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Estimar a prevalência e gravidade de cárie dentária em escolares de 12 e 13 anos de uma escola estadual de Florianópolis, Santa Catarina, Brasil em 2002 e fazer comparações com os resultados de estudos anteriores, realizados em 1971 e 1997, no mesmo estabelecimento de ensino. Trata-se de um estudo transversal que envolveu 181 escolares. Os dados clínicos foram coletados segundo critérios propostos pela Organização Mundial da Saúde (OMS) ¹. O examinador passou por exercício prévio de calibração. A taxa de resposta foi de 93,8%. A concordância intra-examinador, medida dente a dente, foi alta (Kappa > 0,73). As prevalências de cárie registradas foram de 98%, 93,7% ou 80,0% e 57,4% em 1971, 1997 e 2002, respectivamente. O índice CPO-D médio variou de 9,2 em 1971, 6,2 ou 3,0 em 1997, para 1,4 em 2002, tomando-se ambas as idades em conjunto. O primeiro valor de 1997 segue o critério de Klein & Palmer ² e o segundo, o critério da OMS ³. Entre 1971 e 2002, foi constatada redução real na prevalência e gravidade de cárie na população observada, apesar dos diferentes critérios utilizados para medi-las.

Parâmetros psicossociais têm sido recomendados para avaliar o impacto dos problemas bucais na qualidade de vida das pessoas. O objetivo deste estudo foi avaliar o impacto da cárie e fluorose dentárias na satisfação com a aparência e com a mastigação em crianças. Foi realizado um estudo transversal com escolares (n = 695) de 12 anos de idade de Chapecó, Santa Catarina, em 1999. Foram examinadas cárie e fluorose dentária e investigados acesso à consulta odontológica e a hábitos de higiene bucal. Para a identificação dos fatores de risco, foi realizada análise de regressão logística múltipla não condicional. Nenhum dos fatores investigados foram associados à insatisfação com a aparência. Estudar em escola pública, apresentar-se com dentes anteriores e com pelo menos dois dentes posteriores comprometidos pela cárie e ser do sexo feminino foram fatores de risco independentes para a insatisfação com a mastigação. Pode-se concluir que a fluorose dentária não teve impacto sobre a satisfação com a aparência. Quanto maior a severidade da cárie, maior o impacto sobre a insatisfação com a mastigação, isso foi maior em crianças de escolas públicas.

Os objetivos deste estudo foram conhecer a prevalência e severidade da cárie dentária, bem como necessidades de tratamento odontológico, além de testar sua associação com variáveis sócio-econômicas em jovens de 18 anos de idade do sexo masculino em Florianópolis, Santa Catarina, Brasil. Foi realizado um estudo transversal em uma amostra aleatória de alistandos (n = 300) do Exército Brasileiro. Foram utilizados os critérios de diagnóstico da Organização Mundial da Saúde. Utilizou-se um questionário sócio-econômico para se aferir o grau de escolaridade do alistando, de seus pais e a renda familiar. Associações entre a prevalência de cárie, o índice CPO-D e seus componentes e as variáveis sócio-econômicas foram avaliadas por meio dos testes qui-quadrado e Mann-Whitney, respectivamente. A prevalência de cárie foi de 81% e o índice CPO-D médio foi igual a 4,6. Apenas 1,2 dente por pessoa, em média, apresentou-se com necessidade de tratamento. Diferenças estatisticamente significativas foram encontradas na prevalência e severidade de cárie (CPO-D), sendo os piores indicadores verificados nos grupos de menor escolaridade e renda, indicando serem estes grupos prioritários para medidas preventivas e assistenciais.

O objetivo do estudo foi descrever um exercício de calibração de examinadores para estudos epidemiológicos de cárie dentária, comparando os testes estatísticos que medem acurácia e reprodutibilidade. Oito cirurgiões-dentistas examinaram independentemente 17 escolares de 12 anos de idade, utilizando os códigos e critérios propostos pela Organização Mundial da Saúde em 1997. Calculou-se o índice CPO-D médio, as taxas de concordância e o teste kappa considerando os dentes no seu conjunto e dente a dente para cada um dos examinadores comparando-os com o examinador padrão. As taxas de concordância e os valores de kappa quando considerou-se todos os dentes em conjunto, foram superiores aos valores do teste kappa quando calculado dente a dente. A padronização de critérios diagnósticos, o rigoroso treinamento e exercícios de calibração de examinadores e a mensuração e apresentação adequadas dos erros de diagnóstico são fundamentais para o julgamento da validade dos resultados de estudos epidemiológicos. A revisão de literatura assim como os resultados deste estudo mostram que a utilização do teste kappa e seu cálculo com base em cada um dos dentes separadamente é a forma mais adequada de mensuração da acurácia e reprodutibilidade.

O presente trabalho descreve a aplicação da técnica "tribunal do júri" ao conjunto de secretários municipais de saúde do Estado de Santa Catarina, para fins de sensibilização à questão dos deveres do administrador público, realizado como parte introdutória de um ciclo de formação para dirigentes municipais em 1997. As diferentes etapas que compõem a técnica são descritas apresentando-se a avaliação dos resultados obtidos. Dos 156 participantes, 98% foram favoráveis à inovação por considerá-la dinâmica/participativa (31%); educativa/reflexiva (27%) e por traduzir a realidade (24%). A técnica permitiu a discussão das principais temáticas de interesse para o SUS. Embora os cinco tribunais tenham absolvido o réu, a dimensão ética foi referida por 58% como principal atributo necessário ao homem público.

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.

The objective of this study was to assess the prevalence and characteristics of oral lesions and oral self-examination and the association between these variables and life course determinants in a young population. A representative sample (n = 720) of all births occurring in Pelotas, Rio Grande do Sul State, Brazil, in 1982, was investigated and the outcomes were assessed in 2006. Data regarding exploratory variables was collected from other cohort waves. The prevalence of oral lesions was 23.3% (95%CI: 20.3-26.6). A total of 31% of individuals (95%CI: 27.6-34.4) reported never having performed oral self-examination. Multivariable analysis showed that low socio-economic status at birth, lack of oral hygiene instruction from a dentist up to the age of 15 years and smoking habits at the age of 22 year were associated with the presence of oral lesions. Performing oral self-examination was associated with high levels of maternal schooling at birth and having received oral hygiene orientation from a dentist up to the age of 15 years. Socioeconomic and behavioral factors are associated with both presence of oral mucosal lesions and the habit of performing self-examination.

Indicators and analyses that used the database from SB Brazil 2003 (the most recent nationwide oral health survey) have been criticized as unreliable due to sampling problems. The current study countered that this critique was based solely on statistical concepts, unsupported by empirical evidence. The critique's essentially epistemic approach leads to peremptory reductionism that denies other forms of knowledge and fails to recognize the multidisciplinary nature of epidemiology. The current study retrieves information on the implementation of the oral health survey and its impact on knowledge output in the field. The article draws an analogy between science and art, demonstrating the multifaceted images obtained by both. Thus, recognition of validity requires a full grasp of the field and appropriate use of value criteria. The current article concludes that use of the SB Brazil 2003 database is a reliable and relevant application of epidemiology to oral health.

The aim of this study was to estimate patterns of dental services use in a medium-sized city in southern Brazil. A population-based cross-sectional study was conducted in a sample of 4,226 individuals aged 10 years and older. Poisson regression analysis was used to identify associated factors; 50.9% (95%CI: 49.3-52.4) of the sample had consulted a dentist in the previous year. Dental care attendance rates among adolescents, adults, and elders were 52.2%, 53.6%, and 37.2%, respectively. After adjusting for various confounders, the most important determinants of dental services use were: schooling >or= 9 years, high socioeconomic status, and self-reported oral health problems. In addition, adolescents and adults that rated their oral health as good showed 10% and 40% higher prevalence dental services use, respectively, when compared with those who rated their oral health as bad. Determining the prevalence of dental services use and users' characteristics can help policymakers plan future measures to make dental care available to population groups with low rates of dental services use.

This study aimed to analyze fluoride concentration in the public water supply in Chapecó, Santa Catarina State, Brazil, from 1995 to 2005 and to assess the effectiveness of a fluoridation quality intervention in 2003. A total of 989 water samples were analyzed. Fluoride concentrations were classified according to three different criteria used in Brazil. The city conducted a political and legal intervention in 2003. The Prais-Winsten procedure was used to evaluate the fluoride concentrations over time. In the ten years, the water fluoridation system showed 46%, 32%, and 43% of adequate samples, depending on the criterion. Prior to the municipal intervention, the proportion of adequate samples was 40%, 26%, and 36%, increasing to 63%, 49%, and 61% after the intervention, according to the three criteria. Fluoride concentration improved after the municipal intervention. On-going surveillance is recommended, including water fluoridation, dental caries, and dental fluorosis.

The aim of this study was to estimate the prevalence of dental and gingival pain and associated factors among Brazilian adolescents (15-19 years of age). Data from 16,126 adolescents who participated in the Brazilian Oral Health Survey SB-Brazil 2002-2003 were used. The outcome measured was dental and gingival pain in the last six months. Independent variables were per capita income, schooling, school enrollment, gender, skin color, age, area of residence, time since last dental appointment, type of dental service, DMFT index and its components, dental calculus, and Dental Aesthetic Index. Simple and multiple Poisson regression analyses were performed. Prevalence of dental and gingival pain was 35.6% (95%CI: 34.8-36.4). Increased prevalence of pain was associated with: female gender, low income, non-students, students enrolled in public schools, and grade-for-age lag. In addition, adolescents with high levels of dental caries and dental calculus also reported higher prevalence of dental pain. Dental and gingival pain can be considered a relevant public health problem, suggesting the need for preventive measures.

The aim of this study was to estimate the prevalence of tooth loss among Brazilian adults aged 35 to 44 years. The study also tested the association between tooth loss and demographic, socioeconomic, and dental-care utilization variables. Data were analyzed from 13,431 individuals submitted to dental examination and interviewed in the National Oral Health Survey in 2002-2003. The number of lost teeth ( 12) was the outcome. Exploratory variables included geographic area, gender, skin color, age, per capita income, schooling, time since last dental appointment, and type of dental service used. Crude and adjusted prevalence ratios were estimated using a Poisson regression model. The prevalence of edentulism was 9%, while median tooth loss was 11. Tooth loss was strongly associated with living in rural areas, female gender, poor socioeconomic status, low schooling, and older age. Individuals who attended public dental care services and those with more time elapsed since their last dental appointment showed a higher prevalence of tooth loss than their counterparts after controlling for demographic and socioeconomic factors.

Several epidemiological studies have analyzed the association between oral health and social development. However, the use of different variables assessing socioeconomic status impairs the comparative analysis of their findings. The present study describes how recent dental studies have classified population segments according to categories of social stratification. We selected 86 papers on social determinants of dental caries or periodontal conditions, and published in MEDLINE-indexed journals from 1990 to 2001. The studies used different strategies to stratify populations, but occupation, schooling, and income were the most frequently assessed variables. Ethnic differentials, characteristics of households and schools, and access to material resources were also frequently appraised. We also observed a large portion of Brazilian studies focusing on socioeconomic differentials in the distribution of caries and periodontal disease. Knowledge of strategies for social stratification can improve the understanding of factors associated with dental diseases, fostering further studies and allowing the comparison of their results.

The goal of this study was to identify dental caries prevalence and severity among all 12 and 13-year-old schoolchildren enrolled in a public school in 2002 and to establish comparisons with the results of studies conducted previously in the same school in 1971 and 1997. A cross-sectional study involving 181 children was performed. Clinical data were collected by one examiner under World Health Organization (WHO) criteria. The examiner had been through calibration training. The project was approved by the Research Ethics Committee of the Federal University in Santa Catarina. The response rate was 93.8%. Intra-examiner agreement, on a tooth-by-tooth basis, was high (Kappa> or =0.73). The prevalence rates for dental caries were 98%, 93.7% or 80.0%, and 57.4% in 1971, 1997, and 2002, respectively. The mean DMF-T index was 9.2 in 1971, 6.2 or 3.0 in 1997, and 1.4 in 2002, taking both ages as a whole. The first value from 1997 was recorded under the Klein & Palmer diagnostic criterion and the second according to the WHO criterion. Between 1971 and 2002 there was a real reduction in caries prevalence and severity among the schoolchildren, even though different diagnostic criteria were used.

It has been suggested that psychosocial dimensions be used to assess the impact of oral health on people's quality of life. The purpose of this study was to measure the impact of dental caries and dental fluorosis on children's self-perception of appearance and mastication. A dental caries and dental fluorosis cross-sectional study was conducted with twelve-year-old schoolchildren (n = 695) in Chapec , Santa Catarina, Southern Brazil. A questionnaire to assess dental care and dental habits was applied. Risk factors were identified using unconditional multiple logistic regression analysis. None of the variables investigated was associated with dissatisfaction in relation to self-perceived appearance. Independent risk factors for dissatisfaction with self-perceived mastication included enrollment in a public school, caries in an anterior tooth and at least two posterior teeth, and female gender. By way of conclusion, dental fluorosis had no impact on children's self-perception of appearance. Increased severity of dental caries was associated with greater self-perception of impact on chewing. This impact was greater in public schoolchildren, suggesting that there are different values and perceptions between socially different groups.

The aim of this study was to assess the prevalence and severity of dental caries and need for treatment among 18 years-old males in Florianópolis, Southern Brazil. In addition, the associations between dental caries and socioeconomic conditions were tested. A cross sectional study was carried out. A random sample of 300, was selected from a list of Brazilian Army conscripts. Clinical data were collected according to World Health Organization criteria. Socioeconomic data (years of education of the subjects, their fathers and mothers and family income) were collected through interviews. The statistical significance of associations between socioeconomic indicators and dental caries prevalence were tested using the chi-square test whilst for severity of dental caries Mann-Whitney test was used. The prevalence of dental caries was 81% and the mean DMF-T was 4.5. The mean number of teeth that needed treatment was 1.2. Both dental status and treatment need were statistically significantly associated with socioeconomic indicators. Those with low levels of education and income experienced more disease and needed more treatment than those from high levels of education and income.