Functional dentition plays an important role in maintaining masticatory function, which is closely related to the number of teeth present in the mouth. The objective of this study was to investigate the association between individual and contextual factors and functional dentition (defined IntroductionTooth loss is one of the main public health problems affecting the adult population worldwide 1 . This situation directly and indirectly influences the individual's overall health. Compromised masticatory function affects quality of diet, increasing the risk of various health problems like cardiovascular diseases, physical disabilities and even death 2,3 . Edentulous individuals show lower consumption of important macro and micronutrients as compared to those with functional dentition 4,5 . For example, edentulism without rehabilitation with prostheses has been associated with reduced intake of carbohydrates, vitamins, and minerals 4 . Obesity 3 and malnutrition 5 have also been linked to tooth loss.There are various causes of tooth loss, the main ones being dental caries and periodontal disease. Other factors include access to dental services, health system organization, and oral health care 6,7 . Higher tooth loss rates have been associated with unfavorable socioeconomic conditions 8,9 .Functional dentition plays an important role in maintaining masticatory function, which is closely related to the number of teeth present in the mouth 10,11,12 . According to this concept, maintenance of functionality requires a minimum of 20 teeth well distributed in the upper and lower dental arches. In 1992, the World Health Organization (WHO) declared the lifetime reten-ARTIGO ARTICLE
The results are supportive of the use of nystatin and disinfecting agents in the treatment of DS, but clinicians need to be aware that individual studies had high risk of bias and that the overall quality of the individual reports was judged to be low.
Resumo A garantia de atenção odontológica passa pelo desenvolvimento de práticas pautadas na vigilância em saúde, a fim de concretizar a integralidade. Objetivou-se avaliar a associação entre aspectos contextuais dos municípios brasileiros, características do processo de trabalho e a realização de um rol de procedimentos odontológicos curativos pelas equipes de saúde bucal (ESB). Trata-se de estudo exploratório transversal cuja coleta multicêntrica de dados se deu em 11.374 ESB avaliadas pelo Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Foi empregada regressão de Poisson multinível para obtenção da prevalência de realização de procedimentos odontológicos curativos, que foi de 69,51%. As variáveis contextuais e da equipe de saúde que se mantiveram associadas ao desfecho incluíram municípios cuja proporção de internações sensíveis à atenção básica foi menor que 28% e cuja proporção de exodontias foi menor que 8%; bem como ESB de modalidade II que tinham à disposição materiais, insumos e melhores processos de trabalho. Esta análise multinível, que considera o desempenho da atenção odontológica curativa no Brasil, aponta para um cenário de atenção odontológica preocupante.
Objectives This cross‐sectional study aimed to estimate the association between the structural and cognitive dimensions of social capital and self‐reported oral health. Methods This study conducted individual assessments of 9,365 individuals aged 50 years or older from Brazil. Four individual variables based on structural and cognitive dimensions of social capital were assessed. We used hierarchical Poisson regression models to estimate the prevalence ratio of self‐reported oral health with individual structural and cognitive social capital variables adjusted for associated factors. Results Cognitive social capital was associated with self‐reported oral health. Individuals who reported lack of neighbourhood trust and not having friends presented 14% (RP: 1.14; 95% CI: 1.07‐1.21) and 9% (RP: 1.09; 95% CI: 1.01‐1.19), respectively, higher prevalence of poor self‐reported oral health, relative to those who trust in their neighbourhood and reported having friends. Conclusion The cognitive dimension of social capital may be linked with self‐reported oral health. Therefore, social capital can be stimulated in the context of social policies as its encouragement can be an efficient tool for improving individuals’ health and, consequently, the oral health of the older people.
Objectives It is evident that discriminatory attitudes affect different dimensions of personal life, including health. This study aimed to verify the association between perceived discrimination in health services and preventive dental attendance in Brazilian adults. Methods This cross‐sectional study used secondary data from the 2013 National Health Survey (PNS), a representative survey of the Brazilian population. The response rate was 91.9%, with 60,202 adults agreeing to complete the oral health self‐perception questionnaire. Data were analysed using the software STATA 14.0. A descriptive sample analysis was conducted that considered sample weight as well as an association between health discrimination and factors associated with preventive dental attendance through Poisson regression models. Results Adjusted analysis demonstrated that, regarding the reasons that led to discrimination, lack of money, social class and type of working occupation showed a negative association with preventive dental attendance. Conclusion Our findings show that discrimination perpetuates health inequities. Those with worse social conditions need more assistance as they struggle with discrimination and end up going for a check‐up after the disease is established or advanced. Preventive care, which could change the health condition of the disadvantaged population, is often a reality only for those less vulnerable.
O presente estudo sobre tratamento de canais radiculares teve como objetivos: i) fornecer um panorama de atendimentos dos pacientes referenciados pelas Unidades Básicas de Saúde (UBS) de Porto Alegre no CEO da Universidade Federal do Rio Grande do Sul (UFRGS) e ii) investigar a conformidade de preenchimento dos prontuários clínicos dos pacientes atendidos. Foram analisados 242 prontuários. Os dados coletados foram inseridos em uma tabela com as seguintes informações referentes a cada paciente: 1) número do prontuário, 2) idade (anos e meses), 3) gênero (masculino/feminino), 4) dente, 5) número de consultas, 6) presença de radiografia final do dente obturado, restaurado e sem isolamento absoluto (sim/não), 7) qualidade da radiografia (adequada/ inadequada), 8) presença da radiografia final do caso no momento da obturação (sim/não), 9) qualidade da radiografia (adequada/ inadequada), 10) consentimento informado assinado pelo paciente (sim/não), 11) entrevista dialogada preenchida (sim/não), 12) presença da informação sobre o diagnóstico pulpar ou periapical (sim/não), 13) relato da finalização do trata-mento/obturação do dente (sim/não), 14) relato sobre a restauração provisória coronária (sim/não), 15) informação sobre a contra-referência para a UBS (sim/não). Foi realizada análise descritiva (frequência e percentagem) dos dados e correlação entre as variáveis idade (faixa etária) e i) gênero, ii) dente (posterior ou anterior), iii) grupo dentário e iv) número de consultas. Houve predominância de pacientes do sexo feminino (63,2%) em todas as faixas etárias, exceto em pacientes com 60 anos ou mais, onde predominaram pacientes do sexo masculino. Os dentes que mais sofreram intervenção foram os posteriores (60,3%), exceto em pacientes na faixa etária 50 a 59 anos. Os 1os molares foram os dentes que receberam mais tratamento endodôntico (28,9%), principalmente em pacientes adultos-jovens (menores de 19 anos até 39 anos de idade). Na maioria dos casos o tratamento foi concluído em poucas consultas (67,4% das vezes em até 3 consultas). Os pontos negativos observados foram: deficiente armazenamento e qualidade das radiografias; ausência da história médico-odontológica do paciente; falta da descrição do diagnóstico pulpar/periapical e ausência da assinatura do paciente autorizando o tratamento. Os pontos positivos encontrados foram: a finalização do tratamento endodôntico foi documentada em 100% das vezes e a realização da restauração provisória coronária foi documentada na maioria das vezes (95%). Os achados deste estudo, além de evidenciar o perfil de atendimento do CEO-Endodontia da UFRGS, podem contribuir para o desenvolvimento de estratégias que impulsionem mudanças positivas no serviço odontológico, tais como incentivo do pensamento crítico e ético no aluno/profissional em relação à magnitude da importância do correto preenchimento dos prontuários clínicos e geração de ideias que possam aprimorar os meios de armazenamento das radiografias nos prontuários.
Utilização de serviço de saúde bucal no pré-natal na atenção primária à saúde: dados do PMAQ-ABOral healthcare utilization during prenatal care in primary healthcare: data from PMAQ-AB
This study aimed to evaluate the influence of choosing different socioeconomic status indicators in research regarding older adults' oral health. This is a cross-sectional study that analyzed baseline data from the Brazilian Longitudinal Study on Aging (ELSI-Brazil). The outcomes were edentulism (n = 9,073) and self-reported oral health (n = 9,365). The following socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression analysis with robust variance was performed to estimate prevalence ratios (PR), with their respective 95% confidence intervals (CI), after adjusting for socioeconomic and oral health behavior variables. Absolute inequality measures were also estimated. The individual income indicator was not statistically associated with the results after adjustments. When using per capita household income indicator, individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [PR: 0.88 (CI: 0.78-0.98)], relative to the poorest, and there was no association with edentulism. When the wealth index was chosen, there was a 22% lower prevalence of edentulism [PR: 0.78 (CI: 0.64-0.94)] and 15% lower prevalence of self-reported poor oral health [PR: 0.85 (CI: 0.78-0.93)] in individuals of the richest quintile, both relative to the poorest quintile. Regarding absolute inequality measures, for edentulism, the wealth index showed the highest absolute inequality. When considering self-reported oral health, per capita household income showed the greatest absolute inequality. Despite scientific challenges and the difficulty of socioeconomic indicator metrics, further investments in its development are critical to measure, promote, and improve population oral health.
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