Fatores relacionados à autopercepção da necessidade de tratamento odontológico entre idosos

Family Cohesion Is Associated with the Self-Perceived Need for Dental Treatment among Adolescents

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents' level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples (α = 5%). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries (OR = 2.10; IC 95%: 1.22-3.61), tooth loss (OR = 15.81; IC 95%: 2.14-116.56), dental pain in the last six months (OR = 1.87; IC 95%: 1.06-3.31), and enmeshed family cohesion type (OR = 10.23; IC 95%: 3.96-26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

[Access to dental services and related factors: a home-based population study]

The scope of this study was to identify factors associated with lack of access to dental services. It involved a cross-sectional study and a probabilistic complex sample by conglomerates in two stages with 857 participants over 18 years of age in a large city. Multiple analyses by means of logistic and multivariate regression in decision trees were made. The lack of access to dental services was considered a dependent variable. It was identified that 10.3% did not have access. In the multiple and multivariate analyses an association with age was verified and in the logistic regression a greater possibility of lack of access was found for each year of increased age, among those with the lowest per capita income and those who ranked appearance of teeth and gums as "fair/poor/very poor." The lack of access to dental services was greater among the most socially vulnerable. There is a pressing need to increase the allocation of public resources to promote health education and provide knowledge about how to access services when they are needed, focusing on dental care as a human right and ensuring that lack of access does not occur as users get older or among those with low income and also those dissatisfied with their oral appearance.

Fatores associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros

Resumo Este estudo teve como objetivo identificar fatores individuais e contextuais associados à autopercepção da necessidade de tratamento odontológico e de prótese em idosos brasileiros. Foram utilizados dados secundários de 7.619 indivíduos idosos do levantamento epidemiológico SB Brasil 2010. As associações entre as variáveis dependentes e os fatores individuais e contextuais foram estimadas através da razão de chances (odds ratio – OR) e intervalo de confiança de 95%, obtidas por regressão logística multinível. Dos idosos avaliados pelo SB Brasil 2010, 3.848 (50,5%) afirmaram necessitar de tratamento odontológico e 4.236 (55,6%) acreditavam necessitar de prótese. Os resultados da regressão logística multinível mostraram que sexo, cor da pele autorreferida, renda e cobertura pelas equipes de saúde bucal na Estratégia de Saúde da Família estiveram associados à autopercepção. O presente trabalho evidenciou maior influência de fatores individuais na autopercepção da necessidade de tratamento odontológico e de prótese entre idosos brasileiros. Essas informações podem auxiliar na identificação de desigualdades que afetam essa parcela da população e na definição de prioridades para o planejamento dos serviços de saúde.

Oral health conditions and activities of daily living in an elderly population in Brazil

Abstract Objective: To analyze the relationship between the oral health status and functional capacity in performing basic activities of daily living of a population of elderly persons. Method: A cross-sectional population-based study with 441 individuals aged 60 years or over both genders was performed in the municipality of Macaíba, Rio Grande do Norte. From intraoral epidemiological examination, the degree of caries attacks (CPO-D index), periodontal condition (CPI and PIP indexes), the use and need for dental prosthesis and the presence of oral lesions were evaluated. Independence in Activities of Daily Living was used to evaluate functional capacity. Socioeconomic and demographic characteristics were surveyed using a structured questionnaire. Results: Oral health variables were subjected to factor analysis, which resulted in four indicators. There was no association between these indicators and the functional capacity of the elderly. Gender, age, presence of caregiver, dominant area of residence, time of last visit to the dentist, type of care sought during such visit and self-perception regarding prosthesis replacement were significantly associated with oral health indicators. Conclusion: Given the non-identification of the effect of functional capacity on the oral health of the elderly, the time of measurement of the events investigated should be considered. It is suggested that dependency among the elderly occurs at different times from when the consequences of oral problems are observed, considering the cumulative effects of a previous history of invasive dental care.

Factors associated with agreement between self-perception and clinical evaluation of dental treatment needs in adults in Brazil and Minas Gerais

This study sought to describe the agreement between self-perception and clinical evaluation of dental treatment needs in adults and analyze associated factors. The sample comprised adult individuals who took part in SBBrazil 2010 and SBMinas Gerais 2012. The study's outcome was agreement between self-perception and clinical evaluation of dental treatment needs. We used multiple Poisson regression in order to determine the factors associated with the outcome. Agreement between self-perception and clinical evaluation was 78.8% in Brazil and 73.8% in Minas Gerais. Clinical and self-reported oral health conditions that affect function and quality of life were associated with a higher agreement, while a recent visit to the dentist was associated with a lower agreement. Identifying associated factors may enable the development of questionnaires that favor correct self-perception regarding treatment needs.

Autopercepção da necessidade de prótese dentária total entre idosos brasileiros desdentados

Resumo Propõe-se estimar a prevalência da autopercepção da necessidade de prótese dentária total entre idosos (65 a 74 anos) brasileiros desdentados, assim como identificar seus fatores associados. Trata-se de estudo transversal com base no inquérito nacional das condições de Saúde Bucal da população brasileira, denominado SB Brasil – 2010. A variável dependente foi a autopercepção da necessidade de prótese dentária total, considerando a aquisição de prótese nova ou substituição da existente. Foram conduzidas análises descritivas, bivariadas e múltiplas. Foram incluídos 3514 idosos, destes, 2039 (55,0%) perceberam a necessidade de prótese total. A autopercepção da necessidade de prótese total foi maior entre os que necessitavam de prótese dentária inferior e que estavam insatisfeitos com as suas condições de saúde bucal. Além da alta prevalência da autopercepção da necessidade de prótese identificada, os resultados permitiram identificar que condições normativas e subjetivas de saúde bucal se mantiveram associadas a esta autopercepção entre idosos brasileiros.

Oral health in the agenda of priorities in public health

This study describes the scientific production on oral health diffused in Revista de Saúde Pública, in the 50 years of its publication. A narrative review study was carried out using PubMed, as it is the search database that indexes all issues of the journal. From 1967 to 2015, 162 manuscripts specifically focused on oral health themes were published. This theme was present in all volumes of the journal, with increasing participation over the years. Dental caries was the most studied theme, constantly present in the journal since its first issue. Periodontal disease, fluorosis, malocclusions, and other themes emerged even before the decline of dental caries indicators. Oral health policy is the most recurring theme in the last two decades. Revista de Saúde Pública has been an important vehicle for dissemination, communication, and reflection on oral health, contributing in a relevant way to the technical-scientific interaction between professionals in this field. RESUMO Este estudo descreve a produção científica sobre saúde bucal veiculada na Revista de Saúde Pública, nos cinquenta anos de sua publicação. Foi realizado estudo de revisão narrativa, utilizando o PubMed como mecanismo de busca que indexa todos os fascículos da revista. De 1967 a 2015, foram publicados 162 manuscritos com foco específico em temas de saúde bucal. Essa temática esteve presente em todos os volumes da revista, com participação crescente ao longo dos anos. Cárie dentária foi o tema mais estudado, marcando presença constante na revista desde seu primeiro fascículo. Doença periodontal, fluorose, oclusopatias e outros temas emergiram antes mesmo do declínio dos indicadores de cárie. Políticas de saúde bucal é o tema mais recorrente nas duas últimas décadas. A Revista de Saúde Pública tem sido importante veículo de divulgação, comunicação e reflexão sobre saúde bucal, contribuindo de modo relevante para a interação técnico-científica entre os profissionais da área.

Access to information on how to avoid oral health problems among elderly persons registered with the Family Health Strategy

Objectives : To identify the level of access to information regarding how to prevent oral health problems among the elderly, and verify if such levels were higher among members of households registered with the Family Health Strategy Program. Methods : An analytic cross-sectional study was conducted of a probabilistic complex sample of elderly (65-74 years old) members of the population of a large city. The level of access was estimated with adjustment for the design effect, as well as the magnitudes of association. Descriptive, bivariate and logistic regression (OR/CI95%) analysis was performed. Variables related to personal determinants, health services, health-related behavior and health outcomes were considered. Results : Of the 490 participants, 53.4% reported they had access to information about how to prevent oral health problems. This access was higher among elderly persons living in a household registered with the Family Health Strategy Program (2.04/1.14-3.67), and who had at least five years of schooling (2.53/1.67-3.83), regularly used dental services (1.84/1.07-3.17), did not smoke either now or in the past (1.79/1.13-2.82), did not suffer from chronic diseases (2.14/1.34-3.42) and had not suffered social impacts because of their oral health conditions (1.77/1.08-2.91). Conclusion : Most of the elderly persons had access to information about how to prevent oral health problems, with such access being greater among those registered with the Family Health Strategy Program.

[Delayed referrals of oral cancer patients: the perception of dental surgeons]

The scope of this study was to verify the possible reasons to justify the delay in the referral of oral cancer patients to specialized health care sectors from the standpoint of the dental surgeons involved in Primary Health Care (PHC) in Porto Alegre, state of Rio Grande do Sul. This target public of this study was dental surgeons working in five different labor environments in PHC in Porto Alegre. Criteria for inclusion was dental surgeons graduated in and working in PHC. The data collection instrument was the focus group technique and application of a structured questionnaire. After data collection, interpretative analysis was conducted with classification of the information under four main headings: professional, team, community and services network. The results suggest that there are several factors associated with delayed in referral of patients with oral cancer to specialized health care sectors. These include omission of early diagnosis, lack of multidisciplinary work and insufficient attention to the need for joint community responsibility with patients for their own health status. It is also due to deficiencies in the health service network, specifically regarding the quality of communication between professionals at different levels of the health services.

Validade e utilidade da autopercepção de necessidade de tratamento odontológico por adultos e idosos

O objetivo deste trabalho foi determinar a validade das medidas de autopercepção como indicador de necessidades de tratamentos odontológicos em adultos e idosos. A amostra foi composta por indivíduos que participaram da Pesquisa Nacional de Saúde Bucal e da Pesquisa sobre as Condições de Saúde Bucal da População Mineira. A autopercepção da necessidade de tratamento dentário e de prótese total foi comparada com a necessidade determinada a partir do exame odontológico, considerado padrão-ouro. A qualidade das medidas foi avaliada por meio da sensibilidade, da especificidade e de valores preditivos. A sensibilidade variou de 51% a 90%, enquanto a especificidade ficou entre 56% e 90%. Os valores preditivos positivos foram de 11% a 95%, e os negativos, de 23% a 99%. A autopercepção de necessidade de tratamento dentário em adultos e de necessidade de próteses totais em idosos apresentou valores aceitáveis de validade. Por outro lado, a autopercepção da necessidade de tratamento por idosos e da necessidade de próteses totais por adultos não foi considerada útil devido a seu baixo desempenho.

Self-perceived need for dental care

AIMS

The aim of this study is to evaluate the self-perceived need for dental care among medical professionals and general public.

SETTING AND DESIGN

(1) To determine the perceived oral health status. (2) To evaluate the results in understanding the perception of oral health. (3) To determine the patients attitude toward dentist.

SUBJECTS AND METHODS

The study was carried out on 537 patients who came for their regular checkup and treatment.

STATISTICAL ANALYSIS USED

The statistical analysis of this study was based on Chi-square test evaluation. The study was performed among in 537 participants. The participants included from age group of both <30 and >30. The study was made in the form of questionnaires enquiring how they would perceive their personal dental care and their attitude towards dentist.

RESULTS

Self-perceived questionnaires in evaluating general public in age group of <30 and >30 shows, that people in age group more than 30 has good oral hygiene maintenance, whereas attitude toward dentist and attending dental problems were more among group less than 30 of age.

CONCLUSIONS

I conclude that there must be more awareness created by public health dentist among people about various dental problems, their complications and the treatment needs. Hence, that people be aware of their dental problem at the small stage and get cured. By conducting varies Public Health Programs and camp they became very free to contact their dentist for their varies dental problems and people attitude about dentist and toward dentist completely changes.

Prevalence of oral mucosal lesions in a brazilian military police population

BACKGROUND

Data obtained from oral health surveys are very important for identifying disease-susceptible groups and for developing dental care and prevention programs. So, the purpose of the current article was to investigate the prevalence of oral mucosa lesions (OMLs) in a population of Brazilian police.

MATERIAL AND METHODS

Interviews and oral cavity examinations were performed on a sample of 395 police officers who were randomly selected by the calibrated researcher. The number of individuals was obtained by a sample calculation using the finite population correction. The diagnostic criteria were based on the WHO (1997) criteria and adapted to Brazilian surveys.

RESULTS

In total, 8.61% of the population presented some OML. Traumatic injuries and benign migratory glossitis (BMG) were the most prevalent lesions.

CONCLUSIONS

The prevalence of potentially malignant disorders was lower than among the Brazilian population.The most prevalent lesion among the police officers was related to trauma. Patients dissatisfied with oral health had a higher risk of presenting OMLs. Key words:Mouth disease, mouth mucosa, military personnel, public health, oral pathology, oral leukoplakia.

O idoso com comprometimento cognitivo apresenta pior condição de saúde bucal?

A saúde bucal dos idosos sem comprometimento cognitivo foi comparada com a daqueles com comprometimento. A condição cognitiva, o índice de dentes cariados perdidos e obturados (CPOD), o índice de raízes cariadas e obturadas (COR), a necessidade de tratamento dentário, a presença de placa (P) e cálculo (C), o índice periodontal comunitário (CPI), o índice de perda de inserção periodontal (PIP), o edentulismo, o uso de prótese e a necessidade de prótese foram avaliados em uma amostra complexa probabilística por conglomerados de idosos (65-74 anos). Usou-se o PASW(r) 17.0 nas análises estatísticas com correção pelo efeito de desenho, através dos testes Mann Whitney e qui quadrado com 95% de confiança. Foram entrevistados e examinados 736 idosos. Os com comprometimento cognitivo apresentaram maiores médias de CPOD, COR e menores médias de sextantes sadios do CPI, prevalências menores de sextantes sem placa/cálculo e de uso de prótese; maiores prevalências de edentulismo e necessidade de próteses. Idosos com comprometimento cognitivo apresentaram pior saúde bucal.

Self-reported and clinically diagnosed dental needs among institutionalized adults in Vijayawada: A cross-sectional study

BACKGROUND

Frail and functionally dependent elderly people, living in institutions, have difficulties in accessing dental care. Hence, the present study aims to determine the relationship between subjective need and the equivalent clinical findings in an attempt to understand the factors that contribute to individual's perception of the need for dental care among institutionalized adults in Vijayawada.

MATERIALS AND METHODS

A cross-sectional study is conducted in all old age homes in Vijayawada. A total of 182 subjects were interviewed with a questionnaire consisting of demographic details, dental behavior (last visit, reason for the last visit), and self-rating of oral health and impact of oral problems, followed by the clinical examination for oral mucosal condition, dentition status and treatment needs, prosthetic status and treatment needs, and periodontal status by using World Health Organization proforma.

RESULTS

Results showed that normative needs of subjects are significantly more than the self-perceived needs. Response of subjects regarding their present condition of mouth and teeth is 65.4% of subjects reported good and 0.5% reported poor, with respective to perceived oral symptoms 61.9% of subjects' complaints of hypersensitivity and 23.1% of subjects were having toothache and 80.5% subjects are having difficulty in eating. The overall prevalence of complete Edentulous and require complete denture was 12.1%, and 60.4% required partial denture.

CONCLUSION

About half of the participants confirmed need for problem-oriented dental care. The main reason for the problems faced by the institutionalized people is due to lack of teeth which could be prevented by appropriate care.

Satisfação com saúde bucal de idosos brasileiros: um estudo de gênero com modelo hierárquico

Os objetivos do presente estudo foram identificar as diferenças de gênero em relação aos fatores associados à satisfação com saúde bucal de idosos e estimar a prevalência de edentulismo por gênero e faixa etária. Foram incluídos 2.052 idosos com 60 anos e mais de idade, residentes em Sete Lagoas, Minas Gerais, Brasil. A regressão de Poisson foi utilizada para estimar a prevalência de edentulismo. A associação entre satisfação bucal e as variáveis independentes foi realizada por meio da regressão ordinal com modelo hierárquico multidimensional. A prevalência de edentulismo nos gêneros masculino e feminino foi de 63% e 68,8%, respectivamente. A maioria dos idosos do gênero masculino (63%) e feminino (57%) estava satisfeita com a saúde bucal. O modelo final ajustado, para ambos os gêneros, foi formado por variáveis referentes ao ambiente externo, comportamentos de saúde e condições de saúde bucal. Conclui-se que a satisfação com a saúde bucal é influenciada fortemente pelas condições de saúde bucal e por comportamentos de saúde, e que os fatores associados são diferentes para cada gênero.

Autopercepção de pessoas acometidas pela hanseníase sobre sua saúde bucal e necessidade de tratamento

A hanseníase é uma doença infecciosa que produz impacto do ponto de vista físico, social e psicológico. O propósito deste estudo foi avaliar a autopercepção sobre saúde bucal e a necessidade de tratamento em pacientes com hanseníase no Município de Fortaleza (CE), Brasil. Trata-se de um estudo transversal e descritivo, onde 100 pacientes com hanseníase foram submetidos a questionário semiestruturado. Os resultados da análise bivariada entre necessidade de tratamento e características socioeconômicas mostrou que apenas a escolaridade apresentou associação estatística (p = 0,000). Verificou-se associação entre a classificação da saúde bucal e autopercepção da necessidade de tratamento (p = 0,05). Com relação à autopercepção em saúde bucal, 36% dos sujeitos pesquisados classificaram sua saúde bucal como boa. A autopercepção do paciente com hanseníase quanto a sua saúde bucal e necessidade de tratamento deve, juntamente com uma avaliação clínica, servir de guia para a execução de políticas públicas que visem a favorecer um tratamento odontológico mais efetivo para esses pacientes.

[Self-perceived oral health among elderly individuals in a medium-sized city in Northeast Brazil]

This study focused on self-perceived oral health of the elderly and associated variables. The sample consisted of 321 functionally independent individuals 60 years or older living in Parnaíba, Piauí State, Brazil. Oral examinations were performed and questionnaires were applied during home visits. The elderly presented poor oral health, with mean DMFT 29.41 (SD = 4.10). However, their self-perceived oral health was positive, with 52% showing high scores according to the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis showed that predictors of self-perceived oral health included the need for upper prostheses, oral mucosal lesions, and self-rated oral health. The most important predictor was self-rated oral health, with a weight of 20% variation in self-perceived oral health. In conclusion, subjective measurement of oral health in the elderly is less associated with their actual clinical status and more with other subjective factors.

Do the indonesians receive the dental care treatment they need? A secondary analysis on self-perceived dental care need

Increasing access for citizens to health services, including dental care, is one of the primary targets of the Indonesian Ministry of Health. To assess progress toward this goal, we sought to describe the magnitude of unmet needs for dental care among Indonesians. Secondary data of nationally representative surveys conducted from 2003 to 2007 were analysed to describe the associations between unmet needs for dental care in different demographic groups. In average, 2.28% of the Indonesian population reported perceiving need for dental care and 0.74% reported utilizing dental care. The average of unmet need was 72.04%. Logistic regression analysis indicated that respondents who lived in rural areas, who were uninsured, had higher odds ratios in reporting unmet dental care needs. Perceived need for and utilization of dental care among Indonesians was found to be low. Moreover, the unmet need for dental care is relatively high.

Autopercepção da saúde bucal e impacto na qualidade de vida do idoso: uma abordagem quanti-qualitativa

Este estudo, de abordagem quanti-qualitativa, objetivou aprofundar o entendimento das relações entre autopercepção, impacto na qualidade de vida e condições bucais de idosos. Exame clínico e entrevista gravada contendo questões objetivas e discursivas foram realizados com 45 idosos. Conduziu-se análise descritiva quantitativa das questões objetivas e referentes ao exame clínico e à análise de conteúdo das questões discursivas de abordagem qualitativa. Imagens fotográficas do estado bucal foram relacionadas a trechos das entrevistas. A análise quantitativa evidenciou: 4,8 dentes em média; CPOD (número de dentes cariados, perdidos e obturados) médio de 29,9; 57,7% eram desdentados, 60% acreditavam não necessitar tratamento, 75% sofriam impacto na qualidade de vida devido às condições bucais, apesar de 67% perceberem positivamente sua saúde bucal. Na análise qualitativa constatou-se subestimação de sintomas, falta de esperança e resignação frente às limitações impostas pelo precário estado clínico. Muitos encararam as limitações como conseqüência do envelhecimento e não como problema que mereça ser corrigido. O que mais incomodou foram as relações de dependência e a proximidade com a morte, minimizando outros problemas. A população idosa foi informada de que poderia modificar sua autopercepção, conscientizando-a que esta realidade pode ser modificada.

Analysis of socio-demographic and systemic health factors and the normative conditions of oral health care in a population of the Brazilian elderly

OBJECTIVE

To investigate the association of socio-demographic and systemic health factors according to the normative conditions of oral health care (dental caries, edentulism, periodontal disease and oral mucosal lesion) in elderly individuals.

MATERIAL AND METHODS

A cross-sectional study was carried out in a group of elderly with access to community health care (n = 200). The normative conditions of oral health were then investigated according to the WHO and the SB Brazil criteria. Bivariate analyses were evaluated by the chi-square test and Fisher's exact test. An estimation of prevalence for the covariates was performed using Poisson's regression models.

RESULTS

The prevalence of edentulism and oral mucosal lesions was detected in 58% and 21.5% of elderly patients, respectively. In the dentate subjects, the prevalence of dental caries and periodontal disease was 51.2% and 20.8%, respectively. Older men and individuals from lower-income groups exhibited a higher prevalence of dental caries. Elderly women, illiterate individuals, and individuals over the age of 65 years exhibited a higher prevalence of edentulism. Elderly 60-64 years old and those who are employed had a significant association with periodontal disease.

CONCLUSION

Socio-demographic factors were associated with some notable oral diseases in the elderly.

Envelhecimento: análise de dimensões relacionadas à percepção dos idosos

RESUMO OBJETIVOS: Investigar o significado do processo de envelhecimento, bem como os efeitos da assistência odontológica recebida, analisando as repercussões dessas questões na saúde bucal e na vida dos idosos. MÉTODOS: Trata-se de uma pesquisa qualitativa de fundamentação fenomenológica, com amostra intencionalmente definida. Foram selecionados cinco idosos para entrevista, na qual foi utilizado um questionário semiestruturado. Utilizou-se também um diário de campo para a coleta dos dados e expressões dos sujeitos. As variáveis consideradas foram: o significado do processo de envelhecimento para os idosos, a percepção do envelhecimento pela boca, a experiência pregressa de atendimento odontológico e a influência desses aspectos na qualidade de vida. O processamento das informações ocorreu por análise e categorização de conteúdo. RESULTADOS: Da pesquisa resultou o estabelecimento das categorias "envelhecimento", considerando utilidade do idoso, aceitação, estilo de vida, limitação corporal e alterações da boca; a categoria "aspecto psicossocial da boca na velhice com manducação", que representa o movimento realizado pela boca que apreende, tritura, insaliva e deglute, erotismo e linguagem; e a categoria "assistência odontológica", subdividida em assistência mutiladora, necessidade de tratamento e cuidados preventivos. CONCLUSÕES: A dificuldade na mastigação e a perda da capacidade de saborear os alimentos são problemas apontados pelos idosos. A insatisfação estética está diretamente ligada à ausência de dentes e é determinante para desencadear sensações negativas na autoestima dos indivíduos, tendo repercussão nas relações sociais.

Auto-avaliação de saúde bucal em idosos: análise com base em modelo multidimensional

Propôs-se investigar fatores associados à auto-avaliação negativa da saúde bucal. Idosos, participantes do inquérito de saúde bucal do Ministério da Saúde, 2002-2003, que auto-avaliaram sua saúde bucal como ruim/péssima foram comparados aos que a auto-avaliaram como ótima/boa/regular usando-se razões de prevalências (RP) com base na regressão de Poisson. A minoria (870 - 17%) auto-avaliou sua saúde bucal negativamente. A auto-avaliação negativa foi menor entre aqueles com 1-9 dentes e edentados, maior entre pardos/negros/índios, que nunca usaram serviços, que apresentavam alterações de tecidos moles, que relataram pouca e média/muita dor, que auto-avaliaram sua aparência e mastigação como regular ou ruim/péssima, entre os que relataram seus relacionamentos sociais pouco ou muito afetados pelas condições bucais e entre os que avaliavam necessitar de tratamento bucal. Apesar das precárias condições bucais, a maioria auto-avaliou positivamente sua saúde bucal. Condições subjetivas estiveram mais fortemente associadas do que as objetivas. Os resultados sugerem iniqüidade e permitem orientar políticas públicas que objetivem saúde bucal e qualidade de vida.