Este estudo de coorte prospectivo avaliou cárie dentária e qualidade de vida em gestantes com e sem excesso de peso pré-gestacional. As gestantes foram avaliadas depois do 1º trimestre de gestação (T1) e após o parto (T2), sendo divididas em dois grupos: gestantes com excesso de peso pré-gestacional (GPE=53) e com peso normal (GPN=40). As pacientes foram avaliadas quanto a: cárie dentária (ICDAS), qualidade de vida (OHIP-14), dados antropométricos, socioeconômicos e hábitos comportamentais de higiene bucal. Os testes Qui-Quadrado, Mann-Whitney, McNemar e Wilcoxon foram adotados (p<0,05). Na avaliação dentro de cada grupo se comparando os tempos (T1 e T2) houve aumento de manchas brancas em GPN e GPE e neste, houve também aumento de lesões em dentina (p<0,05). Já quanto à análise do tratamento, GPN e GPE tiveram aumento de dentes restaurados e com restaurações deficientes (p<0,05). Dentro dos grupos GPN e GPE, houve diferenças significativas para lesões em esmalte e número de dentes perdidos. Na qualidade de vida, em GPN e GPE, houve diferenças quanto à limitação funcional, dor física e OHIP-14 total. Entretanto, em GPN houve diferença significativa para incapacidade psicológica e em GPE para incapacidade social (p<0,05). Na comparação entre os grupos GPN e GPE na qualidade de vida ocorreu diferença na dimensão invalidez (p<0,05). GPN e GPE mostraram redução no número de escovações diárias, frequência e uso de fio dental, após o parto. Conclui-se que tanto as gestantes com excesso de peso quanto as com peso normal apresentaram maior incidência de lesões em esmalte. Entretanto, aquelas com excesso de peso e obesidade tiveram, também, aumento das lesões em dentina e maior número de dentes perdidos. Após o parto, a qualidade de vida parece melhorar e os hábitos comportamentais de higiene bucal piorar. / This prospective cohort study evaluated dental decay and quality of life in pregnant women with and without excess pre-gestational weight. The pregnant women were evaluated after the first trimester (T1) of pregnancy and after childbirth (T2), been divided in two groups: pregnant women with excess pre-gestational weight (GPE=53) and normal weight (GPN=40). The patients were evaluated for: dental decay (ICDAS), quality of life (OHIP-14), anthropometric data, socioeconomic and behavioral habits of oral hygiene. The testes Chisquare, Mann-Whitney, McNemar and Wilcoxon were adopted (p<0,05). In the intra groups evaluation comparing (T1 and T2) there was an increase of white spots in GPN and GPE and in this, there was also an increase on dentin lesions (p<0,05). Within the GPN and GPE groups, there was significant differences for lesions on enamel and the number of missing teeth. In the quality of life, in the groups GPN and GPE, there was a difference in the limitation of physical pain and OHIP-14 total. However, in GPN there was significant difference for psychological incapacity and in GPE for social incapacity (p<0,05). In the comparison between the GPN and GPE groups in the quality of life, there was difference in the disability dimension (p<0,05). The GPN and GPE groups presented decrease in the number of tooth brushing, frequency and the use of dental floss, after childbirth. It is concluded that the number of pregnant women with or without excess weight presented incidence of enamel lesions. However, the pregnant women with excess weight and obesity also had a higher increase in the dentin lesions and a higher number of missing teeth. After childbirth, the quality of life seems to improve, and the behavioral habits of oral hygiene worsen.

Magister Scientiae Dentium - MSc(Dent) / The prevalence of dental decay is high among lower socio-economic groups in the Southern Cape and Karoo region. 70 - 80% of State employed dentists' time in this region is spent on attempting to reduce the pain and sepsis within the communities for which the primary treatment modality is extraction of the tooth under emergency conditions. In developing countries the prevalence of dental decay is still high. There is a general downward trend of dental decay in developing countries; and it is associated with combinations of exposure to fluoridated water and/ or other forms of fluoride exposure (e.g. in fluoridated tooth paste), the provision of preventive oral health services, an increase in dental awareness through organized oral health education programs and the readily available dental resources. This study looked at the feasibility of implementing community water fluoridation in the Southern Cape and Karoo Region by describing the primary drinking water sources, the population distribution around these sources and the actual levels of fluoride found in the water samples. Each sample was coded and with the use of a global positioning system (GPS), a set of co-ordinates obtained for each. Other options with regard to fluoride supplementation were explored as an attempt to provide an alternative intervention option for exposure to fluoride where community drinking water fluoridation was not the first option. This information will be used to record and update existing tables for fluoride levels in community drinking water of the communities in the Southern Cape and Karoo region that is currently used as a guide for prescribing fluoride supplementation as a means of prophylaxis for the prevention and reduction of dental decay. This study re-iterated the diverse set of variables that communities living in rural areas have to live with. It supports the trend that in developing countries the DMFT (12 years) and dmft (6 years) are higher than those in the same age cohorts of developed countries. This study shows that the fluoride level in borehole water is generally higher than that of dams or reservoirs. Fluoride supplementation is required in the bigger, densely populated areas as the fluoride levels of the water in these areas are below optimal and their water systems can accommodate fluoridation. The long term gains of community water fluoridation at optimal levels for entire communities by far out way the risk of developing fluorosis at above optimal levels. There needs to be a systematic review of treatment needs and treatment modalities for each community so that at some point the need for prevention strategies will be sought out by program managers as best practice for improving the general health (i.e. and oral health) of their communities. There is no single approach for solving issues in communities with different sets of variables determining their needs and so too to the question of community water fluoridation. The recommendation is that at the community level (i.e. the communities should be empowered to do their own situational analysis and prioritize their needs) people need to make decisions for themselves with regard to the type of preventive strategy that they implement. Once they have the data and an intervention option is arrived at, they should lobby with their local health provider to implement that intervention option (e.g. Exposure to fluoride as a means of improving dental health) that they have identified in their towns or villages.