The Impact of COVID-19 Related Lockdown on Dental Practice in Central Italy-Outcomes of A Survey.

The COVID-19 pandemic has affected lives and professions worldwide. We aimed to determine the behavior of dentists during the lockdown in Central Italy through an online survey. We demonstrated that the most frequent of urgencies, not otherwise manageable through telemedicine, was dental pulp inflammation. Although a statistically significant increase in the use of some of the personal protective equipment (PPE) from pre to during lockdown was shown, dentists were afraid of being infected during the dental procedures. Moreover, we showed that digital dentistry, telemedicine, use of the rubber dam, distancing of the appointments and further structural changes at the dental office are necessary to reduce the contagion among dentists and patients. No significant differences were shown between gender.

Willingness of Adults in the United States to Receive HIV Testing in Dental Care Settings: Cross-Sectional Web-Based Study.

BACKGROUND: The Centers for Disease Control and Prevention estimates that 1.1 million people in the United States are living with HIV and 1 in 8 are estimated to be unaware of their serostatus. Little is known about whether individuals would consider being tested for HIV in nontraditional health care settings such as a dentist's office. Studies in selected US cities have indicated high acceptability of receiving an HIV test among people attending dental clinics. However, we are not aware of studies that have assessed willingness to receive HIV testing in dental care settings at a national level. OBJECTIVE: Using a web-based sample of adult residents of the United States, we sought to assess the self-reported willingness to receive any type of HIV testing (ie, oral fluid rapid testing, finger-stick blood rapid testing, or venipuncture blood testing) in a dental care setting and evaluate independent associations of willingness with the extent to which dental care providers were perceived as knowledgeable about HIV and how comfortable participants felt discussing HIV with their dental care providers. METHODS: Participants were recruited using banner advertisements featured on social networking platforms (Facebook and Instagram) from December 2018 to February 2019. Demographic and behavioral data including information on sexual behaviors in the past 6 months, HIV testing history, and dental/health care-seeking history were collected using an anonymous web-based survey. Willingness to receive any type of HIV testing in a dental care setting was assessed on 4-point scale from very willing to very unwilling. Factors independently associated with participants' willingness were identified using a multivariable logistic regression model. RESULTS: Of the 421 participants in our study aged 18 to 73 years, 271 (64.4%) reported having oral sex, 197 (46.8%) reported having vaginal sex, and 136 (32.3%) reported having anal sex in the past 6 months. Approximately one-third had never been tested for HIV (137/421, 32.5%), and the same proportion had not been tested in the past year (137/421, 32.5%). Most participants had dental insurance coverage (356/421, 84.6%), and more than three-fourths reported being very or somewhat willing (326/421, 77.4%) to receive any type of HIV testing in a dental care setting. Higher levels of willingness were associated with being 18 to 24 years versus ≥35 years (aOR 3.22, 95% CI 1.48-6.98), 25 to 34 years versus ≥35 years (aOR 5.26, 95% CI 2.52-10.98), believing that one's dental care provider is knowledgeable about HIV (aOR 2.04, 95% CI 1.06-3.92), and feeling comfortable discussing HIV with one's dental care provider (aOR 9.84, 95% CI 3.99-24.27). CONCLUSIONS: Our data indicate high acceptability of receiving HIV testing in a dental care setting, especially among those who report having a positive patient-provider relationship. Future research should focus on assessing dental care providers' attitudes, self-efficacy, and beliefs about whether HIV testing fits into the scope of dentistry.

Impact of SARS-CoV2 (Covid-19) on dental practices: Economic analysis.

OBJECTIVES: To combat SARS-CoV2 (Covid-19), policy makers worldwide have adopted different policy alternatives, often including mitigation/suppression policies. We assessed the economic impact of such policies on dental practices in Germany using a modelling approach. METHODS: A providers' perspective within German healthcare was taken, with two provider scenarios (low/high volume practice, low/high proportion of non-statutory insurance revenue, low/high staff pool and costs; S1 and S2 scenarios) being modelled. Providers' costs were estimated in different blocks (staff, material, laboratory, others). A telephone-based survey was conducted on 24th March to 2nd April 2020 on a random sample of 300 German dentists (response: n = 146) to determine the experienced dental services utilization changes in these service blocks. A Markov model was constructed, following 100 practices in each scenario for a total of 365 days. Different Covid-19 mitigation/suppression periods (90 days: base-case, 45, 135 days: sensitivity analyses) were modelled. Monte-Carlo micro-simulation was performed and uncertainty introduced via probabilistic and univariate sensitivity analyses. RESULTS: Mitigation/suppression reduced utilization of all services, the most severe for prevention (-80 % in mean), periodontics (-76 %) and prosthetics (-70 %). Within the base-case, mean revenue reductions were 18.7 %/15.7 % from the public insurance, 18.7/18.6 % from private insurers and 19 %/19 % for out-of-pocket expenses in S1/S2, respectively. If the mitigation/suppression was upheld for 135 days, overall revenue decreased by 31 %/30 % in S1/S2, respectively. In this case, 29 %/12 % S1/S2 would have a negative net profit over the course of one year. CONCLUSIONS: Covid-19 and associated policies have profound economic effect on dental practices. CLINICAL SIGNIFIANCE: Policy makers will want to consider our findings when designing governmental subsidy and safety nets with immediate and midterm economic relieve effects. Dentists may consider practice re-organization to reduce costs and maintain minimum profitability.

Screening at the dental office: An opportunity for bridging the gap in the early diagnosis of hypertension and diabetes in Ghana.

Background: The prevalence of hypertension and diabetes is increasing in Ghana and sub-Saharan Africa. Screening is a useful tool in improving the early detection of both diseases to reduce the mortality and morbidity associated with the conditions. This study set out to determine the prevalence of patients with hypertension and hyperglycemia attending a dental clinic in Accra. Methods: A cross-sectional study, modeling a screening exercise, was conducted in a major dental clinic in Accra. Hypertension and diabetes were screened for with serial blood pressure checks at rest and random blood glucose measurements, respectively. Other variables were the pulse rate, the respiratory rate, and the background characteristics of respondents. Data were analyzed with Stata Version 14, and descriptive statistics were generated and reported. Results: There were a total of 175 participants in the study, comprising 76 males (43.4%) and 99 females (56.6%). This represented a male-to-female ratio of 0.8:1. The ages ranged from 18 to 86 years, with the median and mean ages of 40 years and 43.1 years (±16.9), respectively. This study found the prevalence of hypertension and hyperglycemia i the dental clinic to be 31.4% and 24.6%, respectively. Conclusion: The results of this study demonstrate the importance of the dental clinic in detecting both undiagnosed hypertension and diabetes, as well as those who have previously been diagnosed, but do not have their blood pressure and blood sugar under adequate control. With efficient referrals and follow-up systems in place at dental offices, they could be harnessed as a fertile place for hypertension and diabetes screening.

RésuméContexte: La prévalence de l'hypertension et du diabète augmente au Ghana et en Afrique subsaharienne. Le dépistage est un outil utile pour améliorer la détection précoce des deux maladies afin de réduire la mortalité et la morbidité associées à ces affections. Cette étude visait à déterminer la prévalence de l'hypertension et de l'hyperglycémie chez les patients fréquentant une clinique dentaire à Accra. Méthodes: Une étude transversale, modélisant un exercice de dépistage, a été menée dans une grande clinique dentaire à Accra. L'hypertension artérielle et le diabète ont fait l'objet d'un dépistage au moyen d'une vérification sérielle de la tension artérielle au repos et de mesures aléatoires de la glycémie, respectivement. Les autres variables étaient le pouls, la fréquence respiratoire et les caractéristiques de base des répondants. Les données ont été analysées à l'aide de la version 14 de Stata, et des statistiques descriptives ont été produites et présentées. Résultats: Au total, 175 participants ont participé à l'étude, dont 76 hommes (43,4 %) et 99 femmes (56,6 %). Cela représentait un ratio hommes/femmes de 0,8:1. L'âge variait de 18 à 86 ans, l'âge médian et l'âge moyen étant respectivement de 40 ans et 43,1 ans (±16,9 ans). Cette étude a révélé que la prévalence de l'hypertension et de l'hyperglycémie à la clinique dentaire était de 31,4 % et 24,6 %, respectivement. Conclusion: Les résultats de cette étude démontrent l'importance de la clinique dentaire dans la détection de l'hypertension et du diabète non diagnostiqués, ainsi que de ceux qui ont déjà reçu un diagnostic, mais dont la tension artérielle et la glycémie ne sont pas sous contrôle adéquat. Avec des références efficaces et des systèmes de suivi en place dans les cabinets dentaires, ils pourraient être exploités comme un lieu fertile pour le dépistage de l'hypertension et du diabète.

A comparison of visual identification of dental radiographic and nonradiographic images using eye tracking technology.

OBJECTIVES: Eye tracking has been used in medical radiology to understand observers' gaze patterns during radiological diagnosis. This study examines the visual identification ability of junior hospital dental officers (JHDOs) and dental surgery assistants (DSAs) in radiographic and nonradiographic images using eye tracking technology and examines if there is a correlation. MATERIAL AND METHODS: Nine JHDOs and nine DSAs examined six radiographic images and 16 nonradiographic images using eye tracking. The areas of interest (AOIs) of the radiographic images were rated as easy, medium, and hard, and the nonradiographic images were categorized as pattern recognition, face recognition, and image comparison. The participants were required to identify and locate the AOIs. Data analysis of the two domains, entire slide and AOI, was conducted by evaluating the eye tracking metrics (ETM) and the performance outcomes. ETM consisted of six parameters, and performance outcomes consisted of four parameters. RESULTS: No significant differences were observed for ETMs for JHDOs and DSAs for both radiographic and nonradiographic images. The JHDOs showed significantly higher percentage in identifying AOIs than DSAs for all the radiographic images (72.7% vs. 36.4%, p = .004) and for the easy categorization of radiographic AOIs (85.7% vs. 42.9%, p = .012). JHDOs with higher correct identification percentage in face recognition had a shorter dwell time in AOIs. CONCLUSIONS: Although no significant relation was observed between radiographic and nonradiographic images, there were some evidence that visual recognition skills may impact certain attributes of the visual search pattern in radiographic images.

Do Waiting Times in Dental Offices Affect Patient Satisfaction and Evaluations of Patient-Provider Relationships? A Quasi-experimental Study.

PURPOSE: Spending time in waiting rooms prior to dental visits is not uncommon for dental hygiene patients. The objectives were to determine if the length of a patients' waiting time affected their satisfaction with the appointment and their evaluation of their provider. In addition, the patient's level of education and whether the dental visit is a first visit will be examined to determine if these affected the outcome. METHODS: Survey data were collected from 399 adult patients who came for regularly scheduled visits to a dental school clinic. The patients ranged in age from 19 to 93 years (mean=52 years; SD=16.9). For 29% of the patients, this visit was the first visit with this provider. RESULTS: The patients whose providers were early (n=65) were more satisfied, more likely to plan to follow their provider's recommendation and evaluated their relationship with their provider more positively than patients whose providers were on time (n=283), while the patients in the "late" group (n=32) showed the most negative responses to all questions. Patients from higher educational backgrounds were most negative in their responses when their providers were late. Patients with a first visit whose providers were late had the most negative evaluations of the patient-provider relationship. CONCLUSION: Long waiting times prior to a scheduled dental appointment have a negative effect on patients' satisfaction with their visit, the evaluations of the patient-provider relationship and the patients' intentions to return.

Longevity of direct restorations in Dutch dental practices. Descriptive study out of a practice based research network.

OBJECTIVES: The aim of this retrospective practice-based study was to investigate the longevity of direct restorations placed by a group of general dental practitioners (GDPs) and to explore the effect of practice/operator, patient, and tooth/restoration related factors on restoration survival. METHODS: Electronic Patient Files of 24 general dental practices were used for collecting the data for this study. From the patient files, longevity of 359,548 composite, amalgam, glass-ionomer and compomer placed in 75,556 patients by 67 GDPs between 1996 and 2011 were analyzed. Survival was calculated from Kaplan-Meier statistics. RESULTS: A wide variation in annual failure rate (AFR) exists between the different dental practices varying between 2.3% and 7.9%. Restorations in elderly people (65 years and older, AFR 6.9%) showed a shorter survival compared to restorations placed in patients younger than 65 years old (AFR 4.2%-5.0%). Restorations in molar teeth, multi-surface restorations and restorations placed in endodontically treated teeth seemed to be more at risk for re-intervention. CONCLUSION: The investigated group of GDPs place restorations with a satisfactory longevity (mean AFR 4.6% over 10 years), although substantial differences in outcome between practitioners exist. Several potential risk factors on practice/operator, patient, and tooth/restoration level have been identified and require further multivariate investigation.

Actitudes de salud bucodental en relación al nivel socoeconómico en individuos adultos / Oral health attitudes related to the socioeconomic level in adults

Introducción: Las actitudes intervienen de manera decisiva en la aparición y el desarrollo de las enfermedades bucodentales. El presente trabajo se propone analizar las actitudes de salud bucodental y su relación con el nivel socioeconómico (NSE) en individuos adultos de la Ciudad de Corrientes; Argentina. Metodología: Se realizó un estudio transversal. A través de una encuesta domiciliaria se recolectó información referente a datos sociodemográficos y a actitudes de salud bucodental utilizando la técnica de observación directa mediante entrevistador "cara a cara". Se determinó el tamaño de la muestra estableciéndose un nivel de confianza del 95% para la generalización de los resultados (381 individuos). Se aplicó un diseño muestral aleatorio simple para la selección de las viviendas a encuestar, que se complementó con un muestreo no probabilístico por cuotas para la selección de los individuos a entrevistar a partir de los datos proporcionados por el censo 2010. Para el análisis de los datos se empleó el programa SPSS 21.0. Las diferencias según el NSE se analizaron con la prueba Kruskall-Wallis, empleándose pruebas U de Mann-Whitney para valorar las diferencias de a pares. Resultados: Se halló que los individuos de NSE más bajo presentan actitudes de salud bucodental menos favorables, en particular en lo que se refiere a la actitud frente al dolor dental y a los motivos por los cuales se consulta generalmente al odontólogo. Conclusiones: Los resultados de este trabajo pueden ser considerados como un recurso importante para diseñar estrategias de intervención que contemplen los determinantes socioculturales del proceso salud enfermedad (AU)

Introduction: Attitudes intervene decisively in the onset and development of oral diseases. This paper analyses the attitudes toward the oral health and its relationship with socioeconomic status (SES) in adults from the city of Corrientes, Argentina. Methodology: A cross-sectional study was carried out. Information on sociodemographic and oral health attitudes was collected through a household survey using the technique of direct observation by the "face to face" interviewer. The sample size was determined by establishing a confidence level of 95% for the generalization of results (381 individuals). Simple random sampling design was used for the selection of households to be surveyed, which was supplemented with a non-probability sampling procedure for selecting individuals to be interviewed, based on data provided by the 2010 census. We used a SPSS 21.0 program for the analysis of data. Differences according to the socioeconomic level were analyzed with the Kruskal-Wallis test, using UMann-Whitney tests to assess differences between pairs. Results: It was found that individuals from lower socioeconomic level have less favourable attitudes of oral health, particularly in regard to the attitude to dental pain and frequent reason to dentist consultation. Conclusion: The results of this work can be considered as an important resource to design intervention strategies that address the social and cultural determinants of health-disease process (AU)

Reasons for patients' visits in the dental offices of Cracow in the years 2005-2006 and 2013-2014.

INTRODUCTION: Caries is a serious health problem affecting the Polish population, mostly due to a low level of health awareness, which is reflected in irregular check-ups and a tendency for patients to visit the dentist only when they are already experiencing pain. OBJECTIVE OF THE STUDY: to compare patients' reasons for visiting dental offices and the treatment they received during the years 2005-2006 and 2013-2014. MATERIAL AND METHODS: Data was obtained from 495 medical files stored in 4 randomly selected dental offices in Cracow. Information was gathered on age, sex, place of residence, reasons for visiting the dentist, referrals, frequency of dental visits and procedures performed. RESULTS: The study showed that women visited dental offices more frequently (56%) than men. The participants were aged between 1 and 91. The majority of the patients lived in large towns or cities (81.6%). Approximately 50% of the patients visited a dental office once a month. The study showed a significant increase in one-time visits (from 18.5% to 30.6%). The most frequent motivation for visiting a dental office was to receive conservative treatment, while the least common reasons were prophylaxis and tooth injuries. CONCLUSIONS: Throughout the period under review, changes occurred in the profile of the patients who visited dental offices during these periods. One alarming trend was the significant increase in the number of patients who visited dental offices only once (12%). The main reason why patients visited dental offices did not change--more than 60% came to have caries treated but often after a single visit they did not continue the treatment despite needing to do so.

Detection of Helicobacter pylori in city water, dental units' water, and bottled mineral water in Isfahan, Iran.

Helicobacter pylori infection in human is one of the most common infections worldwide. However, the origin and transmission of this bacterium has not been clearly explained. One of the suggested theories is transmission via water. This study was conducted to determine the prevalence rate of H. pylori in tap water, dental units' water, and bottled mineral water in Iran. In the present study, totally 200 water samples were collected in Isfahan province and tested for H. pylori by cultural method and polymerase chain reaction (PCR) by the detection of the ureC (glmM) gene. Using cultural method totally 5 cultures were positive. Two out of 50 tap water samples (4%), 2 out of 35 dental units' water (5.8%) samples, and 1 out of 40 (2.5%) from water cooler in public places were found to be contaminated with H. pylori. H. pylori ureC gene was detected in 14 (7%) of water samples including 5 tap water (10%), 4 dental units' water (11.4%), 1 refrigerated water with filtration, and 4 (10%) water cooler in public places samples. This may be due to the coccoid form of bacteria which is detected by PCR method.

Assessing the community clinic replacement effect on private Medicaid practices in oral health care within rural environments.

OBJECTIVES: Children in Medicaid/CHIP public coverage programs who reside in rural counties have limited access to dental care services. Shortages of dental professionals in rural areas impede utilization of dental care. Public and private initiatives are attempting to address this crisis. Missourians instituted deregulatory policies and invested in community-based initiatives. METHODS: Using a Medicaid/CHIP claims administrative dataset from 2004 to 2007, this research explored patterns of utilization to assess the impact of these efforts. RESULTS: The number of participating private dental office providers declined over the study period, and the number of children utilizing clinics increased. Trends are being observed within the public health dental care market demonstrating clinics are replacing private dentists as providers of Medicaid/CHIP dental services. CONCLUSIONS: Allowing greater market entry through deregulation could provide states with greater improvements to their public dental health infrastructure.

Occupational health problems among dentists in Moldavian Region of Romania.

AIM: The aim of this study was to evaluate the occupational health problems among dentists in the Moldavian Region of Romania. MATERIAL AND METHODS: Questionnaire-based study was conducted on 152 dentists aged between 25-65 years practicing in 6 counties the Moldavian Region of Romania. The questionnaire included questions related to the dentists' occupational health pathology. Data were statistically analyzed using SPSS 14.0 and chi-square test (p<0.05). RESULTS: The majority of the dentists (91%) consider that they are exposed to an occupational risk and 41.8% of them experienced a percutaneus injury caused by sharp instruments in the last year.74.6% of the dentists are protected by vaccination against hepatitis B and 76.1% against influenza. 49.3% of the dentists reported eye injuries caused by solid particles (13.2%), blood splashes (14.7%) and/or chemicals (20,5%). Allergies associated to professional activity were reported by 76.1% of the dentists. CONCLUSIONS: The dental staff must be informed in order to recognize, control and prevent the potential occupational hazards in the workplace.

Iowa dentists' involvement in care for patients who are homebound.

This study investigated the frequency of Iowa dentists' provision of in-office and out-of-office dental care for people who are homebound, as well as comparing the practice and educational characteristics among dentists who did and did not provide care for patients who were homebound. The authors mailed a survey form to all licensed dentists on the Iowa State Health Professional license database (n = 1,168), excluding pediatric dentists and orthodontists. A second mailing was sent to all nonrespondents four months later, resulting in 638 returned forms for a 54.6% response rate. The questionnaire included two outcome responses associated with the treatment in the dentist's office or in the patient's home for patients who are homebound. About 40% of Iowa dentists reported providing care in the office to patients who are homebound, but care outside of the office was provided by fewer dentists (6%) who had more years of practice experience. These results suggest an increased sense of professional or community responsibility among these older Iowa dentists. Education efforts may increase homebound care and more involvement of younger dentists.

Economic impact of dental hygienists on solo dental practices.

The fact that a significant percentage of dentists employ dental hygienists raises an important question: Are dental practices that utilize a dental hygienist structurally and operationally different from practices that do not? This article explores differences among dental practices that operate with and without dental hygienists. Using data from the American Dental Association's 2003 Survey of Dental Practice, a random sample survey of U.S. dentists, descriptive statistics were used to compare selected characteristics of solo general practitioners with and without dental hygienists. Multivariate regression analysis was used to estimate the effect of dental hygienists on the gross billings and net incomes of solo general practitioners. Differences in practice characteristics--such as hours spent in the practice and hours spent treating patients, wait time for a recall visit, number of operatories, square feet of office space, net income, and gross billings--were found between solo general practitioners who had dental hygienists and those who did not. Solo general practitioners with dental hygienists had higher gross billings. Higher gross billings would be expected, as would higher expenses. However, net incomes of those with dental hygienists were also higher. In contrast, the mean waiting time for a recall visit was higher among dentists who employed dental hygienists. Depending on personal preferences, availability of qualified personnel, etc., dentists who do not employ dental hygienists but have been contemplating that path may want to further research the benefits and opportunities that may be realized.

Expanded function allied dental personnel and dental practice productivity and efficiency.

This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.

Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares / Predictors of dental visits for routine check-ups and for the resolution of problems among preschool children / Predictores de la realización de consultas odontológicas de rutina y por problema en preescolares

OBJETIVO: Estimar a prevalência do uso de serviços odontológicos por pré-escolares e fatores associados. MÉTODOS: Estudo transversal com 1.129 crianças de cinco anos de idade da Coorte de Nascimentos de Pelotas 2004, RS, de setembro de 2009 a janeiro de 2010. Registrou-se o uso de serviço odontológico pelo menos uma vez na vida e o motivo para a primeira consulta odontológica da criança. As categorias do desfecho foram: ter feito a primeira consulta por rotina, para resolver um problema ou nunca ter ido ao dentista. Os exames bucais e as entrevistas foram realizados nos domicílios. Aspectos socioeconômicos e variáveis independentes ligadas à mãe e à criança foram analisados por meio de regressão logística multinomial. RESULTADOS: A prevalência de uso por qualquer motivo foi 37,0 por cento. Os principais preditores para consulta de rotina foram nível econômico mais elevado, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Principais preditores para consulta por problema foram ter sentido dor nos últimos seis meses, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Cerca de 45,0 por cento das mães receberam orientação de como prevenir cárie, principalmente fornecida por dentistas. Filhos de mães com história de maior aderência a programas de saúde tiveram maior probabilidade de ter feito uma consulta odontológica de rotina. CONCLUSÕES: A taxa de utilização dos serviços odontológicos por pré-escolares foi inferior às de consultas médicas (puericultura). Além da renda e da escolaridade, comportamentos maternos têm papel importante no uso por rotina. Relato de dor nos últimos seis meses e número elevado de dentes afetados por cárie, independentemente dos demais fatores, estiveram associados ao uso para resolver problema. É necessária a integração de ações de saúde bucal nos programas materno-infantis.

OBJECTIVE: To estimate the prevalence of dental visits among preschool children and determine the factors associated with using dental services. METHODS: A cross-sectional study was conducted with 1,129 five-year-old children from the Pelotas Birth Cohort Study in Pelotas (Southern Brazil) 2004, from September 2009 to January 2010. Use of dental services at least once in the child's life and the reason for the child's first dental visit were recorded. The categories assigned for the first dental visit were: routine check-up, resolution of a problem, or never saw a dentist. The oral examinations and interviews were performed in the children's homes. Socioeconomic aspects and independent variables related to the mother and child were analyzed using multivariable logistic regression. RESULTS: The prevalence of dental visits (both categories combined) was 37.0 percent. The main predictors for a routine visit were higher economic status, mothers with more schooling, and mothers who had received guidance about prevention. Major predictors for a visit because of a problem were having felt pain in the previous six months, mothers with higher education level, and mothers who had received guidance about prevention. Approximately 45.0 percent of mothers received information about how to prevent cavities, usually from the dentist. Children of mothers who adhered to health programs were more likely to have had a routine dental visit. CONCLUSIONS: The rate of preschool visits to dental services was lower than the rate for medical appointments (childcare). In addition to income and education, maternal behavior plays an important role in routine visits. Pain reported in the last six months and a high number of teeth affected by tooth decay, independent of other factors, were associated with visits for a specific problem. It is important to integrate oral health instruction into maternal and child health programs.

OBJETIVO: Estimar la prevalencia del uso de servicios odontológicos por preescolares y factores asociados. MÉTODOS: Estudio transversal con 1.129 niños de cinco años de edad de la Cohorte de Nacimientos de Pelotas 2004, RS, de septiembre de 2009 a enero de 2010. Se registró el uso de servicio odontológico por lo menos una vez en la vida y el motivo para la primera consulta odontológica del niño. Las categorías del resultado fueron: haber realizado la primera consulta por rutina, para resolver un problema, o no haber ido nunca al dentista. Los exámenes bucales y las entrevistas se realizaron en los domicilios. Aspectos socioeconómicos y variables independientes ligadas a la madre y al niño fueron analizados por medio de regresión logística multinomial. RESULTADOS: La prevalencia de uso por cualquier motivo fue de 37,0 por ciento. Los principales predictores para consulta de rutina fueron nivel económico más elevado, madre con mayor escolaridad y haber recibido orientación sobre prevención. Los principales predictores para consulta por problema fueron haber sentido dolor en los últimos seis meses, madre con mayor escolaridad y haber recibido orientación sobre prevención. Cerca de 45,0 por ciento de las madres recibieron orientación de cómo prevenir caries, principalmente suministrada por dentistas. Hijos de madres con historia de mayor adherencia a programas de salud tuvieron mayor probabilidad de haber hecho una consulta odontológica de rutina. CONCLUSIONES: La tasa de utilización de los servicios odontológicos por preescolares fue inferior a la de consultas médicas (puericultura). Además de la renta y de la escolaridad, conductas maternas tienen papel importante en el uso por rutina. Relato de dolor en los últimos seis meses y número elevado de dientes afectados por caries, independientemente de los demás factores, estuvieron asociados al uso para resolver problema. Es necesaria la integración de acciones de salud bucal en los programas materno-infantiles.

Predictors of dental visits for routine check-ups and for the resolution of problems among preschool children.

OBJECTIVE: To estimate the prevalence of dental visits among preschool children and determine the factors associated with using dental services. METHODS: A cross-sectional study was conducted with 1,129 five-year-old children from the Pelotas Birth Cohort Study in Pelotas (Southern Brazil) 2004, from September 2009 to January 2010. Use of dental services at least once in the child's life and the reason for the child's first dental visit were recorded. The categories assigned for the first dental visit were: routine check-up, resolution of a problem, or never saw a dentist. The oral examinations and interviews were performed in the children's homes. Socioeconomic aspects and independent variables related to the mother and child were analyzed using multivariable logistic regression. RESULTS: The prevalence of dental visits (both categories combined) was 37.0%. The main predictors for a routine visit were higher economic status, mothers with more schooling, and mothers who had received guidance about prevention. Major predictors for a visit because of a problem were having felt pain in the previous six months, mothers with higher education level, and mothers who had received guidance about prevention. Approximately 45.0% of mothers received information about how to prevent cavities, usually from the dentist. Children of mothers who adhered to health programs were more likely to have had a routine dental visit. CONCLUSIONS: The rate of preschool visits to dental services was lower than the rate for medical appointments (childcare). In addition to income and education, maternal behavior plays an important role in routine visits. Pain reported in the last six months and a high number of teeth affected by tooth decay, independent of other factors, were associated with visits for a specific problem. It is important to integrate oral health instruction into maternal and child health programs.