Veterans suffer from lower overall well-being than non-veterans due to their unique life course. This study aims to compare the impact of depression on oral health for veteran and non-veteran populations. Data from 11,693 adults (18 +) participating in the NHANES (2011-2018) were analyzed. Outcome variables were dichotomous (at/above mean) DMFT, MT, FT, and DT; the primary predictor variable combined depression screening outcome and veteran status (veteran/depressed, veteran/not depressed, non-veteran/depressed, non-veteran/not depressed). Covariates included socioeconomic factors, demographics, wellness factors, and oral health-related habits. Associations between outcome and predictor variables were assessed with a fully adjusted logistic regression analysis. Veterans, regardless of depression status, had more DMFT, FT, MT and DT compared to non-veterans. After controlling for covariates, veterans suffering from depression had higher odds of DT (1.5, 95% CI:1.0-2.4) compared to non-veterans without depression. In general, veterans who screened negative for depression had better oral health compared to all groups, with lower odd of DT (0.7, 95% CI:0.6-0.9) and more FT (1.4, 95% CI:1.1-1.7) compared to non-veterans with and without depression. This study found that veterans not only have higher odds of overall caries experience, but that veterans suffering from depression have higher odds of active caries compared to non-depressed veterans. Most veterans lack VA oral healthcare benefits and face challenges maintaining oral health on top of medical and mental health burdens. Our results add further urgency to increasing dental care access for this vulnerable population due to the exacerbation of unmet oral healthcare needs attributable to the mental health challenges veterans face.

Syftet med denna studie är att undersöka olika salutogenetiska aspekter för friska äldre och undersöka om dessa kan implementeras i ett preventivt arbete i yngre åldrar. Material och metod: Sökning gjordes i databasen Pubmed. Alla artiklar som uppfyllde inklusionskriterierna och var relevanta för frågeställningen lästes i fulltext. Dessa blev kvalitetsgranskade och sammanfattades i en tabell. Kvalitetsbedömningen skedde med hjälp av en checklista som kan användas för bedömning av både randomiserade och icke-randomiserade kliniska studier.Resultat: Efter sökningen i Pubmed och läsning samt granskning av artiklar inkluderades 29 artiklar. Av de 29 artiklar som inkluderades var 10 review artiklar, 14 tvärsnittstudier, 3 prospektiva studier och 2 fall-kontroll studier. Totalt ingick 13 346 personer i tvärsnittsstudierna, 5 391 personer ingick i de prospektiva studierna och 285 personer i fall-kontroll studierna. Flera determinerande faktorer och orsaker till av patienten upplevd god hälsa och av professionen fastställd god hälsa kunde identifieras efter litteratursökningen. Dessa delades in i livsstil och individrelaterade-, biologiska-, vårdorganisatoriska- och socioekonomiska faktorer. Konklusion: Fler studier behöver göras för att undersöka hur dessa faktorer interagerar och hur man kan implementera dessa i hälsoförebyggande arbete. / Objective: The objective with this study was to explore different salutogenic aspects amongst healthy elderly and to find out whether it could be implemented in younger age to prevent illness.Material and methods: The search was done in the Pubmed database. All articles that met the inclusion criteria and were relevant for the question at issue were read in full text. The included articles were analyzed and quality assessed and were also summarized in a chart. Quality assessment was done using a check-list that can be used for assessment of both randomized and non-randomized clinical studies.Results: After the search and examination of articles, 29 articles were included out of which 10 were reviews, 14 cross sectional studies, 3 prospective studies and 2 case-control studies. Totally there was 13 346 participants in the cross sectional studies, 5 391 participants in the prospective studies and 285 participants in the case-control studies. Several determinants and causes which influenced the patients self-perceived good health and of the professional established good health could be identified after the literature search. These were divided into individual and lifestyle-, biologic-, health care organization- and socioeconomic determinants.Conclusion: Additional studies need to be carried out to investigate how these determinants interact and how they can be implemented in health promotion.

OBJECTIVE: To explore the effect of pet ownership (PO) on the oral health of older adults. METHODS: NHANES data 2005-06 was analyzed (logistic/linear regression), restricted to aged 65 years and older. The outcomes of interest were the presence/absence of untreated dental caries, the presence/absence of dental restorations, and mean number of teeth. The primary independent variable was PO status within the past year. Potential confounders included demographic data (age, gender, race, marital status, poverty income ratio, education), smoking status, depression, physical activities, and mean sugar intake, taking into account NHANES complex sampling. RESULTS: Individuals aged 65-69 were more likely to own pets than those older than 70 years, with dogs being the most popular pet (62%) followed by cats (31%). After adjusting for potential confounders, there was no association between pet ownership in seniors and the outcomes of interest. Non-Hispanic blacks reported the highest tooth loss (-6.42 teeth) among the racial groups and were 40% less likely to have a dental restoration. In the unadjusted model Mexican Americans have 2.83 times the odds of untreated dental caries compared to Non-Hispanic whites, while current smokers had 7 fewer teeth than those who never smoked. CONCLUSIONS: Pet ownership was not associated with improved oral health for older adults. Despite the lack of oral health protection, pet ownership provides companionship, reduces loneliness, and increases socialization among older adults.

Yes / To identify challenges faced by dental interns in the workforce and to suggest Pacific Island Countries (PIC) on further research in this area. Materials and Methods: A comprehensive search of Medline, Embase, Scopus and ProQuest databases was conducted using relevant keywords. All studies, published from 1st January 2000 to 31st January 2021, were taken into consideration. Removal of duplicates and screening the full-text articles using eligibility criteria were used to finalise the number of articles. The significant findings and conclusions were extracted and grouped under themes. Results: A total of 16 studies met the inclusion criteria, involving dental interns, medical interns, postgraduate and undergraduate. Five themes were identified as the main challenges faced by dental interns in the workplace including workplace bullying, handling medical emergencies, community placement, lack of interdisciplinary approach and poor record keeping. Conclusion: There is a need for PIC to conduct research and surveys, to identify the challenges its dental interns may be facing. This will create an ideal foundation from which strategies and initiatives can be implemented and enforced in the dental internship programme. Ensuring that oral health services are delivered efficiently and oral status of the Pacific is not compromised.

Yes / Corona Virus Disease 2019 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) has had significant impact on dentistry in Fiji. Due to lack of previous study, this study aims to explore the perspective of Dental Officers (DOs) and Dental Managers (DMs) on the effects of COVID-19 on dental service delivery in Fiji Islands. This qualitative study was conducted amongst 30 DOs and 17 DMs between 9th August to 12th September, 2021. It was conducted in the government dental clinics, private dental clinics and the School of Dentistry and Oral Health clinic (SDOH), in the Central Division, Fiji. The study settings were randomly selected. Purposive sampling method was used for the selection of participants who met the study criteria. Semi-structure open ended questionnaires were used for data collection through in-depth interviews via zoom. Manual thematic analysis of the data was conducted to derive themes and codes. The participants interviewed for the study included more female DOs (66.7%) and male DMs (58.8%). Seven themes emerged from data analysis: range of services delivered, appointment versus walk-in patients for aerosol generating procedures (AGPs), impact of pandemic on clinic opening hours, impact of COVID-19 on patient numbers, quality of services delivered, resources and infrastructure, perceptions about the burden of disease. COVID-19 has significantly affected dental service delivery. Mostly emergency dental services were delivered. AGPs were delivered on appointment basis. Most participants stated the quality of services had improved. Participants stated that they were not given adequate resources and the infrastructure was not up to standard to provide dental services during the pandemic. The dental disease burden had increased during the pandemic as per the participants. Future research can be conducted amongst other dental professionals in other divisions of the country.

Os objetivos deste estudo de corte transversal, analítico e descritivo, foram: 1) Avaliar a percepção dos pais e/ou cuidadores em relação a qualidade de vida (QVRSB) relacionada à saúde e à saúde bucal de crianças e adolescentes com diagnóstico do TEA. 2) Avaliar se a condição bucal das crianças e adolescentes com diagnóstico do TEA pode interferir na QVRSB e QVRS. Material e métodos: Este estudo transversal contou com a participação de 74 crianças e adolescentes com TEA cadastrados no CAPE (Centro de atendimento a Pacientes Especiais) / FOUSP, entre 2017 e 2018, com idades entre 5 e 18 anos (9,81± 3,70).A Saúde bucal foi caracterizada por meio da avaliação do Índice de sangramento gengival (ISG), Índice de placa (IP), Índice de dentes cariados, perdidos e obturados ceo-d/(CPO-D), Índice de defeito de desenvolvimento do esmalte dentário (DDE), Anomalias dentárias (AD), Hábitos parafuncionais e a Escala comportamental de Venham. Para avaliação da QVRS e QVRSB foi selecionado o instrumento Peds QL® 4.0 - relato dos pais/responsáveis e PedsQL®Escala bucal - relato de crianças pais/responsáveis, uttilizamos a análise de Regressão de Poison. Resultados: as variáveis explanatórias que atuaram negativamente determinado uma pior QVRSB foram: aglomeração domiciliar maior ou igual à 4 pessoas, 3 ou mais filhos, presença de ceo-d/CPO-D maior que zero e e protesto generalizado durante atendimento odontológico. Maior comprometimento emocional esteve associado à renda familiar menor que 2 salários mínimos, ceo-d/CPO-D maior que dois e protesto moderado durante o atendimento odontológico. A piora na atividade escolar esteve associada ao maior número de filhos (3 ou mais filhos) e protesto generalizado durante o atendimento odontológico. Houve associação entre capacidade física e idade da criança, aglomeração familiar e protesto generalizado durante o atendimento odontológico, sendo que valores maiores dessas variáveis determinaram efeito negativo na capacidade física. Houve associação entre construto social e algumas variáveis explanatórias clínicas. Observamos que a pior interação social estava associada com maior CEOd/ CPO-D e protesto intenso durante o atendimento odontológico. Conclusão: De acordo com a percepção dos pais/responsáveis houve impacto negativo reduzido tanto na QVRS, como na QVRSB das crianças/adolescentes com TEA. O construto emocional e o de saúde bucal foram os mais associados às variáveis socioeconômicas e clínicas. / The objectives of this cross-sectional, analytical and descriptive study were: 1) To evaluate the perception of parent sand / or caregivers regarding quality of life (HRQoL) related the health and oral health of children and teenagers diagnosed with Austism Spectrum Disorder (ASD) 2) Evaluateif oral condition of children and adolescents diagnosed with ASD interfere with HRQoL and HRQoL. Material and methods:This cross-sectional study comprised 74 children and teenagers with ASD, enrolled in the CAPE (Special Patient Care Center) / FOUSP between years 2017 and 2018, aged between 5 and 18 years (9.81 ± 3 , 70). Oral health was characterized by evaluation of gingival bleeding index, plaque index, ceo-d /CPO-D, enamel development defect index (DDE). To evaluate behavior durind dental care, the Vehan\'s Behavioral Scale was used. For the evaluation of the HRQoL and QRSRS, the Peds QL® 4.0 instrument - parent / guardian reportand PedsQL® Oral Scale - parent / guardian report were used. Poison Regression analysis was performed to identify possible associations amongs planatory variables. Results:The explanatory variables that negatively worsed OHRQoL were house hold agglomeration greater than or equalto 4 people, 3 or more children, presence of CEO-d/CPO-D greater than 2 and wides pread protest during dental treatment. Highe remotion alimpairment was associated with family income less than 2 minimun wages, CEO-d/CPO-D higher than 2 and moderate protest dudring dental care. The worsening of school activity was associated with higher number of children (3 or more) and wides pread protest during dental care. There wasan association between physical capacity and age of children, family agglomeration and generalized protest during dental care. A higher value of these variables was associated with a negative effect on physical activity. There was also an association between social constructand some clinical explanatory variables. The worse the social interaction, higher the CEO-d/CPO-D and intense protest during dental care. Conclusion: According to the perception of parents there was a reduced negative impact in both HRQoL and OHRQoLof children/adolescents with ASD. The emotional and oral health construcs were the most associated with socioeconomic and clinical variables.

O presente estudo teve por objetivo avaliar a efetividade de um programa de educação odontológica em pacientes com fissura de lábio e/ou palato. A amostra foi composta de 38 pacientes com fissura de lábio e/ou palato, matriculados para tratamento no Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), entre 5 a 12 anos, divididos em 2 grupos: Grupo 1 (controle) - pacientes que realizaram profilaxia profissional e Grupo 2 (experimental) - pacientes que receberam orientação de educação e motivação em saúde bucal e controle de placa bacteriana. Os pacientes foram avaliados durante 6 sessões, com intervalos de 30 dias entre as mesmas. Para avaliar o controle de placa, utilizou-se o índice PHP. A avaliação foi realizada por meio do Aplicativo Dent Clean que faz parte do programa de educação em saúde bucal. Para avaliar o conhecimento sobre saúde bucal foi utilizado um questionário composto de 16 questões na 1a e 6a sessão. Para as comparações do PHP inicial e após 6 meses entre os grupos utilizou-se os testes de Mann-Whitney e Wilcoxon. Os conceitos obtidos pelos questionários foram submetidos à análise estatística por meio do teste t e teste t pareado. Com relação ao exame PHP inicial, não houve diferença estatisticamente significante entre os grupos (p=0,792). Em relação ao exame PHP após 6 meses houve diferença entre os grupos (p<0,001). Em relação ao período estudado, no Grupo 1 não foi observada diferença estatisticamente significante em relação exame PHP inicial e após 6 meses (p=0,813). No Grupo 2, houve diferença quando comparado o período inicial e após 6 meses (p<0,001). Em relação ao questionário, verificou-se que no início e após 6 meses não houve diferença estatisticamente significante entre os grupos (p=0,503 e 0,494). Para avaliação do nível de conhecimento, no Grupo 1 não foi observada diferença em relação ao período estudado inicial e após 6 meses (p=0,067). No Grupo 2 houve diferença estatisticamente significante quando comparado o período inicial e após 6 meses (p<0,001). Com base nos resultados obtidos para amostra estudada, e de acordo com a metodologia aplicada, foi possível constatar que o programa de educação em saúde bucal foi efetivo para crianças com fissura de lábio e/ou palato. / The aim of this study was to evaluate the effectiveness of a dental education program in cleft lip and/or palate patients. The study sample comprised 38 cleft lip and/or palate patients enrolled at the Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), aged between 5 and 12 years-old, who were divided into two groups: Group 1 (control) - patients who underwent dental prophylaxis and Group 2 (experimental) - patients who received instructions on education and motivation in oral health and plaque control. Patients were evaluated during six appointments, at 30-day intervals. PHP index was used to assess plaque control. This was accomplished by Dent Clean App which is part of the education program in oral health, at the first and sixth appointments in both groups. To evaluate the knowledge on oral health, patients filled in a questionnaire composed of 16 questions at the first and sixth appointments. Baseline and 6-month PHP of groups 1 and 2 were compared through Mann-Whitney and Wilcoxon tests. The scores obtained by the questionnaires were statistically analyzed through t test and paired-t test. Concerning to baseline PHP assessment, there were no statistically significant differences between groups (p=0.792). There were statistically significant differences in PHP assessment after 6 months (p<0.001). In relation to the studied period, Group 1 did not demonstrated statistically significant differences between baseline and 6-month PHP assessments (p=0.813). In Group 2, there were statistically significant differences between baseline and 6-month PHP assessments (p<0.001). With regard to the questionnaire, there were no statistically significant differences between groups, at both the first and sixth appointments (p=0.503 and 0.494). In Group 1, the level of knowledge on oral health assessment did not show statistically significant differences between baseline and 6-month periods (p=0.067). In Group 2, there were statistically significant differences when the questionnaire scores were compared between baseline and 6-month periods were compared (p<0.001). Based on the results obtained for the studied sample and the methodology used, it was possible to conclude that the oral health education program was effective in cleft lip and/or palate children.

O presente estudo propô-se a levantar informações sobre a saúde bucal dos trabalhadores, e a verificar a presença - e avaliar como tais serviços são geridos – ou a ausência de serviços odontológicos em algumas empresas do estado de São Paulo no ano de 2004, e elaborar um programa de promoção de saúde bucal dirigido aos funcionários de empresas. A fundamentação teórica necessária ao objetivo proposto apoiou-se na revisão da literatura especificamente voltada à atividade laboral - medicina do trabalho, engenharia do trabalho, direito do trabalho e odontologia do trabalho. Para melhor ilustrar os temas propostos, optou-se por adotar metodologia que permitisse obter uma base de dados quantitativos e qualitativos em profundidade. Os resultados indicaram que apenas 20% dos cirurgiões-dentistas participam dos SESMTs; da mesma forma, 86,67% desses profissionais não participam das CIPAs, embora 6,67% das empresas entendam que é necessário que o CD esteja a par dos assuntos abordados e discutidos em tais reuniões. Das empresas entrevistadas, 80% oferecem algum tipo de serviço odontológico (consultório particular dentro da empresa, atendimento terceirizado e autogestão, entre outros) e, dentre estas, 25% já implantaram os Serviços de Odontologia do Trabalho para melhor gerenciar a saúde dos trabalhadores. Quanto à realização de exames odontológicos ocupacionais, 53,33% das empresas já mantêm esse protocolo em funcionamento, com predominância de realização de exames admissionais e periódicos – cuja obrigatoriedade legal não está prevista na legislação brasileira. Em relação aos afastamentos por intercorrências odontológicas, 60% dos entrevistados relataram que eles existem, e na maioria das vezes implicam de um a três dias de ausência. Em contrapartida, o restante não possui documentação de tais dados. Observou-se, ao final do estudo, que 60% das empresas já abordaram questões relacionadas à orientações e aos cuidados com a saúde bucal de seus trabalhadores em palestras e campanhas educativas. Ao final deste estudo foi elaborado um Programa de Promoção de Saúde Bucal, com o intuito de implementar os cuidados relativos à saúde dos trabalhadores. / This study described herein are comprised of a research on the main companies of the State of São Paulo, in regards to the existence and methodology of their worker’s oral health. The main purpose of this study is to propose an efficient Program of Dentistry Plan addressed to those companies that aware of profitable benefits resulted from a successful worker’s oral health. Despite the labor dentistry be a relative new matter of concern, this research grounded its basis in a complete and intense analyze of different areas of science, such as Industrial Medicine, Labor Engineering and Law, in a way to provide a not only a wide broad data base of information, but also a qualified understanding of its content. In general terms, the results indicated that only 20% of the dentist surgeons participate of SESMT, that 86.67% of them is not member of the CIPA committee, as well as that only 6.67% believe that labor dentistry issue should be included in the agenda of conferences. In the other hand, the research demonstrated that 80% of the companies offer some kind of dentistry services to its employees (internal dentistry centers, outsourced consults etc.) and at least 25% of those companies have already implemented the Labor Dentistry Services to improve the general health condition of its employees. In regards to preventive measures, 53.33% of the companies perform admission or periodical on-the-job dentistry exams, even if still not required by federal applicable law. The company’s concern on promoting educational seminars and campaigns is grounded in the fact that in 60% of the companies, from total of the employee’s absence periods for diseases, 1 to 3 was related to dentistry problems and accordingly, this dissertation proposes the implementation of profitable plan of preventive Employees Dentistry Health.

A organização do processo de trabalho em Saúde Bucal (SB) tem como componente principal a equipe composta pelo Cirurgião-Dentista - CD, Técnico em Saúde Bucal - TSB e Auxiliar em Saúde Bucal ASB. O trabalho em equipe, com a delegação de tarefas para o pessoal auxiliar (ASB e TSB) busca uma maior racionalidade, aumento da qualidade, da resolutividade e cobertura da atenção em saúde. O setor público tem sido o grande responsável, atualmente, pela inserção da equipe de Saúde Bucal nos serviços. O objetivo desta pesquisa, de cunho qualitativo, foi conhecer a percepção dos dentistas quanto à inserção e trabalho do TSB na equipe. O campo de pesquisa foi o município de Embu e a técnica utilizada para a coleta de dados foi o grupo focal sendo os participantes, dentistas da rede pública deste município. Os resultados apontam, segundo os entrevistados, para a importância do TSB no trabalho em equipe, principalmente, no serviço público, onde há uma grande demanda de assistência. Os participantes, ainda, ressaltam que esta experiência não lhes foi apresentada em sua formação acadêmica, vindo a conhecê-la somente no serviço público. A importância de uma formação técnica adequada e dúvidas acerca da regulamentação profissional, também surgiram como destaques no grupo focal. A partir desses resultados, conclui-se que uma melhor ordenação do processo de trabalho em equipe de Saúde Bucal é necessária, além de um aperfeiçoamento na formação dos profissionais da equipe, vinculadas às reais necessidades do SUS. Ainda que avanços tenham ocorrido nos últimos anos com a atual política nacional de saúde bucal, incentivando o trabalho em equipe, este processo requer um maior estímulo por parte de todos os envolvidos, localmente, no planejamento das ações. / The main core of the organization of the work process in Oral Health consists in the team composition which is the Dentist, Dental Therapist (DT) and Dental Assistant (DA). Teamwork with the delegation of tasks to auxiliary personnel seeks a more rational system of assistance, an increase of quality, resolution and coverage of care. Actually, the Public Health System has been greatly responsible for the integration of DT in the oral health team. The objective of this qualitative research was to acknowledge the dentist´s perception about the integration of the DT in the oral health team. The field research was at the city of Embu, State of Sao Paulo, Brazil, and the technique used for data collection was focus group with dentists working in the public health system of this city as participants. The results indicate, according to participants, the importance of the role played by the DT in the oral health team, especially in public service, where there is great demand for assistance besides lessening dentists stress. Respondents also emphasize that this practice based on teamwork was not discussed during their undergraduation and they experienced this only after beginning the public service assistance. The importance of an adequate technical training as well as doubts about the professional regulation also emerged in the focus groups. From the results it is concluded that training of managers for the better ordering of the process of oral health teamwork is required in addition to an improvement in training of dental therapists, linked to the real needs of the Brazilian Public Health System. Although advances have occurred in recent years with the current national policy on oral health, encouraging teamwork, this process requires a greater stimulus.

Objetivo. Este estudo foi realizado com o objetivo de avaliar a autopercepção das condições bucais em idosos. Material e Métodos. Participaram do estudo 337 pessoas, com 60 anos e mais de idade, funcionalmente independentes, que freqüentavam um centro de saúde em Araraquara, SP. Foi aplicado formulário com questões sobre as características sócio-demográficas da amostra, autopercepção da condição bucal e o índice GOHAI. Realizou-se exame clínico para determinar a prevalência das principais doenças bucais. Os testes estatísticos realizados tiveram como objetivo determinar a associação entre as variáveis sócio-demográficas, clínicas e o índice GOHAI com a autopercepção e também identificar os preditores da auto-avaliação. Resultados. O exame clínico revelou que 40,4% das pessoas eram desdentadas, e entre os dentados a cárie e a doença periodontal tiveram grande prevalência. Entre os dentados, 42,7% avaliaram sua condição bucal como regular, enquanto 55,8% dos desdentados afirmaram que era boa. As variáveis associadas à auto-avaliação foram: a classe social, o GOHAI, os dentes cariados e com extração indicada entre os dentados, e a escolaridade e o GOHAI entre os desdentados. A análise multivariada mostrou que os preditores da auto-avaliação foram o GOHAI (em dentados e desdentados), os dentes com extração indicada e o CPITN em dentados. Estes preditores explicaram no máximo 30% da variabilidade da auto-avaliação. Conclusões. Entre outros aspectos concluiu-se que a percepção teve pouca influência das condições clínicas e por isso seria importante o desenvolvimento de ações educativas e preventivas junto a esta população. / Objective. The purpose of this study was to assess the self-perception of oral health status of the elderly. Methods. Results are based on interviews and clinical assessment of 337 subjects aged 60 years and over, functionally independents and who used to go to a Health Care in Araraquara, Brazil. A questionnaire with questions about the social characteristics of the sample, self-perception of oral health status and the GOHAI index was applied. A clinical examination was made to determine the prevalence of the main oral diseases. The objective of statistical tests was to determine the association among the social and clinic variables and the GOHAI index with the self-perception. Moreover the tests had to identify the self-assess predictors. Results. The clinical examination revealed that 40.4% of the people were edentulous and among the dentate the dental caries and the periodontal disease had a significant prevalence. 42.7% of the dentate assessed their oral health status as regular and 55.8% of the edentulous assessed theirs as good. The social class, the GOHAI index and the decayed and missing teeth among the dentate, and also the level of education and the GOHAI among the edentulous, were associated to the self-assess. The multivariate analysis showed that the predictors of the self-assess were the GOHAI index (among dentate and edentulous), the missing teeth and the CPITN among dentate. These predictors explained 30% of the self-assess variability. Conclusions. As the perception had a small influence on the clinical conditions, the development of educated and preventive actions for these people are recommended.