IntroduçãoOs problemas de saúde bucal têm sido cada vez mais reconhecidos como importantes causadores de impacto negativo no desempenho diário e na qualidade de vida dos indivíduos e da sociedade. O relatório da Organização Mundial da Saúde (OMS) 1 reconheceu que as doenças bucais causam dor, sofrimento, constrangimentos psicoló-gicos e privações sociais, acarretando prejuízos em nível individual e coletivo. A saúde bucal, no contexto das definições contemporâneas de saú-de, é entendida como uma dentição confortável, funcional, com uma aparência que permite aos indivíduos desempenharem a sua função social e as suas atividades diárias sem transtornos físicos, psicológicos ou sociais 2,3 .Apesar do reconhecimento da importância dos aspectos sociais e psicológicos na determinação da doença, amplamente debatidos 4,5 , a odontologia continua empregando, quase que exclusivamente, índices biológicos na avaliação e determinação das necessidades de tratamento e apreciação de programas de saúde bucal. O índice de dentes cariados, perdidos e obturados (CPOD) e o índice periodontal comunitário (IPC) são recomendados pela OMS 6 para a avaliação das duas patologias bucais mais prevalentes: a cárie e a doença periodontal. Uma das limitações desses índices é o fato de não considerarem a percepção subjetiva do indivíduo em relação à saúde bucal e de não avaliarem a maneira co-ARTIGO ARTICLE
The aim of this study was to assess the impact of oral status on the daily performances of civil servants from the Public Works and Waste Management Department of the city of Porto Alegre, located in Southern Brazil. A cross-sectional study was conducted on a representative sample composed of 276 civil servants with ages ranging from 35 to 44 years. The Oral Impacts on Daily Performances index developed was employed to measure impacts caused by oral clinical conditions. Oral examinations were performed after the interviews. Multinomial Logistic Regression Analysis was used. After adjusting for sex and educational level, the results showed that the subjects with high DMFT scores were 5.8 times (95% CI = 2.1-16.1) more likely to have high impacts on their everyday life than those with low DMFT scores. Subjects that presented some coronal caries were 4.3 times (95% CI = 1.9-9.8) more likely to have high impacts on their everyday life than those with no coronal caries. Dental status assessed through the DMFT index and coronal caries are important indicators of impacts on the everyday life of the studied population.
The hospital profile has an important role in hospital mortality in the Hospital Information System of the National Unified Health System. Multilevel analysis should be used to estimate the contribution of the profile of mortality in hospitals.
The hospital mortality risk index was shown to be an appropriate predictor for calculating the expected death rate, and it can be applied to evaluate hospital performance. It is recommended that, in comparing hospitals, the adjustment using the predictive likelihood model for the risk should be used, with stratification according to hospital size.
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