Experience of Discrimination and Oral Health Self-Perception: A Cross-Sectional Study among Brazilian Adults.

This cross-sectional study investigated the association between experiences of discrimination and oral health self-perception among a probabilistic cluster sample of Brazilian adults who participated in the 2013 National Health Survey. Oral health self-perception was categorized into three groups (very good + good; fair; poor + very poor). Reported experiences of discrimination included attributions based on the respondent's race/skin color, social class, income, occupation, illness, sexual orientation, religion, sex, and age. Covariates included sociodemographic data, oral health conditions, access to healthcare services, health habits, mental health, and participation in social and/or religious activities. Data were analyzed using ordinal logistic regression for non-proportional odds, considering sample weights and complex samples. Among 60,202 adults, 5.84% perceived their oral health as poor + very poor, with a significantly higher proportion among those experiencing discrimination (9.98%). Adults who experienced discrimination were 1.39 times more likely to report a "poor/very poor/fair" oral health self-perception compared to those who did not experience discrimination. Those who suffered discrimination were 1.28 times more likely to have a "very poor/poor" oral health self-perception than their counterparts who were not affected by discrimination. These findings underscore the importance of considering discrimination experiences as part of the social determinants influencing oral health.

Intersectoral Collaboration to Promote Child Development: The Contributions of the Actor-Network Theory.

An integrated intersectoral care model promises to meet complex needs to promote early child development and address health determinants and inequities. Nevertheless, there is a lack of understanding of actors' interactions in producing intersectoral collaboration networks. The present study aimed to analyze the intersectoral collaboration in the social protection network involved in promoting early child growth and development in Brazilian municipalities. Underpinned by the tenets of actor-network theory, a case study was conducted with data produced from an educational intervention, entitled "Projeto Nascente." Through document analysis (ecomaps), participant observation (in Projeto Nascente seminars), and interviews (with municipal management representatives), our study explored and captured links among actors; controversies and resolution mechanisms; the presence of mediators and intermediaries; and an alignment of actors, resources, and support. The qualitative analysis of these materials identified three main themes: (1) agency fragility for intersectoral collaboration, (2) attempt to form networks, and (3) incorporation of fields of possibilities. Our findings revealed that intersectoral collaboration for promoting child growth and development is virtually non-existent or fragile, and local potential is missed or underused. These results emphasized the scarcity of action by mediators and intermediaries to promote enrollment processes to intersectoral collaboration. Likewise, existing controversies were not used as a mechanism for triggering changes. Our research supports the need to mobilize actors, resources, management, and communication tools that promote processes of interessement and enrollment in favor of intersectoral collaboration policies and practices for child development.

Income- and education-based inequalities of edentulism and dental services utilization in Brazil.

OBJECTIVE: Tooth loss is a worldwide public health problem affecting mainly socioeconomically disadvantaged groups. Dental services utilization may increase access to preventive actions and conservative treatment, reducing the prevalence of tooth loss. This study evaluated the income- and education-based inequalities in edentulism according to the utilization of dental services among adults and older adults in Brazil. METHODS: Data from the National Oral Health Survey (SB Brazil, 2010) of adults (ages 35-44 years, n = 9779) and older adults (ages 65-74 years, n = 7619) were analysed. Socioeconomic indicators (SES) included education and income. The magnitude of inequality in edentulism by education and income levels was estimated by the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The changes in the RII and SII according to the utilization of dental services were estimated. Regression models estimated the association between SES and edentulism and whether dental services utilization modified this association. RESULTS: Higher edentulism prevalence was observed among those with lower education and income levels. The utilization of dental services changed the education-based inequality index in edentulism for adults, with percentage changes of 17.4% (RII) and 56.8% (SII). For adults with low education (0-4 years of study), the odds of edentulism were 80% (OR 0.2; 95% CI 0.1-0.6) and 90% (OR 0.1; 95% CI 0.01-0.2) lower for those who had used dental services within the preceding year and within 1-2 years compared with those who had used such services within the preceding 3 or more years, respectively. CONCLUSION: There was a social gradient in the prevalence of edentulism in adults and older adults, and the education-based inequalities in edentulism were lower among adults reporting utilization of dental services in the preceding year.

Association between Dentin Hypersensitivity and Health/Oral Health-related Quality of Life: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To investigate the association between DH and Health (HRQoL) or Oral Health-Related Quality of Life (OHRQoL). Material and Methods: PubMed, Web of Science, Scopus, EMBASE, Cochrane, Scielo, LILACS/BBO, Biblioteca Digital de Teses e Dissertações (BDTD), Open Grey, and Google Scholar databases were screened in September 2019 (updated in October 2022). Observational studies were selected to compare HRQoL/OHRQoL(outcome) according to DH(exposure) or evaluate the association among these variables. Standardized Joanna Briggs Institute critical appraisal tool for analytical cross-sectional studies was used to analyze the risk of bias. A random-effects meta-analysis was conducted to synthesize evidence for the association between DH and OHRQoL. Results: 10 papers met inclusion criteria and were evaluated. In most studies, presenting or having a greater intensity of DH was associated with a negative impact on one's quality of life. However, most of these studies showed a moderate to high risk of methodological bias. The consistent finding from studies with a low risk of bias suggests a significant association between DH and OHRQoL. Meta-analysis was feasible for three studies with substantial heterogeneity. The pooled Odds Ratio was 2.14 (95%CI 1.15-3.99; I2= 57,44%). Conclusion: Many studies presented a high risk of bias; therefore, the actual effect of DH on one's quality of life remains uncertain.

Hipersensibilidade dentinária e satisfação com a saúde mediada pela presença de impacto físico e psicossocial das condições bucais: uma análise de caminhos / Dentin hypersensitivity and health satisfaction mediated by the presence of physical and psychosocial impacts of oral conditions: a pathway analysis

Objetivo: Objetivou-se investigar associação direta e mediada pela presença de impacto físico e psicossocial das condições bucais entre HD e satisfação com a saúde entre adultos. Métodos: Estudo transversal foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos residentes em Rio Acima (MG). Entrevista e exame bucal foram realizados por examinadoras calibradas. Satisfação com a saúde foi avaliada por meio da pergunta doWHOQoL-bref "Quão satisfeito (a) você está com a sua saúde?" e suas respostas categorizadas entre "satisfeito" e "insatisfeito". HD foi avaliada por estímulo tátil na região cervical dos dentes. Presença de impactos físicos e psicossociais das condições bucais foi definida pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do OHIP-14. Covariáveis foram dados sociodemográficos e econômicos, comportamentos em saúde, condições de saúde bucal e uso de serviços odontológicos. Associações foram investigadas por modelos de Regressão de Poisson e Modelagem de Equações Estruturais (MEE) para estimar associações diretas e indiretas (Stata 16). Resultados: Dos 197 adultos, 132 (66,18%) declararam estar satisfeitos com sua saúde e 73 indivíduos (38,75%) apresentavam HD. Houve associação significativa entre presença de HD e presença de impacto físico e psicossocial das condições bucais (RP: 1.34; IC 95%: 1.08­1.67), enquanto para satisfação a associação com HD não foi significativa (RP: 1.08; IC 95%: 0.75-1.54) após a inclusão da variável presença de impacto físico e psicossocial das condições bucais. MEE demonstrou associação direta não significativa entre HD e satisfação, enquanto a associação indireta mediada pela presença de impacto físico e psicossocial das condições bucais foi significativa. Conclusão: Indivíduos com HD podem relatar maior insatisfação com a vida quando esta experiência dolorosa está associada com impactos físicos ou psicossociais.

Aim: Dentin Hypersensitivity (DH) is a painful condition that affects the Oral Health-related Quality of Life and can affect the satisfaction with health of individuals who have it. This study aimed to investigate the direct association mediated by the presence of physical and psychosocial impacts of oral conditions between DH and satisfaction with health among adults. Methods: A cross-sectional study was carried out between 2018-2019 with a probabilistic sample consisting of a cluster of adults living in Rio Acima (MG). Interviews and epidemiological examinations were performed using calibrated tests. The dependent variable of satisfaction with health was assessed using the WHOQoL-bref question "How satisfied are you with your health?" Participants' answers were categorized between "satisfied" and "dissatisfied". The independent DH variable was assessed by tactile stimulation in the cervical region of the teeth. The presence of physical and psychosocial impacts of oral conditions was defined by the answers "farly often" or "very often" to at least one of the OHIP-14 items. Covariates were sociodemographic and psychological data, health behavior, oral health conditions, and use of dental services. Associations were investigated by Poisson Regression and Structural Equation Modeling (SEM) models to estimate direct and indirect associations (Stata 16). Results: Of the 197 adults, 132 (66.18%) reported being satisfied with their health, and 73 individuals (38.75%) had DH. There was a significant association between the presence of DH and the presence of physical and psychosocial impacts of oral health (PR:1.34; 95% CI: 1.08­1.67), while for receiving the association with DH, it was not significant (PR:1 .08; 95% CI: 0.75-1.54) after including the presence of impact variables. SEM showed a non-significant direct association between DH and satisfaction, while the indirect association mediated by the presence of impact was significant. Conclusion: Individuals with HD may report greater dissatisfaction with life when this painful experience is associated with physical or psychosocial effects.

Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral-health related quality of life among Brazilian adults.

OBJECTIVES: To assess the association between dentin hypersensitivity (DH) (with or without non-carious cervical lesions (NCCL)) and physical and psychosocial oral health impact. METHODS: A cross-sectional population-based study with one-stage random sample of adults living in a Brazilian municipally was conducted between 2018 and 2019. Interviews and oral examinations were performed by calibrated examiners (Kappa ≥0.7). The participant was considered as having physical and psychosocial impact if at least one item of the Oral Health Impact Profile (OHIP-14) was experienced fairly often or very often. NCCL was assessed by the Tooth Wear Index (codes 2 to 4) and DH was evaluated by a tactile test with a probe in the cervical area of teeth. The combination of these clinical variables resulted in categories of the independent variable: without DH or NCCL, NCCL without DH, DH without NCCL, and both DH with NCCL. The covariables were sociodemographic and economic factors, health habits, and oral conditions. Associations were investigated by Poisson Regression models using Direct Acyclic Graph (Stata 17). RESULTS: Of 197 adults, 59.3% had oral health impact and 31.3% had DH with NCCL. Higher frequency of oral health impact was observed in adults with DH alone. A higher impact on the physical pain dimension of the OHIP-14 was observed in adults with DH and NCCL (PR: 2.46; 95% CI: 1.21-5.00) and with DH alone (PR: 2.03; 95% CI: 1.21-3.41). CONCLUSION: NCCL and DH are common conditions in adults and the presence of DH is associated with higher oral health impact. Regardless the presence of NCCL, DH is associated with the physical pain dimension of OHRQoL.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil.

This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil

Abstract This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Prevalência e gravidade de lesões cervicais não cariosas e hipersensibilidade dentinária: associação com qualidade de vida entre adultos / Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with quality of life in adults

A mudança do perfil epidemiológico da saúde bucal graças à diminuição da cárie dentária e doença periodontal, o envelhecimento da população e a manutenção dos dentes por mais tempo em boca têm contribuído para o aparecimento de outras condições bucais e o impacto destas na qualidade de vida (QV) dos indivíduos. Dentre elas, os desgastes das superfícies dentárias localizadas na região cervical, conhecidas como Lesões Cervicais Não Cariosas (LCNC) e, a Hipersensibilidade Dentinária (HD) relacionada à exposição dentinária, na presença ou não de desgastes, têm etiologia multifatorial. Observa-se uma lacuna na literatura sobre estudos epidemiológicos de base populacional que investiguem a associação entre HD, na presença ou não de desgastes dentários, e presença de impactos na QV dos indivíduos, levando em consideração possíveis fatores de confusão que podem interferir nessa associação. Este trabalho avaliou a associação entre HD com ou sem LCNC e a presença de impactos bucais nas atividades diárias. Estudo transversal analítico, de base populacional e natureza quantitativa foi realizado entre 2018-2019 com amostra probabilística por conglomerado de adultos (30-50 anos) residentes em Rio Acima (MG). Entrevista e exame epidemiológico foram realizados por examinadoras calibradas (Kappa >0,7). A variável dependente foi a presença de impactos bucais, caracterizada pelas respostas "repetidamente" ou "sempre" a pelo menos um dos itens do Oral Health Impact Profile (OHIP-14) ou em cada uma de suas dimensões. Diagnóstico e gravidade das LCNC foram identificados pelo Índice de Desgaste Dentário e sua prevalência pelos códigos 2, 3 e 4. A HD foi avaliada por estímulo tátil com sonda e gravidade registrada por Escala Visual Analógica em três níveis: leve (1-2); moderada (2-7); e, intensa (8-10). A combinação das duas variáveis clínicas resultou nas seguintes categorias da variável independente: sem LCNC e sem HD; com LCNC e sem HD; sem LCNC e com HD; e, com LCNC e HD. As covariáveis referiam-se a dados sociodemográficos (idade, sexo e cor autodeclarada) e econômicos (escolaridade e renda familiar mensal), hábitos e comportamentos em saúde (uso de medicamentos, frequência de escovação, dieta, tabagismo e consumo de bebidas alcóolicas) e condições de saúde bucal (sintomas de disfunção temporomandibular, cárie dentária e doença periodontal). Associações foram investigadas por modelos de regressão bruta e ajustada, com correção pelo efeito de desenho e pesos amostrais e um diagrama acíclico direto (DAG) foi elaborado para orientar o ajuste do modelo (Stata 17). Da amostra de 197 adultos, 59,3% (IC95%: 50,5 -67,5) apresentaram impacto das condições bucais nas atividades diárias e 31,3% (IC95%: 22,7 -41,4) apresentavam LCNC e HD concomitantemente. Maior frequência de impacto na dimensão dor física foi observada em adultos com HD com LCNC (RP: 2,46; IC 95%: 1,21 -5,00) e sem LCNC (RP: 2,03; IC 95%: 1,21-3,41). A HD, independentemente da presença de LCNC, é percebida como uma dor devido a problemas bucais e pode afetar a seleção dos alimentos

The change in epidemiological profile of oral health thanks to the reduction of dental caries and periodontal disease, populations' aging, and maintenance of teeth for longer have contributed to the arising of other oral conditions and their impact on quality of life(QoL). Amongst them, tooth wear on the cervical area of teeth, known as Non-Carious Cervical Lesion (NCCL), and Dentin Hypersensitivity (DH) related to dentine exposure, related or not to tooth wear, have a multifactorial etiology. There is a gap in the literature on population-based epidemiological studies that investigate the association between DH, in presence or not of tooth wear, and the presence of impacts on the QoL of individuals, taking into account possible confounding factors that may interfere with this association. The aim of the study was to assess the association between DH, presence or absence of NCCL and oral impacts on daily activities. A cross-sectional study was conducted between 2018 and 2019 with a probabilistic sample of adults (30 to50 years old) residing in a small Brazilian city. Interview and epidemiological exam were performed by calibrated examiners (Kappa > 0.7). The dependent variable was the present of oral impacts, assessed by at least one impact "fairly often" and "very often" in one of dailyactivities, assessed by the validated version in Brazil of the Oral Health Impact Profile (OHIP-14). The Tooth Wear Index was used to assess the prevalence (codes 2, 3 and 4) and severity of NCCL. Tactile stimulus with probe in the cervical area of teeth was the method for DH diagnostic, with severity recording using a Visual Analogue Scale: mild (1-2); moderate (2-7); and intense (8-10). The combination of both clinical variables resulted in the following categories of independent variables: without NCCL,without DH; with NCCL, without DH; without NCCL, with DH; and with NCCL, with DH. The adjusted variables referred to sociodemographic data (age, sex and self-reported color), socioeconomic factors (education and monthly family income), habits and behaviors in health (use of medication, brushing frequency, diet, smoking and alcohol consumption) and oral health conditions (symptoms of temporomandibular disorders, dental caries and periodontal disease). Associations were investigated by crude and adjusted Poisson regression models using a Direct Acyclic Graph (Stata 17). Of the total sample of 197 adults, 59.3%(CI95%: 50,5 ­67,5)had impact of oral conditions in daily activities and 31.3%(CI95%: 22,7 ­41,4)had NCCL and DH, simultaneously. Higher frequencyof impact on physical pain dimension was observed in adults with DH and NCCL(PR: 2.46; 95% CI: 1.21-5.00) and without LCNC (PR: 2.03; 95% CI: 1.21-3.41). Independently of presence or absence of NCCL, DH is perceived as a pain due to oral problems andcan affect the food selection.

Organização e resolutividade dos serviços públicos odontológicos para a atenção em saúde bucal de pré-escolares: estudo em dois municípios brasileiros / Organization and resolubility of public dental services to the oral health care of preschool children: study of two Brazilian cities

Objetivo:Descrever a organização e a resolutividade da rede pública de saúde para a atenção em saúde bucal de crianças de zero a seis anos em dois municípios brasileiros. Métodos:Estudo transversal descritivo realizado com dados secundários dos prontuários de crianças atendidas pelos serviços de saúde bucal [convencional ou Equipes de Saúde Bucal (ESB)] nos municípios de Belo Horizonte, 2014, e Diamantina, em 2015, Minas Gerais, Brasil. A resolutividade foi avaliada pela relação entre os percentuais de Tratamento Odontológico Concluído (TC) e de Primeira Consulta (PC). Nos dois municípios, a Estratégia Saúde da Família (ESF) é o modelo de organização dos serviços da Atenção Primária à Saúde (APS). Em Belo Horizonte, amostra representativa das crianças foi selecionada entre aquelas examinadas no Levantamento de Necessidades pelas ESB em 18 das 147 Unidades Básicas de Saúde (UBS). Em Diamantina, a organização do atendimento odontológico é o convencional e se dá por livre demanda, sendo realizado em quatro das sete UBS. Análise descritiva dos dados foi realizada para obtenção de frequências absolutas e relativas. Resultados:Foram analisados 1.344 prontuários em Belo Horizonte, 595 deles de crianças (44,27%) tiveram PC. Destas, 295 (21,95%) tiveram TC, com resolutividade de 49,58%. No município de Diamantina, todos os 43 prontuários odontológicos de crianças encontrados nas UBS com atendimento odontológico foram avaliados. Destas, 29 crianças (67,44%) tiveram a PC e 11 (25,58%) TC, representando resolutividade de 37,93%. Conclusão:Há diferenças na organização e no modelo de atenção em saúde bucal para crianças nos municípios estudados. Para os dois municípios, o acesso e a resolutividade das crianças ao cuidado em saúde bucal se constituem em desafios para os serviços públicos de saúde na APS. (AU)

Objective: to describe the organization and resolution of the public health network for the oral health care of children from zero to six years of age in two Brazilian cities. Methods: a descriptive cross-sectional study was carried out with secondary data from the charts of children who received dental care by oral health services [conventional or Oral Health Teams] in the cities of Belo Horizonte, in 2014, and Diamantina, in 2015, Minas Gerais, Brazil. The resolution was evaluated by the ratio between the percentages of Completed Treatment and First Appointment. In both cities, the Family Health Strategy is the organizational model of PHC services. In Belo Horizonte, a representative sample of the children was selected among those examined by the Oral Health Teams' survey of needs in 18 of the 147 Health Centers. In Diamantina, the dental care organization is conventional and occurs on demand, and is performed in four of the seven Health Centers. Descriptive data analysis was performed to obtain absolute and relative frequencies. Results: A total of 1,344 medical records were analyzed in Belo Horizonte, 595 of which were children (44.27%) who had their First Dental Appointment. Of these, 295 (21.95%) presented Completed Dental Treatment, with a resolution of 49.58%. In the municipality of Diamantina, all 43 children's dental records found in the Health Center that contained dental care were evaluated. Of these, 29 children (67.44%) had their First Dental Appointment and 11 (25.58%) Completed Dental Treatments, representing a resolution of 37.93%. Conclusion: Differences were found in the organization and model of oral health care for children in the studied municipalities. For both municipalities, children's access and resolution in Oral Health constitute challenges for public health services in Primary Health Care. (AU)

Dependence on others for oral hygiene and its association with hand deformities and functional impairment in elders with a history of leprosy.

OBJECTIVE: To analyse the frequency of dependence on others for oral hygiene and its association with hand deformities, frailty and dependence on others for basic activities of daily living (BADL) among elders with a history of leprosy. BACKGROUND: Dependence on others for oral hygiene has not been considered in multifunctional geriatric assessments. MATERIAL AND METHODS: Edentulous elders with a history of leprosy who used complete dentures and resided in a former leprosy colony were classified as independent or partially/completely dependent on others for brushing their dentures or rinsing and for BADL, and as frail or robust. The presence of hand deformities was assessed by an occupational therapist. RESULTS: 28.4% and 14.9% were completely/partially dependent on others for brushing and rinsing, respectively. The dependence for BADL was observed in 21.6% and hand deformities in 17.6%. A higher odds of dependence for brushing/rinsing was found among elders who were dependent on others for BADL. Brushing dependence (61.5%) was more frequent among participants with hand deformities than those without this condition (21.3%) (OR: 6.8; 95% IC: 1.2-37.9; P = .028). There was no association between frailty and brushing (P = .068) or rinsing (P = .202) dependence. CONCLUSION: Approximately one-third of elders have a dependence on others for brushing; a smaller proportion is dependent on others for rinsing. Older people who are dependent on others for BADL and who present hand deformities are more likely to be dependent on others for denture brushing and rinsing. Elders may perform oral self-care even when they present frailty.

Assessment of the way in which entries are filled out in Child Health Records and the quality of the entries according to the type of health services received by the child. / Avaliação do preenchimento da Caderneta de Saúde da Criança e qualidade do preenchimento segundo o tipo de serviço de saúde usado pela criança.

The scope of this study was to assess the way Child Health Records (CHRs) are filled out and the association between the quality of entries and type of service used to monitor the health of children. It involved a cross-sectional study with a stratified sample - proportional for the nine Health Districts of Belo Horizonte, State of Minas Gerais - of 3- to 5-year-old children selected on Child Vaccination Campaign Day in 2014. Interviews with parents including observation of the 21 CHR items were conducted. The dependent variable was defined by the quality of the CHR entry (satisfactory/unsatisfactory), where satisfactory entries were > 60%. The independent variables were the type of service for monitoring child health, demographic and health conditions of the mother and child and healthcare treatment received by the child, with the participation of 367 (96.10%) parents. The prevalence of unsatisfactory entries was 55.5%. No significant association was found between quality of entry and type of healthcare. Unsatisfactory entries were associated with gestational age < 37 weeks, lack of access to information about the CHR and the absence of parental entries on the CHR. The CHR has been unsatisfactorily employed as a tool for monitoring health, irrespective of the type of service used by the child.

Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Avaliação do preenchimento da Caderneta de Saúde da Criança e qualidade do preenchimento segundo o tipo de serviço de saúde usado pela criança / Assessment of the way in which entries are filled out in Child Health Records and the quality of the entries according to the type of health services received by the child

Resumo Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Abstract The scope of this study was to assess the way Child Health Records (CHRs) are filled out and the association between the quality of entries and type of service used to monitor the health of children. It involved a cross-sectional study with a stratified sample - proportional for the nine Health Districts of Belo Horizonte, State of Minas Gerais - of 3- to 5-year-old children selected on Child Vaccination Campaign Day in 2014. Interviews with parents including observation of the 21 CHR items were conducted. The dependent variable was defined by the quality of the CHR entry (satisfactory/unsatisfactory), where satisfactory entries were > 60%. The independent variables were the type of service for monitoring child health, demographic and health conditions of the mother and child and healthcare treatment received by the child, with the participation of 367 (96.10%) parents. The prevalence of unsatisfactory entries was 55.5%. No significant association was found between quality of entry and type of healthcare. Unsatisfactory entries were associated with gestational age < 37 weeks, lack of access to information about the CHR and the absence of parental entries on the CHR. The CHR has been unsatisfactorily employed as a tool for monitoring health, irrespective of the type of service used by the child.

Use and resolubility of the oral health public services offered to children in a large municipality / Uso e resolutividade de serviços públicos de saúde bucal ofertados a crianças em município de grande porte

ABSTRACT Objective: To evaluate the effect of caries severity and socioeconomic conditions on use of oral health services and treatment situations (completed treatment, evasion, referral) among children with dental treatment needs, using the Unified Health System. Methods: Cross sectional study performed among children up to six years old, with dental treatment needs, coming from public schools in Belo Horizonte, Brazil, examined by the Oral Health Teams in the annual survey of oral health, in 2014. Variables were collected by consulting the medical records and information systems. Services were used by children who had attended the dental appointment at least once. The severity of caries considered the number of cavitated teeth. The socioeconomic variables were: age, sex, skin color and family socioeconomic classification. Resolubility was assessed by the ratio between completed treatment and first appointment. Evasion was defined by absence in more than two consecutive unjustified appointments. Association was tested by chi-square test and Poisson regression. Results: The frequency of services use was 44.3% and there was greater use by children with treatment needs in 4 to 8 teeth (PR=1.48, 1.23-1.78) and in more than 9 teeth (PR=1.80, 1.32-2.46) and lower in those with very high socioeconomic risk (PR = 0.79, 0.63-0.99). The resolubility was of 49.6% and 5.2% abandoned the treatment. Children with lower socioeconomic status presented lower resolubility and greater avoidance. Conclusion: The results suggested a persistent iniquity, with less use and resolubility of oral health services among children presenting worse socioeconomic status.

RESUMO Objetivo: Avaliar o efeito da gravidade da cárie e das condições socioeconômicas no uso dos serviços de saúde bucal e nas situações de atendimento (tratamento concluído, evasão, encaminhamento) entre crianças com necessidade de tratamento odontológico usuárias do Sistema Único de Saúde. Métodos: Estudo transversal entre crianças de até 6 anos de escolas públicas infantis, de Belo Horizonte, examinadas pelas Equipes de Saúde Bucal no levantamento anual de necessidades em saúde bucal de 2014. Foram incluídas as crianças com necessidade de tratamento odontológico. Variáveis foram coletadas por consulta ao prontuário e sistemas de informação. Usaram os serviços as crianças que compareceram pelo menos uma vez, em 2014, à consulta odontológica. A gravidade da cárie considerou o número de dentes cavitados e as variáveis socioeconômicas foram: idade, sexo, cor da pele e classificação socioeconômica da família. Resolutividade foi avaliada pela razão entre tratamento concluído e primeira consulta. Evasão foi definida pela ausência por > 2 consultas consecutivas sem justificativa. Associação foi testada por teste chi-quadrado e Regressão de Poisson. Resultados: A frequência de uso de serviços foi 44,3% e houve maior uso nas crianças com necessidade de tratamento em 4 a 8 dentes (RP=1,48; 1,23-1,78) e em > 9 dentes (RP=1,80; 1,32-2,46) e menor naquelas com muito elevado risco socioeconômico (RP=0,79; 0,63-0,99). A resolutividade foi de 49,6% e 5,2% evadiram. Crianças com pior nível socioeconômico apresentaram menor resolutividade e maior evasão. Conclusão: Sugere-se uma iniquidade persistente, com menor uso e resolutividade dos serviços de saúde bucal entre crianças com pior condição socioeconômica.

Oferta de próteses dentárias na Atenção Primária à Saúde de 2010 a 2016 em Belo Horizonte, Minas Gerais / Supply of dental prostheses in Primary Health Care from 2010 to 2016 in Belo Horizonte, Minas Gerais

Objetivo: O objetivo do presente estudo foi descrever a implementação e oferta de próteses totais removíveis (PT) na Atenção Primária à Saúde (APS) entre 2010-2016, no município de Belo Horizonte (BH). Métodos: Pesquisa documental na nota técnica sobre oferta de PT no Sistema Único de Saúde; legislações e dados sobre credenciamento de Laboratórios Regionais de Prótese Dentária (LRPD) em BH e protocolo para Atenção em Saúde Bucal do município. Com base no consolidado de produtividade das Unidades Básicas de Saúde (UBS) e na nota técnica "Oferta de Prótese Dentária na Rede SUS-BH", 2012, obteve-se o número de próteses ofertadas de 07/2010 a 07/2016 e as taxas de oferta, considerando-se a população estimada com necessidade de PT. Resultados: Em 2004, a Política Nacional de Saúde Bucal instituiu a oferta de próteses na APS. Em 2006, o Protocolo para Atenção em Saúde Bucal definiu a oferta de próteses parciais e totais removíveis em acrílico na APS. Em 2008, houve edital de credenciamento de LRPD. Em 2010, iniciou-se a oferta de PT e houve credenciamento de um LRPD. Cursos de capacitação e suporte por tutor especialista foram disponibilizados. Em 2016, cento e quarenta e oito UBS estavam capacitadas para produção de PT, que foi de 900 próteses em 2010 e 4.573 em 2016, totalizando 25.784 PT ofertadas à população. O aumento foi de 87,6% de 2011 para 2012 e de 44,7% de 2012 para 2013; de 2013 para 2014 reduziu 1,2% e cresceu 15,2% de 2014 para 2015. Houve um aumento nas taxas de produção anual e mensal de próteses. Conclusão: Houve uma ampliação da oferta de PT pela APS de BH. A tutoria e os cursos de capacitação favoreceram a adesão e aperfeiçoamento dos cirurgiões-dentistas na oferta desse serviço.(AU)

Aim: To describe the implementation and supply of total removable dentures (PT) in Primary Healthcare (PHC) between the years of 2010 and 2016 in the city of Belo Horizonte (BH), Brazil. Methods: Documentary research in technical notes on the supply of dental prostheses in the Brazilian Unified Health System (SUS); legislations and data on the accreditation of Regional Dental Prosthesis Laboratories (LRPD) in BH; and protocol for Oral Healthcare in BH. The number of dentures provided from 07/2010 to 07/2016 was obtained based on the consolidated productivity of Basic Health Units (UBS) and the technical notes of "Supply of Dental Prosthesis in the SUS-BH Network" (2012). Results: In 2004, the National Oral Health Policy instituted the supply of prostheses in PHC. In 2006, the Protocol for Oral Healthcare defined the supply of partial and total removable acrylic dentures in PHC. In 2008, there was a bidding process for LRPD accreditation. In 2010, PT began to be provided, and LRPD was accredited. Training and support courses by specialist tutors were provided. In 2016, one hundred fortyeight UBSs were qualified to produce PT, which reached 900 prostheses in 2010 and 4,573 in 2016, with a total of 25,784 PTs offered to the population. The increase was of 87.6% from 2011 to 2012 and of 44.7% from 2012 to 2013; from 2013 to 2014, this number decreased by 1.2%, while it increased 15.2% from 2014 to 2015. Conclusion: There was an expansion of the PTs provided by APS in BH. Tutoring and training courses favored the adherence and improvement of dentists in providing this service.(AU)