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Denicol MM, Leotti VB, de Soares CRS, Hilgert JB. Early-onset neonatal sepsis as a risk factor for peri-intraventricular hemorrhage in premature infants. Rev Bras Epidemiol 2024; 27:e240013. [PMID: 38511823 PMCID: PMC10946291 DOI: 10.1590/1980-549720240013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/14/2023] [Accepted: 01/05/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE To assess early-onset sepsis as a risk factor of peri-intraventricular hemorrhage in premature infants born at less than or equal to 34 weeks' gestation and admitted to a neonatal intensive care unit (NICU). METHODS This retrospective cohort study included premature patients born at less than or equal to 34 weeks' gestation who were admitted to the NICU of a tertiary hospital in southern Brazil, and born from January 2017 to July 2021. Data were collected from patients' medical records. Early-onset sepsis was measured according to the presence or absence of diagnosis within the first 72 hours of life, whereas the outcome, peri-intraventricular hemorrhage, was described as the presence or absence of hemorrhage, regardless of its grade. RESULTS Hazard ratios were calculated using Cox regression models. A total of 487 patients were included in the study, of which 169 (34.7%) had some degree of peri-intraventricular hemorrhage. Early-onset sepsis was present in 41.6% of the cases of peri-intraventricular hemorrhage, which revealed a significant association between these variables, with increased risk of the outcome in the presence of sepsis. In the final multivariate model, the hazard ratio for early-onset sepsis was 1.52 (95% confidence interval 1.01-2.27). CONCLUSION Early-onset sepsis and the use of surfactants showed to increase the occurrence of the outcome in premature children born at less than or equal to 34 weeks' gestation. Meanwhile, factors such as antenatal corticosteroids and gestational age closer to 34 weeks' gestations were found to reduce the risk of peri-intraventricular hemorrhage.
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Affiliation(s)
- Mariana Martins Denicol
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
| | - Vanessa Bielefeldt Leotti
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology – Porto Alegre (RS), Brazil
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Dietrich TR, Debona G, de Spessato Schwerz P, Fagundes MLB, Hugo FN, Hilgert JB, do Amaral Giordani JM, do Amaral Júnior OL. Preventive dental service use and oral health-related quality of life in Brazilian older adults. Gerodontology 2024; 41:40-45. [PMID: 37386716 DOI: 10.1111/ger.12700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Information on the use of preventive dental services and associated variables is needed to guide policy for the old adult population and consequently promote better oral health-related quality of life (OHRQoL). OBJECTIVE To investigate the association between preventive dental service use and OHRQoL by older Brazilians. MATERIALS AND METHODS This cross-sectional study was carried out using the baseline data of participants of the Brazilian Longitudinal Stud of Aging (ELSEI-Brazil) who were aged 60 years or more. Associations with the use of preventive dental services were carried out using Poisson regression models with robust variance, adjusting for confounders. RESULTS The final sample consisted of 5432 older adults. Almost all (90.7%) participants reported not having sought preventive dental services in the last year. Individuals who used dental services for prevention had fewer impacts on their OHRQoL (RR: 0.74; [95% CI: 0.57-0.97]). CONCLUSION Preventive dental service use is associated with a better OHRQoL in older Brazilians. Policies to improve access to preventive dental services may result in improved OHRQoL in this age group.
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Affiliation(s)
- Tauana Rabuske Dietrich
- Department of Oral Health, School of Dentistry, Unidade Central de Educação FAI Faculdades - UCEFF, Itapiranga, Brazil
| | - Gabriela Debona
- Department of Oral Health, School of Dentistry, Unidade Central de Educação FAI Faculdades - UCEFF, Itapiranga, Brazil
| | - Paola de Spessato Schwerz
- Department of Oral Health, School of Dentistry, Unidade Central de Educação FAI Faculdades - UCEFF, Itapiranga, Brazil
| | | | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry Porto Alegre (RS), Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry Porto Alegre (RS), Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | | | - Orlando Luiz do Amaral Júnior
- Department of Oral Health, School of Dentistry, Unidade Central de Educação FAI Faculdades - UCEFF, Itapiranga, Brazil
- Department of Dental Sciences, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
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de Vasconcellos NBT, Fagundes MLB, Menegazzo GR, do Amaral Júnior OL, Hilgert JB, do Amaral Giordani JM. Association between frailty and oral health services use in Brazilian older adults. Gerodontology 2024; 41:46-53. [PMID: 37750043 DOI: 10.1111/ger.12716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To assess the association between frailty and oral health services use in Brazilian older adults. METHODS This cross-sectional study analysed the baseline data from the Longitudinal Study on Brazilian Ageing (ELSI-Brazil) representative of Brazilians aged 50 or over. The outcome was oral health services used in the year prior to the interview. The main exposure variable was Frailty defined by the frailty phenotype. Age, skin colour, wealth, sex, education, type of service, health insurance, number of teeth and self-perceived oral health were included as covariates. Prevalence ratios (PR) with their respective 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. RESULTS 8405 individuals were included in this study. The prevalence of frailty was 7.5%. Regarding frailty status, the prevalence of dental service use was 47.0%, 48.5% and 4.5% for robust, pre-frail and frail individuals, respectively. Frail individuals had a 7% higher prevalence of not using dental (PR: 1.07; 95% CI: 1.01-1.13) than robust individuals. Frailty was independently associated with not using oral health services. CONCLUSION Given the complexity of the determinants of dental service use, frailty adds another dimension to be examined in older adults. Public health strategies considering a common risk factor approach should be endorsed.
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Affiliation(s)
| | | | | | | | - Juliana Balbinot Hilgert
- Departament of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Pinheiro LS, Ritzel IF, Hugo FN, Hilgert JB, Bastos JL, Celeste RK. Associations between psychological stress, discrimination, and oral health-related quality of life: the buffering effects of social support networks. CAD SAUDE PUBLICA 2024; 40:e00123123. [PMID: 38381864 PMCID: PMC10877699 DOI: 10.1590/0102-311xen123123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 02/23/2024] Open
Abstract
Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.
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Seoane M, Lorenzo-Erro SM, Massa F, Hilgert JB, Hugo FN, De Marchi RJ, Celeste RK. Residual dentition, prosthesis type and oral health-related quality of life in Uruguayan adults. Gerodontology 2023; 40:317-325. [PMID: 36214197 DOI: 10.1111/ger.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the association between different types of dental prostheses (and residual dentition) and oral health-related quality of life (OHRQoL). METHODS A population-based study with a representative sample of adults and older adults in Uruguay (2010-2011). The dependent variable was the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, socioeconomic status, education, missing teeth, pain and decayed teeth. Negative binomial regression was used. RESULTS The sample comprised 762 participants. Those participants not wearing a prosthesis and with extensive tooth loss had a mean OIDP of 3.1 (95% CI = 1.6-6.2), while those wearing removable partial dentures (RPD) and having <12 missing teeth had a mean OIDP of 3.6 (95% CI = 1.3-10.0). Participants with a free-end saddle had the highest mean OIDP, at 4.9 (95% CI = 2.0-12.1). For participants with ≤12 missing teeth, any additional missing tooth was associated with an 11% higher OIDP score. Participants who wore RDPs reported fewer impacts on OHRQoL if they had extensive tooth loss or anterior tooth loss than those with a free-end saddle, or who had lost fewer teeth. CONCLUSIONS The use of RPDs is associated with better OHRQoL. These findings may be valuable in clinical practice and prosthetic planning.
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Affiliation(s)
- Mariana Seoane
- Chair of Removable Partial Prosthesis, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Susana Margarita Lorenzo-Erro
- Chair of Social Dentistry, Epidemiology and Statistics Service, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Fernando Massa
- Chair of Social Dentistry, Epidemiology and Statistics Service, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato Jose De Marchi
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Colvara BC, Ritzel IF, Aguiar VR, Hilgert JB, Celeste RK. [Coverage of the Brazilian Income Transfer Program and factors associated with the performance of dental procedures in Brazil, from 2007 to 2011: an ecological study]. CAD SAUDE PUBLICA 2023; 39:e00200622. [PMID: 37466555 PMCID: PMC10494671 DOI: 10.1590/0102-311xpt200622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 07/20/2023] Open
Abstract
In Brazil, there has been an expansion of the coverage of dental services in primary health care (PHC), and the focus of the services has changed to include more efforts in prevention and diagnosis. However, little is known about the influence of the coverage of the Brazilian Income Transfer program on the use of dental services. Our study evaluates the association between municipal coverage of the Brazilian Income Transfer Program and the use of dental services. This ecological study conducted with data from the 5,570 Brazilian municipalities estimates, via logistic regressions, the impact of the coverage of the Brazilian Income Transfer program, the Family Health Strategies (FHS), and the oral health teams on the number of restoration, colective, prevention, and dental extraction procedures performed by the Brazilian Unified National Health System (SUS) between the periods 2007/2008 and 2010/2011. The percentage of municipalities that increased the rates of prevention, colective, restoration, and extraction procedures was 46%, 59.8%, 52.5%, and 44.2%, respectively. In the adjusted model, municipalities with increased coverage of Brazilian Income Transfer program were less likely to increase colective (OR = 0.91; 95%CI: 0.79-1.04) and prevention (OR = 0.92; 95%CI: 0.80-1.05) procedures, and they were more likely to increase rates of restoration (OR = 1.11; 95%CI: 0.97-1.28) and dental extraction (OR = 1,10; 95%CI: 0.95-1.27) procedures. The increase in the coverage rate of the oral health teams was significantly associated with a higher chance of an increase in prevention, restoration, and extraction procedures. We conclude that the coverage of oral health teams was the main variable associated with the increase in dental procedures performed in the public service.
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Cunha-Cruz J, Hilgert JB, Harter C, Rothen ML, Hort K, Mallott E. Feedback on audit and action planning for dental caries control: a qualitative study to investigate the acceptability among interdisciplinary pediatric dental care teams. Front Oral Health 2023; 4:1195736. [PMID: 37456360 PMCID: PMC10348878 DOI: 10.3389/froh.2023.1195736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction American Indian and Alaska Native children suffer from the poorest oral health of all populational groups in the United States. Evidence-based practices (EBP) for caries control are well established, but systematically implementing such practices have proven difficult. Audit and feedback with goal setting, and action planning to implement these EBPs have not been tested or adapted for Alaska Native healthcare settings. The aim of this study was to investigate acceptability and perceived feasibility of an audit and feedback intervention for pediatric dental caries control among dental providers and patient stakeholders. Methods The pilot program was implemented in two dental clinics from a tribal healthcare consortium in Alaska. Key-informant interviews were conducted to investigate the contextual, organizational, and behavioral facilitators and barriers to the implementation and expansion of the program. Interview transcripts were analyzed by two researchers using thematic analysis. Results Eight key informants were interviewed twice (during and after the intervention period), and one once, for a total of 17 interviews. Patient stakeholders were not interviewed due to COVID-19 pandemic clinic closures and social isolation mandates. Three principal themes emerged: a positive organizational climate and culture fostered the acceptability of the program, the positive impacts of the program observed in the pediatric dental teams and the organization, and the challenges to implement the program including understanding the data reports, trusting the accuracy of the data, and competing priorities. Conclusions The intervention of audit and feedback with goal setting and action planning was well accepted and perceived as feasible by the study participants given the financial and human resources provided by the research project. This qualitative study can inform the design and evaluation of process-oriented implementation strategies geared towards decreasing health inequities and improving health outcomes, such as dental caries in American Indian and Alaska Native children and adolescents.
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Affiliation(s)
- Joana Cunha-Cruz
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, United States
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Juliana Balbinot Hilgert
- Post Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Post Graduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Catherine Harter
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, United States
| | - Marilynn L. Rothen
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, United States
| | - Kim Hort
- SouthEast Alaska Regional Health Consortium (SEARHC), Juneau, AK, United States
| | - Elizabeth Mallott
- SouthEast Alaska Regional Health Consortium (SEARHC), Juneau, AK, United States
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Teixeira CNG, Pereira SMDS, Hilgert JB, Oliveira NMAD, Ribeiro CCC, Neves M, Thomaz EBAF, Hugo FN, Alves CMC. [The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis]. Cien Saude Colet 2023; 28:1087-1100. [PMID: 37042890 DOI: 10.1590/1413-81232023284.11452022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 09/20/2022] [Indexed: 04/13/2023] Open
Abstract
The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.
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Affiliation(s)
- Cinthia Nara Gadelha Teixeira
- Universidade de Fortaleza. R. São Mateus 1.650, 402, Vila União. 60410-642 Fortaleza CE Brasil.
- Universidade Federal do Maranhão. São Luís MA Brasil
| | | | | | | | | | - Matheus Neves
- Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Colvara BC, Singh A, Gupta A, Celeste RK, Hilgert JB. Association between cash transfer programs and oral health-A scoping review. J Public Health Dent 2023; 83:69-77. [PMID: 36458510 DOI: 10.1111/jphd.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health; and to identify the theoretical frameworks applied to guide this literature. METHODS A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted. RESULTS Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association. CONCLUSION Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health.
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Affiliation(s)
- Beatriz Carriconde Colvara
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ankur Singh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Adyya Gupta
- Health and Social Development, Deakin University, Burwood, Australia
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Schwertner C, Silva CDD, Grando D, Hilgert JB, Hashizume LN. Oral health status and quality of life of the parental caregivers of children with Down syndrome: A case-control study. J Intellect Disabil 2023; 27:238-249. [PMID: 35144501 DOI: 10.1177/17446295211048737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to investigate the oral health status and quality of life (QOL) of the parental caregivers of individuals with Down syndrome (DS), and to evaluate whether there is an association between these variables. The sample of this cross-sectional study was composed by parental caregivers of children with DS (CCDS) and parental caregivers of children without DS (CNDSC). Oral examination was undertaken and a questionnaire was given to participants. QOL was evaluated by WHOQOL-Bref. CCDS presented a higher number of dental prosthesis users and higher gingival bleeding index compared to CNDSC. When oral health was associated with QOL, the use of dental prosthesis was associated with physical domain and the variables having chronic disease and family income were associated with the social domain for both caregivers. The results suggest that caregivers of children with DS have similar oral health and QOL compared to caregivers of children without DS. In both caregivers, oral health status is associated with QOL.
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Affiliation(s)
- Carolina Schwertner
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Brazil
| | - Caroline Dias da Silva
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Brazil
| | - Débora Grando
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Brazil
| | - Lina Naomi Hashizume
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Brazil
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Amaral Júnior OLD, Fagundes MLB, Bastos LF, Menegazzo GR, Hugo FN, Abreu LG, Iser BPM, Hilgert JB, Giordani JMDA. Dental visits and depression mediating the association of socioeconomic status with oral health behaviors. Braz Oral Res 2023; 36:e094. [PMID: 36651385 DOI: 10.1590/1807-3107bor-2022.vol36.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/07/2022] [Indexed: 01/18/2023] Open
Abstract
Determinants of oral diseases include behaviors, which in turn are influenced by a series of social determinants such as psychosocial aspects and dental care services. Therefore, the aim of this study was to investigate whether depressive symptoms and use of dental care services mediate the relationship between socioeconomic status (SES) and oral health behaviors. This was a cross-sectional study that analyzed data from participants in the 2019 National Health Survey (PNS) (n = 88,531). The eligibility criteria were individuals who were 18 years and older and exclusion criterion was living in households located in special or sparsely populated census tracts. Structural equation modeling (SEM) was used to test direct and indirect pathways from a latent variable for SES to oral health through depressive symptoms (assessed through the "Patient Health Questionnaire-9") and use of dental care services. The maximum likelihood estimator for complex samples with the robust standard error was used. The final model presented an adequate fit: RMESA of 0.008, CFI of 0.998, and SMRM of 0.005. The results showed that higher SES was directly associated with better oral health-related behaviors [standardized coefficient (SC): 0.428; p < 0.01] and indirectly through depressive symptoms [(SC): 0.002; p < 0.01] and dental care services [(SC): 0.089; p < 0.01]. The total effect of SES on oral health-related behaviors was equal to [(SC: 0.519 (p < 0.01)]. In conclusion, the findings suggest that high socioeconomic status, mediated by depressive symptoms and dental care services, has a positive effect on oral health.
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Affiliation(s)
- Orlando Luiz do Amaral Júnior
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stoatology, Santa Maria, RS, Brazil.,Centro Universitário FAI - UCEF, School of Dentistry, Department of Oral Health, Itapiranga, SC, Brazil
| | | | - Lucelen Fontoura Bastos
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Gabriele Rissotto Menegazzo
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stoatology, Santa Maria, RS, Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Child and Adolescent Oral Health, Belo Horizonte. MG, Brazil
| | - Betine Pinto Moehlecke Iser
- Universidade do Sul de Santa Catarina - Unisul, Post-Graduate Program in Health Sciences, Tubarão, SC, Brazil
| | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
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Menegazzo GR, Cunha ARD, Fagundes MLB, Amaral Júnior OLD, Giordani JMDA, Hilgert JB, Abreu LG, Hugo FN. Pathways that explain racial differences on edentulism among older adults: 2019 Brazil National Health Survey. Braz Oral Res 2023; 37:e40. [PMID: 37132727 DOI: 10.1590/1807-3107bor-2023.vol37.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/04/2022] [Indexed: 05/04/2023] Open
Abstract
This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3-52.6), and 36.8% (95%CI: 35.7-37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults.
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Affiliation(s)
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | | | | | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG - School of Dentistry , Department of Child's and Adolescent's Oral Health , Belo Horizonte , MG , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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Rigo L, Bidinotto AB, Hugo FN, Neves M, Hilgert JB. Untreated caries and serum vitamin D levels in children and youth of the United States: NHANES 2013-2014. Braz Dent J 2023; 34:99-106. [PMID: 36888850 PMCID: PMC10027104 DOI: 10.1590/0103-6440202305123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/05/2023] [Indexed: 03/08/2023] Open
Abstract
This study aimed to investigate the association between serum vitamin D levels and untreated caries and determining factors in children and youth. METHODOLOGY This cross-sectional study used data from the National Health and Nutrition Examination Survey (2013-2014). In total, 3,072 participants with ages ranging from 1 to 19 years were included in our sample. The main dependent variable, untreated caries, was defined as having at least one untreated carious surface in any tooth. Serum concentration of 25-hydroxyvitamin D [25(OH)D] was categorized into four groups: ≥75 nmol/ml, 50-74.9 nmol/ml, 25-49.9 nmol/ml, and <25 nmol/ml. Data were analyzed using a binary logistic regression. RESULTS For children aged 1-5 years, age (OR = 1.68, 95% confidence intervals (95% CI) 1.38-2.04) and low levels of vitamin D (25-49.9 nmol/ml, and <25 nmol/ml: OR = 2.55, 95% CI 1.06-6.13) were associated with untreated caries. For children aged 6-11 years, low levels of vitamin D (50-74.9 nmol/ml: OR=1.45, 95% CI 1.16-1.82) remained associated with untreated caries. No associations were found in those between 12 and 19 years of age. CONCLUSION Our findings show an association between low levels of 25(OH)D and untreated caries in children between 1 and 11 years of age, suggesting that this nutrient might interfere in the caries process.
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Affiliation(s)
- Lilian Rigo
- Graduate Program in Dentistry, ATITUS, Passo Fundo, Brazil
| | - Augusto Bacelo Bidinotto
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Matheus Neves
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Rech RS, de Goulart BNG, Dos Santos KW, Marcolino MAZ, Hilgert JB. Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis. Aging Clin Exp Res 2022; 34:2945-2961. [PMID: 36207669 DOI: 10.1007/s40520-022-02258-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Swallowing impairment (SI) is an underdiagnosed dysfunction frequently seen as an expected condition of aging. However, SI can lead to health complications and considerable social impact. METHODS The objective of this systematic review with meta-analysis was to evaluate the frequency and associated factors with SI in community-dwelling older persons. Searches were performed in 13 electronic databases including MEDLINE and EMBASE (from inception to September 18, 2021). Data extraction and methodological quality assessment of included studies were performed by two independent reviewers. Meta-analysis of proportions with 95% confidence interval (CI) and prediction interval (PI) was used to pool estimates. Subgroup analysis by Country and Assessment Method was performed. General meta-analysis was used to pool measures of association between potential risk factors and SI occurrence (odds ratio [OR] or prevalence ratio [PR]). RESULTS The worldwide estimated frequency of SI in community-dwelling older persons was 20.35% (95%CI 16.61-24.68%, 95%PI 4.79-56.45, I2 99%, n = 33,291). This estimation varied across assessment methods and by country. The main factors associated with SI were a dry mouth (OR 8.1, 95%CI 4.9-13.4), oral diadochokinesis (OR 5.3, 95%CI 1.0-27.3), ≥ 80 years old (OR 4.9, 95%CI 2.6-9.2), genetic factor (SNPrs17601696) (OR 4.8, 95%CI 2.7-8.3), and partial dependence (OR 4.3, 95%CI 2.0-9.3). And the main factors associated with SI estimated by PR were dry mouth sensation (PR 4.1, 95%CI 2.6-6.5), oral sensorimotor alteration (PR 2.6, 95%CI 1.4-4.9), osteoporosis (PR 2.51, 95%CI 1.2-5.3), and heart diseases (PR 2.31, 95%CI 1.1-5.0). CONCLUSION One in five older adults worldwide are expected to experience SI and factors associated with this underdiagnosed dysfunction included biological and physiological changes related to aging, physical and psychological conditions, and poor oral health. Early assessment is paramount for the prevention of future clinical complications and should be a high priority in health care practices.
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Affiliation(s)
- Rafaela Soares Rech
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - Karoline Weber Dos Santos
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Miriam Allein Zago Marcolino
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil. .,Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil. .,Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal Do Rio Grande Do Sul, Brazil, Rio Grande do Sul, Porto Alegre, Santa Cecília, Ramiro Barcelos, 2492.
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Fagundes MLB, Amaral Júnior OLD, Menegazzo GR, Bastos LF, Hugo FN, Abreu LG, Iser BPM, Giordani JMDA, Hilgert JB. Pathways of socioeconomic inequalities in self-perceived oral health. Braz Oral Res 2022; 36:e088. [PMID: 35703713 DOI: 10.1590/1807-3107bor-2022.vol36.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
Although there is a large body of evidence of the influence of social determinants on oral health, information on the mechanisms by which these determinants operate is poorly documented. Therefore, we aimed to investigate the pathways through which socioeconomic inequalities may influence self-perceived oral health (SPOH) in Brazilian adults. This cross-sectional study used data from the National Health Survey (NHS) of 2019, with a representative sample of adults aged 18 to 59 years (n = 65,803). The outcome was SPOH, assessed by a global self-item. Structural equation modeling was used to test direct and indirect pathways connecting a latent variable for socioeconomic position (SEP) to SPOH via psychosocial, behavioral, and biological factors. Higher SEP was directly associated with better SPOH [standardized coefficient (SC) = 0.069; p < 0.01)] fewer depressive symptoms (SC = -0.059; p < 0.01), fewer missing teeth (SC = 0.131; p < 0.01), and more healthy behaviors (SC = 0.643; p < 0.01). Fewer depressive symptoms (SC = -0.141; p < 0.01), more healthy behaviors (SC = 0.242; p < 0.01), and fewer missing teeth (SC = 0.058; p < 0.01) were directly associated with good SPOH. Among specific indirect effects of SEP on SPOH, the behavioral pathway was the one that best explained this association (SC = 0.155). Socioeconomic inequities in SPOH are mediate by psychosocial, behavioral, and biological factors. This has implications for positioning health strategies in the social context in which people live, to facilitate healthy choices and promote good oral health.
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Affiliation(s)
- Maria Laura Braccini Fagundes
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Orlando Luiz do Amaral Júnior
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil .,Unidade Central de Educação FAI Faculdades - UCEFF , School of Dentistry , Department of Oral Health , Itapiranga , SC , Brazil
| | - Gabriele Rissotto Menegazzo
- Universidade Federal de Santa Maria - UFSM, School of Dentistry , Department of Dental Sciences , Santa Maria , RS , Brazil
| | - Lucelen Fontoura Bastos
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Child and Adolescent Oral Health , Belo Horizonte . MG , Brazil
| | - Betine Pinto Moehlecke Iser
- Universidade do Sul de Santa Catarina - Unisul, Post-Graduate Program in Health Sciences , Tubarão , SC , Brazil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry , Department of Preventive and Social Dentistry , Porto Alegre , RS , Brazil
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Tôrres LHDN, Hilgert JB, Hugo FN, Sousa MDLRD, De Marchi RJ. Predictors of tooth loss in Brazilian older adults: An 8-year follow-up. Gerodontology 2022; 40:207-212. [PMID: 35474327 DOI: 10.1111/ger.12634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/24/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the risk factors for tooth loss after 8 years among community-dwelling older adults in a southern Brazilian city. METHODS In 2004, 388 dentate community-dwelling older adults from Carlos Barbosa, southern Brazil, were selected using simple random sampling. In 2012, the follow-up consisted of 199 (51.3%) participants. Data collection comprised an interview with data about socio-demographic, behavioural and access to services and an oral examination. The outcome variable of this study is the ratio between the sum of the teeth lost during the 8-year period of follow-up, and the sum of the teeth present in 2004, per person, modelled through binomial regression analysis. RESULTS Being older (IOR = 1.03, 95% CI: 1.00-1.06), living in a rural area (IOR = 1.56, 95% CI: 1.17-2.07), earning two or more monthly minimum wages (IOR = 1.46, 95% CI: 1.09-1.96), living alone (single, widowed or divorced; IOR = 1.36, 95% CI: 1.00-1.85), having more gingival bleeding sites (IOR = 1.01, 95% CI: 1.00-1.02) and wearing partial removable prosthesis (IOR = 2.82, 95% CI: 2.15-3.71) were risk factors for tooth loss. Approximately 48% of the participants lost one or more teeth over the 8-year follow-up period. CONCLUSION Socio-demographic, economic and clinical variables were associated with the risk for tooth loss. This might be a result of social determinants of health influencing people's access to oral health care, oral health behaviours and oral health status. Public policy aimed at older adults living in rural areas, living alone and using removable dentures may contribute to reducing the risk of tooth loss.
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Affiliation(s)
- Luísa Helena do Nascimento Tôrres
- Postgraduate Program in Dental Science, Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Renato José De Marchi
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Hugo FN, Bailey JA, Stein C, da Cunha AR, Iser BPM, Malta DC, Giordani JMDA, Hilgert JB, Abreu LG, Kassebaum NJ. Prevalence, incidence, and years-lived with disability due to oral disorders in Brazil: an analysis of the Global Burden of Disease Study 2019. Rev Soc Bras Med Trop 2022; 55:e0284. [PMID: 35107534 PMCID: PMC9009423 DOI: 10.1590/0037-8682-0284-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/16/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Epidemiological surveys revealed that Brazil has a high burden of oral diseases. However, no prior study has reported estimates of untreated dental caries, periodontitis, and edentulism over a three-decade period. The objective of this study is to report the trends of prevalence, incidence, and years-lived with disability (YLDs) due to untreated dental caries in primary and permanent teeth, periodontitis, and edentulism in Brazil between 1990 and 2019. METHODS Estimates of prevalence, incidence, and YLDs due to dental caries in primary and permanent teeth, periodontitis, and edentulism were produced for Brazil, by sex and age, between 1990 and 2019, using Dismod-MR 2.1, as part of the Global Burden of Disease Study 2019 (GBD 2019). Trends of oral disorders were analyzed using generalized linear regression models applying the Prais-Winsten method. RESULTS Almost 100 million Brazilians presented at least one oral disorder in 2019, which was equivalent to a prevalence of 45.3%. All oral diseases combined ranked eighth among all causes of disability, causing more than 970,000 YLDs. Untreated dental caries in primary teeth were estimated to affect 13.5 million children, and untreated dental caries in permanent teeth affected more than 52 million people. Periodontitis affected 29.5 million people, and edentulism affected almost 22 million. The generalized linear regression models revealed a trend of stability of oral disorders between 1990 and 2019. CONCLUSIONS The burden of oral diseases in Brazil is extremely high. Oral disorders, edentulism in particular, caused disability at levels that are comparable to other important chronic diseases.
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Affiliation(s)
- Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul, Departamento de Odontologia Preventiva e Social, Porto Alegre, RS, Brasil
| | - Jordan A Bailey
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, WA, USA
| | - Caroline Stein
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Epidemiologia, Porto Alegre, RS, Brasil
| | - Amanda Ramos da Cunha
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Odontologia, Porto Alegre, RS, Brasil
| | | | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Departamento de Saúde Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | | | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul, Departamento de Odontologia Preventiva e Social, Porto Alegre, RS, Brasil
| | - Lucas Guimarães Abreu
- Universidade Federal de Minas Gerais, Departamento de Saúde Bucal da Criança e do Adolescente, Belo Horizonte, MG, Brasil
| | - Nicholas J Kassebaum
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, WA, USA
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Bonzanini LIL, Arduim ADS, Lenzi TL, Hugo FN, Hilgert JB, Casagrande L. Molar-incisor hypomineralization and dental caries: A hierarchical approach in a populational-based study. Braz Dent J 2022; 32:74-82. [PMID: 35019021 DOI: 10.1590/0103-6440202104511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/28/2021] [Indexed: 11/22/2022] Open
Abstract
The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children's parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.
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Affiliation(s)
- Laura Izabel Lampert Bonzanini
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Andressa da Silva Arduim
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Post-Graduate Program in Dental Clinic/Pediatric Dentistry, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, RS, Brazil
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Dias C, Schwertner C, Grando D, Bidinotto AB, Hilgert JB, Schuch JB, de Azeredo LA, Bauer ME, Hashizume LN. Caregiving of children with Down syndrome: impact on quality of life, stress, mental and oral health. Spec Care Dentist 2022; 42:398-403. [PMID: 35014048 DOI: 10.1111/scd.12694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
AIM Parental caregivers of children with Down Syndrome (DS) have a greater burden of daily activities that may affect their health. The aim of this exploratory study was to evaluate the impact of caregiving of children with Down syndrome on parenting quality of life, stress, mental and oral health. METHODS Fifty-four parental caregivers of children with DS and 51 parents of children without physical or mental disabilities participated of this study. All participants were clinically examined to evaluate the presence of dental caries, gingival conditions and answered a sociodemographic questionnaire. Depression, anxiety, quality of life and coping strategies were assessed using specific instruments. Hair cortisol level was assessed as biological marker of chronic stress. RESULTS Psychological and quality of life parameters were similar between the groups of caregivers (p > .05). Caregivers of children with DS were older (48.6 vs. 41.5, p < .001), had longer caregiving period (> 10 vs < 10 years, p = .003), presented higher gingival bleeding index (6.1 vs. 4.7, p = .014) and higher cortisol levels (55.9 vs. 38.4, p = .07) as compared with parents of children without disabilities. Sociodemographic data has no influence on cortisol levels (p > .05). CONCLUSIONS These findings suggest that the caregiving of children with DS has an impact on parenting oral health and stress.
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Affiliation(s)
- Caroline Dias
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Schwertner
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Débora Grando
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Augusto Bacelo Bidinotto
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Lucas Araújo de Azeredo
- School of Medicine, Graduate Program of Medicine, Neurosciences, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Moisés Evandro Bauer
- Laboratory of Immunobiology, School of Health and Biological Sciences, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lina Naomi Hashizume
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Pegoraro NDA, dos Santos CM, Colvara BC, Rech RS, Faustino-Silva DD, Hugo FN, Hilgert JB. Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil. Codas 2021; 34:e20210007. [PMID: 34816947 PMCID: PMC9769416 DOI: 10.1590/2317-1782/20212021007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/26/2021] [Indexed: 08/22/2023] Open
Abstract
PURPOSE to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. METHODS a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. RESULTS out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). CONCLUSION the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.
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Affiliation(s)
| | | | | | - Rafaela Soares Rech
- Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA - Porto Alegre (RS), Brasil
| | - Daniel Demétrio Faustino-Silva
- Programa de Pós-Graduação em Avaliação de Tecnologias para o SUS, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul – UFRGS - Porto Alegre (RS), Brasil
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Dos Santos KW, Hugo FN, da Cunha Rodrigues E, Stein AT, Hilgert JB. Effect of oral exercises and photobiomodulation therapy in the rehabilitation of patients with mandible fractures: randomized double-blind clinical trial. Lasers Med Sci 2021; 37:1727-1735. [PMID: 34557956 DOI: 10.1007/s10103-021-03423-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/18/2021] [Indexed: 12/01/2022]
Abstract
Mandible fractures compromise stomatognathic functions, requiring rehabilitation. Evaluate the effectiveness of photobiomodulation (PBM) associated with oral exercises for rehabilitation of patients with mandible fractures. In this randomized clinical trial, we compared PBM with PBM sham in 14 adults with mandibular fractures who underwent surgical intervention. The sessions were performed 24 h and 48 h after surgical procedure, and weekly for 4 weeks after hospital discharge. Both groups performed oral exercises after each PBM session. Restriction of food consistencies, mandibular mobility, pain, and facial sensitivity measured before and after the surgical procedure were the outcomes evaluated, one and 3 months after surgery. Maximum interincisal distances (MID), exercise pain, and restriction of food consistencies were also evaluated during each week of intervention. Both groups showed normal MID (> 35 mm) and food consistencies consumed 1 month after the surgical procedure, with no significant differences between them. Individuals in the PBM group had less pain response to exercise during all the weeks of intervention than the sham group (p < 0.05). The patients presented a reduction in the painful response in MID and mandibular laterality movements 1 month after surgery compared to the preoperative period. In contrast, there was an improvement in laterality in the sham group only 3 months postoperatively and persistent pain in MID. There was no significant difference in facial sensitivity within and between groups during follow-up. The performance of oral exercises associated with PBM effectively facilitated the early rehabilitation of oral functions, with significant gains in pain management.
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Affiliation(s)
- Karoline Weber Dos Santos
- Cristo Redentor Hospital/Conceição Hospital Group (GHC) - 20, Domingos Rubbo Street, Porto Alegre, Rio Grande Do Sul, 91040-000, Brazil.
| | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos 2492, Porto Alegre, RS, 90035-0003, Brazil
| | - Esther da Cunha Rodrigues
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - 245, Sarmento Leite Street, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Airton Tetelbom Stein
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - 245, Sarmento Leite Street, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Rua Ramiro Barcelos 2492, Porto Alegre, RS, 90035-0003, Brazil
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22
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Gonçalves KF, Menegazzo GR, Hilgert JB, Hugo FN, Giordani JMDA. [Contextual and individual factors associated with dissatisfaction with dental care in Brazil]. Cien Saude Colet 2021; 26:3715-3724. [PMID: 34468665 DOI: 10.1590/1413-81232021269.2.04162020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/05/2020] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to evaluate the influence of contextual and individual factors associated with dissatisfaction of users of the Unified Health System (SUS) with the care provided by dentists in Primary Health Care. It is a cross-sectional and multilevel study, based on secondary data derived from a national basic research project to assess user satisfaction with the SUS. Data were collected by the Ombudsman's Department of the SUS by telephone contact with a sample of 35,393 individuals from around the country. Contextual and individual variables were associated with dissatisfaction with the dental service provided by the SUS. For the analysis, Stata version 11.0 software was used together with multilevel random effects logistic regression. A total of 2,331 individuals from 61 municipalities were included in the final sample of satisfaction with the dental service. Only 43% of the participants reported that their claims had been resolved, and a seven times greater chance of dissatisfaction was perceived for those individuals who had unresolved demand in relation to those who resolved it. This research provides input that can subsidize the government in actions aimed at improving access and quality of care provided in dental care.
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Affiliation(s)
- Katiéli Fagundes Gonçalves
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Gabriele Rissotto Menegazzo
- Programa de Pós-Graduação em Ciências Odontológicas, Universidade Federal de Santa Maria. Santa Maria RS Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Fernando Neves Hugo
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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23
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Bidinotto AB, Martinez-Steele E, Thomson WM, Hugo FN, Hilgert JB. Investigation of direct and indirect association of ultra-processed food intake and periodontitis. J Periodontol 2021; 93:603-612. [PMID: 34337743 DOI: 10.1002/jper.21-0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ultra-processed foods are associated with both sugar intake and non-communicable diseases. We aimed to assess whether the intake of ultra-processed food is associated with periodontal disease and whether this association, if present, is dependent on non-communicable diseases. METHODS This analysis used data from cycles 2009 to 2010, 2011 to 2012, and 2013 to 2014 of the National Health and Nutrition Examination Survey (NHANES), including participants aged 30 years or older. Dietary recalls were categorized according to the NOVA classification, and total contribution of ultra-processed foods to daily energy intake (%E) was calculated. Cases of periodontitis were defined as moderate or severe according to the CDC working group criteria for use in population surveillance of periodontitis. Adjustment variables to estimate total and direct associations were defined with directed acyclic graphs. Odds ratios were estimated with logistic regression for moderate/severe periodontitis and severe periodontitis, and ordinal logistic regression for the trichotomized outcome. Analyses were performed using NHANES fasting subsample weights. RESULTS Sample participants numbered 4809 (52.2% female), with a mean age of 52.1 years (SE, 0.3). The prevalence of periodontal disease was 27.8% for moderate and 6.5% for severe cases. Mean %E from ultra-processed foods was 54.4 (SE, 0.5). No significant crude, direct, or total association between ultra-processed %E and periodontal disease was found. CONCLUSION Intake of ultra-processed foods is not associated with periodontal disease in US non-institutionalized adults over 30 years old, whether directly or by mediation.
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Affiliation(s)
- Augusto Bacelo Bidinotto
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eurídice Martinez-Steele
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | | | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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24
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Rech RS, Chávez BA, Fernandez PB, Fridman CG, Faustino-Silva DD, Hilgert JB, Hugo FN. Factors associated with the initiation of breastfeeding in a maternity hospital in Lima, Peru. Codas 2021; 33:e20200173. [PMID: 34190811 DOI: 10.1590/2317-1782/20202020173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To verify the anatomophysiological, psychological, and sociocultural factors of the mother-newborn binomial, as well as their association with the initiation of breastfeeding. METHODS Cross-sectional study conducted in a maternity hospital in Lima, Peru. The sample consisted of 304 healthy neonates and their mothers. Breastfeeding performance was estimated by clinical assessment using the Clinical Evaluation of Breastfeeding Efficacy scale and maternal self-perception by the Breastfeeding Self-Efficacy Scale. Multivariate Prevalence Ratios (PR) were estimated by Poisson Regression with Robust Variance and 95% confidence intervals (CI). RESULTS The prevalence of clinical low breastfeeding performance was 27.6%. Primiparous women were associated with higher prevalence of low performance when they did not trust to succeed [PR:2.02(95%CI:1.18-3.44)] and lower prevalence in having a good latch [PR:0.52(95%CI:0.29-0.95)], as well as in coping successfully [PR:0.59(95%CI:0.37-0.91)]. Multiparous women showed higher prevalence when they were not confident in staying motivated [PR:3.47(95%CI:1.67-7.22)] and in calming the neonate [PR:4.07(95%CI:1.83-9.95)]. There was lower prevalence in keeping the neonate awake [PR:0.32(95%CI:0.14-0.75)] and when they did not feel confident in the presence of their family [PR:0.29(95%CI:0.13-0.64)]. CONCLUSION It is important that health professionals be aware of emotional, social, and cultural issues to promote quality breastfeeding.
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Affiliation(s)
- Rafaela Soares Rech
- Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA - Porto Alegre (RS), Brasil
| | | | | | | | - Daniel Demétrio Faustino-Silva
- Programa de Pós-graduação em Avaliação e Produção de Tecnologias para o Sistema Único de Saúde, Grupo Hospitalar Conceição - GHC - Porto Alegre (RS), Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-graduação em Odontologia, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil.,Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil
| | - Fernando Neves Hugo
- Programa de Pós-graduação em Odontologia, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil
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25
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Baumgarten A, Hilgert JB, Rech RS, Cunha-Cruz J, de Goulart BNG. Caries experience in caregiver-intellectual deficient pair: Influence of caregiver's psychological morbidity. Spec Care Dentist 2021; 41:707-715. [PMID: 34057228 DOI: 10.1111/scd.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Evaluate how determinants of psychological morbidity were associated with dental caries experience in the caregiver-intellectual deficient pair. METHODS A cross-sectional study with 299 pair, who had their oral health status assessed using the DMFT index (decayed, missing and filled teeth). Symptoms of anxiety, depression, stress, quality of sleep, and socioeconomic variables were measured in caregivers. Adjusted prevalence ratios were estimated using Poisson regression with the caregiver and children's caries index as outcome. RESULTS The average prevalence of DMFT/dmft was 7.48 (SD ± 3.9) for students with ID and DMFT was 14.7 (SD ± 8.1) for their caregivers. For the caregiver's oral health, the following psychic comorbidities were associated with worse oral health condition: anxiety (PR = 1.48; 95%CI 1.07-2.06), depression (PR = 1.39; 95%CI 1.05-1.85), high level of stress (PR = 1.58; 95%CI 1.17-2.13) and sleep disorders (PR = 1.59; 95%CI 1.18-2.14). For people with ID, the caregiver's psychic comorbidities also showed association with a worse oral health condition, including anxiety (PR = 1.31; 95%CI 1.03-1.74), depression (PR = 1.28; 95%CI 1.01-1.67) and high level of stress (PR = 1.63; 95%CI 1.14-2.32), as well as mother's high level of DMFT (PR = 1.96; 95%CI 1.28-3.03). CONCLUSION Symptoms of depression, anxiety and stress were associated with higher levels of dental caries experience for caregivers and for people with intellectual disabilities.
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Affiliation(s)
- Alexandre Baumgarten
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafaela Soares Rech
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joana Cunha-Cruz
- School of Dentistry and School of Public Health, University of Washington, Seattle, Washington
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26
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Dos Santos KW, da Cunha Rodrigues E, Rech RS, da Ros Wendland EM, Neves M, Hugo FN, Hilgert JB. Using Voice Change as an Indicator of Dysphagia: A Systematic Review. Dysphagia 2021; 37:736-748. [PMID: 34019177 DOI: 10.1007/s00455-021-10319-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
Voice change post-swallow, observed during a clinical swallow examination, is often used as a clinical indicator of dysphagia risk. However, there has been limited research that evaluated the level of agreement between voice change and swallow dysfunction reported to date. This systematic review aims to investigate existing evidence relating to the relationship between vocal change post-swallow and swallow deficits identified on a Videofluoroscopic Swallow Study (VFSS). The studies were selected by two independent evaluators for inclusion, without restriction on language or date of publication and the methodological quality and the risk of bias were assessed using QUADAS-2. Following the PRISMA recommendation, 271 articles were analyzed, of which 17 were included in the study. Of these, the methodology described in five studies employed voice analyses using only acoustic methods, seven others conducted only auditory-perceptual analyses, and five other studies used both. Across the studies there was no homogeneity in the voice quality parameters assessed, analytic methods used, and results obtained. Forty seven per cent of the studies presented a high risk of bias in the analysis of vocal quality due to lack of clarity and blinding of VFSS. There was no homogeneity in the choice of consistencies evaluated during swallowing, as well as standardization of the outcome investigated in VFSS without a vocal parameter attributable to accurate detection in each outcome. It is not possible to obtain a consensus regarding the recommendation of the use of vocal evaluation as an accurate method for identifying swallowing alterations due to heterogeneity of the vocal evaluation methods, the outcomes evaluated in the VFSS examination, heterogeneity in food and liquid consistencies, and the methodological quality of the studies.
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Affiliation(s)
- Karoline Weber Dos Santos
- Cristo Redentor Hospital/Conceição Hospital Group, 20, Domingos Rubbo Street, Porto Alegre, Rio Grande do Sul, 91040-000, Brazil.
| | - Esther da Cunha Rodrigues
- Federal University of Health Sciences of Porto Alegre (UFCSPA), 245, Sarmento Leite Street, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil
| | - Rafaela Soares Rech
- Federal University of Health Sciences of Porto Alegre (UFCSPA), 245, Sarmento Leite Street, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil
| | - Eliana Márcia da Ros Wendland
- Federal University of Health Sciences of Porto Alegre (UFCSPA), 245, Sarmento Leite Street, Porto Alegre, Rio Grande do Sul, 90050-170, Brazil
| | - Matheus Neves
- Federal University of Rio Grande do Sul (UFRGS), 110, Paulo Gama, Street, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil
| | - Fernando Neves Hugo
- Federal University of Rio Grande do Sul (UFRGS), 110, Paulo Gama, Street, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil
| | - Juliana Balbinot Hilgert
- Federal University of Rio Grande do Sul (UFRGS), 110, Paulo Gama, Street, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil
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27
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Baumgarten A, Hilgert JB, Rech RS, Cunha-Cruz J, Goulart BNG. Association between motor proficiency and oral health in people with intellectual disabilities. J Intellect Disabil Res 2021; 65:489-499. [PMID: 33682246 DOI: 10.1111/jir.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver. METHODS In this cross-sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks-Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance. RESULTS The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06-1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33-0.75) and precision (PR = 0.50; 95% CI 0.26-0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49-0.77), presented better results. CONCLUSION Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.
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Affiliation(s)
- A Baumgarten
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J B Hilgert
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - R S Rech
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - J Cunha-Cruz
- School of Dentistry and School of Public Health, University of Washington, Seattle, WA, USA
| | - B N G Goulart
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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28
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Macarevich Condessa A, Pilotto LM, Celeste RK, Hilgert JB. Use of dental services by disability status in Brazil in 2013. Community Dent Oral Epidemiol 2021; 49:471-477. [PMID: 33521999 DOI: 10.1111/cdoe.12623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/22/2020] [Accepted: 01/12/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the prevalence and factors associated with the use of oral health services in people with and without disabilities in Brazil. METHODS A cross-sectional study was used with the secondary data of 60,202 individuals from the Brazilian National Health Survey of 2013. The main exposure variable was 'Disability', and the main outcome was 'Dental service use'. Independent variables were selected using the modified Andersen and Davidson model, according to four groups: exogenous variables, primary determinants of oral health, health behaviours and oral health conditions. The analysis was based on a hierarchical approach stratified by 'disability (yes/no)', with multiple logistic regression incorporating sampling design. Interaction terms between the disability variable and covariates were tested in logistic regression models. RESULTS A total of 45.5% of the people without disabilities and 34.1% of those with disabilities visited the dentist in the last year. In the crude model, the nondisabled group used dental services more (OR = 1.61, 95%CI = 1.45-1.79), but the difference was no longer significant (OR = 1.18, 95%CI = 0.93-1.51) when adjusted by the health behaviour and oral health condition blocks. Determinants of dental use were similar among people with and without a disability. CONCLUSIONS No difference in dental service use according to disability status was found after adjusting for oral health conditions. Although edentulism is more prevalent among disabled people, they do not go to the dentist as regularly as nondisabled people. Health services should actively schedule maintenance visits to ensure that the needs of disabled individuals are fully addressed.
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Affiliation(s)
- Aline Macarevich Condessa
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciane Maria Pilotto
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
Objective To evaluate the association of dental pain with time living on the street in a sample of homeless people in the city of Porto Alegre, Brazil. Methods A cross-sectional study was carried out with homeless people who accessed social services in 2017. A questionnaire was administered covering socioeconomic variables and including questions about general health, use of tobacco/alcohol/drugs, use of dental services and history of dental pain. The decayed, missing, and filled teeth (DMFT) index was calculated in an oral examination. The association between socioeconomic characteristics, health status, time of homelessness and dental pain was evaluated using chi-square, t-, and Mann-Whitney tests. Results A total sample of 214 homeless people was surveyed. Most were male (76.2%), had a low level of education (67.6%) and experienced many episodes of dental pain during life (91.0%). The last episode of pain was moderate or intense (79.7%) and do-it-yourself measures for pain relief were preferred (62.3%). Individuals who were homeless for longer than 1 year had more dental pain in the past (P < 0.001), more frequency of a recent episode of dental pain (P = 0.03), and sought a dentist or healthcare service to relieve pain less frequently (P = 0.03). Conclusions Dental pain is frequent in the context of homelessness and does not necessarily result in seeking dental services, even where there is universal oral health care.
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Affiliation(s)
- Marcela Obst Comassetto
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Matheus Neves
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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30
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Rech RS, Chávez BA, Fernandez PB, Silva DDFD, Hilgert JB, Hugo FN. Presence of ankyloglossia and breastfeeding in babies born in Lima, Peru: a longitudinal study. Codas 2021; 32:e20190235. [PMID: 33503211 DOI: 10.1590/2317-1782/20202019235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/07/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to evaluate the lingual frenulum and breastfeeding in infants from a maternal-perinatal referral center, as well as to monitor infants with ankyloglossia up to six months of age. METHODS a cohort study conducted at the Instituto Nacional Materno Perinatal - Maternidad de Lima in Lima, Peru. The consecutive intentional sample consisted of 304 newborns and their respective mothers, evaluated during December 2017 and January 2018, which were the baseline of the study. A clinical evaluation of the lingual frenulum adapted and the Clinical Evaluation of Breastfeeding Efficacy (CEBE) scale, was performed. RESULTS of the 304 newborns, 15 (4.9%) were considered with altered frenulum, and only 4 (26.7%) presented a low score in CEBE. The mean of the CEBE score was 9.3. (DP=1.35, Min=3, Max=10). Of the follow-up infants, only 2 (13.3%) persisted with breastfeeding difficulties for which frenotomy was indicated. CONCLUSION This study demonstrates the low prevalence of ankyloglossia in infants, as it does not indicate a trend of difficulty or negative interference in breastfeeding.
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Affiliation(s)
- Rafaela Soares Rech
- Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | | | - Daniel Demétrio Faustino da Silva
- Graduate Program in Technology Production and Assessment for Health Unic System, Grupo Hospitalar Conceição (GHC), Rio Grande do Sul (RS), Brasil
| | - Juliana Balbinot Hilgert
- Graduate Studies Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil.,Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Fernando Neves Hugo
- Graduate Studies Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil
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31
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Giordani JMDA, Amaral Júnior OLD, Hugo FN, Hilgert JB. Factors associated with service user embracement by Primary Health Care teams in Brazil, 2012: a cross-sectional study. ACTA ACUST UNITED AC 2020; 29:e2019468. [PMID: 33146321 DOI: 10.1590/s1679-49742020000500017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate prevalence and factors associated with service user embracement by Primary Health Care teams in Brazil. METHODS This is a cross-sectional study that included teams that took part in the 2012 National Program for Primary Health Care Access and Quality Improvement (PMAQ-AB) (Cycle I). The outcome used was 'user embracement by the health team'. The independent variables were macro-region, municipal profile, Gini index and Family Health Strategy population coverage, team meetings, study of spontaneous demand, consideration of user opinions and existence of continuing education. Multilevel Poisson regression analysis was performed. RESULTS The sample consisted of 13,751 teams. User embracement prevalence was 78.3% (95%CI 77.6;79.1). In the hierarchical analysis, the highest prevalence of user embracement was found among Southern region teams (PR=1.37 - 95%CI 1.27;1.48) taking the Northeast region as a reference. CONCLUSION There is an uneven distribution of Primary Care teams practicing user embracement in Brazil, possibly associated with regional inequalities.
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Affiliation(s)
| | | | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre, RS, Brasil
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Condessa AM, Lucena EHGD, Figueiredo N, Goes PSAD, Hilgert JB. Specialized dental care for people with disabilities in Brazil: profile of the Dental Specialty Centers, 2014. ACTA ACUST UNITED AC 2020; 29:e2018154. [PMID: 32997078 DOI: 10.1590/s1679-49742020000500001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 05/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the oral health care services for people with disabilities treated within the Dentistry for Patients with Special Needs (PSN) specialty. METHODS This was a cross-sectional study with data from the Program for Improving Access and Quality of Dental Specialty Centers (PMAQ-CEO) in 2014. RESULTS Of the total of 932 services evaluated, 89.8% did provide care for PSNs, 30.4% had physical accessibility, 59.7% provided referral to hospital care and most guaranteed complete treatment. Only a third of the Dental Specialty Centers planned 40 or more hours a week for providing clinical care to PSNs. CONCLUSION The care network for people with disabilities is being formed but, even with specific financial incentives, it has limitations. Services need to eliminate physical and attitudinal barriers to ensure universal accessibility. Protocols based on risk classification are necessary, prioritizing care at DSCs for complex cases not attended to in Primary Care and organizing the dental health care network for people with disabilities.
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Affiliation(s)
| | | | - Nilcema Figueiredo
- Universidade Federal de Pernambuco, Centro de Ciências da Saúde, Recife, PE, Brasil
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Colvara BC, Faustino-Silva DD, Meyer E, Hugo FN, Celeste RK, Hilgert JB. Motivational interviewing for preventing early childhood caries: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2020; 49:10-16. [PMID: 33000877 DOI: 10.1111/cdoe.12578] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/13/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity. METHODS Interventions based on motivational interviewing were considered eligible. The main outcome was new caries lesions (some studies included white-spot lesions in total count), and secondary outcomes included caregivers' oral health knowledge, home-care behaviours, plaque index, gingival index and fluoride varnish applications. Controls were any type of oral health education or negative controls without any specific intervention. RESULTS From a total of 1498 studies identified in the databases search, 1078 were assessed for eligibility by reading titles and abstracts, after removal of duplicates. Full-text screening was performed in 61 articles, with 18 reporting on 14 different studies included in the qualitative synthesis and 8 in the quantitative synthesis (four studies included new white-spot lesions in total count). Subgroup analysis was performed by the control group dmft/dmfs and the test for subgroup differences suggests that there is a subgroup effect (P = .06), so population caries experience modifies the effect of MI-based intervention. In populations with high caries experience, the MI-based approach proved preventing an average of 3.15 (95% CI: -6.14, -0.17) dmfs in young children. In samples with low caries experience, differences were smaller, since the caries levels were already lower (-0.31; 95% CI: -0.63, 0.00). CONCLUSION Motivational interviewing has the potential to modify knowledge and behaviours and reduce ECC with a more significant impact on children with high caries experience.
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Affiliation(s)
| | - Daniel Demétrio Faustino-Silva
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC), Porto Alegre, Brazil
| | - Elisabeth Meyer
- Graduate Health Sciences Program, Cardiology Institute (IC/FUC), Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Antunes DS, Naidoo S, Myburgh N, Hilgert JB, Fisher PD, Hugo FN. A Framework for Equity Access to Primary Dental Care. Ciênc saúde coletiva 2020; 25:3669-3676. [DOI: 10.1590/1413-81232020259.29832018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 01/19/2019] [Indexed: 11/22/2022] Open
Abstract
Abstract The objective of this study was to demonstrate face validity with a novel resource allocation framework designed to maximize equity into dental booking systems. The study was carried out in 2014. Eleven experts in primary dental care practice in Southern Brazil participated, using a three-round consensus group technique. First, the experts reached consensus on the items to be included in a 5-level diagnostic scale. They identified 21 clinical conditions and categorized them according to the oral health intervention required. Then, they described workload and activity standards for dental staff to carry out health promotion, oral disease prevention, dental treatment, dental rehabilitation, and urgent dental care. Finally, they agreed upon a set of wait times for primary dental care, establishing maximum waits from 2 to 365 days, according to the diagnostic classification. The framework demonstrated potential ability to promote more equitable access to primary dental services, since equal diagnostic classifications share the same waiting times for the dental care they require.
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Eidt G, Waltermann EDM, Hilgert JB, Arthur RA. Candida and dental caries in children, adolescents and adults: A systematic review and meta-analysis. Arch Oral Biol 2020; 119:104876. [PMID: 32905885 DOI: 10.1016/j.archoralbio.2020.104876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/10/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to investigate whether the presence of fungi of the genus Candida in oral cavity is associated with dental caries in children and adolescents (from 6 to 18 years) or in adults (older than 18 years). DESIGN Electronic search was carried out in MEDLINE, EMBASE and LILACS databases. Studies that evaluated the presence of Candida spp. and dental caries on those individuals were included. Data extraction and evidence quality assessment were performed by two independent investigators. Prevalence ratio (PR) was calculated considering 95 % confidence interval (CI). Meta-analysis was performed using random effect Mantel-Haenszel model. RESULTS Thirty out of 123 publications selected for full-reading were included in the systematic review. Prevalence of Candida spp. in the oral cavity ranged from 7.7 % to 78 %. Prevalence of dental caries in individuals harbouring Candida spp. ranged from 27.2%-100% and was higher than in individuals not harbouring Candida spp. (PR = 1.72 [1.46-2.02]). Prevalence of dental caries was 2.3 times higher in individuals harbouring Candida spp. in mucosa. Moreover, dental caries prevalence was 80 % and 48 % higher in children/adolescents and adults harbouring Candida spp., respectively (95 % CI [1.44-2.25] and [1.20-1.83]). The quality of evidence of most studies (n = 21) was graded as fair. CONCLUSIONS These results suggest that, regardless of age or sample site, individuals with the presence of Candida spp. have a higher prevalence of dental caries when compared to individuals without these microorganisms in the oral cavity.
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Affiliation(s)
- Gustavo Eidt
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Elen Darlise Marques Waltermann
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Juliana Balbinot Hilgert
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
| | - Rodrigo Alex Arthur
- Preventive and Community Dentistry Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, 90035-003, Brazil.
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Tôrres LHDN, De Marchi RJ, Hilgert JB, Hugo FN, Ismail AI, Antunes JLF, Sousa MDLRD. Oral health and Obesity in Brazilian elders: A longitudinal study. Community Dent Oral Epidemiol 2020; 48:540-548. [PMID: 32786084 DOI: 10.1111/cdoe.12566] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Obesity is an important risk factor for chronic diseases and can also result in greater mortality. The aim of this longitudinal study was to investigate whether poor oral health acts as a risk factor for obesity as indicated by body mass index (BMI) and waist circumference (WC). METHODS We included in this analysis all participants who volunteered in a cohort study entitled 'Carlos Barbosa Cohort Study-CBCS' in the city of Carlos Barbosa, Southern Brazil. The interview questionnaire comprised socio-demographic information, behavioural questions and medical history. Oral examinations and anthropometric assessments were carried out. The outcome was obesity measured by both BMI (≥30 kg/m2 ) and WC (>0.80 for women and >0.94 for men). Variables were collected longitudinally. Those associated with the outcome and epidemiologically relevant to the conceptual framework participated in the analysis and were adjusted for socio-demographic, behavioural, general and oral health conditions. RESULTS Six hundred and thirty-three independently living elders participated. The baseline mean age was 67.5 ± 6.1 years. Individuals who never visited a dentist (OR = 3.02, 95% CI: 1.25-7.26) as well as participants who needed a dental prosthesis in the lower arch (OR = 4.38, 95% CI: 1.34-14.32) were more likely to be obese, through BMI and WC measures, respectively. Edentulous participants with complete dentures in both arches (OR = 0.23, 95% CI: 0.06-0.84) and those who perceived their oral health as unsatisfactory (OR = 0.41, 95% CI: 0.19-0.88) had a lower likelihood of being obese, according to BMI and WC measures. CONCLUSIONS Older persons with poor oral health may be at risk for general and central obesity, a relationship that may have important clinical implications.
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Affiliation(s)
| | - Renato José De Marchi
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Department of Social and Preventive Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Amid Ibrahim Ismail
- Department of Oral Health Sciences, Maurice H Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | | | - Maria da Luz Rosário de Sousa
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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TÔrres LHDN, Fagundes MLB, Silva DDD, Neri AL, Hilgert JB, Hugo FN, Sousa MDLRD. Self-rated general and oral health and associated factors in independently-living older individuals. Braz Oral Res 2020; 34:e079. [PMID: 32696912 DOI: 10.1590/1807-3107bor-2020.vol34.0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/20/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to verify the association between sociodemographic, general health, and oral health data with self-rated general health (SRGH) and self-rated oral health (SROH) in independent-living older Brazilians. This cross-sectional study was part of a larger study with older individuals living independently in the city of Campinas, Brazil - the "Rede FIBRA" Study (the Frailty in Brazilian Elderly Study). A random sample of 688 older individuals responded the SRGH and 673, the SROH. SRHG and SROH were both assessed using a single item. The questionnaire included sociodemographic, general, and oral health data. The mean age was 72.28 ± 5.4 years. The adjusted analysis revealed that the probability of rating general health as bad was higher for illiterate participants (PR: 1.77, 95%CI: 1.13-2.77) or with low educational level (PR: 1.76, 95%CI: 1.17-2.65), those with depressive symptoms (PR: 1.45, 95%CI:1.21-1.74), participants that self-reported food limitation due to problems with denture or lack of it (PR: 1.29, 95%CI: 1.05-1.56), and those with xerostomia (PR 1.40, 95%CI: 1.17-1.67). The probability of rating general health as bad was lower for participants that presented 0-2 chronic diseases (PR: 0.64, 95%CI: 0.53-0.78) and were pre-frail (PR: 0.76, 95%CI: 0.61-0.96). With regard to SROH, the probability of rating oral health as bad was higher for participants with natural teeth (PR:1.61, 95%CI: 1.24-2.08), that reported xerostomia (PR: 1.44, 95%CI: 1.13-1.84), and food limitation due to problems with denture or lack of it (PR: 1.43, 95%CI: 1.07-1,91), and lower for participants that reported having enough money to cover daily expenses (PR: 0.78, 95%CI: 0.61-0.99). Oral health data and income seem to be related to self-perceptions of general and oral health.
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Affiliation(s)
| | | | - Débora Dias da Silva
- Departament of Community and Dental Health, Dental School, Universidade Paulista, Campinas, SP, Brazil
| | - Anita Liberalesso Neri
- Departament of Genrontology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Juliana Balbinot Hilgert
- Departament of Preventive and Social Dentistry, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Departament of Preventive and Social Dentistry, Dental School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria da Luz Rosário de Sousa
- Department of Health Sciences and Pediatric Dentistry, Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Condessa AM, Giordani JMDA, Neves M, Hugo FN, Hilgert JB. Barriers to and facilitators of communication to care for people with sensory disabilities in primary health care: a multilevel study. Rev Bras Epidemiol 2020; 23:e200074. [PMID: 32638857 DOI: 10.1590/1980-549720200074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/07/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Communication barriers are the main obstacle for people with sensory disabilities (visual and hearing) to access health services. This study aims to describe the presence of facilitators of communication of basic health units in Brazil and to verify its associated factors. METHODS Cross-sectional multilevel study, of 38,811 health units in 5,543 municipalities between 2012 and 2013, collected in the National Program for Improving Access and Quality in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ-AB). The outcome was defined by grouping facilitators of communication (braille material; hearing resources; visual communication; accessible list of service; professionals to welcome users with sensory disabilities). The two levels were structured, using the variables: level I (contextual): macro region, population size, and GDP per capita; and level II (service): extended professional team (psychologist/social worker); service shifts; welcoming room; publishing of service hours; presence of physical access facilitators. Multilevel Poisson regression with hierarchical modeling was used in both stages. RESULTS The presence of facilitators of communication is small in Brazilian health units (32.1%). It is more frequent in the municipalities with a higher GDP (RP = 1.02, 95%CI 0.92 - 1.12) and population size (RP = 1.25, 95%CI 1.02 - 1.52). CONCLUSION Welcoming users is the main access facilitator and should be the focus of initiatives to improve health care for disabled persons. Universal access with adequate services, removal of communication barriers and encouragement to properly welcome users must be promoted.
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Affiliation(s)
| | | | - Matheus Neves
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Freitas LGD, Cortés MAP, Stein C, Cousin E, Faustino-Silva DD, Hilgert JB. Dietary intake quality and associated factors in one year-old children seen by primary healthcare services. Cien Saude Colet 2020; 25:2561-2570. [PMID: 32667540 DOI: 10.1590/1413-81232020257.14592018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/25/2018] [Indexed: 11/22/2022] Open
Abstract
The purpose of this paper was to analyze the food intake quality in one year-old children seen by a primary healthcare (PHC) service. This is a cross-sectional studied nested within a child oral health cohort study which collected data regarding children born in 2013 and monitored in Porto Alegre for two years. We applied a questionnaire on maternal variables and frequency of pediatric appointments, weight and height measurements, and children's food intake. To that end, a score was generated based on the points assigned according to SISVAN (meaning 'food and nutrition monitoring system,' run by the Brazilian Ministry of Health). A multivariate model was calculated using Poisson regression with robust variance. The sample comprised 249 children. We found 30.5% (76) of poor/regular dietary quality, which in the multivariate model was associated to the guardian's educational background, considering up to incomplete high school (PR = 2.14, CI95% = 1.03-4.44) and complete high school (PR = 1.70, CI95% = 0.81-3.54), as well as their failure to see a dentist (PR = 2.54, CI95% = 1.33-4.84) or having seen one before the age of four months (PR = 1.94, CI95% = 1.01-3.72). It is our conclusion that failing to see a dentist within the first year of life and lower maternal schooling negatively impact on children's dietary quality.
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Affiliation(s)
- Laura Garcia de Freitas
- Grupo Hospitalar Conceição. Av. Francisco Trein 596, Cristo Redentor. 91350-200 Porto Alegre RS Brasil.
| | - Margarita Alexandra Pena Cortés
- Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Caroline Stein
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre RS Brasil
| | - Ewerton Cousin
- Programa de Pós-Graduação em Epidemiologia, UFRGS. Porto Alegre RS Brasil
| | - Daniel Demétrio Faustino-Silva
- Serviço de Saúde Comunitária e Programa de Pós-Graduação Modalidade Mestrado Profissional Avaliação e Produção de Tecnologias para o SUS, Grupo Hospitalar Conceição. Porto Alegre RS Brasil
| | - Juliana Balbinot Hilgert
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, UFRGS. Porto Alegre RS Brasil
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Rech RS, Bulgarelli PT, Condessa AM, Santos CMD, Hilgert JB, Goulart BNGD. Access and use of speech-language therapy services in Porto Alegre, Brazil: a population-based study. Cien Saude Colet 2020; 25:817-825. [PMID: 32159652 DOI: 10.1590/1413-81232020253.17212018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 07/02/2018] [Indexed: 11/22/2022] Open
Abstract
To estimate the prevalence of access and use of speech-language therapy services and identify the variables associated with access. Cross-sectional population-based study. The sample consisted of adult individuals living in Porto Alegre, southern Brazil. The data were collected using an instrument constructed with domains of national research questionnaires, with a module on speech-language therapy. The outcome was the access to a speech-language therapist. Poisson regression with robust variance was used to calculate Prevalence Ratios with 95% confidence intervals. A total of 214 people participated in the study, of which 67.3% (n = 144) were female. The mean age was 54.28 (SD±18.83) years. Fifty-six (26.2%) people mentioned the need for speech-language therapy consultation. All 56 subjects were able to perform speech-language therapy, of which 69.4% (n = 39) in private practice and 19.6% (n=11) used healthcare insurance plans at partnering providers. In the final model, the highest prevalence of access was associated with female (PR=1.09,95%CI1.01-1.18) and had some deficiency (PR = 1.09,95%CI1.03-1.17). Access to a speech-language therapist is more frequent in private services. It is observed that women and the disabled individuals have a higher prevalence of access to speech-language therapist.
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Affiliation(s)
- Rafaela Soares Rech
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-004, Porto Alegre, RS, Brasil.
| | | | | | - Camila Mello Dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Enfermagem, UFRGS. Porto Alegre, RS, Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-004, Porto Alegre, RS, Brasil.
| | - Bárbara Niegia Garcia de Goulart
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2492, Santa Cecília. 90035-004, Porto Alegre, RS, Brasil.
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Cardozo DD, Hilgert JB, Stein C, Hauser L, Harzheim E, Hugo FN. Presence and extension of the attributes of primary health care in public dental services in Porto Alegre, Rio Grande do Sul State, Brazil. CAD SAUDE PUBLICA 2020; 36:e00004219. [DOI: 10.1590/0102-311x00004219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/08/2019] [Indexed: 11/21/2022] Open
Abstract
The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p < 0.05). The extent of PHC attributes in services was poor (overall highest score was 5.75 in CHS). The CHS was the only service witch half of the users (83; 49.1%) rated oral health services as having a high overall score for PHC. It is concluded that there were differences among the organizational arrangements of PHC oral health services, however, there is much to be improved in the orientation of dental care services for PHC. More studies are necessary to evaluate the differences in PHC services considering oral health.
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Stein C, Santos KWD, Condessa AM, Celeste RK, Hilgert JB, Hugo FN. [Presence of Specialized Dentistry Centers and the relationship with dental extractions in the oral healthcare network in Brazil]. CAD SAUDE PUBLICA 2019; 36:e00054819. [PMID: 31939546 DOI: 10.1590/0102-311x00054819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/03/2019] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the association between the presence of Specialized Dentistry Centers and dental extractions as a proportion of all dental procedures in public services in Brazil. This was an ecological study that assessed sociodemographic data, oral health services, and outpatient production in 5,333 municipalities in 2000-2001 and 2015-2016. The principal exposure variable was the presence of Specialized Dentistry Centers, and the outcome was the mean national proportion of dental extractions in relation to all preventive and curative dental procedures. Interaction and multiple regression analyses were performed using a binomial model with log link function. The mean national proportions of dental extractions in relation to preventive and curative dental procedures were 27.07% and 15.11% in 2000-2001 and 2015-2016, respectively. In the analysis of interaction between the presence of Specialized Dentistry Centers and coverage greater than 80% by the oral health teams, there were lower proportions of dental extractions in relation to preventive and curative dental procedures (OR = 0.71; 95%CI: 0.71-0.72). In the multiple regression analysis, municipalities with Human Development Index of 0.6-0.7 (OR = 0.77; 95%CI: 0.77-0.77), annual per capita GDP greater than BRL 20,000 (OR = 0.45; 95%CI: 0.45-045), and proportionally higher urban populations (OR = 0.72; 95%CI: 0.72-0.72) showed fewer dental extractions as a proportion of all preventive and curative dental procedures in 2015-2016. In conclusion, there were lower proportions of tooth extractions in municipalities with at least one Specialized Dentistry Center and with a coverage of greater than 80% by the oral health teams, highlighting that municipalities with a consolidated Oral Health Care Network present better performance in the supply of dental care.
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Affiliation(s)
- Caroline Stein
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Arenas-Márquez MJ, Tôrres LHDN, Silva DDD, Hilgert JB, Hugo FN, Neri AL, Souza MDLRD. Validity of self-report of oral conditions in older people. Braz J Oral Sci 2019. [DOI: 10.20396/bjos.v18i0.8657271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: To verify if self-report is a valid instrument to study the clinical oral condition in older people without cognitive deficit. Methods: A Cross-sectional study was conducted with 647 older people from the community, without cognitive deficit, living in Campinas, Brazil. A self-report questionnaire assessing the presence or absence of teeth (edentulism) and use of complete denture was applied, identifying the location of the denture, whether in the upper and/or lower arch. In the same session oral clinical exams were performed, considered the gold standard. The self-report validation was performed by calculating sensitivity, specificity, predictive values, odds ratios and Kappa agreement. Results: There were high percentages of sensitivity (95–99%), specificity (84–97%), positive (81–97%) and negative (95–98%) predictive values, obtaining an elevated level of confidence and quality intrinsic value of self-report. Agreement with the clinical examination was excellent for all variables (greater than 0.80). The likelihood ratios showed compelling evidence that with self-report an edentulous individual (+LR 32), non-edentulous (-LR 0.06) and absence of complete denture (-LR 0.01) could be correctly identified, with moderate evidence to identify the presence and location of complete denture use (+LR 6.5 to 6.9). Conclusion: Self-report is a valid instrument to study the clinical oral condition in the older people of the community.
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Bastos LF, Hugo FN, Hilgert JB, Cardozo DD, Bulgarelli AF, Santos CMD. Access to dental services and oral health-related quality of life in the context of primary health care. Braz Oral Res 2019; 33:e018. [PMID: 31432923 DOI: 10.1590/1807-3107bor-2019.vol33.0018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to evaluate the association between access to oral health care in the Primary Health Care (PHC) and Oral Health-Related Quality of Life (OHRQoL). The present study was a cross-sectional study, and the sample was composed of 412 users living in the areas covered by the public PHC services who visited a health unit for an oral exam or treatment in the last 24 months. Participants in the study responded to a home-based interview with questions that addressed socioeconomic status, behavioral, general health, dental prostheses, access to dental services in the PHC and their OHRQoL as measured by the Oral Health Impact Profile (OHIP-14) instrument. After the interview, a dental examination was performed to count the number of teeth. Chi-square tests, Student's t tests and multivariate analyses were performed using a hierarchical model and a Poisson regression with robust variance to evaluate the association between independent variables and OHRQoL. Access to oral health services in the PHC was statistically associated with OHRQoL, and the estimated prevalence rate was PR = 1.17 (CI 95% 1.00-1.37). In this study, the definition of access was based on the availability of dental consultations on demand. The study identified that lack of access to oral health services offered by the PHC was associated with a higher prevalence of impact on the quality of life of individuals.
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Affiliation(s)
- Lucelen Fontoura Bastos
- Universidade Federal do Rio Grande do Sul - UFRGS, Collective Health Postgraduate Programme, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | | | - Alexandre Fávero Bulgarelli
- Universidade Federal do Rio Grande do Sul - UFRGS, Collective Health Postgraduate Programme, Porto Alegre, RS, Brazil
| | - Camila Mello Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, Collective Health Postgraduate Programme, Porto Alegre, RS, Brazil
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Faustino‐Silva DD, Colvara BC, Meyer E, Hugo FN, Celeste RK, Hilgert JB. Motivational interviewing effects on caries prevention in children differ by income: A randomized cluster trial. Community Dent Oral Epidemiol 2019; 47:477-484. [DOI: 10.1111/cdoe.12488] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Demétrio Faustino‐Silva
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC) Porto Alegre Brazil
| | | | - Elisabeth Meyer
- Graduate Program in Health Sciences Instituto de Cardiologia (IC/FUC) Porto Alegre Brazil
| | - Fernando Neves Hugo
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Roger Keller Celeste
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC) Porto Alegre Brazil
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Juliana Balbinot Hilgert
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
- Graduate Program in Epidemiology Federal University of Rio Grande do Sul Porto Alegre Brazil
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Bonfadini I, Pereira JT, Knorst JK, Luz PB, Scapinello M, Hugo FN, de Araujo FB, Hilgert JB. Maternal characteristics, home environment, and other factors associated with traumatic dental injuries in preschool children. Dent Traumatol 2019; 36:33-40. [PMID: 31355995 DOI: 10.1111/edt.12502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIMS The importance of external factors such as maternal and home characteristics on traumatic dental injuries needs to be investigated. The aim of this study was to evaluate the association between maternal and home characteristics and dental trauma in preschool children. MATERIAL AND METHODS This cross-sectional study using a cluster random sample evaluated children between 3 and 4 years of age from Porto Alegre, Brazil. Mothers completed the Brazilian version of the Beck Depression and Anxiety Inventories (BDI and BAI). They answered questions about sociodemographics, maternal behaviors, and home characteristics. Dental trauma was assessed by the Children's Dental Health Survey criteria. Malocclusion and deleterious habits were also assessed. The multinomial logistic regression model was used to investigate the association of exploratory variables with different categories of dental trauma. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS A total of 163 pairs of children and mothers agreed to participate (78.4% response rate). The prevalence of dental trauma was 49.8%. Mother's work outside the home, overjet, and anterior crossbite were associated with the occurrence of enamel trauma, while having a younger mother, families having more siblings, and having a mother with university education were associated with increased odds of dentin/pulp trauma. CONCLUSION Depression and anxiety in the mothers were not associated with dental trauma, while malocclusion characteristics were more relevant for less severe, enamel trauma. Socioeconomic and home environment characteristics played a role in more severe, dentin/pulp trauma.
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Affiliation(s)
- Inaiá Bonfadini
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Patrícia Blaya Luz
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Monique Scapinello
- Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Pediatric Dentistry Department, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliana Balbinot Hilgert
- Preventive and Social Dentistry Department, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Rezende G, Dos Santos NML, Stein C, Hilgert JB, Faustino-Silva DD. Asthma and oral changes in children: Associated factors in a community of southern Brazil. Int J Paediatr Dent 2019; 29:456-463. [PMID: 30807677 DOI: 10.1111/ipd.12487] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/06/2019] [Accepted: 02/20/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Asthma is a chronic disease that involves several healthcare services that need attention in relation to its treatment and prevention. AIM The objective of this study was to evaluate caries, erosion, and enamel defects in children with and without asthma. DESIGN Cross-sectional study, with a sample of 228 children ages 6-12 years, stratified as asthmatic (n = 112) and non-asthmatic (n = 116), at two Primary Health Units of the Community Health Service, Brazil. The evaluation consisted of an oral examination and a structured interview with parents/guardians, in addition to data from medical records. Data were analysed by Poisson regression with a robust error variance, all of them at a level of significance of P < 0.05. RESULTS Of 112 asthmatic children, 63 (51.2%) had dental caries and 25 (53.2%) enamel defects. In the adjusted analysis, dental caries and use of salbutamol were associated (PR = 1.32, 95% CI = 1.01-1.72). In addition, children who performed oral hygiene more than three times a day showed a greater prevalence (PR = 2.36, 95% CI = 1.02-4.85) of dental erosion compared with children who performed it only once a day. CONCLUSIONS There is no evidence for an association between asthma, caries, erosion, and enamel defect in children aged from 6 to 12 years. There was, however, an association between dental caries and use of salbutamol.
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Affiliation(s)
- Gabriela Rezende
- Postgraduate Studies Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Caroline Stein
- Postgraduate Studies Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Balbinot Hilgert
- Department of Preventive and Social Dentistry - School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel Demétrio Faustino-Silva
- Grupo Hospitalar Conceição - Community Health Service and Graduate Program Professional Masters Modality Assessment and Production of Technologies for the SUS, Porto Alegre, Rio Grande do Sul, Brazil
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Rech RS, Hugo FN, Tôrres LHDN, Hilgert JB. Factors associated with hyposalivation and xerostomia in older persons in South Brazil. Gerodontology 2019; 36:338-344. [PMID: 31148246 DOI: 10.1111/ger.12415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to investigate characteristics associated with xerostomia and hyposalivation in older persons. BACKGROUND Saliva is one of the most important body fluids and plays an important role in food bolus formation, lubricating the oral mucosa and protecting teeth against demineralisation. MATERIALS AND METHODS This is a cross-sectional study nested within a cohort and includes a sample of 872 older persons living independently in the community, both in rural and urban areas in Carlos Barbosa, Brazil. Data collection included standardised interviews to identify sociodemographic, behavioural and health-related variables, as well as oral clinical examination performed by two trained/calibrated dentists. Poisson regressions with robust variance were used to calculate the crude and adjusted prevalence ratios (PR) and their respective 95% confidence intervals. RESULTS The mean age was 68.5 ± 6.7 years, and the majority of the sample consisted of women (65.3%). The prevalence of xerostomia, of low stimulated salivary flow rate and low at rest salivary flow rate were 338 (38.8%), 494 (56.6%), 320 (36.7%), respectively. In the final adjusted model, women had a significantly increased prevalence of xerostomia (PR = 1.34; 95% CI: 1.12-1.61), as well as participants taking medication continuously (PR = 1.45; 95% CI: 1.16-1.82) and those with depressive symptoms (PR = 1.49; 95% CI: 1.27-1.76). Lower at rest (PR = 1.45, 95% CI: 1.22-1.72) and lower stimulated salivary flow were more prevalent in women (PR = 1.27, 95% CI: 1.11-1.44), while lower stimulated salivary flow was more prevalent in older persons taking medication continuously (PR = 1.24, 95% CI: 1.07-1.43). CONCLUSION Salivary hypofunction and xerostomia were more prevalent in women and in those with continuous medication use; however, depressive symptoms were associated only with xerostomia. Measures are required to promote oral comfort in cases of xerostomia, thereby reducing the unpleasant sensation of dry mouth and hyposalivation consequences in clinical practice.
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Affiliation(s)
- Rafaela Soares Rech
- Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Studies Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Juliana Balbinot Hilgert
- Graduate Studies Program in Dentistry, Graduate Studies Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Baumgarten A, Rech RS, Bulgarelli PT, Souza KR, Santos CMD, Frichembruder K, Hilgert JB, Bulgarelli AF. Actions for tuberculosis controlin Brazil: evaluation of primary care. Rev Bras Epidemiol 2019; 22:e190031. [PMID: 31038612 DOI: 10.1590/1980-549720190031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 08/14/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe and evaluate the factors associated with actions for the control of tuberculosis (TB) in primary care (PC) in the five Brazilian macroregions. METHODS This cross-sectional study was carried out with data from the second cycle of the National Program for Improving Access to and Quality of Primary Care. Theoutcome of the study was constructed based on a set of items that were considered essential for the treatment and control of tuberculosis in Primary Care Units (PCUs). Data were analyzed using the χ2 test and Poisson regression with robust variance. RESULTS The national prevalence of the set of items to control tuberculosis was 17.22%. TheNortheast (11.18%) and North (12.15%) had the worst performance. The main results indicate association with this outcome for PCUs performing educational actions for TB (PR = 1.53; 95%CI 1.45 - 1.62), those performing HIV serology (PR = 1.68; 95%CI 1.11 - 2.54), those that have a reception room (PR = 1.61; 95%CI 1.46 - 1.79) and those performing continuing education activities (PR = 1.73; 95%CI 1.54 - 1.95). CONCLUSION The results show a weakness in the structures and in the work process of PC in relation to the control of tuberculosis in all Brazilian regions.
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Affiliation(s)
- Alexandre Baumgarten
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Rafaela Soares Rech
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Patrícia Távora Bulgarelli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Kellyn Rocca Souza
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Camila Mello Dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Karla Frichembruder
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Juliana Balbinot Hilgert
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.,Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Alexandre Fávero Bulgarelli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
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Faustino-Silva DD, Meyer E, Hugo FN, Hilgert JB. Effectiveness of Motivational Interviewing Training for Primary Care Dentists and Dental Health Technicians: Results from a Community Clinical Trial. J Dent Educ 2019; 83:585-594. [PMID: 30858274 DOI: 10.21815/jde.019.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/08/2018] [Indexed: 11/20/2022]
Abstract
Motivational interviewing (MI) is an approach that uses dialogue about behavioral change to encourage a constructive relationship between professionals and patients. The aim of this study was to evaluate the maintenance of basic MI skills in the daily practice of dentists and oral health technicians (OHTs) after a training course and for two years of follow-up in the context of primary health care (PHC). A randomized community trial, from September 2012 to September 2014, was conducted at the Community Health Service of Conceição Hospital Group in Porto Alegre, RS, Brazil. The experimental group consisted of all 41 dentists and OHTs who received an intensive eight-hour training course in basic MI principles; the control group consisted of 31 dentists and OHTs who did not receive MI training. The follow-up assessments were at one and two years using three instruments validated for MI. In the one- and two-year follow-ups, improvement was maintained in responses with a statistically significant difference for use of open questioning, reflective listening, and total percentage of correct answers (p<0.001), with a large effect size (ES=1.12). On the Helpful Responses Questionnaire, the participants continued using open questioning and reflective listening (p<0.001), maintaining an increase in the percentage of responses compatible with MI (p<0.001). Likewise, the effect size remained large (ES=1.33) over time. These results suggest that the training course with dentists and OHTs of the PHC oral health staff was effective over the two-year follow-up in enabling them to act in the spirit and techniques of MI.
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Affiliation(s)
- Daniel Demétrio Faustino-Silva
- Daniel Demétrio Faustino-Silva, DDS, is at the Graduate Program in Assessment Technology for the National Health System, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil; Elisabeth Meyer, PhD, is a Psychologist, Graduate Program in Health Sciences of the Cardiology Institute, Porto Alegre, RS, Brazil; Fernando Neves Hugo, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; and Juliana Balbinot Hilgert, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Elisabeth Meyer
- Daniel Demétrio Faustino-Silva, DDS, is at the Graduate Program in Assessment Technology for the National Health System, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil; Elisabeth Meyer, PhD, is a Psychologist, Graduate Program in Health Sciences of the Cardiology Institute, Porto Alegre, RS, Brazil; Fernando Neves Hugo, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; and Juliana Balbinot Hilgert, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Daniel Demétrio Faustino-Silva, DDS, is at the Graduate Program in Assessment Technology for the National Health System, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil; Elisabeth Meyer, PhD, is a Psychologist, Graduate Program in Health Sciences of the Cardiology Institute, Porto Alegre, RS, Brazil; Fernando Neves Hugo, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; and Juliana Balbinot Hilgert, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Daniel Demétrio Faustino-Silva, DDS, is at the Graduate Program in Assessment Technology for the National Health System, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil; Elisabeth Meyer, PhD, is a Psychologist, Graduate Program in Health Sciences of the Cardiology Institute, Porto Alegre, RS, Brazil; Fernando Neves Hugo, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; and Juliana Balbinot Hilgert, DDS, is at the Graduate Dentistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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