Orientador: Maria da Luz Rosario de Sousa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T05:24:17Z (GMT). No. of bitstreams: 1 Batista_MariliaJesus_M.pdf: 1179085 bytes, checksum: b8392fa7a78ace760fd5a4f94060c0b2 (MD5) Previous issue date: 2010 / Resumo: Os objetivos deste trabalho foram verificar as condições de saúde bucal de adultos de 20 a 64 anos (cap. 1), identificar os indicadores de risco associados às perdas dentárias (cap. 2), bem como avaliar o impacto da saúde bucal na qualidade de vida (cap. 3). Este estudo foi realizado nas 11 unidades de uma empresa do ramo atacadista, na Região metropolitana de São Paulo e Jundiaí. Foram examinados 386 adultos de 20 a 64 anos, a faixa etária foi dividida em classes, de 20 a 34 anos, de 35 a 44 anos, e de 45 a 64 anos. Os exames clínicos seguiram as recomendações da Organização Mundial da Saúde (1997) e um questionário foi aplicado para obtenção de dados demográficos, socioeconômicos, de autopercepção em saúde, e de utilização de serviços odontológicos, o impacto da saúde bucal na qualidade de vida foi avaliado através do OHIP 14 (Oral Health Impact Profile). Foi realizada uma análise descritiva das variáveis estudadas, o teste Kruskal Wallis para comparar o CPOD (índice que expressa a soma de dentes cariados, perdidos e obturados) entre os grupos etários, e teste do qui-quadrado para verificar as necessidades de tratamento entre os grupos. A perda dentária foi analisada em dois desfechos, a perda de algum dente, e a perda de quatro ou mais dentes, utilizando-se do modelo de Regressão de Poisson. O quartil de impacto mais severo do OHIP foi o desfecho do capítulo 03, que foi analisado pelo modelo de regressão de Poisson com as variáveis demográficas, socioeconômicas, clínicas e de utilização de serviços. O CPOD da amostra geral foi 14,56 (±8,31), variando de 10,79 (±6,95) a 22,10 (±7,32) nos grupos etários. Este aumento ocorreu pelo componente dentes perdidos. Quanto à condição periodontal observou-se que 78,8% apresentou sangramento, a perda de inserção foi observada em 46,4% da amostra. Necessidades de tratamento para a cárie foram encontradas em 53,5% dos adultos. A média de dentes perdidos foi 5,38, e variou de 1,30 nos mais jovens a 24,75 nos adultos de 60 a 64 anos. Encontrou-se maior prevalência de perda dentária de um ou mais dentes nos mais velhos, nos que apresentaram placa visível no momento do exame, e em quem foi ao dentista há menos de um ano. Os indicadores de risco da perda de quatro dentes ou mais foram: ser mais velho, apresentar placa visível e possuir renda familiar mais baixa. Observou-se neste estudo que as dimensões mais afetadas do OHIP foram dor física e desconforto psicológico. Ser mulher, possuir menor renda familiar, procurar o dentista motivado por dor, ter perdido 4 dentes ou mais e ter apresentado alguma necessidade de tratamento para a cárie foram fatores associados ao maior impacto na qualidade de vida. É necessária a implantação de programas de promoção de saúde bucal baseados na equidade, integralidade e universalidade, que visem ao empoderamento da população jovem e adulta, a fim de que sejam prevenidas novas perdas dentárias, melhorando a qualidade de vida de adultos trabalhadores e diminuindo os efeitos das desigualdades socioeconômicas. / Abstract: The objective of this study was to verify the oral health conditions of adults between the age of 20 and 64 years old (chapter 1), identify the risk indicators of tooth loss (chapter 2) and measure the impacts of oral disorders on quality of life (chapter 3). This study was conducted in 11 units of a company's supermarket business of Sao Paulo region. This cross-sectional study examined 387 adults aged 20 to 64 years, expanding the age range of adults recommended by WHO (35-44 years old). The age range was divided into classes of 20 to 34 years, from 35 to 44 years, and 45 to 64 years. The exams followed the recommendations of WHO (1997) and a questionnaire was administered to obtain demographic, socio-economic, health perception and use of dental services data. OHIP14 was used to evaluate the oral health impact on quality of life. A descriptive analysis was realized, Kruskal Wallis test to compare the DMFT between the groups, and chi-square test to determine differences in treatment needs among the groups were used. Tooth loss was analyzed in two outcomes, the loss of a tooth, and the loss of four or more teeth, using the model of Poisson regression. The quartile of greater impact of OHIP was analyzed by the model of regression of Poisson with the demographic, socioeconomic, clinical and service utilization. The DMFT of the sample was 14.56 (± 8.31), ranged from 10.79 to 22.10 (± 7.32) among age groups. The missing teeth component was responsible for this increase. Majority of the adults had bleeding gums, with the lost of insertion affecting more than the sextant 3 (tooth 24 to 28), especially in older age groups. Treatment needs for caries was found in 53.5% of adults. The mean of missing teeth was 5.38, ranging from 1.30 in the young adults to 24.75 in the 60 to 64 year group. Tooth loss was more pronounced in the age group between 30 and 35 years old. The outcome of losing some teeth showed a higher prevalence of tooth loss in older people, in those with visible plaque at the time of examination, and those who visited the dentist less than one year ago. The outcome of losing four teeth or more were associated with being older, visible plaque and lower family income. Higher scores among these workers were found in physical pain and psychological disconfort mainly. Being a woman, have lower family income, look for a dentist motivated by pain, having lost 4 or more teeth and have made some need treatment for tooth decay were factors associated with greater impact on quality of life. It is necessary to implement programs to promote oral health based on fairness, integrity and universality, aimed at the empowerment of young and adult population, so that they are prevented new tooth loss, improving the quality of life of adult workers and reducing the effects of socioeconomic inequalities. / Mestrado / Saude Coletiva / Mestre em Odontologia

Orientador: Maria da Luz Rosario de Sousa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T13:15:51Z (GMT). No. of bitstreams: 1 Perianes_LilianBertaRihs_D.pdf: 3343194 bytes, checksum: 4ff9b4ba0319ef4e2e776a5210a86149 (MD5) Previous issue date: 2010 / Resumo: Tendo em vista a escassez de trabalhos que avaliem as condições bucais relacionadas à qualidade de vida em idosos com diferentes níveis de fragilidade, os objetivos deste estudo foram: Avaliar as condições de saúde bucal em uma população idosa não institucionalizada que apresentava diferentes graus de fragilidade (capítulo 1); apresentar a prevalência de xerostomia e sua associação com variáveis sócio-demográficas, clínicas e de autopercepção em saúde bucal (capítulo 2); verificar a autopercepção sobre as condições de saúde bucal em idosos, segundo a fragilidade (capítulo 3); verificar o impacto das condições bucais na qualidade de vida em idosos com diferentes níveis de fragilidade (capítulo 4). Este trabalho é parte integrante de um projeto temático e multidisciplinar: "Qualidade de vida em idosos fragilizados: indicadores de saúde e bem estar subjetivo", realizado em freqüentadores de um ambulatório de geriatria. Foram realizados um exame bucal segundo recomendações da Organização Mundial de Saúde (OMS, 1997) e uma entrevista com questões relativas à: sua autopercepção de saúde bucal, a sensação de boca seca e Geriatric Oral Health Assessment Índex (GOHAI). A avaliação da fragilidade foi feita após a aplicação de 5 critérios clínicos propostos por Fried et al. (2001). Os idosos fragilizados foram divididos em: pré-frágeis e frágeis. A análise dos dados foi realizada através do programa SPSS 17. No capítulo 1(n=67) obtiveram-se como resultados que 61,2% (n=41) dos examinados eram edêntulos; a média de dentes presentes foi de 4,8 (DP=7,5) e o CPOD de 28,8 (DP=5,1), sendo a maior parte do índice composta pelo componente perdido (94,4%). 50,7% (n=34) foram considerados pré-frágeis e 49,3% (n=33), frágeis. Quando as variáveis odontológicas foram comparadas com a condição de fragilidade, todas foram melhores nos indivíduos pré-frágeis. No capítulo 2 (n=150), a prevalência de xerosotmia foi de 68%. Verificou-se que os idosos considerados não brancos apresentaram menos sensação de boca seca (p=0,017/RP=0,68 [IC95%=0,49-0,93]). Dentre os idosos frágeis, quem era analfabeto tinha mais xerostomia (p=0,03/RP=1,31 [IC95%=1,02-1,68]). No capítulo 3 (n=57), para as variáveis clínicas em que a autopercepção foi comparada entre os diferentes níveis de fragilidade, apenas para os que apresentavam necessidade de qualquer tipo de prótese observou- se que os pré-frágeis classificaram sua saúde bucal de forma negativa. No capítulo 4 (n=66), nos indivíduos que obtiveram uma autopercepção da sua saúde bucal negativa, apenas a média de dentes presentes foi menor entre os indivíduos frágeis. Pode-se concluir que, apesar deste grupo de idosos apresentar condições de saúde bucal precárias, com extensas perdas dentárias e alta prevalência de xerostomia, não foi verificada relação entre a condição de fragilidade e autopercepção de saúde bucal. Considera-se que outras condições sistêmicas de maior impacto no cotidiano destes idosos tiveram um peso maior que as condições bucais na sua autopercepção e, para reverter esta realidade, torna-se necessário o direcionamento de programas odontológicos específicos para adultos, voltados para promoção de saúde e controle da cárie e doença periodontal, evitando-se assim a perda dos elementos dentários em idosos, o que consequentemente melhorará sua ualidade de vida. / Abstract: Given the scarcity of studies to assess the oral health conditions related to quality of life in elderly people with different frailty levels, the objectives of this study were: to evaluate the oral health conditions in a non-institutionalized elderly population with different frailty levels (Chapter 1), to present the xerostomy prevalence and its association with socio-demographic and clinical variables, as well as the self-perceived oral health (Chapter 2); to verify the self-perception on the oral health conditions in elderly people, compared with the frailty level (Chapter 3) and to verify oral health-related quality of life impact elderly people with different frailty levels (Chapter 4). This work is part of a thematic and multidisciplinary project: "Quality of life in frail elders: health indicators and subjective well-being". Non-institutionalized elderly aged 60 or more that presented different frailty levels were examined, being attended at the geriatric clinic of the State University of Campinas (UNICAMP). An oral examination following the recommendations from WHO (1997) was carried out, as well as an interview with questions relating to: self-perceived oral health, dry mouth sensation and GOHAI. The frailty condition evaluation was made after the application of 5 clinical criteria proposed by Fried et al. (2001). The frail elders were divided into two groups: pre-frail and frail. Data analysis was performed using SPSS 17. Chapter 1 shows that 61.2% (n=41) of those examined were edentulous; the mean of present teeth was 4.8 (SD=7.5) and DMFT of 28.8 (SD=5.1), and most of the index was composed of the lost component (94.4%). 50.7% (n=34) were considered pre-frail and 49.3% (n=33), frail. When dental variables were compared with the frailty condition, all were better in pre-frail individuals. In Chapter 2, it was found that older people considered as non-white were less likely to experience dry mouth (p=0.017/RP=0.68 [IC95%=0.49-0.93]). Among the frail elderly, who were illiterate had more dry mouth (p=0.03/RP=1.31 [IC95%=1.02-1.68]). In chapter 3, for the clinical variables in which the self-perception was compared between the different frailty levels, only for those who had need of any type of prosthesis it was observed that pre-frails rated their oral health in a negative way. In Chapter 4, in individuals who have obtained a negative self-perception of their oral health, only the mean present teeth was worse among frail individuals. It could be concluded that although this group of elderly people presented poor oral health conditions, with extensive tooth loss and high dry mouth prevalence, no relationship was found between the frailty and selfperceived oral health. It was considered that other systemic conditions of greater impact on the daily life of these elderly individuals had a greater weight than the oral self-perceived oral conditions, and to reverse this situation, it is necessary targeting dental programs specific for adults aimed at promoting health and control of dental caries and periodontal disease, thus avoiding the loss of teeth in the elderly, which in turn will improve their quality of life. / Doutorado / Saude Coletiva / Doutor em Odontologia

Este estudo teve como principal objetivo descrever a situacao de saude bucal da populacao idosa da faixa etaria de 60 a 75 anos, residente em cinco unidades asilares da regiao metropolitana de Fortaleza. A pesquisa teve como desenho um corte transversal de carater descritivo, verificando a realidade de todos os idosos dessa faixa etaria com um total de 160 idosos investigados. Foi realizado um levantamento epidemiologico investigando os indices CPOD para a obtencao da situacao de prevalencia e severidade da doenca carie, IPC (Indice Periodontal Comunitario) para verificar a condicao periodontal e uso e necessidade de protese para averiguar a extensao da mutilacao dental e a tentativa reabilitadora. Foi aplicado um questionario estruturado e padronizado sobre variaveis socioeconomicas, habitos de higiene, acesso aos servicos e o indice GOHAI (Geriatric Oral Health Assement Index) que sonda a capacidade de autopercepcao do idoso de seus problemas bucais. O CPOD medio encontrado foi de 29,6, com 88,3% de dentes excluidos, 56,9% dos examinados eram desdentados totais bimaxilares, em relacao ao uso de proteses, observou-se que 58,8% dos entrevistados nao usavam protese superior enquanto 73,7% dos individuos necessitavam de protese superior parcial ou total, ao se analisar a arcada inferior constata-se que 74,4% nao usavam protese inferior e que 81,2% necessitavam desse tipo de protese. O resultado do IPC permitiu visualizar a extensao de mutilados bucais pois 66,2% dos entrevistados nao apresentavam nenhum sextante que pudesse ser codificado pela usencia de dentes. Dentre os examinados, o sextante que esteve mais presente foi o central inferior, 15,6% dos entrevistados tiveram como maior codigo do IPC a presenca de calculo dental. O GOHAI medio da populacao foi de 34,4 revelando que apesar de todo esse quadro epidemiologico desfavoravel, essa populacao avalia sua condicao bucal como boa, nao apresentando maiores dificuldades para realizar tarefas como alimentar-se, falar e relacionar-se com outras pessoas. / ORAL HEALTH CONDITIONS OF INSTITUTIONALIZED ELDERLY IN FORTALEZAâS METROPOLITAN REGION This study had as main purpose to describe the situation of the oral health of old-aged people from 60 to 75 years old, who live in five units of shelters of the metropolitan region of Fortaleza. The research had as a crosssectional desing with descriptive character, verifying the reality of all old-aged people from this age range with a total of 160 people investigated. A epidemic survey was accomplished investigating the CPOD indexes to obtain the prevalent and severe situation of the caries disease, CPI (Community Periodontal Index) to verify the periodontal condition, the use and necessity of prosthesis to inquire the extension of dental mutilation and attempt of rehabilitation. A structured and standardized questionnaire was applied about social-economic variables, hygiene habits, access to dental services and the GOHAI (Geriatric Oral Health Assessment) index which sounds the capacity and auto-perception of old-aged people and their mouth problems. The average CPOD found was 29.6, with 88.3% of excluded teeth, 56.9% of the examined people had no teeth in both maxillaries; concerning the use of prosthesis, it was noticed that 58.8% of the people who were interviewed did not wear upper prosthesis while 73.7% of these people needed partial or total upper prosthesis;analyzing the lower dental arch it was noticed that 74.4% did not use the lower prosthesis and that 81.2% needed this kind of prosthesis. The IPC result allowed a visualization of the extension of mouth mutilated people because 66.2% of people who were interviewed did not show any problem that could be codified by the lack of teeth. Among the examined people, the most frequent problem was the mid-lower ,15.6% of the people interviewed had as the higher code of IPC the presence of dental stone. The average GOHAI of the population was 34.4 revealing that despite of all the unpropitious epidemiological situation, this population estimates as good their oral condition, not presenting major difficulties to accomplish daily tasks such as to feed themselves, to talk and to relate to other people

Orientador: Marcelo de Castro Meneghim / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T16:16:41Z (GMT). No. of bitstreams: 1 Oliveira_ArleteMariaGomes_D.pdf: 1603074 bytes, checksum: d9795e329abd5970a9362ee169c569fe (MD5) Previous issue date: 2014 / Resumo: O objetivo do estudo foi analisar o impacto na determinação do diagnóstico da necessidade de prótese em idosos institucionalizados, utilizando-se como critérios os indicadores sócio-dentais e clínicos de diagnóstico. Trata-se de um estudo com desenho epidemiológico, observacional e transversal. A amostra foi composta por idosos institucionalizados (n=208), de 60 anos ou mais, ambos os gêneros, independentes ou parcialmente dependentes segundo critérios de Katz, selecionados aleatoriamente de duas instituições (asilos) de Piracicaba/SP. O tamanho da amostra foi calculado de acordo com Demidenko (2007, 2008), considerando-se o poder do teste de 0,80, nível de significância de 0,05 e odds ratio = 2. Os instrumentos de pesquisas utilizados para a avaliação sócio-dental foram: questionário de autopercepção (GOHAI), avaliação de qualidade de vida (IODD) e auto-avaliação da saúde bucal. Os instrumentos para avaliação clínica, para o uso e necessidade de prótese, seguiu-se a metodologia utilizada por Colussi (2004), adaptado para esse estudo. Após a coleta, os dados foram agrupados e inseridos em modelo para a avaliação conjunta entre o padrão de necessidades percebidas pelo paciente (autodeclaração da necessidade de prótese), as variáveis sóciodemográficas, critérios de avaliação clínicos e sócio-dentais. Os resultados foram avaliados pela análise bivariada pelo Qui-quadrado e multivariada para verificar a necessidade de tratamento. As variáveis com p<0,20 foram testadas na análise de regressão logística múltipla, permanecendo no modelo aquelas com p<0,05. De acordo com os resultados obtidos, 52,88% (110) dos participantes eram edêntulos, 68,75% usavam algum tipo de prótese e 64,91% necessitavam de prótese, 60,58% dos participantes auto avaliaram a saúde bucal (SB) como boa e excelente e 39,42% como regular e ruim. Na análise bivariada, as variáveis que se associaram com a autodeclaração de necessidade de prótese foram: edentulismo (p=0,003), necessidade de prótese (p=0,03), auto avaliação SB (p=0,0024), religião, (p<0,0001) e qualidade de vida (p<0,0001). A prevalência de impactos severo na qualidade de vida associou-se a autodeclaração de necessidade de prótese. Os impactos mais relatados foram "comer e sentir o sabor dos alimentos", "falar ou pronunciar as palavras corretamente" e "sorrir e mostrar os dentes sem constrangimento". Na análise de regressão logística múltipla para autodeclaração de necessidade de prótese, as variáveis com associação significante (p<0,05) foram qualidade de vida (p<0,0001, OR=0,14, IC95%=0,06 - 0,30) e necessidade de prótese (p=0,0254, OR=0,39, IC95%=0,21-0,71). O estudo mostrou que a necessidade de prótese foi elevada na avaliação clínica. Para os idosos que avaliaram sua saúde bucal como ruim, os resultados apontam uma maior necessidade de uso de próteses. Concluiu-se que a medida subjetiva auto declaração de necessidade de prótese esteve fortemente associada à avaliação com os critérios de diagnóstico clínicos para a necessidade de uso de próteses / Abstract: The aim of this study was to analyze the impact on determining the diagnosis of the need to wear dentures in institutionalized and non institutionalized elderly persons, using socio-dental and clinical diagnostic indicators as criteria. This was a study with an epidemiological, observational and cross-sectional design. The sample was composed of elderly persons 9n=208) over 60 years of age, of both genders, independent or partially dependent - according to the criteria of Katz, randomly selected from two old-age home institutions in Piracicaba, SP, Brazil. The sample size was calculated in accordance with Demidenko (2007, 2008), considering a power of test of 0,80, level of significance of 0,05 and odds ratio=2. The research instruments used for socio-dental evaluation were: self-perception questionnaire (GOHAI), quality of life evaluation (IODD) and self evaluation of oral health. The instruments for clinical evaluation of the use of and need for dental prostheses, were in accordance with the methodology proposed by the WHO (1999) and used by Colussi (2004), adapted to this study. After collection, the data were grouped and inserted into a model for the joint evaluation between the pattern of needs perceived by the patient (self-declared need for dental prostheses), the sociodemographic variables, clinical and socio-dental evaluation criteria. The results were evaluated by bivariate analysis, the Chi-square and multivariate testing to verify treatment need. The variables with p<0,20 were tested in multiple logistic regression analysis, and only those with p<0,05 remained in the model. According to the results obtained, 52,88% (110) of the participants were edentulous, 68,75% wore some type of denture, and 64,91% needed dental prostheses. Of the participants, 60,58% self-evaluated their oral health (OH) as being good and excellent and 39,42% as being regular and poor. In the bivariate analysis, the variables that were associated with the self-declaration of the need for dental prostheses were: edentulism (p=0,003), need for dentures (p=0,03), self evaluation OH (p=0,0024), religion, (p<0,0001) and quality of life (p<0,0001). The prevalence of severe impacts on quality of life were associated with self-delcaration of the need for dentures. The most frequently reported impacts were "to eat and taste the flavor of foods", "speak or pronounce words correctly" and "smile and show one¿s teeth without embarrassment". In the multiple logistic regression analysis for self-declaration of the need for dentures, the variables with significant association (p<0,05) were quality of life (p<0,0001, OR=0,14, IC95%=0,06 ¿ 0,30) and need for dentures (p=0,0254, OR=0,39, IC95%=0,21-0,71). The study showed that the clinical evaluation revealed a high need for dentures. For the elderly who evaluated their oral health as poor, the results pointed toward greater necessity and less use dentures. It was concluded that the subjective measure of self-declaration of the need for dentures was strongly associated with the evaluation made by means of the clinical diagnostic criteria, to necessity of the use to prostheses / Doutorado / Saude Coletiva / Doutor em Odontologia

Abstract The aim of this study was to describe the planning, implementation and evaluation of a community-wide programme of oral health promotion that begun in 1993 in the Pitkäranta district of Russian Karelia. Baseline analysis of the community included clinical dental examinations and questionnaire surveys which were carried out in the same way as in the Finnish reference areas, Kuopio and Jyväskylä, in 1992. In addition, interviews of stomatologists and dentists, observations at local shops, kiosks, schools and dental clinics, and determinations of fluoride levels in drinking water were carried out in the Pitkäranta district. Previous information on oral health and its determinants among children in the Republic of Karelia was sought in the literature, from local statistics and from patient documents in the Pitkäranta district. Community analysis at baseline revealed that in the Pitkäranta district the occurrence of dental diseases was high. Behaviours related to oral health were generally unfavourable, and professional prevention at dental offices was practically non-existent. Therefore, the results of the baseline analysis of the community in 1993 called for an intervention with emphasis on enhancing healthy lifestyles, reorienting the methods of action of the system of oral health care towards health promotion and prevention of diseases, creating a supportive environment and empowering community actions as suggested in the Ottawa Charter. The goal was to achieve at least the same level of oral health as that found among children in the Finnish reference areas. In the 2001 follow-up, community oral health was analysed with the methods used in 1993. The results of the follow-up community analysis were used to monitor the changes in 1993–2001 and to assess the strengths and weaknesses of the programme. The improvements in oral health and in oral health-related behaviours among children as well as other developments in the community were impressive. Some oral health-related behaviours, such as frequent use of sugary snacks, non-daily use of fluoridated toothpaste and increasing smoking among adolescents, called for further actions.

Magister Scientiae Dentium - MSc(Dent) / A qualitative study was carried out to assess the role of traditional healers in oral health care in Kwa-Zulu Natal province, South Africa. The aim and objectives of the study were to assess the oral care knowledge and practices among traditional healers, to determine the extent to which traditional healers can diagnose oral conditions and how they could be used in the provision of primary health care and prevention of the spread of HIV infection. Another objective was to use the information collected to serve as a guide for collaborative oral disease prevention programme development.Three categories of traditional healers were identified in the sample: Isangomas, Nyangas and Umthandezelis. The average age of the sample was 45 years and the majority was female. Most healers were in training for between eight months and ten years. All traditional healers reported seeing patients with oral diseases and 93% reported that they referred patients elsewhere for additional help. All healers treated their patients with natural remedies. Seventy three per cent of the sample reported that they treated patients with HIV/AIDS. Less than 30% of the sample knew that AIDS was caused by a virus and 47% reported being &lsquo;told&rsquo; by the ancestors whether an oral disease was HIV/AIDS.In this study traditional healers were shown a series of ten photographs of common oral diseases and oral HIV lesions and asked to identify as many lesions as possible. Following basic training and education about the causes and diagnostic features of the lesions, 100% of traditional healers were then able to identify aphthous ulcers, 80% Kaposi's sarcoma and 73% could recognize cancer of the tongue. These results showed that given proper education, traditional healers could play an important role in early detection of not only the common oral diseases but also the oral manifestations of HIV/AIDS. In addition, most traditional healers are skilled in interpersonal relations and if provided with the correct information they could be very effective as AIDS councilors.The traditional healers demonstrated good knowledge of the transmission, risk groups and prevention strategies for HIV/AIDS and they could serve as an important resource of information and should be incorporated in community based AIDS prevention and other programmes. / South Africa

In this paper, the impact of caffeinated beverages on oral and systemic health was evaluated bringing to light a variety of outcomes. Coffee, tea and energy drinks are beverages that so many individuals around the globe consume in their daily lives yet the potential beneficial or adverse effects are rarely taking into consideration as drinks are consumed. These beverages cause positively influence antimicrobial, anti-cariogenic and anti-inflammatory responses on oral health yet there are also negative consequences that can arise. Society leads individuals to believe that these beverages are a necessity in people’s lives. Therefore, this thesis is written in hope to better understand the effects and impact these beverages have on the human body specifically the oral cavity. Some of these beverages, such as coffee and energy drinks, can have detrimental effects on oral health, teeth and systemic health. Outcomes from excessive intake of these drinks include dental erosion, cavities, and systemic health consequences. These types of beverages should be taken in moderation, otherwise negative effects can arise. On the other hand, sometimes caffeinated beverages can be beneficial to oral health such as when green or black tea are consumed. Considerable research has been performed to better understand the relationship between caffeinated beverages and how they influence the oral cavity. This thesis will evaluate this literature including both the positive and negative effects. With moderate intake, these types of beverages can play a beneficial role in oral and systemic health. In summary, studied have documented the significant beneficial effects of caffeinated beverages including tea, coffee and energy drinks on oral and systemic health. These benefits include antibacterial and anti-cariogenic effects in the oral cavity and improvement in cardiovascular health, metabolism, overcoming fatigue and anti-inflammatory properties with respect to systemic health. As with many things, high or excess intake of caffeinated products can lead to negative consequences such as increased risk of cardiovascular disease, loss of tooth integrity due to sugar and staining leading to tooth discoloration. Research has made great strides in understanding the oral and systemic effects of such beverages. However, there are still unanswered questions that should be pursued in order to truly elucidate the mechanism of action specifically related to the ingredients seen in caffeinated beverages

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Goal and Objectives. The main goal of this study is to assess childcare center directors (CCCDs) oral health literacy, knowledge, and attitudes towards pediatric oral health. We also determined the associations between CCCDs oral health literacy, knowledge, attitudes towards pediatric oral health, and 1) number of oral health preventive strategies (OHPS) implemented in their child care center (CCC), and 2) intent to adopt OHPS in the future. Background. Childcare utilization has substantially increased over the past decade with children enrolled in these centers spending substantial amount of time. CCCs, a non-traditional setting, can be used to actively promote pediatric oral health. However, before this setting can be used to promote oral health, a better understanding of Florida CCCDs' oral health literacy, knowledge, and attitudes on pediatric oral health is needed. Methods. In this cross-sectional study we used a 45-item pre-tested questionnaire to survey Florida CCCDs working primarily in licensed CCCs through survey monkey online portal. Descriptive, bivariate statistics and multivariate regression analyses were conducted using SAS analysis software. Results. Of the 877 CCCD participants, 90% did not train staff about traumatic dental injuries, 87% did not have an oral health consultant, and 82% did not promote enrollees to brush their teeth after meals or snacks. Mean oral health literacy (12.3±2.3) and attitude levels (16.8±2.7) were high, however mean oral health knowledge (1.6±2.0) was low. CCCDs with more years of experience (p=0.01), who work at Head Start CCCs ( p<0.0001), and have more positive attitudes (p<0.0001), were more likely to have implemented OHPS in their centers compared to their counterparts. Non-White CCCDs (p=0.03), those with more positive attitudes(p=0.001), and who reported to have already implemented one or more OHPS (p=0.002) were more willing to implement OHPS in the future compared to their counterparts. Conclusions. No significant associations between oral health literacy, knowledge and number of OHPS implemented were observed. Similarly, oral health literacy, oral health knowledge was not associated with intent to implement OHPS in the future. CCCDs with more positive attitudes towards pediatric oral health had implemented more OHPS within their CCCs, and also were willing to implement more OHPS in the future compared to their counterparts.

The oral health knowledge, attitudes and practices of primary school children and teachers in Mofolo, Soweto were determined. The enabling and inhibiting factors for oral health promotion in the school environment were also assessed. The aim of the study was to determine if there was any difference in knowledge, attitudes and, practices in learners and teachers and their environment at schools that were exposed to a preventive, educational and tooth brushing programme and those learners and teachers that were not exposed to the programme. Three hundred and thirty-six primary school children six to twelve years of age from four primary schools in Mofolo, i.e. Itekeng, Vukani, Emsebeni and Tshedimoso completed questionnaires. Itekeng and Vukani primary schools were part of an existing tooth brushing, educative and preventive programme, and Emsebeni and Tshedimoso primary schools were not. Four focus group discussions (one from each school) were held with regard to knowledge of oral health and hygiene and the school environment. Seven teachers from two of the four schools and eight teachers from each of the other two schools attended the discussions. Both the learners and teachers at all the schools had little knowledge of dental care, like tooth brushing with fluoridated toothpaste. Frequency of brushing was poor. Most of the learners (61 percent) for the exposed learners and 50 perecent from the unexposed learners reported brushing their teeth once a day. Dietary habits of the learners revealed a high consumption of sugary snacks in between meals and sugar. Fifty-five percent of the exposed learners bought sweets and cakes and 56 percent of the unexposed learners bought fizzy drinks and fruit juices at school. Forty-six percent of the exposed and 58 percent of the unexposed learners said they took more than three spoons of sugar with their breakfast. . Utilisation of primary dental health services in the community by both teachers and learners was poor. More learners from the exposed schools (97 percent) than the unexposed (82 percent) had been to a dentist because they had a toothache. Only 1 percent from the exposed schools and 8 percent from the unexposed had been for a routine check up. Learners from both school categories and teachers had no knowledge of fluoride or benefits of water fluoridation. Over 98 percent of learners from both school categories had never heard of fluoride. The teachers believed it was their responsibility to teach learners and parents about oral health and showed willingness to participate in oral health promotion programmes. The main source of oral health knowledge among the learners was home. Several inhibiting factors to oral health promotion like poverty, lack of adequate oral health knowledge and poor school environment were identified in all the schools.There was no school policy regarding oral health promotion In conclusion, there were no significant differences in the reported knowledge, attitudes and practices between the learners and teachers from the two schools that were part of the preventive, educational and brushing programme and those from the other schools that were not part of the programme. This therefore shows that while preventive and educational programmes are an important component of oral health promotion, they are not adequate in changing knowledge, attitudes and oral health practices.

Early childhood caries (ECC) is a rampant, infectious dental disease that affects children up to age six, with effects lasting well into their adulthood. ECC predicts high rates of morbidity in adulthood, is one of the most frequently found childhood illnesses, and is theoretically preventable. Lesion formation follows a particular pattern based in part on the pattern of primary tooth eruption, and is similar to caries formation at any age, with the balance of demineralization and remineralization. Commonly observed effects of ECC include failure to thrive due to pain and discomfort with eating, decreased attentiveness and socialization, and increased number of missed school days. The lesions associated with ECC are often very painful and frequently remain untreated in high-risk populations. Unfortunately, children’s oral health needs are often overlooked in research and public health practices, leaving many untreated and suffering. Risk indicators for ECC include socioeconomic status and race or ethnicity. One of the most critical risk factors for the disease is dietary quality, which has been studied to some extent in attempts to discern the epidemiology of ECC, and which has been shown to have causative effects on the disease process. What has not been studied, however, is how these risk indicators and risk factors interrelate to contribute to the high prevalence of ECC in the United States. Without studying the effect that an overlap in associated risks for these problems has, it is not possible to create a truly comprehensive public health prevention program that will efficaciously decrease the incidence of early childhood caries. Multiple studies have shown the effects of poor diet quality on the development of ECC. When studying nutritional intake alone, ECC is far more common in groups consuming a less healthful diet. Not only does dietary intake affect the formation of caries, caries experience also affects the ability to consume a nutritious diet. Socioeconomic status has also been cited as a crucial determinant of risk for developing ECC. Those children living at or below the Federal Poverty Line are at high risk for disease, regardless of their race or ethnicity. This is hypothesized to relate to nutrition, as healthier diets are frequently found to be more costly than cariogenic diets, which rely heavily on refined and processed grain products. Nutrition is the single risk factor that bridges the risk indicators of socioeconomic status and race or ethnicity. For this reason, improving dietary quality and nutritional status may prove to be the most effective method of decreasing the prevalence of ECC in the United States. Future studies should focus on effective methods to educate the population to alter the quality of the American diet as a whole. By doing so, the prevalence of this disease can be reduced, and more children can have successful, happier, and healthier childhood years. Creating better oral health in children will decrease morbidity for both oral and systemic disease in adulthood, ultimately improving the overall health of the population of the United States.