The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition’s measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.
This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.
Objectives: To systematically review the literature on the prevalence of dental fear in adults to estimate a worldwide pooled prevalence and to investigate factors related to the heterogeneity of estimates. Methods: Inclusion criteria were population-based studies reporting the prevalence or data that allowed the calculation of prevalence of dental fear in adults and/or elders. Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library (BVS) and Web of Science) were searched. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed to investigate variability between studies. Results: The search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 13.8%, 11.2% and 2.6%, respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instrument used to measure dental fear also affected the prevalence of the outcome. Conclusions: Dental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women.
ResumoIntrodução: A doença cárie e as alterações periodontais são problemas frequentemente encontrados em pacientes com deficiência. Objetivo: Avaliar as condições periodontais e de higiene bucal em escolares com deficiência neuropsicomotora matriculados em um centro de reabilitação. Método: A pesquisa envolveu entrevista com os responsáveis e exame clínico do escolar, para registro do índice de placa e do índice de sangramento. Após o exame, foi realizada profilaxia profissional, orientação de higiene bucal e esclarecimento de dúvidas. Os dados foram observados por meio de estatística descritiva. Resultado: A amostra foi constituída por 41 escolares com deficiência neuropsicomotora, com idades entre sete e 14 anos, sendo 20 do sexo feminino (48,8%) e 21 do sexo masculino (51,2%), e com idade média de 10,8 anos. A maioria dos pacientes tinha a figura da mãe como principal cuidador (85%). Observou-se que 71% dos escolares necessitavam de ajuda para realizar a higiene bucal e quase 40% dos cuidadores apresentavam dificuldade para realizá-la, principalmente pelo fato de o paciente "não abrir a boca". Quase a totalidade dos escolares não usava fio dental. Constatou-se, ainda, que 87,2% apresentaram sangramento gengival à sondagem e que, em 84,7%, verificou-se índice de placa maior ou igual a '2' . Conclusão: Concluiu-se que os escolares com deficiência neuropsicomotora incluídos neste estudo apresentaram condições periodontais e de higiene bucal insatisfatórias, demonstrando a necessidade de serem instituídas ações preventivas focadas na orientação aos pacientes e cuidadores, para a efetividade da higiene bucal.Descritores: Higiene bucal; pessoas com deficiência; gengivite. AbstractIntroduction: Caries and periodontal disease are problems frequently affecting patients with disabilities. Objective: In this study we aim to evaluate the periodontal conditions and the oral hygiene in students with neuropsychomotor disorders enrolled in a rehabilitation center. Method: Data collect was based in interview with the responsible and the scholar's clinical exam to register the plaque index and the bleeding index. After the clinical exam were performed professional prophylaxis, oral hygiene orientation and explanation of doubts. Result: The sample consisted of 41 students with neuropsychomotor disabilities, with ages among 7 and 14 years, 20 females (48.8%) and 21 males (51.2%) with a mean age of 10.8 years. Most patients had the figure of the mother as primary caregiver (85%). It was observed that 71% of students need help in performing oral hygiene and nearly 40% of caregivers had difficulty doing it, in most of the cases because the patient "did not open his mouth". Almost the totality of the students doesn't use dental floss. It was also found that 87.2% had gingival bleeding and 84.7% had the plaque index greater or equal to 2. Conclusion: It was concluded that disabled students included in this study had bad periodontal conditions and poor oral hygiene. It shows the need of preventive programs to guide themselves and the...
Dione Dias TORRIANI (in memorian)6 RESUMO: o objetivo deste estudo foi revisar na literatura estudos que abordem formas de realização de promoção de saúde e prevenção de doenças bucais para pacientes com deficiência visual. Foi realizada revisão sistemática da literatura nas bases de dados PubMed Central, Biblioteca Virtual de Saúde (BVS) e Scopus, sem limite de data de publicação. Foram incluídos ensaios clínicos nas línguas inglesa, portuguesa e espanhola, com algum tipo de intervenção de promoção de saúde bucal voltada para deficientes visuais totais ou parciais. Os artigos foram selecionados e os dados extraídos pelos autores. A busca resultou em 688 artigos dos sites PubMed, BVS e Scopus. Foram eliminados 303 artigos repetidos e, dentre os demais, selecionados nove que abordavam o tema desta revisão. As datas de publicação dos estudos variaram de 1991 a 2013. O total de deficientes visuais participantes destes estudos foi de 431 com idades entre seis e 49 anos. Todas as intervenções educativas foram efetivas e realizadas por odontólogos. A orientação verbal foi o recurso educativo mais utilizado Os resultados encontrados nos estudos deixam clara a necessidade e importância da implantação de estratégias de educação em saúde bucal para essa população. Programas de orientação de higiene bucal envolvendo recursos adaptados e comunicação verbal são efetivos no estabelecimento de uma rotina de higiene adequada, agregando conhecimento aos pacientes e seus familiares e resultando em melhora nos índices de saúde bucal. PALAVRAS-CHAVE:Educação Especial. Saúde Dental. Cegueira. ABSTRACT:The aim of this study was to review the literature about oral health promotion and oral disease prevention for patients with visual impairment. A systematic literature review was conducted using PubMed Central, BVS (Virtual Health Library) and Scopus without restriction for publication date. Clinical trials in English, Portuguese and Spanish that presented any oral health promotion intervention targeting people with visual impairments were included. The articles were selected and data extracted by author. The search resulted in 688 articles from the PubMed, BVS and Scopus websites. Three hundred and three repeated items were eliminated and, among the others, 9 that addressed the topic of this review were selected. The publication dates of the studies ranged from 1991 to 2013. The total number of visually impaired participants of these studies was 431, aged 6 to 49 years. All educational interventions were effective and performed by dentists. The verbal guidance was the most used educational resource. The results demonstrated the need and importance of implementing strategies for oral health education for this population. Oral hygiene orientation programs involving tailored resources and verbal communication are effective in establishing a routine for proper hygiene, providing knowledge to patients and their families, with improvement in oral health indices.
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