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Prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous populations in Brazil: a systematic review and meta-analysis. Braz Oral Res 2023; 37:e094. [PMID: 37820252 DOI: 10.1590/1807-3107bor-2023.vol37.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 04/18/2023] [Indexed: 10/13/2023] Open
Abstract
The aim of this review was to evaluate the prevalence of dental caries, periodontal disease, malocclusion, and tooth wear in indigenous in Brazil. A systematic review of observational studies was performed according to the PRISMA guidelines (CRD42020218704). The search strategy involved the electronic databases of Embase, LILACS, PubMed, Web of Science, Scopus, and the CAPES Theses and Dissertations for gray literature. The eligibility criteria consisted of publications that assessed the prevalence of oral conditions in indigenous populations in Brazil. Studies with indigenous people living in urban area were excluded. The risk of bias was evaluated by using JBI Critical Appraisal for prevalence studies. Thirty studies were included in the review, and the majority showed a low risk of bias. A meta-analysis of 20 studies was conducted using the random-effects model and a 95% confidence interval. Several ethnicities were studied in isolation or in groups (n = 7,627 for dental caries; n = 2,774 for periodontal disease; n = 1,067 for malocclusion; n = 150 for tooth wear). The prevalence of caries ranged from 50% among indigenous people aged 18-36 months to 100% among those aged 65-74 years. The prevalence of periodontal disease ranged from 58% to 83%. The prevalence of malocclusion was 43%. Tooth wear was assessed in only one ethnic group and showed a prevalence of 100% in indigenous people aged >18 years. The certainty of evidence assessed by the GRADE system ranged from very low to moderate. This systematic review showed significant differences in the prevalence of dental caries, periodontal disease and malocclusion between indigenous population groups and territories in which indigenous people live.
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[Recommendation of tooth extraction and associated factors: cross-sectional study in the Kiriri indigenous population]. CIENCIA & SAUDE COLETIVA 2021; 26:5223-5232. [PMID: 34787213 DOI: 10.1590/1413-812320212611.3.25352019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 10/13/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this cross-sectional study was to evaluate the prevalence and the associated factors of the recommendation of dental extraction in the adult Kiriri Indigenous population of northeastern Brazil. A total of 225 natives (≥19 years) were evaluated. The extraction criteria were teeth with clinical attachment loss ≥50% in at least 3 sites, and residual roots. Statistical models were used to evaluate associations between the need for dental extraction and selected variables. The percentage of teeth recommended for dental extraction was 4.98%, characterizing a mean of 1.24 tooth per individual. A regression analysis showed that age ≥35 years (OR=2.24, 95%CI: 1.13-4.43, p=0.02), income <R$ 570.00 (OR=3.34, 95%CI: 1.19-9.37, p=0.02) and plaque index ≥40% (OR=2.38, 95%CI: 1.24-4.56, p=0,01) were significantly associated with indication for dental extraction. A prevalence of 33% of subjects with dental extraction recommendation were associated with age older than 35 years, plaque index ≥40% and income less than a minimum wage were related with the recommendation for extraction. This study reflects the importance of prioritizing oral health prevention, as well as the need to expand complex dental services.
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Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis. Caries Res 2021; 55:268-287. [PMID: 34107490 PMCID: PMC8491513 DOI: 10.1159/000516137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.
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Dental caries, periodontal disease and restorative dental care among Indigenous and non-Indigenous groups in Brazil: A descriptive study. Community Dent Oral Epidemiol 2020; 49:63-69. [PMID: 32985016 DOI: 10.1111/cdoe.12577] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare patterns of dental caries, periodontal disease and dental care among Indigenous and non-Indigenous Central-West Brazilian subpopulations. METHODS Data were from two population-based cross-sectional studies involving 5-, 12-, 15-19- and 35-44-year-olds. The first examined were the Guarani, Kaiowá, Terena and Kadiwéu Indigenous groups from Mato Grosso do Sul Brazilian state and the second comprised a non-Indigenous population. Mean numbers of sound teeth, decayed, missing and filled teeth (dmft/DMFT), prevalence of poor oral hygiene for adults (35-44 years) and of periodontal disease were estimated. Restorative dental service utilization was measured using the Care Index. RESULTS The study populations comprised of 1830 Indigenous and 29 395 non-Indigenous people. The Kaiwoá ethnic group had the lowest DMFT among Indigenous groups for ages 12, 15-19 years; 0.9 (95% CI 0.7-1.1) and 2.4 (95% CI 1.9-2.9), respectively. The highest values were observed among the 12-year-old Terena ethnic group and 15- to 19-year-old Kadiwéo groups; 2.2 (95% CI 1.8-2.5) and 3.7 (95% CI 3.1-4.4), respectively. The mean DMFT values were significantly lower among Indigenous than non-Indigenous people for all age groups. The prevalence of bleeding and calculus was 70.3% (95% CI 64.5%-75.5%) and 80.1% (95% CI 74.8%-84.5%), respectively, for Indigenous people and 43.9% (95% CI 34.4%-50.7%) and 61.5% (95% CI 55.4%-67.2%), respectively, for the non-Indigenous population. Restorative services were higher among 5-year-old non-Indigenous children and adults than for Indigenous groups. Among Indigenous groups, the Terena had the highest level of restored teeth (38.0% at 12 years) and Kadiwéu the lowest level (8.8% at 12 years). CONCLUSION In our study, Indigenous people had a lower caries burden, but less access to restorative services than their non-Indigenous counterparts. These disparities likely reflect differences in historical, socioeconomic, cultural, environmental and political determinants that both groups have experienced differently over time.
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Dental health status and its indicators in adult Brazilian Indians without exposition to drinking water fluoridation: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:34440-34447. [PMID: 31637613 DOI: 10.1007/s11356-019-06571-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Water fluoridation is considered a cost-effective and practical method for controlling and preventing dental caries in the general population. The objective of this study was to evaluate the dental health status and risk indicators for dental caries in adult Brazilian Indians without exposition to dental caries-preventive effects of water fluoridation. Decayed (DT), missing (MT), and filled (FT) permanent teeth (DMFT), as well as plaque index, unstimulated salivary flow rate, salivary buffering capacity, and fasting blood glucose were examined in 225 adult Indians. Smoking habits and sociodemographic data were evaluated using a structured questionnaire. Drinking water samples from 10 Indian villages were analyzed for the natural fluoride concentration. The mean DMFT was 10.33 ± 6.91 (DT, 4.19 ± 3.99; MT, 4.99 ± 5.64; FT, 1.14 ± 1.75). DMFT index ≥ 9 was associated with age ≥ 35 years (p = 0.000), lower education (p = 0.03), and plaque index > 40% (p = 0.003). DT was associated only with plaque index (p = 0.03). MT was associated with age (p < 0.001) and plaque index (p = 0.01). FT was negatively associated with age (p = 0.02) and income (p = 0.02). Fluoride concentration varied from 0.01 to 0.07 mg/L and was not associated with dental health status (p ≥ 0.29). In conclusion, poorer dental health status was associated with older age, higher plaque index, and lower education and income levels. The fluoride level in the drinking water of Kiriri villages was lower than the level recommended for preventing dental caries. Water fluoridation may be recommended for this population.
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Human ecological and social determinants of dental caries among the Xavante Indigenous people in Central Brazil. PLoS One 2018; 13:e0208312. [PMID: 30566453 PMCID: PMC6300322 DOI: 10.1371/journal.pone.0208312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 11/15/2018] [Indexed: 11/18/2022] Open
Abstract
This community study evaluates complex interactions between macro and micro determinants of oral health in a local Indigenous population based on a theoretical framework of demographic, economic, and healthcare transformation over the last half century. The study population included all residents of eight Xavante villages in Central Brazil. Our hypothetical model posited multiple direct and indirect associations between dental caries and village groups with differentiated territorial and oral care histories, as well as household socioeconomic indicators and food acquisition patterns, individual sociodemographic characteristics, use of dental health services, and oral hygiene practices. Structural equation modelling methods were used to evaluate direct and indirect associations linking exogenous factors and dental caries. Results include 18 direct and 14 indirect statistically significant pathways between determinant variables and dental caries. Significant links with dental caries were shown for socioeconomic indicators, oral healthcare variables, household food acquisition patterns, sex, and age. These findings suggest that the oral health of Xavante residents in the villages studied is associated with determinant factors of different epidemiological and historical scales. The specific historical frame of territorial circumscription and demographic crisis followed by rapid population increase since the 1970s should be considered a cause-of-cause determinant of the economic, healthcare, and sociodemographic profile contributing to oral health among the Xavante. Considering the limitations of cross-sectional studies, our findings underline the importance for oral health determination of historical currents affecting minority ethnic groups within national societies.
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Dental caries in South American Indigenous peoples: A systematic review. Community Dent Oral Epidemiol 2018; 47:142-152. [DOI: 10.1111/cdoe.12436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/30/2018] [Accepted: 10/25/2018] [Indexed: 10/27/2022]
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Abstract
BACKGROUND To describe the frequency of diabetic retinopathy (DR) and its associated variables in Brazilian Xavante Indians. METHODS A population-based survey carried out in two Xavante Reservations between 2008 and 2012, included 948 Indians aged 20 years or more, identified 246 individuals with type 2 diabetes. A non-probabilistic cluster sample of 140 diabetic individuals were submitted to ophthalmologic examination. Due to operational conditions and to optimize the field work, only the larger Xavante villages were included. Ophthalmologic examinations were performed during one trip to each reservation, in their villages and consisted of measurement visual acuity, anterior segment biomicroscopy, applanation tonometry, and direct and indirect ophthalmoscopy. RESULTS The frequency of DR was 19.3%, distributed as follows: mild non-proliferative retinopathy in nine (33.3%) subjects, moderate in nine (33.3%), severe in six (22.3%), very severe in two (7.4%), and high-risk proliferative DR in one (3.7%). The occurrence of DR was higher among those with a longer duration of diabetes, higher levels of glycated hemoglobin (HbA1c) and fasting glucose, papillary excavation ≥ 0.5, and among individuals in older age group. Using the log-binomial regression model, diabetes duration > 24 months and HbA1c ≥ 6.5% were significantly associated with the occurrence of DR. CONCLUSIONS The presence of DR (19.3%) in Xavante Indians is an alert for health care providers for this population, since diabetes is a new disease among them. Its association with disease duration, high levels of HbA1c and blood glucose calls attention for the necessity of more actions to improve diabetes control in this recently contacted ethnic group that needs particular attention.
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Subjective oral symptoms associated with self-rated oral health among Indigenous groups in Central-West Brazil. Community Dent Oral Epidemiol 2018; 46:352-359. [DOI: 10.1111/cdoe.12375] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 02/15/2018] [Indexed: 11/30/2022]
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Epidemiological analysis and need for endodontic treatment among the indigenous Sateré-Mawé and Tikuna. Braz Oral Res 2018. [PMID: 29538481 DOI: 10.1590/1807-3107bor-2018.vol32.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze the epidemiological profile of oral health of Sateré-Mawé indigenous people living in Barreirinha, Amazonas (AM), Brazil, and the Tikuna indigenous people living in the urban area of Manaus (AM), in addition to characterizing the need for endodontic treatment between the two ethnic groups. A total of 138 individuals participated in the study, of whom 98 were Tikuna and 40 were Sateré-Mawé; they were distributed in age groups ranging from seven to 75 years. A very high prevalence of caries was observed in both ethnic groups. For the Sateré-Mawé in the 7-12 age group, the decayed, missing, and filled teeth (DMFT) index presented a mean value of 3.17. Comparing the DMFT index and the need for endodontic treatment in each of the ethnicities, these variables were found to be correlated, because as the DMFT index increases, the chances of needing endodontic treatment increase. The Sateré-Mawé presented a higher prevalence of need for endodontic treatment compared to the Tikuna. The association of comorbidities and the need for endodontic treatment were demonstrated only in the Tikuna, and there was only a correlation of this necessity with the presence of diabetes mellitus (DM) in one case. The need to expand access to oral health in these communities is emphasized, taking into account geographical access and technological, environmental, linguistic, and cultural barriers.
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[Indigenous peoples' access to health services in Cuiabá, Mato Grosso State, Brazil]. CAD SAUDE PUBLICA 2017; 33:e00132215. [PMID: 28614451 DOI: 10.1590/0102-311x00132215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 06/24/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate indigenous peoples' access to medium and high-complexity health services in the municipality of Cuiabá, Mato Grosso State, Brazil, through the Casa de Saúde Indígena or Indigenous Peoples' Clinic (CASAI Cuiabá). A single case study with a qualitative approach was conducted at CASAI Cuiabá. Data were obtained from observation of the work routines at CASAI Cuiabá, semi-structured interviews with health professionals and administrators from the Cuiabá Special Indigenous Health District (DSEI) and CASAI Cuiabá, and document analysis. Data analysis used a matrix derived from the theoretical and logical model of accessibility, validated by the Delphi method with a group of experts on indigenous peoples' health. Despite advances achieved by CASAI in improving indigenous peoples' access, there are persistent social, organizational, cultural, and geographic barriers in access to medium and high-complexity health services in Cuiabá. The study highlights the need for specific strategies to improve access to health services by indigenous peoples in Mato Grosso State.
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Abstract
BACKGROUND The aim of this cross-sectional study was to evaluate the risk indicators of tooth loss in adult Kiriri Indians from Brazil. METHODS A representative sample of 225 Indians (≥ 19 years of age) was assessed. Interviews using a structured written questionnaire were performed to collect data on demographics and socio-economic status, and health-related data. Probing depth, the distance between the cement-enamel junction and the free gingival margin, and decayed, missing or filled teeth were evaluated. Bivariate and logistic models were used to assess associations between tooth loss and age, sex, income, education, diabetic status, smoking habits, dental caries, severe periodontitis, plaque index and previous dental visit. RESULTS Eighty per cent of subjects had lost one tooth or more, and 20% had lost eight teeth or more. Mean (± standard deviation) tooth loss was 5.09 (± 5.83) teeth. After adjustment for covariates, loss of one tooth or more was associated with older age [≥ 35 years; odds ratio (OR) = 4.06, 95% confidence interval (95% CI): 1.38-11.94, P = 0.01], severe periodontitis (OR = 3.35, 95% CI: 0.99-11.24, P = 0.05), higher dental caries (OR = 3.24, 95% CI: 1.35-7.78, P = 0.01) and previous dental visit (OR = 23.32, 95% CI: 5.75-94.63, P < 0.001). CONCLUSION Tooth loss is highly prevalent in Kiriri Indians. Older age, severe periodontitis, higher caries index and previous dental visit were associated with tooth loss. Prevention and treatment programmes, targeting high-risk groups, are required to promote the oral health of the population.
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Abstract
Investigations into the oral health status of indigenous populations are scarce. The aim of this study was to evaluate caries experience and associated factors among 342 indigenous children and adolescents aged 5-15 years of the Xukuru community in the municipality of Pesqueira, Brazil. A cross-sectional census study was carried out using the criteria of the World Health Organization to determine caries experience. Examinations were performed by two calibrated dentists and a questionnaire was administered to parents/caregivers addressing socio-demographic data, diet and oral hygiene habits. Logistic regression analysis were performed, with dmft and DMFT as the dependent variables (P < 0.05). Caries experience (dmft/DMFT) was high in both the primary and permanent dentition (75.6% and 62.9%, respectively). Mean dmft and DMFT indices were 3.11 and 2.21, respectively. Caries experience in the primary dentition was associated with children residing in villages far from urban areas (P = 0.016), while caries in the permanent dentition was associated with older children (P < 0.001) and with children from villages at an intermediate distance and far from urban areas (P < 0.001). The indigenous subjects exhibited a high degree of caries experience, which was associated with age and group of villages. Public policies are needed to improve the oral health status of this population.
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Destructive periodontal disease in adult Indians from Northeast Brazil: cross-sectional study of prevalence and risk indicators. J Clin Periodontol 2013; 40:1001-6. [PMID: 24164568 DOI: 10.1111/jcpe.12147] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 11/27/2022]
Abstract
AIM The aim of this cross-sectional study was to evaluate the prevalence of destructive periodontal disease and its risk indicators in adult Kiriri Indians from Northeast Brazil. MATERIALS AND METHODS Full-mouth periodontal examinations were performed on a sample of 215 Indians (≥19 years). Bivariate analyses and logistic models were applied to assess associations between periodontitis and its putative risk factors. RESULTS Prevalence of clinical attachment loss of ≥3, ≥5 and ≥7 mm was 97.8%, 63.8% and 30.8% respectively. Percentage of teeth per individual showing clinical attachment loss of ≥3, ≥5 and ≥7 mm was 49.8%, 18.4% and 8.0% respectively. After adjustment for covariates, individuals aged ≥35 years (OR = 5.83, 95% CI: 3.09-11.00; p < 0.001), men (OR = 2.18, 95% CI: 1.15-4.11; p = 0.02) and diabetics (OR = 3.92, 95% CI 1.03-14.99; p = 0.05) had a higher risk for destructive periodontitis, classified according to the CDC/AAP case definition. CONCLUSION Though periodontitis was highly prevalent in Kiriri Indians, only few teeth showed advanced disease, and periodontitis was associated with higher age, male sex and diabetes. A public health action that includes programs of prevention and treatment targeting high-risk groups is vital to improve the periodontal status of this population.
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População indígena: uma reflexão sobre a influência da civilização urbana no estado nutricional e na saúde bucal. REV NUTR 2010. [DOI: 10.1590/s1415-52732010000300013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Embora ainda existam sociedades indígenas que mantêm um modo tradicional de viver, nas quais uma alimentação adequada em quantidade e qualidade provém da caça e da prática de agricultura, a maioria dos índios vem sofrendo um processo de aculturação oriundo do contato com a civilização urbana, pois eles não mais dispõem de terra suficiente que garanta a subsistência. Desse modo, acabam tornando-se dependentes do comércio local e consumindo alimentos industrializados que podem ser prejudiciais à saúde bucal e ao estado nutricional. A presente comunicação tem como objetivo identificar a influência da transição alimentar, devido ao contato com a civilização urbana, no estado nutricional e na condição bucal da população indígena brasileira. Os dados relacionados nessa investigação foram obtidos na base de dados do SciELO e do MedLine, PubMed, pesquisando-se os termos de indexação: "índios sul-americanos", "comportamento alimentar", "estado nutricional", "saúde bucal". Estudos revelaram a prevalência de desnutrição infantil, sobrepeso e obesidade em adultos, índice de cárie elevado e doença periodontal nas comunidades indígenas que vêm passando por mudanças de hábitos culturais. Conclui-se que a transição alimentar pode levar a desordens nutricionais e ao desenvolvimento de doenças bucais, sugerindo a necessidade de uma intervenção e/ou monitoramento por meio de programas dirigidos à assistência à saúde, ao saneamento básico, ao acesso à terra e à educação.
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Diferenciais de cárie dentária entre os índios Xavante de Mato Grosso, Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010. [DOI: 10.1590/s1415-790x2010000200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi avaliar níveis de experiência de cárie entre subgrupos Xavante que vivem em diferentes Terras Indígenas (T.I.) no Estado de Mato Grosso, Brasil, a fim de investigar a presença de desigualdades no interior de uma mesma etnia indígena. Os dados foram coletados através de um censo de saúde bucal realizados em 2004. Das sete T.I. Xavante existentes, foram investigadas quatro (Pimentel Barbosa, Sangradouro, Areões e Marechal Rondon), nas quais foram selecionadas a maior aldeia de cada. Foram adotados os critérios preconizados pela Organização Mundial da Saúde, e utilizado o índice CPOS. Para mensurar as diferenças entre as T.I. foi estimada a razão de prevalência (RP) por meio de análise de regressão de Poisson, efetuada na faixa etária entre 6 e 34 anos para cada sexo, incluindo a idade como covariável. Nesta faixa etária, as perdas variaram entre 26 a 30%. Pimentel Barbosa foi considerada como referência para comparações por apresentar menor prevalência de cárie em todas as faixas etárias analisadas. A maior disparidade foi notada entre as T.I. Pimentel Barbosa e Sangradouro, tanto em homens (RP 2,68- IC95% 2,41 a 2,97) como em mulheres (RP 2,03- IC95% 1,85 a 2,23). A RP do componente obturado em Areões e Marechal Rondon (diferença relativa a Pimentel Barbosa) é muito pequena em relação à carga de doença total nestas T.I., indicando menor presença de serviço odontológico restaurador. Conclui-se que a transição em saúde bucal não é homogênea entre os Xavante e que as diferenças podem estar associadas a particularidades do processo histórico de interação com a sociedade não-indígena. Determinantes locais e regionais, incluindo fatores demográficos, características econômicas e sócio-culturais específicas, acesso e utilização de serviços de saúde, podem ter determinado as desigualdades de ataque de cárie observadas entre os Xavante.
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Abstract
BACKGROUND The oral health conditions of indigenous peoples in Amazonia are closely associated with ecological and dietary changes related to interaction with non-Indians. AIM The study investigated the incidence of caries in an indigenous community from Central Brazil focusing on gender differences. SUBJECTS AND METHODS The research was conducted among the Xavante Indians and was based on longitudinal data collected in two surveys (1999 and 2004). The study included 128 individuals, 63 (49.2%) males and 65 (50.8%) females, divided in four age brackets (6-12, 13-19, 20-34, 35-60 years of age). The DMFT (decayed, missing and filled teeth) index and incidences (difference between 1999 and 2004) were calculated for each individual. The proportion of incidence was also calculated. Differences in caries risk between gender and age brackets were compared by parametric and non-parametric tests. RESULTS There were statistically significant differences in relation to caries incidence between age brackets and gender. The greatest incidence was observed in the 20-34 age bracket, which presented 3.30 new decayed teeth, twice the risk of the 6-12 age bracket (p<0.01), chosen as reference. While females in most age groups did not show higher risk for caries when compared to males, there was a 4.04-fold risk in the 20-34 age bracket (p<0.01). CONCLUSION It is concluded that factors related to the social functions of each sex (gender issues) and differential access to information, health services, and education may help to understand the differences observed in the incidence of caries.
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Saúde bucal dos índios Guaraní no Estado do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2009; 25:37-46. [DOI: 10.1590/s0102-311x2009000100004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Accepted: 06/12/2008] [Indexed: 11/22/2022] Open
Abstract
Este estudo teve por objetivo descrever a situação de saúde bucal em índios Guaraní do Estado do Rio de Janeiro, Brasil. Um inquérito epidemiológico em saúde bucal, utilizando critérios da Organização Mundial da Saúde foi realizado em 508 sujeitos (90,7% da população). Aos 5 anos, 38,5% das crianças estavam livres de cárie e aos 12 o CPOD foi igual a 1,7. Observou-se que 54,2% dos indivíduos entre 35-44 anos e 12% entre 65-74 apresentavam 20 ou mais dentes. O número de dentes para 35-44 e 65-74 anos foi de 18,5 e 8,5. Enquanto o ceod não diferiu entre sexos, o CPOD e a perda dentária foram maiores em mulheres. Aproximadamente 60% da população não demonstraram problemas periodontais, enquanto 20,9% e 11,3% apresentaram sangramento gengival e cálculo como condições periodontais mais graves. Sangramento e cálculo foram mais comuns em homens, e sextantes excluídos em mulheres. Ações de promoção de saúde bucal são necessárias para esse grupo étnico e devem contemplar especificidades para diferentes grupos etários e de gênero.
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Cárie dentária e necessidade de tratamento odontológico entre os índios Baniwa do Alto Rio Negro, Amazonas. CIENCIA & SAUDE COLETIVA 2008; 13:1985-92. [DOI: 10.1590/s1413-81232008000600034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2006] [Accepted: 12/11/2006] [Indexed: 11/22/2022] Open
Abstract
Pesquisas epidemiológicas em comunidades indígenas no Brasil têm evidenciado forte relação entre a deterioração da saúde bucal e o consumo de itens industrializados (e do açúcar refinado em particular), aliados à precariedade da atenção odontológica. Este estudo abordou a população Baniwa do pólo-base de Tunuí-Cachoeira, São Gabriel da Cachoeira, Amazonas, Brasil. Foi realizado inquérito transversal sobre as condições de saúde bucal, de acordo com critérios da OMS. Foram observadas as condições dentárias e a necessidade de tratamento, examinando-se 590 indivíduos (49,2% da população > 2 anos). A média de dentes atacados pela doença cárie foi 6,0, 8,2 e 22,1 nas faixas etárias 12-14, 15-19 e mais de 50 anos, respectivamente. O maior valor de ceo-d (5,3) foi encontrado na idade de 5 anos. Do total de pessoas examinadas, 73,6% apresentaram alguma necessidade de tratamento cirúrgico-restaurador. Os indivíduos entre 15-19 anos apresentam as mais elevadas freqüências de restaurações. O CPO-D da população Baniwa é elevado, o que deve estar relacionado a processos recentes de mudanças socioeconômicas, particularmente na dieta. Enfatiza-se a necessidade de ampliação da atenção à saúde bucal, considerando-se a complexidade da questão sociocultural dos povos indígenas.
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Cárie dentária em população ribeirinha do Estado de Rondônia, Região Amazônica, Brasil, 2005/2006. CAD SAUDE PUBLICA 2008; 24:2347-53. [DOI: 10.1590/s0102-311x2008001000015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Accepted: 02/25/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi analisar experiência de cárie dentária na população ribeirinha residente às margens dos rios Machado e Preto (Rondônia, Brasil), em 2005 e 2006. Foram examinados 469 indivíduos com formulário preconizado pela Organização Mundial da Saúde, sob luz natural e utilização de espátulas de madeira e sonda CPI. Na faixa etária de 4-5 anos de idade, ceod = 4,30 e 19,64% livres de cárie; 6-10 anos, CPOD = 1,04, ceod = 3,52, 17,05% livres de cárie; aos 12 anos, CPOD = 2,65 e 30,76% livres de cárie; aos 18 anos, CPOD = 5,41 e 19,51% livres de cárie; 35-44 anos, CPOD = 17,74 e 2,98% livres de cárie; 65-74 anos, CPOD = 21,56 e 4,34% livres de cárie. Na análise por componentes, constatou-se que o componente cariado tem maior prevalência nas idades de 0-3, 4-5, 6-10, 12 e 18 anos. Em adultos e idosos, o componente que mais contribui é o perdido. Conclui-se que a população apresenta índices de cárie dentária elevados, sendo necessária a atuação em âmbito educativo, preventivo e curativo.
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[Rate of dental treatment needs: the case of the Xakriaba Indians]. CIENCIA & SAUDE COLETIVA 2008; 13:1017-22. [PMID: 18813595 DOI: 10.1590/s1413-81232008000300024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 08/07/2007] [Indexed: 11/21/2022] Open
Abstract
The present study was developed among Xakriabas Indians in Minas Gerais and aimed at identifying their needs for dental treatment so that patients could be scheduled for treatment. Native health agents were trained by dental-surgeons for conducting the survey in household visits. The total Indian population is of 6.498 inhabitants, 3.686 of these living within the territory of the "Base Mata Fome", where 61% of the population was examined. Results showed that the population is mainly young, a great number of individuals presented no need for treatment and dental caries was the most frequent problem. The survey is expected to help in the organization of a schedule that allows giving priority to the more serious cases and promoting equity.
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