Orientador: Marcelo de Castro Meneghim / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-19T10:45:55Z (GMT). No. of bitstreams: 1 Fonseca_DirceAparecidaValerioda_M.pdf: 1162791 bytes, checksum: 8fb1a9e51bab970eb765452af7768025 (MD5) Previous issue date: 2011 / Resumo: Este estudo tem como objetivo analisar a influência de fatores sociodemográficos e da organização do serviço público odontológico na procura por atendimento em um pronto atendimento odontológico, a fim de auxiliar o poder público no planejamento de ações integradas de saúde. Foram utilizados todos os registros dos usuários que procuraram por atendimento no Serviço de Pronto Atendimento Odontológico de Piracicaba-SP, no período de 01/01/2007 a 31/12/2009, sendo classificados segundo a característica dos bairros de residência, da idade, do gênero, da data e do período do atendimento. O mapa de inclusão/exclusão social do município foi utilizado para classificá-los quanto à questão sociodemográfica, a localização da unidade de saúde de referência e a existência de serviço odontológico inserido na mesma foi verificada junto a Secretaria de Saúde do município. Foram analisados 57.231 registros de atendimento, onde 5,24% da população estimada do município utilizaram o serviço no período estudado, com maior procura na faixa etária de 20 a 49 anos (63,84%), o período da tarde durante os dias úteis apresentou maior procura e o período da manhã dentre os finais de semana e feriados. Não houve diferença estatisticamente significativa na procura quanto ao gênero. Os procedimentos mais executados foram os cirúrgicos (54,90%), sendo que os procedimentos cirúrgicos e os conservadores apresentaram um comportamento inverso no decorrer do período, com um declínio dos cirúrgicos. Conclui-se que os usuários residentes em áreas de maior exclusão social apresentaram 4,15 vezes mais chance de procurar pelo serviço de pronto atendimento, e não foi observada associação estatisticamente significativa entre a procura pelo serviço de pronto atendimento e a existência de equipe de saúde bucal na área de residência. Os municípios têm investido na expansão da rede de atenção básica por meio da estratégia de saúde da família, e os resultados sugerem a necessidade da continuidade dos investimentos, principalmente nas áreas de maior exclusão social, na tentativa de minimizar as desigualdades e valorizando o princípio da equidade / Abstract: This study aimed to evaluate the influence of socio-demographic factors and organization of public dental services on the demand for emergency dental care, in an attempt to aid the local government in planning health integrated actions. Approved by the Ethics Committee for Dental and Human Research of Piracicaba Dental School - University of Campinas (UNICAMP), this study included all users who seek emergency dental care in Piracicaba between Jan 1st, 2007 and Dec 12th, 2009. Users were classified according to place of dwelling, age, gender, and date and time of dental service delivery. The social inclusion/exclusion map of Piracicaba was used to classify users in the perspective of socio-demographic status and location of the health unit of reference. Information on the provision of dental care in public health units was provided by the local health department; analysis included 57.231 records, revealing that 5.24% of the estimated population, age 20-49 years, used the service during the study period, with the age group 20-49 years showing the highest prevalence (63.84%), the afternoon showed greater demand for the service and the mornings on weekends and holidays. With respect to gender, no statistically significant difference was found for dental service demand. Surgical procedures were the most prevalent (54.90%). The prevalence of surgical procedures was observed to decrease while that of conservative ones to increase during the period assessed (2007-2009).Users living in areas of greatest social exclusion were 4.15 times more likely to seek emergency dental care. No statistically significant association was found between the demand for emergency dental care and the existence of a local oral health team. Municipalities have attempted to expand the network of primary care by family health strategy; the results showed the need for further investment in the area, particularly those of greatest social exclusion, in an attempt to reduce inequalities and to value the principle of equity / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

Orientador: Maria da Luz Rosário de Sousa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T19:32:40Z (GMT). No. of bitstreams: 1 Costa_AndreaMoscardinida_M.pdf: 1067532 bytes, checksum: fb2e5085a3c3f9b64efdc64ddcfea5e6 (MD5) Previous issue date: 2012 / Resumo: O objetivo deste trabalho foi verificar a presença de lesões em tecido mole bucal, a necessidade de reabilitação protética, bem como, o conhecimento sobre câncer bucal, fatores sócio-demográficos, comportamentais e de Saúde Bucal de idosos examinados durante a Campanha de Prevenção ao Câncer Bucal dos anos de 2007 a 2011 em 41 Unidades Básicas de Saúde (UBS) de Piracicaba, SP, segundo as seis regiões administrativas do município. Exames clínicos foram realizados por cirurgiões-dentistas treinados previamente segundo as variáveis de interesse. A análise estatística foi feita através do teste qui-quadrado de tendência para as variáveis: necessidade de prótese e presença de lesões. A Campanha de Prevenção e Diagnostico Precoce do Câncer Bucal atingiu 3.452, 2.508, 2.756, 3.041 e 2.217 idosos nos anos de 2007, 2008, 2009, 2010 e 2011, respectivamente. A necessidade de prótese total (PT) (dupla) variou de 3,3% a 49% e a presença de lesões em tecido mole bucal entre os idosos piracicabanos, variou de 2,3% a 43,3%. Segundo as regiões administrativas do município de Piracicaba, SP, todas as zonas apresentaram tendência decrescente tanto de necessidade de PT (dupla) quanto de lesões em tecido mole, embora alguns dos resultados não tenham obtido significância estatística. Quanto à variável lesão em tecido mole bucal, a zona leste apresentou tendência crescente, porém não significante. Nos anos de 2010 e 2011, 103 idosos responderam a um questionário com questões referentes ao conhecimento sobre câncer bucal, doenças prévias e hábitos como fumo e uso de bebidas alcoólicas. Entre os participantes, as mulheres representaram 53% da amostra nos dois anos de estudo. Quase a totalidade dos respondentes relatou já ter ouvido falar em câncer bucal, porcentagem que variou de 93,1% (2010) a 97,8% no segundo ano de avaliação. Neste mesmo ano (2011), menos de 26,7% souberam se prevenir do câncer bucal, valor que em 2010, foi de 8,6%. Menos da metade da população avaliada examina a boca em casa e a porcentagem daqueles que já receberam alguma instrução a respeito variou de 24,1% em 2010 a 37,8% em 2011. Conclui-se então, que a população idosa de Piracicaba não possui, no período analisado, conhecimento adequado sobre os fatores de risco e prevenção do câncer bucal, e que, os percentuais decrescentes de necessidade de PT (dupla) e presença de lesões, sugerem um necessário monitoramento da saúde bucal conjuntamente a um tratamento direcionado para esta faixa etária, apesar das campanhas e dos esforços da Odontologia para a conscientização da população sobre a manutenção da saúde da boca e prevenção ao câncer bucal, pois alguns dados necessitam confirmação por não termos obtido, ate o momento ,todos os resultados com significância estatística / Abstract: The aim of this work was to verify the presence of soft tissue lesions in the mouth, the need for prosthetic rehabilitation, as well as knowledge about oral cancer, sociodemographic and behavioral factors, and oral health on elderly people from 41 Basic Health Units (BHU) of Piracicaba-SP. These analyzes were performed by dentists, previously trained, during the Campaign for Prevention and Early Diagnosis of Oral Cancer at 2007 to 2011, according to the six administrative regions of the city and variables of interest. Statistical analysis was performed using the chi-square for trend on the variables: need prostheses and lesions. The Campaign for Prevention and Early Diagnosis of Oral Cancer evaluated 3.452, 2.508, 2.756, 3.041 e 2.217 elderly people in 2007, 2008, 2009, 2010 and 2011, respectively. The need for double prostheses and the presence of oral soft tissue lesions ranged from 3.3% to 49% and 2.3% to 43.3%, respectively. According to the administrative regions of Piracicaba-SP, all the administratives zones showed decreasing trend of need for dental prosthesis and soft tissue lesions, although some results don't have significant stathistics. For the oral soft tissues lesions, East zone showed increasing tren, althogh not significant. In 2010 and 2011, 103 elderly people answered a questionnaire regarding oral cancer and previous diseases knowledge, smoking and alcohol habits. The women represented, approximately, 53% of the sample in two years of study. Almost all reported having heard about oral cancer, ranged from 93.1% (2010) to 97.8% in the second year of evaluation. On the same year, 26.7% reported about oral protection, compared with 8.6%, in 2010. Less than half of the respondents perform oral self-exam at home, and the values about who had some instruction ranged from 24.1% (2010) to 37.8% (2011), respectively. Thus we can conclude that the elderly people from Piracicaba don't have, in the analyzed period, adequate knowledge about oral cancer, its risk factors and prevention. The conclusions also suggest a necessary monitoring of oral health and treatment directed to this age group because there were decreasing on the percentages of need for prostheses and presence of lesions, even with campaigns about oral health and oral cancer prevention and efforts of dentistry, and some data need confirmation because we don't have, all the results with significant stathistics / Mestrado / Gerontologia / Mestra em Gerontologia

This thesis is an exploration of various aspects of oral health in the early-modern period. It examines evidence taken from texts belonging to a range of genres including surgical manuals, botanical texts, midwifery manuals, poets and plays. Building on existing academic work relating to the history of dentistry and venereal disease, it aims to assimilate material from across science and the arts in order to gain a sense of what general social expectations were in relation to the condition of the teeth and palate, and how people suffering with a decline in oral health were advised, or what treatments were available to them either from a professional or in the home. It aims to challenge existing preconceptions that people living in this period displayed a negligent attitude towards the health of their teeth and oral hygiene. The thesis contains four chapters which each focus on a different aspect of oral health, though many themes recur across all four chapters. The first chapter investigates advice that was available in print, and therefore likely to be in public consciousness, to the early-modern individual in relation to maintaining their teeth. It then considers the portrayal of unattractive teeth and bad breath in early-modern literature. Chapter Two deals with early-modern explanations of what caused the toothache and how it could be remedied. Analysis of the depictions of toothache in various poetry and plays follows in order to explore how wider society made sense of medical thinking at the time. The palate becomes the sole focus of Chapter Three, which considers what specific health concerns posed a threat to the condition of the roof of the mouth, and what difficulties could arise for the individual whose palate has been damaged by disease or injury. The thesis concludes with a chapter which investigates the history of a congenital oral birth defect, the cleft lip and palate. The thesis was designed to allow each chapter to deal with a separate facet of oral health; they encompass in turn: oral hygiene, dental pain, the impact of disease on the palate and an exploration of an oral birth defect. An undercurrent of the thesis is to use a range of material to ascertain a realistic idea of what it was like for an individual to experience oral health difficulties in this period. It is therefore interested in how society perceived people who were experiencing problems with their oral health, and what could be done to improve their quality of life. The research presented here represents a contribution to the field of the history of oral health and aims to provoke further questions relating to the responsibility early-modern individuals took for their own oral health, and the specific situations in which intervention, either surgical or medicinal, was deemed necessary.

Abstract Dental diseases such as dental caries and periodontal disease could well be seen as being behaviour-related. The high prevalence of periodontal disease in the Finnish adult population mirrors the need for improving oral health behaviours in a comprehensive manner. Thus far, scant attention has been drawn to the underlying psycho-social factors that could, in part, explain oral health and oral health behaviours. Deficiencies in oral health behaviour may also be indicative of an individual's poor health behaviour in general. The aim of this study was to introduce the salutogenic approach, called sense of coherence, into the domain of oral health and health behaviour. The present study uses data from the nationally representative Health 2000 survey carried out in 2000–2001 by the National Public Health Institute of Finland. The subjects of this study numbered 4175 in article I, 4131 in article II, 4039 in article III, and 4096 in article IV, and were 30- to 64-year-old dentate men and women. The cross-sectional data was collected via home interviews, self-administered questionnaires, or clinical examinations. Sense of coherence was positively associated with oral health behaviours, such as dental attendance and tooth-brushing frequency. In addition to tooth-brushing frequency, sense of coherence was also positively associated with the level of oral hygiene. The association between sense of coherence and level of oral hygiene weakened only marginally after controlling for tooth-brushing frequency. A strong sense of coherence was strongly associated with a positive oral health-related quality of life (OHIP). Sense of coherence was also associated with all of the OHIP sub-scales, and the association was most evident in the psychological discomfort, psychological disability and handicap sub-scales. Among males, health behaviours seemed multidimensional, whereas they tended to be unidimensional among females. A strong sense of coherence was a common determinant of healthy behaviours in general, as well as of a good subjective health status. The present study recognizes the sense of coherence as a common health-promoting determinant of oral and general health behaviours, good oral health, and a good oral health-related quality of life. The results thus suggest that the role of psycho-social factors should not be underestimated in health promotion.

Magister Scientiae Dentium - MSc(Dent) / Patient satisfaction is critical for the growth of oral health service and practice. The present study was a descriptive study on patient satisfaction with oral health care provided by a district dental clinic. The aim of the study was to determine whether patients attending the dental clinic of the Lagos State University hospital were satisfied with the care they received. / South Africa

Magister Scientiae Dentium - MSc(Dent) / Introduction: Children with disabilities and other special needs present unique challenges for oral health professionals in the planning and execution of dental treatment. The oral health of children with special health care needs is influenced by various socio-demographic factors, including their living conditions and severity of the impairment. According to United States (US) Maternal and Child Health Bureau, special health care needs (SHCN) children are defined as “those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally”. Aim and Objectives: The aim was to determine the oral health status of children with special needs. The objectives were to determine the prevalence of dental caries, periodontal disease and oral mucosal lesions among children with special needs in Khartoum State aged 5 to 15 years old attending educational and rehabilitation institutions. Methodology: A descriptive cross–sectional study was carried out. Data were collected with a data capture sheet that was a modified WHO Oral Health Assessment Clinical Oral Examination Guideline. Demographic variables, dmft, periodontal disease and oral mucosal lesions were recorded. Results: The mean dmft /DMFT scores was 2.02/1.25. The DMFT score increased with age, girls showed higher score than boys and autistic children had the poorest oral health among other disabilities. More than two third of the examined sextants were healthy, less than quarter had bleeding (18.3%) and 5% calculus accumulation. Fissured tongue was the most frequent oral lesion found. Conclusion: Children with special needs in Khartoum State demonstrated a high prevalence of dental caries and periodontal disease and do not receive adequate dental care. There is an urgent need for both preventive and treatment programmes to improve the oral health of children with special needs.

Magister Chirurgiae Dentium - MChD / Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) present with oral manifestations of HIV as the first sign of the disease. While Lesotho has a population of fewer than 2 million people, it is faced with the harsh reality of a dire shortage of health care workers including oral health care workers (OHCWs). The high prevalence of HIV is of major concern to oral health workers who regularly encounter patients presenting with oral lesions associated with HIV disease. Oral health care workers need to have adequate knowledge of these conditions for effective management thereof. To determine the knowledge, attitudes and practises of oral health care workers (OHCWs) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCWs in 26 public and private care facilities in all ten districts of Lesotho. A self–administered questionnaire was used to gather information on demographic characteristics of OHCWs and their knowledge, attitudes and practices regarding the management of oral lesions associated with HIV. A visual aid depicting seven colour images of lesions strongly associated with HIV was used to assess knowledge. Data was analysed using Microsoft Excel® and the R statistical package. The outcome of the study was then presented using tables and charts as appropriate. Frequencies, means and 2x2 contingency tables were generated and Fisher‟s exact tests were used for associations. A significance level of (p<0.05) was used.

Magister Scientiae Dentium - MSc(Dent) / Introduction: South Africa has an estimated HIV prevalence rate of 29.5%, in Gauteng province, the prevalence rate in women attending ante-natal clinic is 28.7% and in the Johannesburg Metro District, the prevalence rate is 41%. The early identification of HIV in the HIV positive well patient or HIV positive unwell patient can lead to the commencement of early intervention and treatment, thus resulting in a higher quality of life for the patient and lower treatment costs for the State. Aim: To determine the oral health knowledge, practices and treatment patterns of nurses at ARV clinics in Johannesburg Metro District. Materials and Methods: The study design was a convenient cross-sectional survey conducted between May 2014 and January 2015 in the Johannesburg Metro District. The study population comprised of nursing staff at ARV clinics in the Johannesburg Metro District. 147 questionnaires were distributed among the nurses that were in contact with the patients. Only 100 (n=147) questionnaires came back completed. The data collected was entered into Microsoft Excel and imported to STATA 13.1 to determine statistical significance using chi-squared test. A p-value was regarded significant if <0.05. Results: The results of the study depicted poor knowledge on oral manifestations of HIV/AIDS from the nursing staff at the ARV clinics in the district. Although 85% could describe the oral lesions found in the oral cavity and 66% perceived that they could identify Oral Candidiasis (OC), only 47% could correctly identify the lesion. 57% perceived knowing the condition associated with OC and only 46% correctly named the condition (p- value=0.001). Only two thirds of 43% of nurses could manage OC using drugs from the protocol accessible at the clinics, 25% referred and 32% did not know how to manage the OC (p-value=0.001). Only 40% (n=100) of the nurses referred patients for oral health promotion. Almost all the nurses (81%) indicated repeatedly that they need more training on oral health and oral health promotion. Conclusions: There is a need to include the oral manifestations of HIV in the nursing curriculum. Continued professional development should include Oral Health Promotion. Further research is needed to explore means of incorporating an oral health and disease module in the nursing curriculum.

Philosophiae Doctor - PhD / Background: Teledentistry is the use of information and communications technology (ICT) to provide oral health care services and enhance oral health care delivery to communities in geographically challenged areas. The public health services in South Africa needs to be overhauled to address the inadequacies in the current system. As an attempt to minimise or repair the inadequacies in the public health sector, South Africa has identified the use of ICT’s as a potential tool in improving the delivery of health care. However, although SA has recognised telemedicine as a potential solution to improve access to health care, teledentistry does not feature at all in the dental public health sector. Teledentistry and mobile health has the potential to eliminate or minimise the oral health disparities that exist in South Africa with the use of health information systems. Teledentistry can be initiated in an incremental approach by 'piggy-backing' on existing telemedicine sites, thus reducing ICT costs for the public health sector. Stake holders and government officials need to embrace technology to address some of the challenges that exist in the South African public health sector. This study could aid in providing evidence-based information to assist in the introduction of teledentistry in South Africa as an innovative dental screening and management tool. The most recent SA National Oral Health Survey showed that at least 80% of dental caries in children is untreated (Department of Health, 2003) and this poses a significant public health problem. To reduce the double burden of dental caries in children and human resource shortages in the public sector, the use of teledentistry as a school screening tool has been recommended. Teledentistry screening has the potential to improve access and delivery of oral health care to children in underserved and the rural areas. The aim of the study is to compare traditional dental screening versus teledentistry screening for dental caries in children. Methodology: This study consists of two parts: the first part a concordance study and the second part the determination of user satisfaction with regards to the technology used. The concordance study assessed the diagnostic agreement between traditional and teledentistry screening of dental caries in school children aged between 6-8 years old. The methodology included traditional face-to-face dental screening by two trained and calibrated evaluators, and the teledentistry screening method included the same two evaluators together with two trained and calibrated teledentistry assistants (who were of non-dental background). For the traditional face-to-face dental screenings the two evaluators examined 233 children at selected rural primary schools and scored them for DMFT. For the teledentistry screening method the teledentistry assistants captured intraoral images of the same children and web-based stored the images in corresponding eFiles. After a two week wash out period these intraoral images were then examined by the same two evaluators and scored for DMFT. To determine concordance across methods, Kappa Statistics was applied to the data and this revealed intra-examiner reliability. To determine user satisfaction levels, close-ended questionnaires were designed based on the role of the evaluators and TAs in the teledentistry screening process. Results: The intra-rater agreement and reliability across methods for evaluator one was 98.30%, and for evaluator two it revealed a result of 95.09%. Kappa statistics thus revealed that both evaluators were in agreement between a range of 95%-98.30% of the classifications, or 92.79% of the way between random agreement and perfect agreement (p=0.000). The high concordance level indicated that there was no statistical difference between the traditional dental screening method and the teledentistry screening method (intra-rater reliability), thus suggesting that the teledentistry screening method is a reliable alternative to the traditional dental screening method. For the user satisfaction part, both of the evaluators agreed with 8 of the 13 statements (62%). The statements that were agreed upon related mainly to user satisfaction on the technology which included accessing the intraoral images for screening and the ease of scoring decayed and missing teeth off the images; time and technology suggested the screening process of the images saved time; and indicated teledentistry as being an innovative and easy system to use that will save clinical time for dental professionals. The statements they disagreed with related to the clarity of the images, scoring interproximal caries off the images, and the dental screening method of choice. Both of the TAs agreed with 7 of the 11 statements (64%). They agreed upon statements related mainly to perception of children’s attitudes & behaviour which suggested the children were comfortable during the imaging process and in addition they were excited to see pictures of their teeth; they found teledentistry to be an innovative and easy system to use; they found teledentistry to be a sterile process and hence they were happy with infection control. Both TAs disagreed with the statement that suggested clear images could be captured irrespective of poor lighting. Discordant statements related mainly to user satisfaction on technology which related to ease of using the intraoral camera, ease of storing the captured images into the eFiles and ease of deleting unwanted images. Conclusion: The key findings of this study highlights the reliability of utilising teledentistry as a dental screening and diagnostic tool which can be valuable in the delivery of oral health care in South Africa. This research study further revealed valuable data on user satisfaction levels of the evaluators and TAs, and has an impact on the utilisation of the teledentistry screening system. To ensure adoption and adaptation of the screening process all users must be satisfied with the ICTs used in the teledentistry system. User friendliness can impact negatively on the adoption of teledentistry.

Orientador: Sandra Maria Herondina Coelho Ávila de Aguiar / Coorientador: Elerson Gaetti Jardim Júnior / Banca: Cristiane Duque / Banca: Cleide Cristina Rodrigues Martinhon / Banca: Cássia Cilene Dezan Garbelini / Banca: Cíntia Megid Barbieri de Oliveira Pinto / Resumo: Distúrbios nutricionais são comuns em pacientes com desordens neurológicas. Este estudo analisou a microbiota bucal e orofaríngea de pacientes com desordens neurológicas e nutrição enteral, os componentes salivares que pudessem influenciar nas condições de saúde bucal e estabeleceu um protocolo de prevenção em saúde bucal para os pacientes avaliados. Participaram do grupo de estudo pacientes com desordens neurológicas e nutrição enteral por sonda de gastrostomia (GGT/ n=11). O grupo controle (GC) foi composto de pacientes (n=13) com desordens neurológicas e dieta normal, por via oral. Foram realizadas coletas de saliva, biofilme supragengival, biofilme subgengival, secreção de mucosa (jugal, assoalho bucal e dorso lingual) e secreção de orofaringe, para análise microbiológica por cultura e PCR. Um protocolo de higiene bucal foi estabelecido para o GGT, incluindo raspagem dentária mensal, escovação dentária diária com creme dental para controle de cálculo dentário, e limpeza da cavidade bucal com gaze embebida em solução a base de digluconato de clorexidina a 0,12% com xilitol a 5%. A cultura bacteriana apontou alta prevalência de microorganismos entéricos (18,1%) e leveduras (89,0%) no GGT, porém o PCR apresentou cerca de 23,9% de amostras positivas no GGT para P. gingivalis, T. forsythia, T. denticola, dentre outros microrganismos avaliados, enquanto no GC a prevalência destas bactérias foi estatisticamente significante (39,9%). A nova rotina realizada em pacientes (n=6) do GGT mostrou melhora expressiva no Índice de Sangramento Gengival (ISG) médio, que apresentou redução de 15% após 6 meses de uso do protocolo, e a média do Índice de Higiene Oral Simplificado (IHOS), baixou de 1,48 para 0,57 (redução de 60%) no mesmo período. Um grupo de voluntários (n=14) sem... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Nutritional disorders are common in patients with neurological disorders. This study examined the oral and oropharyngeal microbiota of patients with neurological disorders and enteral nutrition, the salivary components that could influence the oral health status and it was established a protocol for prevention in oral health for these patients. The study group was composed by patients with neurological disorders and enteral nutrition by gastrostomy tube (GGT / n = 11). The control group (CG) consisted of patients (n = 13) with neurological disorders and orally normal diet. It was collected saliva, supragingival biofilm, dental biofilm, secretion of mucous (buccal, mouth floor and tongue dorsum) and oropharyngeal secretions for microbiological analysis by culture and PCR. An oral care protocol was established for GGT, including dental scraping monthly, daily tooth brushing with toothpaste to dental calculus control, and cleaning the oral cavity with soaked gauze in solution based on digluconate chlorhexidine 0.12% with 5% of Xylitol. The bacterial culture showed high prevalence of enteric microorganisms (18.1%) and yeast (89.0%) in GGT, but the PCR showed about 23.9% of the positive samples for P. gingivalis, T. forsythia, T. denticola, among other microorganisms evaluated, while in the GC group the prevalence of these bacteria was statistically significant (39.9%). The new routine performed in the GGT patients (n=6) showed significant improvement in average of the Gingival Bleeding Index (GBI), which declined by 15% after 6 months of using these protocol, and the average of the Simplified Oral Hygiene Index (OHI ) decreased from 1.48 to 0.57 (60% reduction) in the same period. A group of volunteers (n = 14), without neurological disorders, was added to the search for biochemical analysis of saliva. The unstimulated saliva... (Complete abstract click electronic access below) / Doutor