chi-squared Automatic Interaction Detector) algorithm, as well as hierarchically adjusted Poisson regression analyses were performed. The variables were entered in a hierarchical model at distal (demographic), intermediate (access to health) and proximal (housing conditions) levels. Results: the results showed a high prevalence of sugar consumption (85.5%; CI95%=83.7-87.2) and highlighted inadequate feeding practices among non-white children (p=0.001), resident in the North (p<0.001) and Northeast (p=0.010) of Brazil and in towns in the countryside (p<0.001) presented feeding practices that were not recommended for consumption in the food groups. Conclusions: non-white children, who lived in the North and Northeast regions of Brazil and in the countryside, which are known to be more socioeconomically vulnerable, were more likely to experience inadequate feeding practices.

Resumo Objetivos: estudo transversal analítico, de natureza quantitativa buscou identificar características demográficas, de acesso aos serviços de saúde e de condições de moradia relacionadas à prática alimentar de crianças brasileiras de 12 a 23 meses de vida. Métodos: a partir dos dados da Pesquisa Nacional de Saúde 2013, as práticas alimentares de 2541 crianças brasileiras de 12 a 23 meses, foram analisadas quanto à recomendação de consumo dos grupos alimentares. A análise das características associadas às práticas alimentares foi realizada pela árvore de decisão usando o algoritmo CHAID (Chi-squared Automatic Interaction Detector) e análise de regressão de Poisson ajustada hierarquicamente. As variáveis foram inseridas em modelo hierárquico em níveis distal (demográficas), intermediário (acesso à saúde) e proximal (condições de moradia). Resultados: verificou-se uma alta prevalência no consumo de açúcar (85,5%; IC95%=83,7-87,2) e que crianças que não eram da cor branca (p=0,001), e residiam nas regiões Norte (p<0,001) e Nordeste (p=0,010) do país e em cidades do interior (p<0,001) apresentaram práticas alimentares que não atingem a recomendação de consumo dos distintos grupos alimentares. Conclusão: crianças que não eram da cor branca, residentes no Norte/Nordeste e no interior, áreas de maior vulnerabilidade do país, foram mais propensas à práticas alimentares inadequadas. Medidas para melhorar tais práticas devem abordar as desigualdades socioeconómicas e intervenções de promoção à saúde.

Fatores individuais associados à má oclusão em adolescentes / Individual factors associated to malocclusion in adolescents

Resumo O objetivo deste artigo foi identificar a severidade da má oclusão e fatores associados em adolescentes brasileiros. Foram analisados dados dos 5.445 adolescentes que participaram do inquérito nacional de saúde bucal (SB Brasil 2010), sendo que destes, 4276 permaneceram no estudo com base nos critérios de inclusão. A variável dependente foi má oclusão severa e muito severa, classificada pelo índice de estética dentária (DAI > 30). As variáveis independentes foram: local de moradia, macrorregião, cor da pele autorreferida, renda, sexo, escolaridade, acesso a serviço de saúde bucal, presença de cárie não tratada e dentes perdidos por cárie, anteriores e posteriores. Foi realizada analise de regressão logística múltipla hierarquizada considerando o plano amostral complexo de conglomerados. A prevalência de má oclusão severa e muito severa foi de 17,5%. Após ajustes, o grupo preto/pardo (OR1,59 IC95%1,09-2,34), a menor renda familiar (OR0,67 IC95%0,55-0,82), a perda por cárie de dentes anteriores (OR2,32 IC95%1,14-4,76) e posteriores (OR1,45 IC95%1,14-1,84) mostraram associação com o desfecho. Concluiu-se que o grupo pretos/pardos, os que possuem menor a renda familiar e os que têm mais dentes anteriores e posteriores perdidos por carie, apresentam maior a chance de ter má oclusão severa/muito severa.

Abstract The study aimed to identify the severity of malocclusions and associated factors among Brazilian adolescents. Data from 5,445 adolescents participating in the Brazilian Oral Health Survey (SBBrasil 2010) were evaluated, of which 4,276 were included in the study based on the inclusion criteria. The dependent variable was severe and very severe malocclusion, according to the Dental Aesthetic Index (DAI > 30). The independent variables were place of residence, macro-region, self-reported ethnicity, income, gender, schooling, access to dental care, untreated caries and front and back teeth loss due to caries. A hierarchical multiple logistical regression analysis was performed, considering the complex cluster sampling plan. Prevalence of severe/very severe malocclusions was 17.5%. After adjustments, black/brown ethnicity group (OR = 1.59, 95% CI: 1.09-2.34), lower household income (OR = 0.67, 95% CI: 0.55-0-82), front (OR = 2.32, 95% CI: 1.14-4.76) and back teeth (OR = 1.45, 95% CI: 1.14-1.84) loss due to caries were associated with the outcome. Therefore, we conclude that black/brown ethnicity, lower household income and greater number of front and back teeth loss due to caries increased the odds for severe/very severe malocclusion.

Self-perception of oral health among schoolchildren in a city of Amazonas, Brazil: related factors / Autopercepção em saúde bucal em escolares de uma cidade do Amazonas: fatores relacionados

ABSTRACT Objective: The association between self-perception in oral health, history of caries and sex was evaluated in students from São Gabriel da Cachoeira, in the Brazilian state of Amazonas. Methods: The sample was composed of 509 students enrolled in six public schools of the municipal and state education system. The epidemiological study was performed by a calibrated examiner (Kappa=0.98) using the DMF-T and dmf-t indices. Self-perception in oral health was measured using the CPQ8-10 Child Perceptions Questionnaire for children aged between 8 and 10 and the CPQ11-14 for children aged between 11 and 14, in which the domains were oral symptoms, functional limitation, emotional well-being and social well-being. Results: The significance of the associations between the variables was tested using bivariate analysis, and the associations that presented p-values lower than 0.20 (p<0.20) were tested using multiple logistic regression models, the intention being to keep those with p≤0.05. The group aged between 8 and 10 years showed a mean DMF-T of 0.82 (± 1.33) and dmf-t of 2.54 (± 2.59), whilst the group aged between 11 and 14 had a DMF-T of 2.08 (± 2.41) and dmf-t of 1.5 (± 1.77). Conclusion: Sex was the variable that most influenced the dimensions evaluated, followed by the oral condition. The presence of decayed teeth did not influence the children's self-perception about their oral health.

RESUMO Objetivo: Avaliar a associação entre a autopercepção em saúde bucal com a experiência de cárie e sexo em estudantes do município de São Gabriel da Cachoeira, Amazonas - Brasil. Métodos: A amostra foi composta por 509 alunos matriculados nas seis escolas públicas da rede municipal e estadual de ensino do município. O exame epidemiológico foi realizado por examinador calibrado (Kappa=0,98), utilizando-se os índices CPO-D e ceo-d e a autopercepção em saúde foi aferida utilizando-se os instrumentos Child Perceptions Questionnaire CPQ8-10 para as crianças entre 8 a 10 anos e CPQ11-14 para as crianças entre 11 a 14 anos, considerando-se os domínios sintomas orais, limitação funcional, bem-estar emocional e bem-estar social. Resultados: As significâncias das associações entre as variáveis foram testadas pela análise bivariada e as associações que apresentaram p-valor inferior a 0,20 (p<0,20) foram testadas nos modelos de regressão logística múltipla, permanecendo aquelas com p≤0,05. O grupo de 08 a 10 anos apresentou valor médio do CPO-D de 0,82 (± 1,33) e o ceo-d 2,54 (± 2,59), enquanto o grupo de 11 a 14 anos o CPO-D foi de 2,08 (± 2,41) e o ceo-d 1,5 (± 1,77). Conclusão: Conclui-se que o sexo foi a variável que mais influenciou nas dimensões avaliadas, seguida da condição bucal e que a presença de dentes cariados não influenciou a autopercepção das crianças sobre a sua saúde bucal.

Influence of Soft Drink Intake on the Salivary pH of Schoolchildren

Objective: To evaluate the influence of Coca-Cola® consumption on the salivary pH of 12-year old children. Material and Methods: The convenience sample was composed of forty-five 12-year old students of both genders from public schools of Itatiba, state of São Paulo, Brazil. Salivary pH was measured with pH colorimetric tape indicator (Merck). The reading of the colorimetric method was made by an experienced evaluator under uniform lighting conditions. The colorimetric tape was positioned in the back of the student's tongue, which remained with the mouth shut for 30 Seconds. For control, the first measurement (T0) was performed before the intake of the soft drink (baseline pH). Subsequently, students were instructed to slowly drink 100 ml of Coca-Cola® using a plastic disposable cup. Immediately after ingestion, the pH was measured again with the colorimetric tape (t1). The oral pH values were also measured 5 minutes (t2), 10 minutes (t3) and 15 minutes (t4) after the soft drink intake, keeping the tape positioning always the same in all measurements. The statistical SAS software was used for data analysis. Comparisons of oral pH values at different times were performed by the Tukey-Kramer test adopting 5% significance level. Results: Immediately after soft drink intake, the salivary pH significantly decreased (pH = 6.26) (p <0.05) compared to baseline (pH = 7.23) (p <0.05). Fifteen minutes after ingestion, although an increase in the pH was observed (pH = 6.64), it had not yet returned to baseline (T0) (p <0.05). Conclusion: Coca-Cola® intake caused a significant reduction in salivary pH, without, however, reaching critical pH for enamel demineralization.