A saúde bucal de adolescentes: aspectos de higiene, de cárie dentária e doença periodontal nas cidades de Recife, Pernambuco e Feira de Santana, Bahia

Oral health of quilombola and non-quilombola rural adolescents: a study of hygiene habits and associated factors

This study evaluated oral hygiene habits and their association with sociocultural, environmental factors and factors related to the use of dental services among Quilombola and non-Quilombola rural adolescents from inland Bahia. Thiswas a cross-sectional study conducted in 2015. Prevalence and prevalence ratios were estimated for the outcomes and multiple Poisson regression analysis with robust variance was performed. We interviewed 390 adolescents, of which 42.8% were Quilombola. Poor tooth brushing and non-flossing were found in 33.3% and 46.7% of adolescents, respectively. Poor tooth brushing was increased by male gender (PR = 1.45), not living with both parents (PR = 1.45), lower hand hygiene habit (PR = 1.72) and worse oral health self-assessment (PR = 1.38). Non-flossing was associated with economic level E (PR = 1.54), older age (PR = 0.91), lower hand hygiene habit (PR = 1.53) and worse oral health self-assessment (PR = 1.33). Different associated factors were observed between Quilombola and non-Quilombola. It is necessary to consider the specificities of the populations for the promotion of adolescent oral health and the importance of the intersectoriality between education and health and care to families.

Prevalence of gingivitis and calculus in 12-year-old Puerto Ricans: a cross-sectional study

Background

Gingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender.

Methods

A probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25–49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types.

Results

Gingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02).

Conclusions

Gingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended.

Electronic supplementary material

The online version of this article (10.1186/s12903-017-0471-5) contains supplementary material, which is available to authorized users.

[Tooth decay and associated factors among adolescents in the north of the State of Minas Gerais, Brazil: a hierarchical analysis]

This is a cross-sectional population-based study (n = 763) conducted in the north of the State of Minas Gerais, which aimed to investigate the prevalence of tooth decay among adolescents and to identify the potential determinants of same. Probability sampling by conglomerates in multiple stages was used. Trained and calibrated professionals performed the data collection by means of intraoral examination and interviews in the previously selected households. In the analysis of the determinant factor for the presence of tooth decay, hierarchical binary logistic regression models were used. The prevalence of tooth decay, decayed, missing and filled teeth were 71.3%, 36.5%, 55.6% and 16%, respectively. The following averages were observed: DMFT (3.4 teeth), number of decayed (0.8 teeth), restored (2.4 teeth) and missing (0.2 teeth). The incidence of tooth decay was higher among adolescents who stated they were black/indigenous/brown (OR = 1.76), lived in crowded households (OR = 2.4), did not regularly visit or had never been to a dentist (OR = 1.9), used public or philanthropic services (OR = 1,8), had smoking habits (OR = 4.1), consumed alcohol (OR = 1.8), perceived their oral health negatively (OR = 5.9 and OR = 1.9) and had toothac in the last six months (OR = 2.0).

Socioeconomic inequalities and changes in oral health behaviors among Brazilian adolescents from 2009 to 2012

OBJECTIVE To analyze oral health behaviors changes over time in Brazilian adolescents concerning maternal educational inequalities. METHODS Data from the Pesquisa Nacional de Saúde do Escolar (Brazilian National School Health Survey) were analyzed. The sample was composed of 60,973 and 61,145 students from 26 Brazilian state capitals and the Federal District in 2009 and 2012, respectively. The analyzed factors were oral health behaviors (toothbrushing frequency, sweets consumption, soft drink consumption, and cigarette experimentation) and sociodemographics (age, sex, race, type of school and maternal schooling). Oral health behaviors and sociodemographic factors in the two years were compared (Rao-Scott test) and relative and absolute measures of socioeconomic inequalities in health were estimated (slope index of inequality and relative concentration index), using maternal education as a socioeconomic indicator, expressed in number of years of study (> 11; 9-11; ≤ 8). RESULTS Results from 2012, when compared with those from 2009, for all maternal education categories, showed that the proportion of people with low toothbrushing frequency increased, and that consumption of sweets and soft drinks and cigarette experimentation decreased. In private schools, positive slope index of inequality and relative concentration index indicated higher soft drink consumption in 2012 and higher cigarette experimentation in both years among students who reported greater maternal schooling, with no significant change in inequalities. In public schools, negative slope index of inequality and relative concentration index indicated higher soft drink consumption among students who reported lower maternal schooling in both years, with no significant change overtime. The positive relative concentration index indicated inequality in 2009 for cigarette experimentation, with a higher prevalence among students who reported greater maternal schooling. There were no inequalities for toothbrushing frequency or sweets consumption. CONCLUSIONS There were changes in the prevalences of oral health behaviors during the analyzed period; however, these changes were not related to maternal education inequalities.

Social determinants of health and dental caries in Brazil: a systematic review of the literature between 1999 and 2010

OBJECTIVE: To review epidemiological studies conducted in Brazil that investigated the distribution of dental caries according to socioeconomic status and demographic characteristics. METHODS: The systematic review included articles published between 1999 and 2010 available in six bibliographic sources, without any other restriction. We analyzed the bibliometric and methodological characteristics of the studies, and the direction and statistical significance of associations tested. RESULTS: Of the 1,128 references identified, 67 were incorporated into this study. There was a higher percentage of publications in the last two years and most of the studies were conducted in the South and Southeast of the country with a young population. The cross-sectional design, using a complex sampling procedure, was the most commonly adopted. The DMFT and dmft indexes were the most commonly used to measure dental caries, while sex/gender, income, education, race/skin color and type of school were the most common socioeconomic exposures. CONCLUSIONS: Most studies identified a high rates of dental caries among the poorest, least educated, black and brown and female individuals. A more detailed methodological and theoretically sound study of the relationship between dental caries and socioeconomic conditions is needed.

[Assessment of educational actions on the oral health of adolescents within the Family Health Strategy]

OBJECTIVE

to evaluate the actions of education on the oral health of adolescents within the scope of the Family Health Strategy.

METHODOLOGY

A questionnaire was applied and a clinical exam conducted evaluating biofilm and gingival inflammation in 80 adolescents before and after interventions. A qualitative study of the brushing technique was also performed on 15 adolescents in the sample.

RESULTS

there was an improvement in oral hygiene of adolescents who participated in actions at school and an increase in the number of adolescents who had healthy gums or only mild inflammation in the second test in school groups and home visits. With respect to the consumption of candies, both the weekly group and the school group saw a decrease in candy consumption between the first and second tests. There was an increased frequency of brushing in the school group.

CONCLUSION

considering the importance of educational activities observed in this study, the process of training and joint planning of activities among the school staff and health professionals would appear to be important.

Individual and contextual determinants of periodontal health in 12-year-old schoolchildren in a brazilian capital city

The study aimed to describe periodontal health status and its association with individual and contextual factors among 12-year-old schoolchildren in a midwest Brazilian capital city. This cross-sectional study included data from an oral health survey carried out in 2010 in the city of Goiania, Brazil (n = 2, 075) and secondary data obtained from the local health authority. Data were collected through oral clinical examinations and interviews. For assessment of periodontal status two components of the community periodontal index (CPI) were used: calculus and bleeding after probing. Dependent variable was presence of any periodontal condition. Independent individual variables were the children's sex and color/race, and their mother's level of schooling. Contextual variables were related to the schools (type and existence of toothbrushing program) and its geographic location in the health districts. Rao-Scott test and multilevel Poisson analysis were performed. The prevalence of calculus and/or bleeding was 7%. Brown color, public schools, and those located in health district with intermediate socioeconomic indicators were associated to a higher prevalence of this condition. The prevalence of adverse periodontal condition was low and the inequalities in its distribution were determined by individual as well as contextual factors related to the schools and the geographic area.

Periodontal outcomes and social, racial and gender inequalities in Brazil: a systematic review of the literature between 1999 and 2008

The objective of this study was to review the Brazilian epidemiologic literature on periodontal outcomes and socio-demographic factors, assessing bibliographic and methodological characteristics of this scientific production, as well as the consistency and statistical significance of the examined associations. A systematic review was carried out in six bibliographic sources. The review was limited to the period between 1999 and 2008, without any other type of restriction. Among the 410 papers identified, 29 were included in the review. An increasing number of articles, specifically in the last four years of study, was observed. However, there is a concentration of studies in the South and Southeast regions of Brazil, and many of them are not closely connected to theoretical formulations in the field. In spite of these shortcomings, the review findings corroborate the idea that poor socioeconomic conditions are associated with periodontal outcomes, as demonstrated primarily by income and schooling indicators.