Dependence in instrumental activities of daily living and its implications for older adults' oral health.

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged ≥60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.

The relation between gender in the access to dental services and goods / Relação entre o gênero no acesso ao serviço odontológico e aos artigos de higiene bucal / La relación del género en el acceso al servicio odontológico y los artículos de higiene bucal

Objective: Identify the influence of gender in the access to dental services and goods such as consultation, toothbrush, toothpaste and dental prostheses use. Methods: Cross-sectional, quantitative and population coverage study, with the population of Guaiuba municipality. Data were collected by Community Health Agents from 2007 to 2008. We used the Community Oral Health Indicator to verify the access to oral health services, oral hygiene, dental visit, use and need of dental prosthesis. Data were analyzed using SPSS 15.0 software, using the chi-square test and significance level of 5%. Results: 2581 people participated, with a mean age of 24.42 years (SD± 19, 365), predominance of females (n=1628; 63.1%). Among the interviewees, 2,341 (90.7%) had access to a toothbrush, 2272 (88.0%) to toothpaste, and 1175 (45.5%) to a dental appointment. The need for dental prosthesis was higher in women, 581 (35.7%) versus 221 (23.2%) men and their access [354 (60.9%)] versus [96 (43.4%)] with p<0.05. Conclusion: The access to health services and dental treatment presents gender as an influence factor. Women have most of the needs and benefits.

Objetivo: Identificar a influência do gênero no acesso ao serviço odontológico e aos artigos de higiene bucal. Métodos: Estudo transversal do tipo quantitativo, tendo como universo a população do Município de Guaiuba-Ceará e coleta de dados realizada por Agentes Comunitários de Saúde treinados, entre 2007 a 2008. Utilizaram-se variáveis do Indicador Comunitário em Saúde Bucal para averiguar acesso aos serviços de saúde, itens de higiene bucal, consulta odontológica, assim como uso e necessidade de prótese dentária. Os dados foram analisados com teste Qui-quadrado de Pearson com nível de significância de 5%. Resultados: Participaram 2.581 indivíduos, com idade média de 24,4 anos (DP ± 19,7). Predominou sexo feminino (63,1%; n=1628). Dos entrevistados, 2.341 (90,7%) tiveram acesso à escova dental, 2.272 (88,0%) ao dentifrício, 1.175 (45,5%) à consulta odontológica. A necessidade de prótese dentária foi maior nas mulheres com 581 (35,7%) versus 221 (23,2%) homens e seu acesso [354(60,9%)] versus [96 (43,4%)] com p<0,05. Conclusão: O acesso a artigos de higiene bucal e serviços de saúde e a oferta para tratamento odontológico, apresenta o sexo como fator influenciador. As mulheres possuem a maioria das necessidades e dos benefícios.

Objetivo: Identificar la influencia del género en el acceso al servicio odontológico y los artículos de higiene bucal. Métodos: Estudio transversal de abordaje cuantitativo con la población Del Município de Guaiuba-Ceará y recogida de datos realizada por Agentes Comunitarios de Salud entrenados, entre 2007 y 2008. Se utilizaron variables del Indicador Comunitario en Salud Bucal para verificar el acceso a los servicios de salud, ítems de higiene bucal, consulta odontológica bien como el uso y necesidad de prótesis dental. Los datos fueron analizados con la prueba de Chi-cuadrado de Pearson con nivel de significación del 5%. Resultados: Participaron 2.581 individuos con edad media de 24,4 años (SD ± 19,7). Hubo predominio del sexo femenino (63,1%; n=1628). De los entrevistados 2.341 (90,7%) tuvieron acceso al cepillo de dientes, 2.272 (88,0%) al dentífrico, 1.175 (45,5%) a la consulta odontológica. La necesidad de prótesis dental fue mayor en las mujeres con 581 (35,7%) versus 221 (23,2%) hombres y su acceso [354(60,9%)] versus [96 (43,4%)] con p<0,05. Conclusión: El acceso a artículos de higiene bucal y servicios de salud y la oferta de tratamiento odontológico presenta el sexo como factor influyente. Las mujeres poseen la mayoría de las necesidades y beneficios.

Child, neglect and oral health.

BACKGROUND: Despite advancements in oral health policies, dental caries still a problem. The lack of parents/caregiver's care regarding child's oral health, which characterizes neglect, may lead to a high prevalence of caries. Therefore, the objective of this study was to analyze the relation between dental caries and neglect in five year-old children. METHODS: Quantitative study performed in two different moments. First, the children underwent oral examinations and physical inspection. Then, a semi-structured interview was performed with parents of children with high and low caries rate. RESULTS: In all, 149 physical inspections and oral exams were performed. The number of decayed, missing and filled teeth - dmf-t was 2.75 (SD 2.83); 16 children had extremely high values (dmf-t ≥ 7), 85 intermediate values (1 ≤ dmf-t ≥ 6) and 48 extremely low (dmf-t = 0). Nearly all caregivers were female (96.7%; n = 29), mostly mothers (93.3%; n = 28). Associations were found between caries experience and reason of the last consultation (p = 0.011), decayed teeth and child's oral health perception (p = 0.001). There was a trend towards a significant association between general health and decayed teeth (p = 0.079), general hygiene and caries experience (p = 0.083), and caries experience and number of times the child brushes the teeth (p = 0.086). CONCLUSION: There's a relation between caries experience and children's oral health perception by caregivers, as well as between caries experience and children's access to dental care. There is a trend towards association between caries experience and risk factors suggestive of neglect.