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Silva ÉT, Ferreira RC, Diniz FC, Gomes MR, Martins AMEDBL, Chalub LLFH, Senna MIB. Disparities in the protagonism of oral health teams in the work process of Primary Healthcare. Rev Saude Publica 2024; 58:14. [PMID: 38695443 PMCID: PMC11037909 DOI: 10.11606/s1518-8787.2024058005759] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/08/2023] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE Evaluate and compare the protagonism of Oral Health teams (OHt) in the teamwork process in Primary Healthcare (PHC) over five years and estimate the magnitude of disparities between Brazilian macro-regions. METHODS Ecological study that used secondary data extracted from the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Healthcare) from 2018 to 2022. Indicators were selected from a previously validated evaluative matrix, calculated from records in the Collective Activity Form on the degree of OHt's protagonism in team meetings and its degree of organization concerning the meeting agendas. A descriptive and amplitude analysis of the indicators' variation over time was carried out, and the disparity index was also calculated to estimate and compare the magnitude of differences between macro-regions in 2022. RESULTS In Brazil, between 3.06% and 4.04% of team meetings were led by OHt professionals. The Northeast and South regions had the highest (3.71% to 4.88%) and lowest proportions (1.21% to 2.48%), respectively. From 2018 to 2022, there was a reduction in the indicator of the "degree of protagonism of the OHt" in Brazil and macro-regions. The most frequent topics in meetings under OHt's responsibility were the work process (54.71% to 70.64%) and diagnosis and monitoring of the territory (33.49% to 54.48%). The most significant disparities between regions were observed for the indicator "degree of organization of the OHt concerning case discussion and singular therapeutic projects". CONCLUSIONS The protagonism of the OHt in the teamwork process in PHC is incipient and presents regional disparities, which challenges managers and OHt to break isolation and lack of integration, aiming to offer comprehensive and quality healthcare to the user of the Unified Health System (SUS).
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Affiliation(s)
- Érika Talita Silva
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Raquel Conceição Ferreira
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Fabiano Costa Diniz
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Milena Ribeiro Gomes
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Maria Inês Barreiros Senna
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Clínica, Patologia e Cirurgia OdontológicasBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Clínica, Patologia e Cirurgia Odontológicas. Belo Horizonte, MG, Brasil
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Campos FL, Rodrigues LG, Campos JR, Rhodes GAC, Morais GF, Chalub LLFH, Ferreira RC. Association between shortened dental configurations and health outcomes: a scoping review. BMC Oral Health 2024; 24:111. [PMID: 38243284 PMCID: PMC10799365 DOI: 10.1186/s12903-023-03714-4] [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: 07/10/2023] [Accepted: 11/25/2023] [Indexed: 01/21/2024] Open
Abstract
This study mapped definitions of shortened dental configurations and health outcomes employed in association studies. A scoping review was conducted using the PubMed/Medline, Scopus, Web of Science, SciELO and Cochrane databases. Two trained researchers selected studies and extracted data. Studies that investigated the association between shortened dental configurations (exposure) and person-centered outcomes (general and oral health) related to health behavior (dietary patterns). Clinical outcomes were classified according to the International Classification of Functioning, Disability and Health and the International Classification of Diseases of the World Health Organization (WHO). Shortened dental configurations were defined as at least 20/21 teeth or the position of the teeth, including esthetics, dental occlusion and periodontal status (Eichner Index, Shortened Dental Arches, Functional Dentition Classification System, Posterior Occluding Pairs, Functional Tooth Units). The initial search resulted in 12,525 records in English, Portuguese and Spanish, 432 of which addressed the association of interest. General health (n = 203) and oral health (n = 201) were addressed in a similar number of studies. Most outcomes were related to general health (n = 184), the most frequent of which were endocrine, nutritional or metabolic diseases (n = 57) and mental functions (n = 26). Person-centered measures were addressed in 153 studies, most of which were about oral health and oral health-related quality of life (n = 62). Oral health outcomes were predominantly related to intake functions (n = 44) and diseases or disorders of the orofacial complex (n = 24). Dietary patterns (n = 43) and mortality (n = 38) were also studied. The cross-sectional design (n = 257) and non-probabilistic sampling (n = 218) were more frequent. The shortened dental configurations defined by the WHO were the most frequent in the studies (n = 206). The effects of shortened dental configurations have been investigated mainly in relation to endocrine, nutritional or metabolic diseases and measures of oral health-related quality of life. The findings point to a diversity of health outcomes assessed and substantial methodological variability.
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Affiliation(s)
- Fernanda Lamounier Campos
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Lorrany Gabriela Rodrigues
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Julya Ribeiro Campos
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Gabriela Aparecida Caldeira Rhodes
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Gabrielli Flores Morais
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Loliza Luiz Figueiredo Houri Chalub
- School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil.
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627, Belo Horizonte, Minas Gerais, Brazil
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Campos FL, Rhodes GAC, Vasconcellos WA, Bomfim RA, Sampaio AA, Chalub LLFH, Ferreira RC. Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies. Braz Oral Res 2023; 37:e045. [PMID: 37162058 DOI: 10.1590/1807-3107bor-2023.vol37.0045] [Citation(s) in RCA: 1] [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: 02/06/2022] [Accepted: 09/19/2022] [Indexed: 05/11/2023] Open
Abstract
The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.
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Affiliation(s)
- Fernanda Lamounier Campos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | | | - Walison Arthuso Vasconcellos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
| | - Rafael Aiello Bomfim
- Universidade Federal do Mato Grosso do Sul - UFMS, School of Dentistry, Department of Community Dentistry, Campo Grande, MS, Brazil
| | - Aline Araujo Sampaio
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Clinical, Pathology and Dental Surgery, Belo Horizonte, MG, Brazil
| | - Loliza Luiz Figueiredo Houri Chalub
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Raquel Conceição Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
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Paula JSD, Rodrigues PA, Mattos FF, Abreu MHNGD, Chalub LLFH, Zina LG. Mother's education and family relations protect children from dental caries experience: a salutogenic approach. Braz Oral Res 2022; 36:e111. [PMID: 35946739 DOI: 10.1590/1807-3107bor-2022.vol36.0111] [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: 10/26/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to identify dental caries-protective factors among 5-year-old children using the salutogenic theory. A cross-sectional study was conducted in a small-sized municipality in the Southeast region of Brazil, with a representative sample of 247 children registered in preschool and their respective mothers. The data were collected through questionnaires administered to the mothers about the socioeconomic, behavioral, and biological aspects of the mother and children. Additionally, the collections included validated instruments concerning psychosocial aspects, such as a sense of coherence, resilience, family cohesion and religiosity, and intraoral examinations of the children through the decayed-missing-filled primary teeth (dmft) index. All examinations were performed by a trained and calibrated examiner. The non-adjusted and adjusted odds ratios (OR) and their respective confidence intervals (CI) were estimated using multiple logistic regression with a hierarchical model. Among the examined children, 41.7% were caries-free. In the final model, the chances of the absence of dental caries experience (dmft = 0) were greater in children with mothers who had higher education levels (> 8 years of study) (OR = 2.55 [95%CIi:1.42-4.59]) and those who lived in an environment of high family cohesion (OR = 3.66 [95%CI: 1.19-11.29]). The results indicated that mothers' level of education and family relationships are protective factors against dental caries in 5-year-old children, which overlapped with behavioral and biological factors.
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Affiliation(s)
- Janice Simpson de Paula
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
| | - Priscila Almeida Rodrigues
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
| | - Flávio Freitas Mattos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
| | - Lívia Guimarães Zina
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry , Department of Community and Preventive Dentistry , Belo Horizonte , MG , Brazil
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Campos FL, Kawachi I, Rhodes GAC, Sampaio AA, Chalub LLFH, Ferreira RC. Brazilian Adults Believe that Complete Dentures would be the Solution to the Oral Impacts Caused by Reduced Dentition. Pesqui Bras Odontopediatria Clín Integr 2022. [DOI: 10.1590/pboci.2022.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Soares ARDS, Chalub LLFH, Barbosa RS, Campos DEDP, Moreira AN, Ferreira RC. Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral-health related quality of life among Brazilian adults. Heliyon 2021; 7:e06492. [PMID: 33748509 PMCID: PMC7970350 DOI: 10.1016/j.heliyon.2021.e06492] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To assess the association between dentin hypersensitivity (DH) (with or without non-carious cervical lesions (NCCL)) and physical and psychosocial oral health impact. Methods A cross-sectional population-based study with one-stage random sample of adults living in a Brazilian municipally was conducted between 2018 and 2019. Interviews and oral examinations were performed by calibrated examiners (Kappa ≥0.7). The participant was considered as having physical and psychosocial impact if at least one item of the Oral Health Impact Profile (OHIP-14) was experienced fairly often or very often. NCCL was assessed by the Tooth Wear Index (codes 2 to 4) and DH was evaluated by a tactile test with a probe in the cervical area of teeth. The combination of these clinical variables resulted in categories of the independent variable: without DH or NCCL, NCCL without DH, DH without NCCL, and both DH with NCCL. The covariables were sociodemographic and economic factors, health habits, and oral conditions. Associations were investigated by Poisson Regression models using Direct Acyclic Graph (Stata 17). Results Of 197 adults, 59.3% had oral health impact and 31.3% had DH with NCCL. Higher frequency of oral health impact was observed in adults with DH alone. A higher impact on the physical pain dimension of the OHIP-14 was observed in adults with DH and NCCL (PR: 2.46; 95% CI: 1.21–5.00) and with DH alone (PR: 2.03; 95% CI: 1.21–3.41). Conclusion NCCL and DH are common conditions in adults and the presence of DH is associated with higher oral health impact. Regardless the presence of NCCL, DH is associated with the physical pain dimension of OHRQoL.
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Affiliation(s)
| | | | | | | | - Allyson Nogueira Moreira
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Kato CDNADO, Nunes LFM, Chalub LLFH, Etges A, Silva TA, Mesquita RA. Retrospective Study of 383 Cases of Fibro-Osseous Lesions of the Jaws. J Oral Maxillofac Surg 2018; 76:2348-2359. [PMID: 29859157 DOI: 10.1016/j.joms.2018.04.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 04/26/2018] [Accepted: 04/28/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The aims of this study were to describe the clinical and radiologic features of 383 fibro-osseous lesions (FOLs) from an oral pathology reference service in Brazil and to compare the findings with previous studies. The hypothesis of the study was that the most common type of FOL would differ from other investigations. MATERIALS AND METHODS We conducted a descriptive and retrospective study with review of the records of the clinical and biopsy services (1990 to 2015). All records of the patients included showed a definitive diagnosis of FOL. The primary outcome variable was the type of FOL, and the predictor variables were gender, age, ethnicity, location, and clinical and radiologic characteristics. Descriptive analyses and χ2 tests were performed. The P value was set at .05. RESULTS From the 27,998 records available, 383 showed FOLs, with 187 (48.8%) being cemento-osseous dysplasias (CODs), 103 (26.9%) being fibrous dysplasias (FDs), and 93 (24.3%) being ossifying fibromas (OFs). The mean age of the patients was 38.5 ± 17.5 years. CODs presented a predilection for female gender (n = 314, 82.0%), African descent (n = 134, 71.6%), and the mandible (n = 248, 64.6%). The most common radiologic feature was a mixed radiolucent-radiopaque image (n = 149, 51.7%). FDs and OFs were commonly diagnosed during the first and second decades of life (P < .001), whereas CODs were more frequently diagnosed beyond the third decade (P < .001). Secondary osteomyelitis was more significantly observed in CODs (P < .001) than in FDs and OFs. Swelling was more frequently reported for FDs and OFs than for CODs (P < .001). CONCLUSIONS CODs were the most frequently observed FOLs in this Brazilian population. Female patients, patients of African descent, and patients with mandibular localization were most commonly affected by these conditions. The most common type of FOL differed from that in similar case reports or series from various geographic locations. It is believed that the data source (clinical and/or biopsy services) can directly influence the outcome.
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Affiliation(s)
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Professor, Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Etges
- Professor, Departament Oral Pathology, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Tarcília Aparecida Silva
- Professor, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Professor, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Chalub LLFH, Ferreira RC, Vargas AMD. Influence of functional dentition on satisfaction with oral health and impacts on daily performance among Brazilian adults: a population-based cross-sectional study. BMC Oral Health 2017; 17:112. [PMID: 28697751 PMCID: PMC5504983 DOI: 10.1186/s12903-017-0402-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 02/10/2017] [Accepted: 07/04/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dental esthetics, chewing and speech should be preserved in a dentition denominated functional and are closely related to satisfaction with oral health (SOH), impacts caused by oral problems and have a possible association with Oral Health-Related Quality of Life. Thus, the purpose of the present study was to investigate the influence of different concepts of functional dentition (FD) on both SOH and impacts on daily performance (IDP) among Brazilian adults. METHODS A cross-sectional study was conducted with 9564 adults (35-44 years). SOH and IDP were evaluated using the Oral Impacts on Daily Performance (OIDP) questionnaire. FD was considered based on four different definitions: I-classification of the World Health Organization (FDWHO = ≥20 teeth); II-well-distributed teeth (WDT = ≥10 teeth in each arch); III-classified by esthetics and occlusion (FDClass5 = sequential presence of one tooth in each arch, ≥10 teeth in each arch, 12 anterior teeth, ≥three posterior occluding pairs [POPs] of premolars and ≥one POP molar bilaterally); and IV-classified by esthetics, occlusion and periodontal status (FDClass6 = FDClass5 plus all sextants with CPI ≤ 3 and/or CAL ≤ 1). The proportion of adults satisfied with oral health and without overall impact (OIDP = 0) was calculated for each definition of FD. Multiple Poisson regression models were adjusted by demographic-socioeconomic characteristics, self-reported oral problems and the use of dental services for each dependent variable. RESULTS When FDClass5 and FDClass6 were considered a greater proportion of adults reported being satisfied (52.1 and 53.1%, respectively) and have OIDP = 0 (52.4 and 53.3, respectively). In the multiple models, SOH was associated with FDClass5 (RP = 1.21) and FDClass6 (RP = 1.24) and OIDP = 0 was associated with WDT (RP = 1.14) and FDClass6 (RP = 1.21). CONCLUSIONS The greater influence of WDT, FDClass5 and FDClass6 on aspects related to quality of life in comparison to FDWHO demonstrates the need for the establishment of a broader definition of FD that encompasses subjective aspects.
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Affiliation(s)
- Loliza Luiz Figueiredo Houri Chalub
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627 – Campus – CEP, Belo Horizonte, Minas Gerais 31270-911 Brazil
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627 – Campus – CEP, Belo Horizonte, Minas Gerais 31270-911 Brazil
| | - Andréa Maria Duarte Vargas
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627 – Campus – CEP, Belo Horizonte, Minas Gerais 31270-911 Brazil
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Chalub LLFH, Borges CM, Ferreira RC, Haddad JPA, Ferreira e Ferreira E, Vargas AMD. Association between social determinants of health and functional dentition in 35-year-old to 44-year-old Brazilian adults: a population-based analytical study. Community Dent Oral Epidemiol 2014; 42:503-16. [PMID: 24909059 DOI: 10.1111/cdoe.12112] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 03/19/2013] [Accepted: 05/07/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To verify the association between functional dentition and social determinants of health in 35-year-old to 44-year-old adults residing in the metropolitan municipalities of Minas Gerais, Brazil. METHODS This cross-sectional study assessed a sample of 850 adults obtained using a cluster sampling scheme. Five of 33 municipalities were randomly selected, followed by the random selection of census tracts and neighborhood blocks. Every household in the randomly selected blocks was visited and every resident adult was interviewed and examined by five previously calibrated researchers (κinter , 0.8-0.9; κintra , 0.8-1.0) between May and December 2010. The condition of the dental crown was recorded using the World Health Organization (WHO) criteria, with the exception of the third molars. The dependent variable functional dentition was defined as the presence of 20 or more teeth in the mouth and obtained by counting the number of teeth lost due to any reason, followed by subtraction of this number from the total of 28 teeth. Independent variables were grouped, according to a theoretical model adapted from those proposed by Dahlgren and Whitehead and Petersen, into distal factors (contextual, socioeconomic, and housing conditions), intermediate factors (availability and use of oral health services), and proximal factors (lifestyle, risk behaviors, and demographic conditions). The association between functional dentition and the independent variables was investigated using simple and multiple Poisson regression with robust variance, which followed a modeling strategy in accordance with the hierarchy outlined by the theoretical model. The analyses were processed on SPSS 17.0. RESULTS The average age of the participants was 39.4 ± 3.2 years, and the average per capita monthly family income was US$214.52 ± 261.11. Most adults presented functional dentition (80.6%; 95% CI: 77.3-83.5). Independently of marital status, age group and sex, the prevalence ratio (PR) of subjects with a per capita monthly family income ≥US$168.54 was 1.09 (P = 0.048); the PR of adults with at least an undergraduate degree was 1.14 (P = 0.001), and the PR of the participants who most often used a dental service other than a public service supplementary healthcare plan or private service was 1.13 (P = 0.021). The prevalence of functional dentition was 17% higher among nonsmokers (P = 0.012) and 16% higher among those who used dental floss (P = 0.006). CONCLUSIONS Income, education, type of dental service most often used, lifestyle, risk behaviors and demographic conditions are distal, intermediate and proximal social determinants of health associated with functional dentition in adults, demonstrating the need for public policies aimed to promoting oral health including intersectoral actions.
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Affiliation(s)
- Loliza Luiz Figueiredo Houri Chalub
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Brazil
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