Posição socioeconômica e autoavaliação da saúde bucal no Brasil: resultados da Pesquisa Nacional de Saúde

Poor Self-Rated Oral Health Status and Associated Factors Amongst Adults in Algeria

BACKGROUND

Understanding the proportion and correlates of self-rated oral health (SROH) can assist in prioritising interventions. The aim of this study was to assess the prevalence of poor SROH and associated factors in a national community survey amongst adults in Algeria.

METHODS

This World Health Organisation (WHO) STEPS cross-sectional survey in Algeria in 2016 and 2017 included 6989 people (18-69 years; median age, 37 years) selected by multistage cluster sampling. The assessment included questionnaire information, physical measures, and biochemistry tests. The measures included questions on SROH, oral conditions, oral health behaviour, general health behaviour, and measures of health status.

RESULTS

The sample included 6989 people aged 18 to 69 years. Of the total sample, 17.1% had removable dentures, 35.5% had 0 to 19 natural teeth, 43.9% had dental pain in the past year, 40.5% had impaired oral health-related quality of life (OHRQoL), 26.9% cleaned their teeth 2 times/d or more, 79.6% used toothpaste, and 41.2% had visited a dentist in the past year. The prevalence of poor SROH was 37.3%. In the final logistic regression model, older age (45-69 years) (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.09-1.65), having removable dentures (AOR, 1.46; 95% CI, 1.14-1.87), dental pain (AOR, 2.16; 95% CI, 1.82-2.57), impaired OHRQoL (AOR, 2.69; 95% CI, 2.26-3.20), current smokeless tobacco use (AOR, 1.45; 95% CI, 1.12-1.89), and inadequate fruit and vegetable intake (AOR, 2.69; 95% CI, 2.26-3.20) increased the odds of poor SROH. Men (AOR, 0.76; 95% CI, 0.65-0.90), having 20 or more teeth (AOR, 0.35; 95% CI, 0.28-0.42), twice or more a day teeth cleaning (AOR, 0.72; 95% CI, 0.60-0.86), and using toothpaste (AOR, 0.67; 95% CI, 0.55-0.82) were protective against poor SROH.

CONCLUSIONS

Adults in Algeria reported a high prevalence of poor SROH, and several associated factors (sociodemographic, oral conditions, oral and general health-compromising behaviour) were found that can guide in oral health promotion strategies in Algeria.

Factors associated with the absence of Brazilians in specialized dental centers

Aim

To identify the individual and contextual factors associated with the absence of Brazilians at a scheduled appointment in Dental Specialties Centers (DSC).

Methods

This cross-sectional design uses the National Program for Improving Access and Quality of Dental Specialties Centers database, 2018. The outcome was the users' lack of at least one of the scheduled appointments. Contextual and individual independent variables were used, considering Andersen's behavioural model. The analyses were performed with the R Core Team and SAS (Studio 3.8, Institute Inc, North Carolina, U.S, 2019) programs.

Results

Of the 10,391 patients interviewed, 27.7% missed at least one of the consultations. In the adjusted multivariate model, the interpretation based on the effect size and 95% CI showed that the behaviour individual predisposing factors such as age ≤ 42 years (OR = 1.10; 95%CI:1.01–1.21), individual need factors such as participation in the “Bolsa Família” program (OR = 1,14; 95%CI:1.02–1.27), not being covered by the Family Health Strategy (OR = 1.15; 95% CI:1.02–1.30), and users of periodontics services (OR = 1.22;95%CI:1.05–1.40) were associated with absences. The behavioural factor associated with the outcome was that the DSC facilities were not in good condition (OR = 1.18; 95%CI:1.03–1.34). DSC located in the capital (OR = 1.12; 95% CI: 0.92–1.48) were 12% more likely to have dental absences than those in the interior region.

Conclusion

There are individual and contextual barriers associated with patients not attending specialised public dental consultations. DSC should offer adequate hours to patients, especially young adults and vulnerable people.

Social and racial inequity in self-rated oral health in adults in Southern Brazil

This study aimed to estimate social and racial inequalities in self-rated oral health in adults from the Brazilian birth cohort study. This study belongs to 1982 Pelotas (Brazil) birth cohort study. Data from this study was collected for oral health conditions 31 years old (Oral Health Study). The outcome was self-rated oral health, dichotomized into positive (good/very good) and negative (regular/bad/very bad). Analyses were stratified by gender, racial/skin color groups, schooling level and income. For statistical analysis, the slope index of inequality (SII) and the concentration index (CIX) were used. The prevalence of negative self-rated oral health was 36.1%. Social inequalities were observed in self-rated oral health in both absolute and relative terms. A SII of -30.0 (95%CI: -43.6; -16.4) was observed for income, and -27.7 (95%CI: -41.9; -13.4) for schooling level. Both the individuals’ income and the schooling level had negative CIX (CIXincome -14.6 [95%CI: -21.2; -8.0] and CIXschooling level -14.1 [95%CI: -20.7; -7.5]). Furthermore, the prevalence of negative self-rated oral health in black/brown/indigenous individuals from the highest income/schooling level was comparable to prevalence of the outcome in the white individuals belonging to the lowest income/schooling levels. This study results demonstrate racial disparities in oral health regardless of income and schooling levels. Furthermore, a higher concentration of negative self-rated oral health was identified among the most socioeconomically vulnerable individuals. Our findings reinforce the presence of racial and socioeconomic inequalities in oral health.

Inter-examiner agreement in the application of an oral health assessment instrument in hospitalized elderly

OBJECTIVES

to analyze the correspondence between nurse and dental surgeon assessments in the application of an Oral Health Assessment in dental screening of elderly hospitalized patients.

METHODS

cross-sectional study with elderly patients (n = 54) admitted to University Hospital from the Federal University of São Paulo. Data were collected through the assessment of oral cavity. Descriptive statistical techniques were used to analyze them, using tables and graphs.

RESULTS

there was correlation and agreement between nurse and dental surgeon assessments referring to application of an Oral Health Assessment in dental screening of hospitalized elderly.

CONCLUSIONS

oral Health Assessment in dental screening for hospitalized elderly by nurses demonstrated excellent reproducibility and may be a resource to identify buccal alteration, helping the planning and execution of nurse care associated to oral health.

Characterizing Socioeconomic Inequalities in Professionally Applied Topical Fluoride Treatment Courses in Schoolchildren from a Developing Country

The objective of the present study was to characterize socioeconomic inequalities in the patterns of professionally applied topical fluoride (PATF) in Mexican schoolchildren. A cross-sectional study was carried out on 3029 Mexican schoolchildren. A questionnaire was administered to caregivers to determine sociodemographic, socioeconomic, and behavioral variables. The dependent variable was prevalence of PATF, coded as 0 = without PATF and 1 = with PATF, at any point in life, and separately, in the previous year. Various indicators of socioeconomic position were included. Logistic regression was used in the final multivariate analysis. The prevalence of PATF any time in life was 33.8%, while in the previous year it was 11.4%. The variables associated (p < 0.05) with PATF any time in life were child's older age (OR = 1.12), older age when tooth brushing started (OR = 1.57), higher brushing frequency (OR = 1.60), having health insurance [public (OR = 1.61) or private (OR = 1.45)], if family owned a car (OR = 1.29) and better socioeconomic position [parents' education, second (OR = 1.48) and third (OR = 1.75) tertile]. For PATF in the previous year, the variables associated were older age of mother (OR = 1.03), older age when tooth brushing started (OR = 1.99), higher brushing frequency (OR = 1.68), having health insurance [public (OR = 1.62)] and better socioeconomic position (parents' education, second (OR = 1.57) and third (OR = 1.97) tertile). This study suggests the existence of socioeconomic inequalities in PATF, manifested through socioeconomic position, access to health insurance and household having a car. Identifying and addressing PATF inequalities would improve oral health in the child population.

Oral Health Related Quality of Life in an Adult Jamaican Population

Objectives The aim of this study is to evaluate the impact of sociodemographic characteristics, oral health status and behaviours on Oral Health Related Quality of Life (OHRQoL) on an adult Jamaican population. Methods Adults who presented for treatment at the UWI Mona Dental Polyclinic participated in this cross-sectional study. Participants responded to a structured questionnaire consisting of sociodemographic and oral hygiene habits and were also examined for the presence of decayed, missing and filled teeth (DMFT). OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. Descriptive statistical analysis, univariate and multiple Poisson Regression with robust variance were performed to identify the factors impacting OHRQoL. Results The study sample consisted of 120 adults between the ages of 18-59 years. The mean OHIP-14 score was 9.81 (±9.06), 24% presented impaired OHRQoL and 76% presented frequent impaired OHRQoL. The most prevalent domain was physical pain (80%) followed by psychological discomfort (59%) and the mean DMFT score was 9.92 (±8.78). In the adjusted logistic regression, participants aged between 29-46 years (PR 0.58, CI 0.37-0.90, p= 0.016) and the use of fluoride toothpaste (PR 0.52, 95%, CI 0.35- 0.77, p = 0.001) were negatively associated with OHRQoL. Conclusion Physical pain was the dimension that most impacted domain in OHRQoL. The most negative OHRQoL was associated with the 29 to 46 years age-group and the use of fluoride toothpaste. These findings are important for oral health strategies in this population.