O acesso à prótese dentária na atenção primária no Brasil / Access to dental prosthesis in primary care in Brazil / Acceso a prótesis dental en atención primaria en Brasil

Este artigo tem como objetivo avaliar o acesso à prótese dentária na Atenção Primária em Saúde (APS) no Brasil. É um estudo transversal, em que foram utilizados dados do Programa de Melhoria do Acesso e da Qualidade Atenção Básica (PMAQ-AB), segundo e terceiro ciclos, com enfoque em saúde bucal e atendimento à prótese dentária por estado brasileiro. Ao comparar as Unidades Básicas de Saúde (UBS) que fazem instalações de prótese nos dois ciclos de avaliação, foi observada diferença estatisticamente significativa (teste Mann Whitney, p = 0,04), mostrando maior número de instalações no terceiro ciclo. O percentual de UBS que instalavam prótese dentária no segundo ciclo foi de 8,4% e no terceiro ciclo, 14,1%. Ao se avaliar os locais em que os pacientes fizeram a prótese dentária, verifica-se que a maioria fez suas próteses no serviço privado. Conclui-se, então, que a APS não consegue suprir a demanda por prótese dentária.

This cross-sectional study evaluates access to dental prosthesis in Primary Health Care (PHC) in Brazil. Data were obtained from the Access and Quality Improvement Program (PMAQ-AB), second and third cycles, focusing on oral health and dental care provided by the Brazilian State. Comparison of the Basic Health Units (BHU) that perform prosthesis installations in the two evaluation cycles (Mann Whitney test, p = 0.04) revealed a statistically significant difference, showing a greater number of installations in the third cycle. In the second and third cycles 8.4% and 14.1% of UBS, respectively, installed dental prostheses. When evaluating where patients acquired their dental prosthesis, most sought the private service. In conclusion, PHC cannot meet the demand for dental prosthesis.

Este artículo tuvo por objetivo evaluar el acceso a las prótesis dentales en la atención primaria de salud (APS) en Brasil. Se trata de un estudio transversal que utiliza datos del Programa de Mejoramiento del Acceso y Calidad de la Atención Primaria (PMAQ-AB, por sus siglas en portugués), segundo y tercer ciclo, con foco en salud bucal y atención con prótesis dental por estado brasileño. Al comparar las Unidades Básicas de Salud (UBS) que instalan prótesis en los dos ciclos de evaluación, se observó diferencia estadísticamente significativa (prueba de Mann Whitney, p = 0,04), con un mayor número de instalaciones en el tercer ciclo. El 8,4% de las UBS instalaron prótesis dental en el segundo ciclo, y el 14,1% en el tercer ciclo. En cuanto a los locales donde los pacientes hicieron su prótesis dental, la mayoría fue realizada por el servicio privado. Se concluye que la APS no logra satisfacer la demanda de prótesis dentales.

Assessment of bulk-fill of resins microhardness longitudinal

Aim: This study aimed to assess the polymerization effectiveness of bulk-fill composite resins in longitudinal microhardness. Methods: Blocks of bulk-fill composite resin with thicknesses of 6 mm were analyzed with Vickers microhardness. The resin blocks were divided into two groups (n=6): resin AURA and OPUS. The microhardness test was performed before (base and top) and after (longitudinal microhardness) sectioning the blocks at distances of 2 mm, 4 mm, and 6 mm from the top of the block. The mean microhardness values were tabulated and subjected to ANOVA followed by Tukey's test (p<0.05). Results: The OPUS bulk-fill resin samples presented microhardness means of 55.9 kgf/mm2, 53.7 kgf/mm2, and 49.3 kgf/mm2, the AURA bulk-fill resin samples presented microhardness means of 57,02 kgf/mm2, 55,86 kgf/mm2 e 51,77 kgf/mm2 for the distances of 2 mm, 4 mm, and 6 mm, respectively. Tukey's statistical test showed a significant difference in microhardness values at different distances of 2 mm, 4 mm, and 6 mm (p<0.001) for each resin. Although there was a statistically significant difference within and between the groups assessed, all samples showed polymerization effectiveness when comparing the top and base of the block. Conclusion: Polymerization was effective in different thicknesses (2 mm, 4 mm, and 6 mm) in both resins studied. The microhardness ratio was adequate when comparing the base and top

Perfil epidemiológico dos pacientes com necessidades especiais em Sergipe / Epidemiological profile of patients with special needs in Sergipe

Introdução:No Brasil, em 2010, aproximadamente 24% da população apresentava algum tipo de deficiência e 25% da população no estado de Sergipe. Devido a tal demanda, em 2004, foi criada a Política Nacional de Saúde Bucal que, entre outras, foi instituída o atendimento em nível secundário em saúde para as Pessoas com Deficiência (PD). Objetivo:Verificar o perfil das PD atendidas no Centro de Especialidades Odontológicos (CEO) de São Cristóvão/SE e os procedimentos odontológicos mais realizados. Materiais e métodos:Para tal, foram analisados os prontuários dos PD atendidos no período de janeiro de 2019 até setembro de 2022. Resultados:Foi verificado que houve atendimento em 2019 de 101 pacientes, 2020 de 71 pacientes, 2021 em 33 pacientes e, em 2022, 87 pacientes. Acidade de origem dos PD é em 68,7 % do município sede do CEO (São Cristóvão). Sobre o diagnóstico dos pacientes, os mais prevalecentes foram autismo (10%), seguido de síndrome de Down (4%) e paralisia cerebral (4%). Do total de procedimentos realizados, 160 ATF (Aplicação Tópica de Flúor), seguido por 148 profilaxias, 116 adequações do meio bucal, 138 exodontias, 98 restaurações com resina, 58 restaurações com amálgama, 111 atendimentos de periodontia (raspagem e alisamento radicular) e 45 orientações de higiene oral. Conclusões: Diante dos dados, observou-se que o CEO de São Cristóvão se comporta com predomínio de atendimentos de seus munícipes e ainda há alta prevalência de atendimento de exodontias.

O impacto do isolamento social no ensino a distância em cursos da área de saúde / The impact of social isolation on distance learning in healthcare courses

Resumo Introdução O conceito de qualidade de vida é multidimensional, apresenta uma organização complexa e dinâmica dos seus componentes, difere de pessoa para pessoa de acordo com seu ambiente/contexto e mesmo entre duas pessoas inseridas em um contexto similar. Em dezembro de 2019 surgiu na China uma epidemia pelo coronavírus, surgindo a necessidade de mudanças, incluindo isolamento social e ensino a distância. Objetivo Avaliar o impacto do isolamento social e ensino a distância na qualidade de vida dos graduandos da área da saúde da Universidade Federal de Sergipe. Material e método Foi aplicado aos estudantes de graduação da área de saúde da Universidade Federal de Sergipe, no período de janeiro de 2021, o questionário de qualidade de vida, Short-Form Health Survey. O questionário foi aplicado via o sistema online. Resultado Foram aplicados 678 questionários, sendo 672 concordando em participar do estudo. Dos estudantes avaliados, 58% eram do sexo feminino e 50% com idade de 21 a 25 anos. Ao se analisar o questionário, verifica-se que para capacidade funcional os valores variaram de 80 a 89, ou seja, com bom escore de qualidade de vida. Os aspectos emocionais apresentaram os menores escores e 21 a 37,3, sendo o pior resultado encontrado nos estudantes do curso de fonoaudiologia. Não houve diferença estatisticamente significativa entre os diferentes cursos de saúde estudados. Conclusão Verifica-se que o aspecto emocional tem sido o mais afetado entre os estudantes de saúde da Universidade Federal de Sergipe.

Abstract Introduction The concept of quality of life is multidimensional, presents a complex and dynamic organization of its components, and differs from person to person according to the environment/context and even between two people in a similar context. In December 2019, a Coronavirus epidemic emerged in China, aiming to make some changes, including social isolation and distance learning. Objective Evaluate the impact of social isolation and distance learning on the quality of life of undergraduates in the health area at the Federal University of Sergipe. Material and method The quality of life questionnaire, Short-Form Health Survey, was applied to undergraduate students in the health area at the Federal University of Sergipe in January 2021. The questionnaire was applied online. Result 678 questionnaires were applied, with 672 agreeing to participate in the study. According to the evaluated students, 58% were female and 50% were aged from 21 to 25 years. When analyzing the questionnaire, it appears that the values ​​ranged from 80 to 89 for functional capacity, with a good quality of life score. Emotional aspects had the lowest scores from 21 to 37.3, the worst result in speech therapy students. There was no statistically significant difference between the different health courses studied. Conclusion It appears that the emotional aspect has been the most affected among health students at the Federal University of Sergipe.

Trends of incidence, mortality, and disability-adjusted life years of oral cancer in Latin America.

OBJECTIVE: To describe the trend in incidence, mortality and Disability Adjusted Life Years of oral cancer in Latin America according to sex between 2000 and 2020. METHODS: This ecological study extracted oral cancer information from 20 Latin American countries from the GBD-2020 database. Oral cancer burden was described by age-standardized rate (ASR) of incidence, mortality, and DALYs. The data was compared according to sex and countries. Trends (Average Annual Percentage Change-AAPC) were estimated for each indicator, sex, and country between 2000 and 2020 using Joint-point software. RESULTS: Between 2000 and 2020, the highest incidence of oral cancer (ASR) occurred in Cuba (5.18), Brazil (4.38) and Uruguay (4.62). The countries with the highest mortality for both sexes were (ASR): Cuba (2.89), Brazil (2.71) and the Dominican Republic (2.58). The DALYs registered an average of 37.52 (Women: 22.39; Men: 52.62). The Dominican Republic reports increasing trends in incidence (AAPC: Men: 2.2; Women: 1.4), in mortality (AAPC: Men: 1.8; Women: 1.1), and in DALYs (AAPC: Men: 1.0; Women: 2.0). Costa Rica shows decreasing trends in men in incidence (AAPC: -1.3), mortality (AAPC: -1.6), and DALYs (AAPC: -1.8). CONCLUSION: Oral cancer shows increasing trends in: the incidence in both sexes in 10 countries, in mortality and DALYs in 6 countries, while the affectation between sexes does not show differences in trends.

Trends of incidence, mortality, and disability-adjusted life years of oral cancer in Latin America / Tendencia de la incidencia, mortalidad y años de vida ajustados por discapacidad del cáncer oral en América Latina

ABSTRACT Objective: To describe the trend in incidence, mortality and Disability Adjusted Life Years of oral cancer in Latin America according to sex between 2000 and 2020. Methods: This ecological study extracted oral cancer information from 20 Latin American countries from the GBD-2020 database. Oral cancer burden was described by age-standardized rate (ASR) of incidence, mortality, and DALYs. The data was compared according to sex and countries. Trends (Average Annual Percentage Change-AAPC) were estimated for each indicator, sex, and country between 2000 and 2020 using Joint-point software. Results: Between 2000 and 2020, the highest incidence of oral cancer (ASR) occurred in Cuba (5.18), Brazil (4.38) and Uruguay (4.62). The countries with the highest mortality for both sexes were (ASR): Cuba (2.89), Brazil (2.71) and the Dominican Republic (2.58). The DALYs registered an average of 37.52 (Women: 22.39; Men: 52.62). The Dominican Republic reports increasing trends in incidence (AAPC: Men: 2.2; Women: 1.4), in mortality (AAPC: Men: 1.8; Women: 1.1), and in DALYs (AAPC: Men: 1.0; Women: 2.0). Costa Rica shows decreasing trends in men in incidence (AAPC: −1.3), mortality (AAPC: −1.6), and DALYs (AAPC: −1.8). Conclusion: Oral cancer shows increasing trends in: the incidence in both sexes in 10 countries, in mortality and DALYs in 6 countries, while the affectation between sexes does not show differences in trends.

RESUMEN Objetivo: Describir la tendencia de la incidencia, mortalidad y los Años de Vida Ajustados por Discapacidad del cáncer oral en América Latina según género entre los años 2000 y 2020. Métodos: Este estudio ecológico extrajo información del cáncer oral de 20 países de América Latina de la base de datos GBD-2020. La carga del cáncer oral se describió según tasa estandarizada por edad (ASR) de incidencia, mortalidad y AVAD. Se estimaron las tendencias (Promedio de cambio porcentual anual — AAPC) en cada indicador, género y país, entre el 2000 y el 2020 usando el software Joint-point. Resultados: Entre 2000 y 2020, la mayor incidencia de cáncer oral (ASR) se presentó en Cuba (5,18), Brasil (4,38) y Uruguay (4,62). Los países con mayor mortalidad para ambos géneros fueron: Cuba (2,89), Brasil (2,71) y República Dominicana (2,58). Los AVAD registraron un promedio de 37,52 (Mujeres: 22,39; Hombres: 52,62). República Dominicana reporta tendencias crecientes en la incidencia (AAPC: Hombres: 2,2; Mujeres: 1,4), en la mortalidad (AAPC: Hombres: 1,8; Mujeres: 1,1), y en los AVAD (AAPC: Hombres: 1,0; Mujeres: 2,0). Costa Rica muestra tendencias decrecientes en los hombres en incidencia (AAPC: −1,3), mortalidad (AAPC: −1,6) y AVAD (AAPC: −1,8). Conclusiones: El cáncer oral muestra tendencias al aumento en: la incidencia en ambos sexos en 10 países, en la mortalidad y los AVAD en 6 países, mientras la afectación entre sexos no muestra diferencias en las tendencias.

Tendências de Mortalidade por Câncer Bucal no Brasil por Regiões e Principais Fatores de Risco / Trends in Oral Cancer Mortality in Brazil by Region and main Risk Factors / Tendencias de la Mortalidad por Cáncer Bucal en Brasil por Región y Principales Factores de Riesgo

Introdução: O câncer bucal ainda é destacado como preocupante problema de saúde pública. Objetivo: Verificar a tendência de mortalidade por câncer bucal por Região brasileira e fatores de risco, avaliando o intervalo de tempo entre o diagnóstico e o tratamento. Método: Estudo com dados secundários do DATASUS (taxa de mortalidade e tempo para tratamento) e do Vigitel (consumo de álcool e cigarro); análises de séries temporais e correlações entre taxas de mortalidade (2010-2019) e consumo de álcool e cigarro (2010-2019), para idade superior a 40 anos, e análise descritiva do tempo entre diagnóstico e tratamento. Resultados: Houve aumento da tendência de câncer bucal por Regiões e sexo, com predominância para o sexo masculino. A variação percentual anual (VPA) da ingestão de álcool e o uso de cigarro foram considerados estacionários na maioria das Regiões analisadas. Ao correlacionar as variáveis, verificou-se correlação estatisticamente significativa entre taxa de mortalidade (2010-2019) e percentual de consumo de álcool (p=0,011; r=0,957), percentual de consumo de cigarro (p=0,019; r=0,936) e taxa bruta de mortalidade em homens (2019) (p=0,005; r=0,97). Verificou-se que, na maioria dos casos (74%), o tempo para início do tratamento é de mais de 60 dias. Conclusão: Embora o consumo de álcool e o tabagismo sejam fatores de risco para o câncer bucal, o presente estudo concluiu que houve aumento da mortalidade por câncer e os fatores de risco analisados permaneceram estacionários. O início de tratamento foi maior do que 60 dias a partir do diagnóstico. Palavras-chave: neoplasias bucais/mortalidade; tabagismo; consumo de bebida alcoólica; estudos de séries temporais; saúde pública

Introduction: Oral cancer still stands out as a concerning public health issue. Objective: Verify the trend of oral cancer mortality by Brazilian regions and risk factors, evaluating the time interval between diagnosis and treatment. Method: Study with secondary data from DATASUS (mortality rate and time to treatment) and Vigitel (alcohol and cigarette use). Time series analyzes and correlations were performed among mortality rates (2010-2019) and alcohol and cigarette use (2010-2019) for over 40 years of age. Descriptive analysis of the time between diagnosis and treatment was also performed. Results: There was an increase in the tendency to oral cancer by region and sex, with a predominance of males. The annual percentage change (APC) of alcohol intake and cigarette use was considered stationary in most regions analyzed. When correlating the variables, there was a statistically significant correlation for mortality rate (2010-2019) and percentage of alcohol use (p=0.011; r=0.957), percentage of cigarette use (p=0.019; r=0.936) and crude mortality rate in men (2019) (p=0.005; r=0.97). It was found that most cases (74%) take more than 60 days to start treatment. Conclusion: Although alcohol and tobacco use are risk factors for oral cancer, the present study showed an increase in cancer mortality and stationary for the risk factors analyzed. The beginning of the treatment was over 60 days after diagnosis

Introducción: El cáncer oral todavía se destaca como un problema de salud pública preocupante. Objetivo: Verificar la tendencia de la mortalidad por cáncer bucal por región brasileña y factores de riesgo, evaluando el intervalo de tiempo entre el diagnóstico y el tratamiento. Método: Estudio con datos secundarios de DATASUS (tasa de mortalidad y tiempo de tratamiento) y Vigitel (consumo de alcohol y cigarrillos). Se realizaron análisis de series de tiempo y correlaciones entre las tasas de mortalidad (2010-2019) y el consumo de alcohol y cigarrillos (2010-2019) para los mayores de 40 años. También se realizó un análisis descriptivo del tiempo transcurrido entre el diagnóstico y el tratamiento. Resultados: Hubo un incremento en la tendencia al cáncer bucal por región y sexo, con predominio del sexo masculino. El cambio porcentual anual (APV) de la ingesta de alcohol y el consumo de cigarrillos se consideró estacionario en la mayoría de las regiones analizadas. Al correlacionar las variables, hubo una correlación estadísticamente significativa para tasa de mortalidad en hombres (2010- 2019) y porcentaje de consumo de alcohol para hombres (p=0,011; r=0,957), porcentaje de consumo de cigarrillos en hombres (p=0,019; r=0,936) y tasa bruta de mortalidad en hombres (2019) (p=0,005; r=0,97). Se encontró que la mayoría de los casos (74%) demoran más de 60 días en comenzar el tratamiento. Conclusión: Aunque el consumo de alcohol y el tabaquismo son factores de riesgo para el cáncer oral, el presente estudio mostró un aumento en la mortalidad por cáncer y estacionario para los factores de riesgo analizados. Hubo un alto porcentaje de inicio del tratamiento durante 60 días después del diagnóstico

Level of Satisfaction and Quality of Life of Caregivers of People with Disabilities in Secondary Dental Care

Abstract Objective: To assess the level of satisfaction and quality of life (QOL) of caregivers of Patients with Special Needs seen at the Dental Specialties Center in Aracaju, Brazil. Material and Methods: The Program for Primary Care Access and Quality Improvement (PMAQ - DSC) and the World Health Organization's Quality of Life - Brief (WHOQOL-BREF) questionnaires were applied to PSN and caregivers. Results: The PMAQ questionnaire was applied to 31 patients or caregivers; 97% had no paid work and 61% used public transportation to reach the Dental Specialties Center. The WHOQOL-BREF questionnaire was applied to 20 caregivers; 60% considered their life to be good; however, 60% had practically no leisure time. Correlation tests (Pearson's coefficient) showed a statistically significant correlation between the physical and psychological domain (p=0.02; r=0.64), the psychological and social domain (p=0.033; r=0.48), and the psychological and environment domain (p<0.001; r=0.80). Conclusion: The caregivers and patients with special needs felt satisfied with the specialized oral health service offered by the municipality. Concerning the quality of life of caregivers, the majority stated they had a good quality of life, despite not having the opportunity to participate in leisure-oriented activities and often having negative feelings.

Percepção dos idosos não institucionalizados em relação à saúde bucal / Perception of the non institutionalized elders in relation to oral health

Objetivo ­ Avaliar a autopercepção da saúde bucal e uso de próteses dentárias em idosos não institucionalizados. Métodos ­ Os dados foram coletados por meio de entrevista semi-estruturada, utilizando a escala geriátrica da depressão (EGD) abreviada e o índice GOHAI, além de fatores socioeconômicos, sociais e uso de prótese dentária. Participaram do estudo 51 idosos, que participam do projeto "Universidade para a Melhor Idade" promovido pelo Centro Universitário Dr. Leão Sampaio de Juazeiro do Norte-CE. Resultados ­ Foram entrevistados 43 idosos do gênero feminino e 8 gênero masculino. Dos entrevistados 66.6 % apresentou índice GOHAI abaixo de 30, ou seja, com autopercepção de saúde bucal ruim. Sobre o índice de depressão geriátrica 88.8% dos entrevistados apresentaram abaixo ou igual a 5, ou seja, não apresentando depressão. Os fatores sócios econômicos e sociais foram associados aos índices, sendo encontrada diferença estatisticamente significativa apenas para estado civil quando associado ao GOHAI e renda associado ao EGD. Ao se correlacionar a escala de GOHAI com a EGD (correlação de Pearson, p=0.46) não é encontrado valor significativo estatisticamente. Conclusão ­ A percepção de saúde bucal foi baixa para mais da metade da população dos idosos examinados, contudo a maior parte dos examinados não apresentava depressão

Objective ­ To evaluate the self-perception of oral health and the use of dental prostheses in non-institutionalized elderly. Methods ­ Data were collected through a semi-structured interview, using the index abbreviated EGD (geriatric scale depression) and the GOHAI index. Fifty-one elderly people participated in the study. Theses elderly studied in the program "University for the Best Age" promoted by Centro Universitário Dr. Leão Sampaio in Juazeiro do Norte-CE. Results ­ We interviewed, 43 female and 8 male. Of those interviewed, 66.6% presented a GOHAI index below 30, that is, with poor self-perception of oral health. About the index of geriatric depression 88.8% of the respondents presented below or equal to 5 that is, not presenting depression. The socioeconomic and social factors were associated with the indices, and a statistically significant difference was found only for the civil status when associated with GOHAI and income associated with EGD. When correlating the GOHAI scale with EGD (Pearson's correlation, p = 0.46) no statistically significant value was found. Conclusion ­ The perception of oral health was low for more than half the population of the elderly examined, however, the majority of those examined did not present depression

Efecto de las políticas de control de factores de riesgo sobre la mortalidad por cáncer oral en América Latina / Effect of risk factor control policies on oral cancer mortality in Latin America

OBJETIVO: La mortalidad por cáncer oral, la prevalencia de los principales factores de riesgo y la implementación de las políticas para su control presentan tendencias y distribución desiguales entre los países de América Latina. El objetivo de este trabajo fue describir las tendencias de la mortalidad por cáncer oral entre 2000 y 2017, según sexos, en 20 países de América Latina, y conocer el efecto de las medidas de control del consumo de tabaco y el consumo de alcohol sobre la mortalidad por cáncer oral. MÉTODOS: Estudio ecólogico que evaluó la relación entre las tasas estandarizadas por edad del fallecimiento por cáncer oral según el sexo, la prevalencia del consumo de tabaco y del consumo de alcohol,y la implementación de las políticas de control. Para calcular la variación porcentual de cambio anual de las tasas, se usó la regresión Prais-Winsten; y el efecto de las medidas de control de los factores de riesgo sobre la mortalidad por cáncer oral se evalúo mediante correlaciones de Spearman. RESULTADOS: Los mayores descensos en la mortalidad por cáncer oral fueron en los hombres de Brasil (APC -7,83; -14,25; -0,93). La mortalidad por cáncer oral mostró relación positiva entre hombres y la prevalencia del consumo de tabaco y del consumo de alcohol (r=0,358, r=0,537) (p<0,01), y entre la no implementación de las políticas de control de tabaquismo (r=0,738) (p=0,003), las restricciones en los horarios y días de venta de alcohol (r=0,737, p=0,001), y los reglamentos sobre patrocinio y promoción de venta de alcohol (r=0,739, p=0,040). CONCLUSIONES: El efecto de la implementación de las políticas de control se evidencia en una mayor relación con la mortalidad por cáncer oral en los países con menor avance en su ejecución

OBJECTIVE: Mortality from oral cancer, the prevalence of the main risk factors and the implementation of policies to control current trends and the distribution of data among the countries of Latin America. The objective of this study was to describe the trends of mortality from oral cancer between 2000 and 2017, by sex, in 20 countries in Latin America, and to know the effect of measures to control tobacco consumption and alcohol consumption on the Mortality from oral cancer. METHODS: Ecological study that evaluates the relationship between the rates standardized by the age of cancer by oral sex, the prevalence of tobacco consumption and alcohol consumption, and the implementation of control policies. To calculate the annual percentage change of the rates, the Prais-Winsten regression was used; and the effect of measures of control of risk factors on oral cancer mortality is assessed by Spearman correlations. RESULTS: The greatest decreases in oral cancer mortality were in men in Brazil (APC -7.83, -14.25,-0.93). Mortality from cancer the oral relationship between men and the prevalence of tobacco consumption and alcohol consumption (r = 0.358, r 0.537) (p <0.01), and between the non-implementation of control policies of smoking (r = 0.738) (p= 0.003), the restrictions on the hours and days of sale of alcohol (r = 0.777, p = 0.001), and the states on sponsorship and promotion of alcohol sales (r =0.739 , p =0.040). CONCLUSIONS: The effect of the implementation of control policies is evidenced by a greater relationship with oral cancer mortality in the countries with the least progress in their execution

Report of dental care experience, preventive and restorative, in a riverside community / Relato de experiência de atendimento odontológico, preventivo e restaurador, em uma comunidade ribeirinha

INTRODUCTION: Dental caries, despite having declined in recent years, presents groups considered polarized with highest rate of the disease, among other reasons due to the lack of access to health services. EXPERIENCE REPORT: Description of a dental care experience (preventive, educational and restorative) in children aged 0 to 15 years in a riverside community in the state of Pará. The first visit to the community (February 2014) lasted 3 days and was carried out as an epidemiological survey according to World Health Organization criteria. Educational and preventive activities besides dental treatments were provided to this community. At the second visit (February 2015), again with duration of three days, oral health from this community was reevaluated. Data from the two analyzed periods, distant one year between each analysis, were compared. A total of 34 children aged 1 to 6 years according to the dmft index and 54 children/adolescents aged 7 to 15 years according to the dmft/DMFT index were examined. Statistically significant differences were found in aspects: caries (p=0.03), missing teeth (p=0.04), and filled teeth (p=0.01). CONCLUSION: Access to health services associated with educational and preventive activities showed positive results in the visited riverside community.

INTRODUÇÃO: A cárie dentária, apesar de ter tido declínio nos últimos anos, apresenta grupos considerados polarizados nos quais detém os maiores valores da doença, entre outros devido à falta de acesso a serviços de saúde. RELATO DE EXPERIÊNCIA: Descrição de uma experiência de atendimento odontológico (preventivo, educativo e restaurador) em crianças/adolescentes de 0 a 15 anos em uma comunidade ribeirinha do Pará. A primeira visita à comunidade (Fevereiro de 2014) teve duração de três dias e foi um levantamento epidemiológico seguindo critérios da Organização Mundial de Saúde. Foram ainda realizadas atividades educativas e preventivas, além de tratamentos odontológicos nesta comunidade. Na segunda visita (Fevereiro de 2015), novamente com duração de três dias, a condição de saúde bucal desta comunidade foi reavaliada. Os dados dos dois períodos analisados, distando um ano entre cada análise, foram comparados. Foram examinadas 34 crianças de 1 a 6 anos de acordo com o índice ceod e 54 crianças/adolescentes de 7 a 15 anos de acordo com o índice ceod/CPOD. Foi encontrada diferença estatisticamente significante nos aspectos dentes cariados (p=0,03), perdidos (p=0,04) e obturados (p=0,01). CONCLUSÃO: O acesso aos serviços de saúde associado a atividades educativas e preventivas demonstrou resultados positivos na comunidade ribeirinha visitada.

Conhecimento de estudantes de Educação Física de Juazeiro do Norte-CE sobre o atendimento emergencial ao trauma dental, avulsãom e reimplante dental / Knowledge of Physical Education students from Juazeiro do Norte-CE about emerrgency care dental trauma, avulsion and dental reimplant

Objetivo ­ Avaliar o conhecimento dos estudantes de graduação em Educação Física do Centro Universitário Doutor Leão Sampaio (UnilLeão), Juazeiro do Norte-CE sobre o atendimento emergencial ao trauma dental. Métodos ­ Foi realizada uma pesquisa transversal junto aos estudantes de graduação de Educação Física, mediante aplicação de um questionário, contendo perguntas sobre idade, gênero, conhecimento sobre primeiros socorros ao traumatismo dental e simulação de casos clínicos de fratura coronária e avulsão e reimplante. Resultados ­ Participaram 120 estudantes, sendo 62% homens e 38% mulheres, dos quais 86% responderam que o tratamento deve ser imediato, 56% reimplantariam o dente no alvéolo, apenas 44% sabiam o que era reimplante dental. Em relação ao acondicionamento do dente, 36% o manteriam em água, 29% em guardanapo, 14% soro fisiológico e 7,5% lavaria no leite. Dos participantes 39% afirmaram não saber o que fazer com o dente avulsionado coberto de sujeira, 20% o escovaria com escova de dente, e 17,5% lavaria em água corrente. Em relação à fratura coronária, 19% procuraria o pedaço do dente e o acondicionaria corretamente. Em relação ao reimplante dental 46% escolheram o reimplante imediato. Conclusão ­ Verificou-se um conhecimento insuficiente sobre o manuseio dos dentes traumatizados, indicando a necessidade de promover campanhas educativas além da inclusão deste tema durante a formação dos profissionais.

Objective ­ To assess the knowledge of Physical Education students of the Centro Universitário Doutor Leão Sampaio (UniLeão), Juazeiro do Norte-CE on emergency care to dental trauma. Methods ­ A cross-sectional survey was conducted among students, by applying a questionnaire containing questions about age, gender, knowledge of first aid to dental trauma and simulation of clinical cases of coronary fracture and avulsion and replantation. Results ­ Participants were 120 students, 62% men and 38% women, of which 86% responded that treatment should be immediately, 56% reimplant the tooth in the dental alveolus, only 44% knew about the technique to dental reimplant. Regarding the preparation of the tooth, 36% responded put on water, 29% put on napkin, 14% put on the saline solution and 7.5% put on milk. Of the participants 39% said they did not know what to do with the tooth avulsed covered in dirt, 20% would use the toothbrush, and 17,5% would use the wash in running water. Regarding coronary fracture, 19% seek for the piece of tooth and kept it properly. Regarding to dental reimplant, 46% chose the immediate reimplantation. Conclusions ­ There was insufficient knowledge about the handling of traumatized teeth, indicating the need to promote educational campaigns and training of professionals about this issue.

Validade da medida indireta relativa à frequência de escovação com dentifrício / Validity of an indirect assessment instrument on the frequency of brushing with toothpaste

O efeito do dentifrício fluoretado na prevenção da cárie dentária aumenta conforme a frequência do seu uso. Essa frequência tem sido estimada em populações por meio de medidas indiretas. Entretanto a validade desse modo de mensuração não é conhecida. O objetivo foi determinar a validade de medidas indiretas da quantidade de dentifrício utilizada, do tamanho da cabeça da escova e da frequência de escovação com dentifrício. Excetuando-se o tamanho da cabeça da escova, os valores relativos à quantidade de creme dental utilizada e à frequência de escovação foram superestimados pela medida indireta. Recomenda-se que as estimativas produzidas por medida indireta semelhante à testada neste estudo sejam consideradas com cautela.

The effect of fluoride dentifrice in the prevention of tooth decay increases with the frequency of use. This frequency has been estimated in populations using indirect instruments, however, their validity is still unknown. This study aimed at determining the validity of indirect instruments related to the amount of dentifrice used, the size of the brush head and the frequency of brushing with toothpaste. Except for the size of the brush head, the values corresponding to the amount of toothpaste used and the frequency of brushing were overrated by the indirect instrument. The estimates obtained using the indirect instrument in this study should be considered with caution.

Avaliação dos tratamentos propostos pelos dentistas em casos de fraturas coronárias / Evaluation of treatments plans for managment of crown fractures proposed by dentists

Introdução: a odontologia prioriza a manutenção e integridade dos dentes na boca e a ocorrência de traumatismos dentais vem dificultando o cumprimento desta meta, uma vez que suas consequências envolvem danos funcionais, estéticos, psicológicos, sociais e terapêuticos, além dos altos custos para a reabilitação e acompanhamento por longos períodos de tempo. Objetivo: avaliar o conhecimento dos cirurgiões dentistas da região metropolitana de Juazeiro do Norte sobre as condutas clínicas baseadas nos planos de tratamentos propostos por estes profissionais sobre fraturas coronárias com ou sem exposição pulpar. Método: a partir de um questionário descritivo, foram abordadas questões referentes ao perfil dos profissionais entrevistados e procedimentos empregados na conduta frente a fraturas coronárias. Setenta e cinco questionários foram devidamente preenchidos, sendo 34 mulheres e 41 homens. Resultados: dos entrevistados 13 relataram nunca terem atendido casos de trauma dental, 26% relataram serem incapazes de tratar todos os casos de traumatismo dentário. E mesmo a maioria tendo formação especializada, grandes dificuldades foram encontradas nos planos de tratamento propostos em relação a fraturas mais complicadas. Discussão: as lesões dentais traumáticas envolvendo tecidos duros e de sustentação podem representar padrões de cicatrização bastante complexos. As lesões traumáticas do tipo fraturas coronárias apresentam um prognóstico favorável para a manutenção da vitalidade pulpar em relação às fraturas coronárias complicadas. As fraturas corono-radiculares com ou sem envolvimento pulpar, foram as que apresentaram mais indicações inadequadas de tratamento, provavelmente por necessitarem de uma abordagem multidisciplinar. Conclusão: considera-se primordial a multidisciplinaridade durante a formação acadêmica do clinico geral, bem como o aperfeiçoamento ao atendimento a pacientes com trauma dental. (AU)

Introduction: Dentistry prioritizes the maintenance and integrity of teeth in the mouth and the occurrence of dental trauma is hampering the achievement of this goal, since its consequences involve functional, aesthetic, psychological, social and therapeutic damage, in addition to high costs for rehabilitation and monitoring for extended periods of time. Objective: The objective of this study was to assess the knowledge of dentists in the metropolitan region of Juazeiro do Norte on the clinical management based on treatment plans proposed by these professionals on crown fractures with or without pulp exposure. Methods: For that, starting from a descriptive questionnaire, some questions regarding the profile of inquired professionals and procedures used in the performance of treatment of crown fractures. Results: Seventy-five questionnaires were fully completed, 34 women and 41 men. Only 13 reported ever having met cases of dental trauma, 26% reported being unable to deal with all cases of dental trauma. And even most having specialized training, great difficulties were encountered in the proposed treatment plans for the most complicated fractures. Discussion: Traumatic injuries involving pulp and periapical tissues can represent very complex healing patterns. The crown fractures have a favorable prognosis for the maintenance of pulpal vitality in relation to coronary complicated fractures. The corono-root fractures with or without pulp involvement, were the ones that had more inadequate treatment, probably because they require a multidisciplinary approach. Conclusion: it is essential for multidisciplinary academic training of general practitioner as well as improving service to patients with dental trauma. (AU)

Percepção dos profissionais que trabalham na Unidade de Terapia Intensiva (UTI) quanto à inclusão do cirurgião-dentista na equipe / Perception of the professionals working in the Intensive Care Unit (ICU) about the inclusion of dental surgeons on staff

Este trabalho objetivou analisar a opinião dos profissionais da UTI (Unidade de Terapia Intensiva) (médicos, enfermeiros, fisioterapeutas e fonoaudiólogos) sobre a inclusão do cirurgião dentista na equipe, avaliar o conhecimento destes profissionais sobre a associação da condição oral com a PAV (Pneumonia Associada à Ventilação Mecânica) e analisar a existência de protocolos de higiene oral para o paciente entubado na UTI do Hospital Regional do Cariri-CE (HRC). Foi realizado um estudo transversal, no qual foi aplicado um questionário para os profissionais de saúde que atuavam na UTI do mesmo Hospital. Sobre o conhecimento dos profissionais a respeito do projeto de lei 2.766/2008, constata-se que aproximadamente 40% dos pesquisados desconheciam a lei. Entretanto, ao se questionar sobre a PAV, 95,7% dos entrevistados conhecem as causas de ocorrência do evento e 87% concordam que a inclusão do cirurgião dentista (CD) beneficiaria a equipe que atua na UTI. Quando questionados sobre a higienização bucal dos pacientes durante a permanência dos mesmos na UTI, todos os entrevistados responderam que indicam o uso de Clorexidina a 0,12%. Ao se questionar qual a função do CD na equipe, 95,7% assinalaram prevenção e controle dos eventos da microbiota bucal; 82,6% atendimento de emergência, tratamento de traumatismo e 78,3% limpeza bucal. Conclui-se a presença do CD é importante na UTI para reduzir os riscos da PAV e realizar procedimentos específicos em sua área (AU).

This study aimed to analyze the opinion of professionals from the Intensive Care Unit (doctors, nurses, physiotherapists, and speech therapists) about the inclusion of dentists on staff; assess the knowledge of these professionals about the association of oral status with PAV (pneumonia associated with mechanical ventilation); and analyze the existence of protocols of oral hygiene for patients intubated in the ICU of the Hospital Regional Cariri (HRC). A cross-sectional study was conducted using questionnaire answered by health professionals who worked in the ICU at HRC. About the knowledge of professionals in relation to the bill 2766/2008, 40% of respondents were unaware of the law. However, when questioned about the PAV, 95.7% of respondents know the causes of occurrence of the event and 87% agreed that the inclusion of the dentist (CD) would benefit the team working in the ICU. When asked about the oral hygiene of patients during their permanence in the ICU, all respondents indicated the use of chlorhexidine 0.12%. When questioned about the function of the CD on the staff of the ICU, 95.7% indicated prevention and control of the events of the oral microbiota; 82.6% emergency care, treatment of trauma; and 78.3% mouthwash. It was concluded that the presence of CD in the ICU is important to reduce the risk of VAP and perform specific procedures in your area (AU).

Avaliação do conhecimento popular, atitudes e práticas cotidianas em saúde bucal / Evaluate of popular knowledge, attitudes and daily practices in oral health

Objetivo ­ Avaliar os conhecimentos e as percepções relacionadas à saúde bucal dos pacientes da clínica escola da Faculdade Leão Sampaio-CE. Métodos ­ Estudo observacional, com amostra composta por 204 pacientes. Nesta amostra foram aplicados questionários sobre os temas conhecimento sobre a etiologia e prevenção da cárie dentária e autopercepção das condições de saúde bucal, além de questões sobre aspectos sócio econômico e educacionais. Resultados ­ Dos participantes, 143 eram do gênero feminino e 61 do gênero masculino, com faixas etárias predominantes situadas em 21 até 39 anos (46%). Em relação à renda mensal familiar, houve predominância da faixa salarial de um salário-mínimo. Dos 204 entrevistados 119 receberam IHO (Instrução de Higiene Oral) e 85 não receberam. Observou-se que os entrevistados com maior escolaridade também receberam mais IHO, sendo encontrada diferença estatisticamente significativa (p<0,05). Dos pacientes que receberam IHO, houve diferença estatisticamente significativa (p<0,05) para os itens analisados: técnica utilizada para escovação; frequência de uso do fio dental; o que fazer para não ter cárie; para que serve o flúor. Conclusão ­ Os pacientes apresentaram bons hábitos de higiene bucal, contudo apresentaram um limitado conhecimento sobre a etiologia da cárie e a forma mais adequada para preveni-la.

Objective ­ To assess the knowledge and perceptions related to oral health of patients attended in the Dental School ­ Leão SampaioCE. Methods ­ A cross-section study was conducted with 204 patients, aged from 18 years old and above. Self applicable questionnaires were applied about the perception of oral health, knowledge about the etiology and prevention of dental caries, self-perception of oral health conditions, and economic and educational aspects. Results ­ Of the participants, 143 were female and 61 were male, with aged to 21 to 39 years old (46%). The family income predominant was until minimum wage. Of the 204 interviewed, 119 received OHI (Oral Health Instructions) and 85 didn't. It was observed that respondents with higher education also received OHI, with a significant statistical difference (p <0.05). In relation of patients who received OHI, there was a statistically significant difference (p <0.05) to the items analyzed: technique to brushing as the most important item to tooth brushing; frequency of the use of dental floss; what to do to avoid caries; the utility of fluoride. Conclusions ­ The patients showed good oral hygiene habits, but had limited knowledge of the etiology of caries and the best way to prevent it.

Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food.

OBJECTIVE: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h). METHOD: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels. RESULTS: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%). CONCLUSION: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives.

Estimates of self-reported dietary behavior related to oral health among adolescents according to the type of food

Objective: To compare estimates of food behavior related to oral health obtained through a self-report measure and 24 hour dietary recalls (R24h). Method: We applied three R24h and one self-report measure in 87 adolescents. The estimates for eleven food items were compared at individual and group levels. Results: No significant differences in mean values were found for ice cream, vegetables and biscuits without filling. For the remaining items, the values reported by the adolescents were higher than the values estimated by R24h. The percentage of adolescents who reported intake frequency of 1 or more times/ day was higher than the value obtained through R24h for all food items except soft drinks. The highest values of crude agreement between the instruments, individually, were found in the biscuits without filling (75.9%) and ice cream (72.4%). Conclusion: The results suggest that adolescents tend to report a degree of exposure to the food items larger than what they actually experience in their daily lives. .

Photoelastic analysis of all-on-four concept using different implants angulations for maxilla.

Conventional tilted implants are used in oral rehabilitation for heavily absorbed maxilla to avoid bone grafts; however, few research studies evaluate the biomechanical behavior when different angulations of the implants are used. The aim of this study was evaluate, trough photoelastic method, two different angulations and length of the cantilever in fixed implant-supported maxillary complete dentures. Two groups were evaluated: G15 (distal tilted implants 15°) and G35 (distal tilted implants 35°) n = 6. For each model, 2 distal tilted implants (3.5 x 15 mm long cylindrical cone) and 2 parallel tilted implants in the anterior region (3.5 x 10 mm) were installed. Photoelastic models were submitted to three vertical load tests: in the end of cantilever, in the last pillar and in the all pillars at the same time. We obtained the shear stress by Fringes software and found values for total, cervical and apical stress. The quantitative analysis was performed using the Student tests and Mann-Whitney test; p ≥ 0.05. There is no difference between G15 and G35 for total stress regardless of load type. Analyzing the apical region, G35 reduced strain values considering the distal loads (in the cantilever p = 0.03 and in the last pillar p = 0.02), without increasing the stress level in the cervical region. Considering the load in all pillars, G35 showed higher stress concentration in the cervical region (p = 0.04). For distal loads, G15 showed increase of tension in the apical region, while for load in all pillars, G35 inclination increases stress values in the cervical region.

Dental caries trends among preschool children in Indaiatuba, SP, Brazil

AIM: To evaluate caries experience and associated factors in 5-year-old preschool children in the city of Indaiatuba, SP, Brazil. METHODS: This was a cross-sectional, representative study, conducted from an epidemiological oral health survey (2010) with 303 children. The sample was established by the systematic probabilistic method, in public and private schools, in accordance with WHO criteria. The sample was checked for caries experience (dmft) by four trained and calibrated dentists, reaching acceptable levels of agreement for data collection. Parents or guardians answered questions related to their education and monthly income, and the children answered questions related to dental care and pain. Descriptive and bivariate analyses of independent variables were performed. Variables with p<0.20 were included in the model (Poisson regression analysis). RESULTS: The sample consisted of 151 boys and 152 girls, with a mean dmft of 1.46. The reasons for visiting a dentist due to pain or need for treatment were associated with dmft > 0 (PR=3.76, 95%CI=2.06-6.84) after adjustment of the regression model. CONCLUSIONS: Among the preschool children of this study, pain or need for treatment due to caries disease in the primary dentition and the reason to visit the dentist due pain emphasizing the importance of the professional not only in curative actions, but as a health promoter at the first contact with the child.