This study describes dental caries data and fluorosis in seven municipalities in the Sorocaba region, S o Paulo State, Brazil, comparing those with fluoridated as opposed to non-fluoridated water. Criteria were those proposed by the World Health Organization (WHO, 1997), adapted by the School of Public Health, University of S o Paulo. The sample was selected at random, without replacement, and was calculated by age, accepting a design error of 2 and a sampling loss of 20% (n = 96 per age). There were six trained examiners, with accepted agreement percentage above 89% for all variables. In the Sorocaba region, the dmft index in 5 year-old children was 3.1, and 37.6% were caries-free (DMFT = 0). At age 12, 32.3% were caries-free (DMFT = 0), and the DMFT index in the region was 2.6, thus characterizing the area as having a low prevalence of caries. In areas with fluoridated water, the proportion of caries-free children at 12 years was higher than in those without fluoridated water (p = 0.019), and the DMFT was lower (p = 0.001). Prevalence of fluorosis at age 12 was 12.7% in the Sorocaba area and did not pose a public health problem according to the community fluorosis index (CFI).
O objetivo deste estudo foi verificar a relação entre tipo de escola, como medida de condição sócio-econômica e a prevalência de cárie em pré-escolares e escolares de Rio Claro, São Paulo, com água fluoretada. Os dados obtidos são secundários e a amostra foi de 888 escolares de 5 a 12 anos dos ensinos público e particular. A experiência de cárie foi medida por meio dos índices ceod e CPOD ¹, além do Índice de Cuidados. Empregou-se os testes qui-quadrado e Mann-Whitney com significância de 5%. Aos cinco anos, o ceod foi de 2,50 e 42,20% não apresentaram experiência de cárie. Aos 12 anos, o CPOD foi de 2,70 e 28,90% estavam livres de cárie. A prevalência de cárie nas crianças de escolas públicas foi maior do que nas particulares, sendo respectivamente de 74,50 e 61,20% (p < 0,0001), assim como os índices ceod e CPOD (p < 0,05). O Índice de Cuidados foi maior nas crianças do ensino particular (71,20%) do que nas do ensino público (52,80%). Encontrou-se uma maior experiência de cárie nos escolares do ensino público e assim a variável tipo de escola foi sensível para discriminar diferentes condições de saúde bucal, sugerindo-se que outras variáveis também sejam avaliadas.
Os objetivos deste estudo foram verificar a prevalência de hipoplasia, opacidade demarcada e fluorose dentária em escolares nas dentições decídua e permanente e verificar a associação entre a presença desses defeitos de esmalte e a cárie dentária. A amostra foi de 624 pré-escolares de 5 anos e 309 escolares de 12 anos. A prevalência de cárie dentária foi avaliada por meio dos índices ceod e CPOD, e a prevalência dos defeitos de esmalte, com o índice DDE. A fluorose dentária foi medida pelos critérios do índice de Dean. O teste do qui-quadrado foi usado para verificar a associação e a razão de chances, analisando a força e a direção da associação. Aos cinco anos de idade, em crianças com experiência de cárie, houve associação positiva entre cárie dentária e defeitos de esmalte. Entretanto, na dentição permanente, apenas a hipoplasia e a opacidade demarcada foram associadas à cárie. Os resultados deste estudo indicaram maior chance de crianças virem a ter cárie, tanto na dentição decídua como na permanente, na presença de defeitos de esmalte, porém mais estudos são necessários para a comprovação dessa associação.
An epidemiological survey was conducted in Paulínia, São Paulo State, Brazil, in 2000, aimed at verifying the prevalence of principal oral health problems, using the DMFT index and WHO diagnostic criteria. The sample (1,151) was randomly selected. The dmft was 1.90 in 5-year-olds, with 54.2% caries-free. DMFT was 1.00 in 12-year-olds, with 46.4% caries-free in the permanent dentition. Fluorosis prevalence in 7 to 12-year-olds was 30.5%, mostly the very mild form (22.9%). Prevalence of opacities and hypoplasias was 9.1%. In adults, the dental care index was 55.4% and an average of 21.30 teeth presented caries experience. In the elderly, DMFT was 29.50, consisting predominantly of extracted teeth (93.0%).
Relationship between fl uoride levels in the public water supply and dental fl uorosis ABSTRACT OBJECTIVE: To assess the prevalence of dental fluorosis among schoolchildren subjected to different fl uoride concentrations in the public water supply of their cities. METHODS:The sample comprised 386 seven-year-old schoolchildren living in two municipalities in the State of São Paulo that practiced external control over the fl uoridation of the water from 1998 to 2002: one with homogenous fl uoride concentration and the other with oscillating concentration. Dental fl uorosis was determined by dry examination of the upper permanent incisors using Dean's index. Scores classifi ed as questionable were considered to represent fl uorosis. Sociodemographic variables and questions regarding oral health were assessed using a structured questionnaire sent to the children's parents or the adults responsible for these children. Correlates of fl uorosis were assessed using multivariate logistic regression (p<0.05). RESULTS:Both municipalities presented a mild degree of fl uorosis. The prevalence of fl uorosis in the municipality with oscillating fl uoride content in the water was 31.4%, and it was 79.9% in the municipality with homogenous fl uoride content. The prevalence of fl uorosis was associated with the municipality with homogeneous fl uoride levels in the water (OR=8.33, 95% CI: 5.15;13.45) and with not owning a car (OR=2.10, 95% CI: 1.27;3.49). CONCLUSIONS:The prevalence of dental fl uorosis was higher in the city with better control of fl uoride levels in the water supply, however, this higher prevalence was not related with children's satisfaction with the appearance of their teeth.
Fatores associados à experiência de cárie em escolares de um município com baixa prevalência de cárie dentária
The aim of this study was to evaluate the prevalence of caries-free children using DMFT and significant caries (SiC) indexes in different caries prevalence groups in cities of the region of Campinas, São Paulo State, Brazil. The methodology proposed by the World Health Organization (1997) was used for caries diagnosis in 2,378 individuals. According to the DMFT index obtained in each evaluated city, 3 prevalence groups with representative samples were formed, being classified as low, moderate and high. SiC index was used to classify the one third of the population with the highest caries prevalence. In the low prevalence group, 32.4% of the children were caries free (DMFT=0), with mean DMFT of 2.29 and SiC index of 4.93. In the moderate prevalence group, 21.8% of the children were caries free, with mean DMFT of 3.36 and SiC of 6.74. Only 6.9% of the children in the high prevalence group were caries free and the mean DMFT was 5.54 (SiC=9.62). There was a great heterogeneity in dental caries distribution within the studied population, as well as a high caries prevalence considering the 3 classifications. Other indexes besides DMFT could be used to improve oral health assessment during establishment of the treatment plan and intervention.
Objective:To evaluate the role of socioeconomic variables and self-perceived oral health in the polarization of caries among adolescents in Santa Bárbara D'Oeste, Brazil.Material and Methods:Cross-sectional study. Sampling was randomized and sample size was defined according to WHO criteria. Two hundred and seventy seven adolescents (15 to 18 year-old) were examined by five trained examiners that assessed DMFT index according to WHO criteria. Self-perceived oral health, access to dental services and socio-demographic variables were self-reported. Student's t tests, chi-square tests, and multivariate logistic regression (with significant caries index (SiC) as the outcome), were performed.Results:Mean DMFT was 5.48 (±4.22) and the proportion of "caries free" subjects was 15.5%. Mean DMFT (9.71±2.85) and mean D (1.67±2.18) of SiC positive subjects were significantly higher than mean DMFT (2.88±2.17) and mean D (0.45±0.87) of SiC negative subjects (p<0.0001). Mean D of white (0.76±1.51) was significantly smaller than mean D of non-white subjects (1.32±2.01). The only variable independently associated with the "SiC positive" outcome was "report of toothache within six months prior to the study" [OR=1.83 (95%CI 1.08 to 3.12)], p<0.001.Conclusion:SiC was associated with "report of toothache" but not with sociodemographic variables in the studied population.
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