Reflexões metodológicas sobre prevalência da fluorose dentária nos inquéritos de saúde bucal

Abstract

OBJECTIVE:To evaluate the influence of social inequalities of individual and contextual nature on untreated dental caries in Brazilian children. METHODS:The data on the prevalence of dental caries were obtained from the Brazilian Oral Health Survey (SBBrasil 2010) Project, an epidemiological survey of oral health with a representative sample for the country and each of the geographical micro-regions. Children aged five (n = 7,217) in 177 municipalities were examined and their parents/guardians completed a questionnaire. Contextual characteristics referring to the municipalities in 2010 (mean income, fluorodized water and proportion of residences with water supply) were supplied by the Brazilian Institute of Geography and Statistics -Fundação Instituto Brasileiro de Geografia e Estatística. Multilevel Poisson regression analysis models were used to assess associations. RESULTS:The prevalence of non-treated dental caries was 48.2%; more than half of the sample had at least one deciduous tooth affected by dental caries. The index of dental caries in deciduous teeth was 2.41, with higher figures in the North and North East. Black and brown children and those from lower income families had a higher prevalence of untreated dental caries. With regards context, the mean income in the municipality and the addition of fluoride to the water supply were inversely associated with the prevalence of the outcome. CONCLUSIONS:Inequalities in the prevalence of untreated dental caries remain, affecting deciduous teeth of children in Brazil. Planning public policies to promote oral health should consider the effect of contextual factors as a determinant of individual risk.

Aspectos sociodemográficos relacionados à gravidade da maloclusão em crianças brasileiras de 12 anos

“…Diferenças regionais no acometimento de outros agravos e doenças bucais, tais como cárie 35 e fluorose dentária 36 , entre crianças brasileiras tem sido identificada em estudos prévios. Ressalta-se ainda que tanto as desigualdades sociais, como a presença de agravos bucais, podem comprometer a qualidade de vida e impactar negativamente na vida diária das pessoas 37 .…”

“…O nível muito grave foi maior entre os residentes de capitais (OR 1,36; IC 95%;1,71) e que avaliaram sua saúde bucal como nem satisfeito/nem insatisfeito (OR 1,58; IC 95%;1,05) e insatisfeito (OR 2,44; IC 95%;1,03 …”

Dental fluorosis: prevalence and associated factors in 12-year-old schoolchildren in Goiânia, Goiás

“…Besides, there is evidence that mild fluorosis has no adverse impact on the quality of life in children and adolescents 11,26 . Some methodological aspects of the surveys that assess dental fluorosis deserve attention, because it is an essentially subjective assessment 7,27 . The percentage increase in the prevalence of fluorosis in Brazil between 2003 and 2010, for example, should be viewed with caution, because in 2003 the examiners of the survey were encouraged to evaluate the two most affected teeth with the proviso that if these two elements were similarly compromised, the value of the least affected between them should be registered 28 .…”

Fluoretação da água dos dez maiores municípios do estado do Tocantins, Brasil

“…[16][17][18][31][32][33] . Comparison between data provided by the Vigiagua Program, concerning water quality in the state of Tocantins, Brazil, at two different times, 2014 and 2017.…”