Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil

Timing, reasons, and predictors for first dental visits among children seen at two university hospitals

BACKGROUND

Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years.

AIM

The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children.

DESIGN

Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well-baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist.

RESULTS

The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves.

CONCLUSION

Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences.

What makes inequality in the area of dental and oral health in developing countries? A scoping review

Background

Equity in health is an important consideration for policy makers particularly in low and middle income developing country. The area of oral and dental health is not an exception. This study is conducted to explore the main determinants that make inequality in oral and dental health area in developing countries.

Methods

This was a scoping review applying the framework enhanced by Levac et al. Four databases of Scopus, PubMed, WOS and ProQuest were systematically searched applying to related keywords up to 27.11.2020. There restriction was placed in the English language but not on the study design. All the related studies conducted in the low or middle income developing countries were included. A qualitative thematic analysis was applied for data analysis and a thematic map was presented.

Results

Among 436 articles after excluding duplications, 73 articles were included that the number of publications from Brazil was greater than other developing countries (33.33%). Thematic analysis of the evidence has led to 11 determinants that may result in inequality in oral and dental health services in developing countries including personal characteristics, health status, health needs and health behaviours, social, economic, cultural and environmental factors, as well as insurance, policies and practices and provided related factors.

Conclusion

The policymakers in the low and middle income developing countries should be both aware of the role of inequality determinants and also try to shift the resources to the policies and practises that can improve the condition of population access to oral and dental services the same as comprehensive insurance packages, national surveillance system and fair distribution of dentistry facilities. It is also important to improve the population’s health literacy and health behaviour through social media and other suitable mechanisms according to the countries’ local contexts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12962-021-00309-0.

Trends in Breastfeeding and Associated Factors in a Primary Healthcare Service in the South of Brazil: 2004 to 2015

The aim was to monitor the frequency of Breastfeeding (BF) and Exclusive Breastfeeding (EBF) in a Primary Healthcare Service, between the years of 2004 to 2015. This is a historical series is composed of eight cross-sectional surveys that were carried out during the annual vaccination campaigns. A total of 6027 children were evaluated, with a mean age of 6.2 months. There was a significant increase in the rates of BF (7.2%) and EBF (9.5%) in children less than four months old. In infants from four to five months old, a substantial decline was observed in the EBF rate between 2010 and 2015 (6.3%). The frequency of BF had a 10.1% increase in infants from six to nine months old and remained stable in children from 10 to 11 months of age. Among children less than six months old, monitoring by the health service had a positive impact on the frequency of BF (p < 0.001) and EBF (p < 0.001). The better BF and EBF rates seen in this study in infants followed up by the primary healthcare centers reinforce the evidence on the importance of expanding and qualifying primary healthcare as support for mother and child healthcare.

Acesso a bens e serviços de saúde bucal por escolares de 7 a 10 anos em Vitória-ES

Resumo Introdução A utilização dos bens e serviços de saúde é considerada uma expressão positiva de acesso, influenciada por diversos fatores. Objetivo Analisar o acesso aos serviços e bens em saúde bucal, com seus fatores determinantes, entre escolares de 7-10 anos. Material e método Estudo seccional realizado com escolares de amostra probabilística por conglomerado. Os dados foram coletados através de formulário aplicado às crianças e questionário enviado aos pais/responsáveis. O desfecho de interesse foi o acesso aos bens e serviços de saúde odontológicos, a partir das variáveis “primeira consulta odontológica” e “posse de escova dental própria”. As variáveis independentes (características infantis, maternas e socioeconômicas) que apresentaram significância estatística ≤0,10, na análise bivariada, foram incluídas no modelo de Regressão Logística Multivariada. O nível de significância adotado no modelo final foi de 5%. Resultado Associaram à posse de escova dental: idades de 8 (OR=3,303; IC95%= 1,135 – 9,610), 9 (OR=3,452; IC95% = 1,176 - 10,137) e 10 anos (OR= 6,901; IC95% = 1,468 – 32,434); tabagismo materno (OR=4,509; IC95% = 2,021-10,060). Associados à primeira consulta odontológica: idades de 9 (OR=2,321; IC95% = 1,340 – 4,022) e 10 anos (OR= 3,155; IC95% = 1,687 – 5,899); escola privada (OR=3,691; IC95% = 1,343-10,145); dois ou mais quartos na residência (OR: 3,691; IC95% = 1,343 – 10,145) e posse de escova dental própria (OR=2,065; IC95% = 1,009 – 4,226). Conclusão Os resultados apontam para desigualdade no acesso à saúde odontológica. Crianças mais velhas, com mães não fumantes e melhores condições socioeconômicas apresentam maior acesso aos serviços e bens em saúde bucal.