Brazilian National Oral Health Survey Research Articles

Untreated dental trauma among homeless people in Midwest Brazil.

Homeless people are usually more exposed to traumatic events that may cause dental injuries than those with more stable housing. Previous studies on the oral health condition of this population group have shown high levels of dental caries, periodontal diseases, and tooth loss, but evidence on dental trauma is scarce. Furthermore, there is no report from Latin American countries. The aim of this study was to describe the prevalence of untreated traumatic dental injuries (TDI) among adult homeless people in a Brazilian capital city. A sample of 102 adults attending a public homeless shelter was clinically examined using the criteria of the 2010 Brazilian National Oral Health Survey. TDI was found in 10.8% of the participants, and the most common types of injury were enamel-dentin fractures and avulsion. The overall prevalence was relatively low, but the proportion of anterior tooth loss due to trauma and other reasons shows the need for more appropriate health care for this vulnerable population group.

Racial inequalities in public dental service utilization: Exploring individual and contextual determinants among middle-aged Brazilian adults.

To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics. A total of 6196 adults aged 35-44years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self-reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self-reported need for treatment, dental pain in the last 6months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate. Pardos and Blacks were 1.25 (95% CI 1.10-1.42) and 1.73 (95% CI 1.41-2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics. Racial differences in dental service utilization were evident for middle-aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites.

Individual- and City-Level Socioeconomic Factors and Tooth Loss among Elderly People: A Cross-Level Multilevel Analysis.

This study aimed to test the association of contextual and individual socioeconomic status with tooth loss among Brazilian elderly people aged 65–74 years. Data from 5435 elderly participants from the Brazilian National Oral Health Survey (2010) were linked to city-level data for 27 state capitals and the Federal District. Tooth loss was clinically assessed according to the number of missing natural teeth. Contextual social variables included Human Development Index income (HDI-income) and HDI-education. Individual socioeconomic measures were monthly family income and years of schooling. Covariates included sex, skin colour, number of residents per room and number of goods. Multilevel Negative Binomial regression models were used to estimate rate ratios (RR) and 95% confidence intervals between contextual and individual variables and tooth loss. Contextual and individual income and education measures were consistently associated with tooth loss. Elderly people living in cities with low HDI-income and low HDI-education were respectively 21% and 33% more likely to present tooth loss. Cross-level interaction suggested that the relationship of lower income and lower schooling with tooth loss is different across levels of city-level income and city-level education inequality, respectively. Public policies aiming to reduce the income and education gaps and preventive dental interventions are imperative to tackle tooth loss among elderly people.

Influence of eating habits and socioeconomic profile on students’ oral health

ABSTRACT Objective: To evaluate the association between the presence of tooth decay and the eating habits, oral hygiene habits, and socioeconomic profile of children in the fifth grade at the state secondary and elementary school Pedro Simão in Alegre, ES. Methods: Questionnaires were used to evaluate the socioeconomic profile, eating habits, and oral hygiene habits of the fifth-grade students. Then an epidemiological survey on dental caries and on the presence of dental plaque was conducted. After the first clinical examination, the students completed educational and preventive activities about nutritional and oral hygiene education. One week after the performance of the educational actions, the dental plate index was evaluated. Results: The variables “family income” and “number of members” in the family were statistically significant (p≤0.20) with caries association using a bivariate regression analysis. However, variables related to diet did not present a significant association with caries (p>0.20). The initial and final IHOS were 1.85 and 0.92, respectively, which was significantly lower after the intervention (p<0.05). The DMFT was 1.81, which is higher than the average for the Southeast Brazil, obtained in 2010 by the Brazilian National Oral Health Survey (SB Brazil). Conclusion The caries prevalence was high in the sample studied, and the intervention was important to reduce the students’ dental plaque levels and improve their oral hygiene condition. Thus, it is necessary to develop continuous educational programs so that oral health is maintained.

Threshold-effect of income on periodontitis and interactions with race/ethnicity and education

The aims of this study were to explore the shape of the relationship of income and education with periodontal health, and to assess the interactions between them and race/ethnicity. Individual level data from the Brazilian National Oral Health Survey in 2010 (Pesquisa Nacional de Saúde Bucal-SB Brasil 2010) were obtained for 9,779 subjects. Relations between per capita income and education with periodontal health were smoothed using Locally Weighted Scatter-plot Smoother (Lowess) technique. Multivariable logistic regression was used to assess independent effects of income, education, race/ethnicity adjusted for age, sex and time since last dental appointment. Prevalence of adults with moderate to severe and severe periodontitis was 17.6 and 6.5%, respectively. The relationship between periodontal health and income was curvilinear, showing a threshold of no relationship for income levels higher than US$ 600/month. In multivariable analysis, after controlling for covariates, only income was significantly associated with periodontal health. There was no significant interaction of income with race or education, neither between race and education. The relation between periodontal health and income was curvilinear and indicated the presence of a threshold, supporting income transfer programs. Beyond the threshold, only education presented a negative linear relationship with moderate to severe periodontitis.

The association between normative and subjective oral health conditions and dissatisfaction with dental services among adult Brazilians

The prevalence of dissatisfaction with dental services and its association with normative and subjective oral health conditions among adult Brazilians was evaluated. This cross-sectional study used data from the last Brazilian National Oral Health Survey (SBBrasil), conducted in 2010. It was considered a representative sample of the adult Brazilian population. Data were analyzed by descriptive, univariate and multiple statistics (OR / 95% CI), with correction by the design effect. Among the 4539 adults included in the study, 614 (13.4%) reported dissatisfaction with dental services. Dissatisfaction was higher among adults who had any decayed teeth (1.61 / 1.06; 2.44), adults who were dissatisfied with their teeth and mouth (2.36 / 1.39; 4.02) and adults who had reported toothache in the previous six months (1.99 / 1.29, 3.07). The conclusion drawn was that the prevalence of dissatisfaction with dental services among Brazilian adults was low and associated to normative and subjective oral health conditions.

Association of adverse oral health outcomes with socioeconomic inequalities and dental needs in Brazilian adolescents.

This study aimed to explore the relations between adverse oral outcomes and socioeconomic, demographic, and self-rated oral health variables and to describe their distribution. Principal component analysis was conducted on data from adolescents in the Brazilian National Oral Health Survey (N = 5,445). Higher loadings were found for crowding (0.6), maxillary and mandibular irregularities (0.5), and count of communitary periodontal index (CPI) sextants with bleeding and dental calculus (0.5). The mean rates for periodontal and occlusal disorders were at least two times higher in adolescents from lower income families and those reporting the need for dental prostheses, as well as those dissatisfied with their dental and overall oral health. Increased mean rates of occlusal disorders were associated with schooling delay and history of toothache in the previous six months. The mean scores suggested accumulation of at least one of the negative oral health indicators in the lower income strata, among adolescents with schooling delay, and in those reporting dental needs. The results suggest priorities for planning and monitoring as a function of oral health requirements.

O edentulismo no Brasil: epidemiologia, rede assistencial e produção de próteses pelo Sistema Único de Saúde.

O objetivo do estudo foi analisar a conjuntura nacional quanto ao perfil epidemiológico do edentulismo, rede de atenção à saúde bucal e produção de próteses no âmbito do Sistema Único de Saúde. Foram utilizados dados epidemiológicos do Projeto SBBrasil 2010 e investigada a distribuição das Equipes de Saúde Bucal (ESB), Centros de Especialidades Odontológicas (CEOs), Laboratórios Regionais de Próteses Dentárias (LRPDs) e tratamento protético no SUS. Foram elaborados mapas para investigação da distribuição geográfica de variáveis do estudo e realizadas análises descritivas e correlacionais. A prevalência de perda dentária foi alta, especialmente entre mulheres, idosos e indivíduos de baixo nível de escolaridade e renda familiar, com destaque da região Norte. As necessidades de prótese foram superiores nas regiões Norte e Nordeste. Houve correlação entre o número de CEOs e LRPDs com tamanho populacional, índice de desenvolvimento humano e número de ESB (p<0,001; 0,082≤r≤0,422). As produções laboratoriais e ambulatoriais foram superiores no Sul, Sudeste e Nordeste. Apesar dos avanços proporcionados pela Política Nacional de Saúde Bucal, permanece o quadro de alta prevalência de perda dentária, necessidade de tratamento protético e desigualdades na oferta dos serviços.

Association of traumatic dental injuries with individual-, sociodemographic- and school-related factors among schoolchildren in midwest Brazil.

The objective of this study was to assess the association of untreated traumatic dental injuries (TDI) with individual-, sociodemographic- and school-related factors among 12-year-old schoolchildren in Midwest Brazil. This cross-sectional study was carried out in 2010 in the city of Goiania, Brazil. A random sample of 2075 schoolchildren was examined and interviewed. Untreated TDI in the permanent incisors was assessed using the methodology of the Brazilian National Oral Health Survey. Rao-Scott test and multinomial logistic regression were used to analyze the associations between independent variables and three categories of TDI, using a hierarchical method. Independent variables were children’s sex, self rated color/race and size of incisal overjet, their mother’s level of schooling, and the schools’ type and geographic location. The prevalence of trauma was 17.3% (CI 95% = 15.2–19.4); enamel fractures were the most common TDI (13.1%). In the adjusted model, a higher chance of having two or more teeth with TDI was found among boys, those whose mothers had lowest level of schooling, and those attending schools located in health districts with lower socioeconomic indicators. It was concluded that the prevalence of TDI was low and that it was associated with individual factors as well as the school environments.

Diversity of dental patterns: Application on different ages using the Brazilian National Oral Health Survey

Methods of individual identification using human remains are widely used in forensic anthropology; however, there are few studies that use statistical methods in order to obtain a correct definition of parameters. The objectives of the study were to verify the diversity of dental patterns in the Brazilian population and analyse its application on different ages. Data from the Brazilian National Oral Health Survey were used to verify the presence and absence of dental treatment among 35,613 individuals of several age groups: 15-19, 35-44 and 65-74. Information referring to every dental element was described: higid (H), decayed (D), filled (F), missing (M) and prosthesis (P). Coincidences that were observed in pairs of homologous teeth were analysed according to clinical situation, gender and age. Ordinary findings (presented in more than 10% of pairs) and extraordinary ones (presented in less than 10% of pairs) were described. Total and conditional diversity estimates were performed. Among adolescents, H were the most frequent teeth, and the first molar teeth were the ones presenting less frequency of H. Among adults, the frequency of M teeth among females ranged from 15.17% to 71.59%, and among males they ranged from 9.00% to 87.20%. Among the elderly, M teeth were observed in the largest frequency, and anterior teeth presented fewer losses than posterior ones. M was the condition that most coincided with both sides in the elderly. In adults, some pairs of teeth presented H, but mostly pairs of teeth presented as M. Among adolescents, there was more concordance of the H component. Among male and female adolescents, we observed extraordinary findings in DMFP dental conditions in most of the teeth. Among adults, the less frequent dental condition was P, which was found in several teeth. The extraordinary findings among elderly male teeth were codes H, D, F and P; among females, they were H, D, F and P codes. The high prevalence of healthy teeth in adolescents and a high rate of edentulism in the elderly interfered with the analysis performed. However, when an estimation of diversity that corrects those distortions was used, all of the groups presented satisfactory results that were homogeneous in the performed analysis.