Factors associated with the municipal provision of orthodontics in the Brazilian Unified Health System.

BACKGROUND: The Brazilian federal government issued Ministerial Ordinance No. 718 in 2010 to expand the funding of orthodontic treatment provided by Brazilian municipalities via the Unified Health System (SUS in Portuguese). AIM: To identify social and structural factors associated with Brazilian municipalities that provide fixed orthodontic appliance therapy and interceptive orthodontic therapy. METHODS: Official Brazilian government databases were used for data collection. Poisson regression with robust variance was used for statistical analysis. RESULTS: Municipalities hosting Dental Specialty Centers (DSCs) with greater installed capacity (type III DSC with 7 dental chairs or over), which employed dentists specializing in pediatric dentistry and orthodontics, were more likely to offer orthodontic services via SUS. CONCLUSIONS: Federal, state, and municipal managers need to review the funding of orthodontic services via SUS, which can be used for creating DSCs and hiring professionals with expertise in orthodontics.

Parents' perceptions and related factors of the oral health status of Brazilian children enrolled in public preschools.

PURPOSE: This study aimed to evaluate parents' perceptions of the oral health status of children enrolled in public preschools and associated factors. METHODS: This was a cross-sectional study with data collected via self-administered questionnaire. A total of 474 questionnaires were distributed in public preschools in the city of Canoas, Rio Grande do Sul, the southernmost state of Brazil. Poisson regression models were used in the multivariate analysis (p < 0.05). RESULTS: The study included 171 (36%) valid questionnaires. The prevalence of parents who perceived the oral health status of their children as negative was 29.8% (n = 51). Mother being unemployed (vs employed) increased by 16% the likelihood of parents perceiving the oral health status of their children as negative (prevalence ratio [PR] 1.16; 95% confidence interval [CI] 1.02-1.31. Parents having (vs having not) observed difficulties in the child's ability to eat increased by 27% the likelihood of perceiving the child's oral health status as negative (PR 1.27; 95% CI 1.08-1.48), while child's tooth brushing 1-2 (vs 3 or more) times a day and family income up to 2 (vs 3 or more) minimum wages increased it by 14% (PR 1.14; 95% CI 1.03-1.27 for both). Current or past use (vs no use) of pacifiers increased by 12% the likelihood of parents' negative perceptions (PR 1.12; 95% CI 1.00-1.25). CONCLUSION: We can conclude that unemployed mothers, low-income families, parents having observed child's feeding difficulties, child's tooth brushing 1-2 times a day, and current or past use of pacifiers contributed significantly to parents' negative perception of the child's oral health status. These factors are essential for the planning, implementation, monitoring, and evaluation of actions aimed at controlling the oral health of children enrolled in public preschools.

Clinical performance and wear resistance of two compomers in posterior occlusal restorations of permanent teeth: six-year follow-up.

This study evaluated the clinical performance and wear resistance of compomer restorations placed in the occlusal cavities of posterior permanent teeth after six years. In 1999, 72 Class I restorations were placed by a single operator in 33 patients. Eighty-two percent of these restorations were located in molars. Each patient received at least two restorations, one with F2000 (3M ESPE) and another with Dyract AP (Dentsply). The finished and polished restorations that were free of any failure were considered the baseline. The restorations were clinically evaluated at baseline and at one-, two- and six-year intervals using modified USPHS criteria for color mismatch, marginal discoloration, surface roughness, marginal adaptation, anatomic form and secondary caries. Polyvinylsiloxane impressions (Express, 3M ESPE) were also taken, and models were obtained for indirect wear assessment (Leinfelder scale) at the same intervals. After six years, 11 patients attended the recall. Twenty-seven compomer restorations (11 with Dyract and 16 with F2000) were reevaluated. Data were submitted to the Friedman's test, ANOVA with repetitive measures, Tukey's test (clinical data), Wilcoxon and Kruskal-Wallis tests and the Spearman's correlation test (wear evaluation), all at a significance level of p < 0.05. When comparing the materials, F2000 and Dyract presented similar clinical performance and occlusal wear at the end of the clinical trial. The two compomers showed a significant increase in wear at the six-year follow-up, and a positive correlation (r2 = 0.65) was detected between wear and evaluation time (p < 0.001). Despite the decrease in restoration quality and the increase in occlusal wear, nearly all restorations were considered acceptable after the six-year evaluation.