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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
331

Transforming inter-professional dental care: assessment of non-dental healthcare workers' knowledge and attitudes towards children's oral health

Redwan, Alaa Kamil H. 29 July 2020 (has links)
INTRODUCTION: Children’s Oral Health (OH) is a vital part of their general health. Since many OH problems begin during early childhood, prevention of these problems can be achieved through early and routine preventive dental care. The dental community alone cannot adequately address all oral health care needs. The establishment of an interprofessional oral health primary care workforce team can help provide holistic health care services that can improve children’s OH, particularly among under-served populations. OBJECTIVE: The aim of our study was to assess the effect of Interprofessional Education (IPE) on the level of OH knowledge among pediatricians, nurses, speech-language pathologists, nutritionists, and social workers. MATERIALS AND METHODS: Questionnaires assessing participants’ oral-health knowledge were collected from pediatricians, nurses, speech-language pathologists, nutritionists and social workers who are working or studying in Boston, Massachusetts. Pre-test questionnaires were used to evaluate baseline oral-health knowledge and attitude towards IPE. Post-test survey immediately after the IPE training and a follow-up survey after 6-12 months were used to evaluate immediate and long-term retention of knowledge. Pre-, post- and follow-up scores were assigned based on the participants’ responses. Univariate parametric analysis methods such as T-test and non-parametric tests such as Kruskal-Wallis and Wilcoxon rank-sum tests were used to assess retention of knowledge and attitude towards IPE. Fisher’s Exact test was used to evaluate differences in the number of high scores. Multiple linear regression models were used to adjust for potential confounders. Statistical significance was reported when p-value <0.05. RESULTS: Among the 557 participants, the immediate post-test scores showed significant improvement when compared to the baseline knowledge scores across different professions (p<0.01). The long-term follow-up scores was lower than the immediate post-test scores (statistical significance was not detected across all professions), however, still significantly higher when compared to the pre-test scores (p<0.01). Among all the participants, the attitude towards collaboration was high (100%). CONCLUSION: Our results highlight the need for collaboration between dental and non-dental healthcare workforce by incorporating IPE into existing curriculum to enhance the retention of knowledge and increase collaboration after graduation. Continuing education programs can significantly contribute towards long-term retention of knowledge. / 2022-07-29T00:00:00Z
332

Oral Health-Related Quality of Life, Oral Conditions, and Risk of Malnutrition in Older German People in Need of Care—A Cross-Sectional Study

Schmalz, Gerhard, Denkler, Clara Rosa, Kottmann, Tanja, Rinke, Sven, Ziebolz, Dirk 04 May 2023 (has links)
Background: The present cross-sectional study assessed oral health, nutritional condition, and oral health-related quality of life (OHRQoL) in older German people in need of care. Methods: The participants were recruited from eight nursing homes (including three nursing homes with assisted living) and one mobile nursing service. Oral health, including dental status (decayed, missing and filled teeth (DMF-T), root caries), periodontal treatment needs, and prosthetic conditions, was recorded. Nutritional status was assessed using the screening of the “Mini Nutritional Assessment” (MNA). The OHRQoL was measured using the German short-form of the Oral Health Impact Profile (OHIP-G14) and summarized as a total sum score as well as the four dimensions “oral function”, “psychosocial impact”, “pain” and “orofacial appearance”. Statistics: Linear logistic regression analyses. Results: A total of 151 participants (age: 84.17 ± 7.8 years) were included. Most participants (60.3%) were nursing home residents. Nearly half of the individuals (47%) were edentulous and 75.4% of the dentate subjects required periodontal treatment. A total of 115 of the subjects had at least one denture. According to the MNA screening, 107 (70.9%) older people were at risk of malnutrition or already suffered from malnutrition. The median OHIP-G14 sum score was 3 (mean 5.7 ± 7.67). Regression analysis revealed MNA to be influenced by DMF-T, D-T, M-T and OHIP G14 sum score and root caries (pi < 0.01). Within the regression model, missing teeth (β: −11.9, CI95: −6.4–−1.9; p < 0.01) were the strongest influential factor on MNA, followed by DMF-T (β: 5.1, CI95: 1.7–6.2; p < 0.01). Conclusions: Older people in nursing settings show a high prevalence of oral diseases, risk of malnutrition and nearly unimpaired OHRQoL. Dental care should be fostered in these individuals, whereby OHRQoL might be a further hint for increased risk of malnutrition.
333

Kunskap och attityder gällande munhälsoarbete bland omsorgspersonal inom äldreomsorg / Knowledge and attitudes of oral health work among nursing staff in older care

Jafari, Masoumeh, Al-Khdhairi, Tasnim January 2024 (has links)
No description available.
334

Perceptions on the factors influencing oral health seeking behaviour of communities in Randfontein, Gauteng, South Africa

Makubalo, Mlungisi Patrick January 2012 (has links)
<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>
335

Perceptions on the factors influencing oral health seeking behaviour of communities in Randfontein, Gauteng, South Africa

Makubalo, Mlungisi Patrick January 2012 (has links)
<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>
336

A incorpora??o da sa?de bucal no Programa Sa?de da Fam?lia do Rio Grande do Norte: investigando a possibilidade de convers?o do modelo assistencial

Souza, Tatyana Maria Silva de 09 February 2005 (has links)
Made available in DSpace on 2014-12-17T15:30:55Z (GMT). No. of bitstreams: 1 TatianaMSS.pdf: 644050 bytes, checksum: 04ba840cc19aa0c3d292c0d2a4e7bec0 (MD5) Previous issue date: 2005-02-09 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Health Family Program (HFP) was founded in the 1990s with the objective of changing the health care model through a restructuring of primary care. Oral health was officially incorporated into HFP mainly through the efforts of dental professionals, and was seen as a way to break from oral health care models based on curative, technical biological and inequity methods. Despite the fast expansion of HFP oral health teams, it is essential to ask if changes are really occurring in the oral health model of municipalities. Therefore, the purpose of this study is to evaluate the incorporation of oral health teams into the Health Family Program by analyzing the factors that may interfere positively or negatively in the implementation of this strategy and consequently in the process of changing oral health care models in the National Health System in the state of Rio Grande do Norte, Brazil. This evaluation involves three dimensions: access, work organization and strategies of planning. For this purpose,19 municipalities, geographically distributed according to Regional Public Health Units (RPHU), were randomly selected. The data collection instruments used were: structured interview of supervisors and dentists, structured observation, documental research and data from national health data banks. It was possible to identify critical points that may be impeding the implementation of oral health into HFP, such as, low incomes, no legal employment contract, difficulty in referring patients for high-complexity procedures, in developing intersectoral actions and program strategies such as epidemiologic diagnosis and evaluation of the new actions. The majority of municipalities showed little or no improvement in oral health care after incorporating the new model into HFP. All of them had failures in most of the aspects mentioned above. Furthermore, these municipalities are similar in other areas, such as low educational levels in children from 7 to 14 years of age, high child mortality rates and wide social inequalities. On the other hand, the five municipalities that had improved oral health, according to the categories analyzed, offered better living conditions to the population, with higher life expectancy, low infant mortality rates, per capita income among the highest in the state as well as high Human Development Index (HDI) means. Therefore, it is possible to conclude that public policies that include aspects beyond the health sector are decisive for a real change in health care models / O Programa Sa?de da Fam?lia (PSF) surgiu na d?cada de 1990, como uma proposta de mudan?a do modelo assistencial a partir de uma reorganiza??o da Aten??o B?sica, atrav?s da vigil?ncia ? sa?de. Entendendo a sa?de bucal como integrante desse processo, a sua incorpora??o oficial no PSF, fruto principalmente de uma luta corporativa, tem sido vista como possibilidade de romper com os modelos assistenciais em sa?de bucal baseados no curativismo, tecnicismo, biologicismo e excludentes. Apesar da r?pida expans?o das Equipes de sa?de bucal no PSF, ? preciso questionar se realmente est? ocorrendo mudan?as no modelo assistencial em sa?de bucal dos munic?pios. Portanto, este trabalho tem como objetivo avaliar a incorpora??o da Sa?de Bucal no Programa Sa?de da Fam?lia a partir da an?lise de fatores que possam interferir positiva ou negativamente, na implementa??o dessa estrat?gia e, conseq?entemente no processo de mudan?a nos modelos assistenciais de sa?de bucal no Sistema ?nico de Sa?de no estado do Rio Grande do Norte. Esta avalia??o tomou como refer?ncia tr?s dimens?es as quais foram, o acesso, a organiza??o do trabalho e as estrat?gias de programa??o. Para isto, foram sorteados 19 munic?pios no estado, distribu?dos geograficamente pelas Unidades Regionais de Sa?de P?blica (URSAPs). Os instrumentos de coleta foram a entrevista estruturada aplicada a gestores e dentistas; a observa??o estruturada; a pesquisa documental e os dados do Sistema de Informa??o em Sa?de dos munic?pios. Foi poss?vel identificar pontos cr?ticos, que podem estar dificultando a implementa??o da sa?de bucal no PSF, os quais foram as prec?rias rela??es de trabalho, as dificuldades no referenciamento dos pacientes para a??es de m?dia e alta complexidade, no desenvolvimento de a??es intersetoriais e nas estrat?gias de programa??o como diagn?stico epidemiol?gico e avalia??o das a??es. A maioria dos munic?pios apresentou pouco ou nenhum avan?o no modelo assistencial em sa?de bucal, ap?s a incorpora??o da mesma no PSF, demonstrando falhas na maior parte dos aspectos relacionados acima. Al?m disso, s?o munic?pios, que apresentam caracter?sticas semelhantes em outros aspectos, como altas taxas de analfabetismo em crian?as de 7 a 14 anos, altas taxas de mortalidade infantil e grandes desigualdades sociais. Por outro lado, os cinco munic?pios que demontraram avan?os na sa?de bucal, de acordo com as categorias analisadas, apresentaram caracter?sticas de melhores condi??es de vida da popula??o, como alta expectativa de vida ao nascer, baixas taxas de mortalidade infantil, valores per capita entre os mais altos do estado, bem como, altos valores de IDH-M. Portanto, ? poss?vel concluir que as pol?ticas p?blicas mais amplas, que contemplem aspectos situados al?m do setor sa?de, s?o decisivas para uma real mudan?a nos modelos assistenciais em sa?de
337

Perceptions on the factors influencing oral health seeking behaviour of communities in Randfontein, Gauteng, South Africa

Makubalo, Mlungisi Patrick January 2012 (has links)
Magister Public Health - MPH / The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents. / South Africa
338

Oral Health Care and Humanitarian Health Praxis / Munhälsa och humanitärt hälsoarbete

Liebe-Harkort, Carola January 2016 (has links)
Background: Oral and dental diseases is a major part of the global disease burden. Poor oral health has a significant impact on the general well-being of people. In contrast with prior decades high rates of oral diseases may be found in low- and middle income countries. Populations that are particularly vulnerable are more likely to develop poor oral health. As a consequence of human distress related to war, poverty and natural disasters the accomplishments of humanitarian aid organizations has a direct impact on people´s health and well-being. Purpose: The aim of the present study is to examine the International Red Cross and Red Crescent Movement as well as Doctors without borders concerning documents and guidelines on oral health. A further aim is to explore the knowledge of oral health related topics of delegates from the International Federation of the Red Cross and Red Crescent Societies (IFRC). Method: The study is designed as a literature review and a questionnaire survey. Results: Within the International Red Cross and Red Crescent Movement and Doctors Without Borders there are a limited number of guidelines on oral health and they are rarely mentioned in the same documents as non-communicable diseases (NCDs). The responses of the study revealed that the participants generally have a limited knowledge about measures on oral health in the IFRC. Conclusion: Both the literature review and the questionnaire survey study confirms that there is an absence of clear and specific guidelines on oral health care related activities within IFRC. / Bakgrund: Mun- och tandsjukdomar utgör en stor del av den globala sjukdomsbördan. Dålig mun- och tandhälsa har en stark påverkan på det allmänna välbefinnandet. I motsats till tidigare, ses idag höga frekvenser av karies även i låg- och medelinkomstländer. Populationer vilka befinner sig i extra utsatta kontexter löper större risk att utveckla dålig munhälsa. Som en följd av mänskligt lidande i form av händelser relaterade till krig, fattigdom och naturkatastrofer har aktiviteter utförda av humanitära hjälporganisationer en direkt inverkan på hälsa och välbefinnande. Syfte: Syftet med föreliggande studie är att studera dokument och riktlinjer rörande munhälsa inom Internationella Röda korset och Röda halvmånen och Läkare utan gränser. Ett ytterligare syfte är att undersöka kunskapen om hälsorelaterade frågor kring munhälsa hos delegater från Internationella federationen för Röda Korset och Röda Halvmånen (IFRC). Metod: Studien är utförd som en litteratur-sammanställning och som en enkätundersökning. Resultat: Inom Internationella Röda korset och Röda halvmånen samt Läkare utan gränser återfinns begränsat antal riktlinjer rörande oral hälsa vilka dock sällan nämns i samma dokument som icke-smittsamma sjukdomar (NCDs). Av enkätsvaren i studien framgår det att de medverkande generellt har en begränsad kunskap kring åtgärder rörande munhälsa inom IFRC. Konklusion: Deltagarna i denna studie bekräftar resultaten i litteraturstudien om en avsaknad av tydliga och konkreta riktlinjer för munhygienrelaterade aktiviteter inom IFRC.
339

Como os integrantes profissionais de uma Unidade Básica de Saúde (UBS) conhecem e praticam os conteúdos de Odontologia - análise de um caso / How the agents of a Basic Health Unit (UBS) know and practice the dental content - analysis of a case

Kulik, Marco Antonio 03 June 2015 (has links)
A Atenção Primária em Saúde (APS), que é base para o Sistema Único de Saúde (SUS), tem dois componentes fundamentais que são a integralidade e a educação em saúde. Compreender as moléstias crônicas em seu contexto social e familiar é dever dos profissionais que atuam nas equipes de Saúde da Família (eSF). Neste cenário, a incorporação dos profissionais da área de Saúde Bucal (SB) à Estratégia Saúde da Família (ESF) trouxe novas necessidades de conhecimento e prática para os trabalhadores da equipe de Saúde da Família executarem suas tarefas especialmente no atendimento domiciliar. Portanto, há necessidade de criação de materiais educacionais em Teleodontologia que sejam adequados às necessidades de informação e que respeitem o conhecimento prévio dos trabalhadores sobre Saúde Bucal (SB). Assim, é importante saber o que os profissionais da Estratégia Saúde da Família (ESF) conhecem e como aplicam os conceitos da promoção em Saúde Bucal (SB). Esta pesquisa procura saber o quanto cada categoria de profissionais de uma equipe de Saúde da Família (eSF) do Município de Platina, SP, conhecem e praticam Saúde Bucal (SB) e aplicam em suas atividades diárias. Para isso, foi elaborado um questionário aberto de livre adesão e os respondentes emitiam, com total e irrestrita liberdade, as suas observações, avaliações e sugestões relativas às suas experiências pessoais no seu trabalho na eSF a que pertencem. A coleta de dados contemplou uma única equipe, o que permitiu trabalhar com dados confiáveis. A partir das respostas tabuladas, analisadas qualitativamente e com percentuais de frequência, verifica-se que há necessidade dos trabalhadores se instrumentalizarem para as tarefas de ensinar e supervisionar o conjunto dos membros das famílias atendidas, quanto aos procedimentos de prevenção, de manutenção e promoção da saúde bucal, tornando a integralidade e conhecimento com educação em saúde bucal uma consequência efetiva na saúde geral de cada cidadão e da comunidade / The Primary Health Care (APS), the basis of the Unified Health System (SUS), has two main components: completeness and health education. Understanding the chronic diseases in their social and family environment is the duty of the professionals who work in the Family Health Teams (eSF). In this context the incorporation of professionals from the oral health area (SB) into the Family Health Strategy (ESF), brought new needs of knowledge and practice to the agents of the Family Health Teams (eSF) to perform their tasks especially in home care. Therefore, it is necessary to create educational materials on Teledentistry that are appropriate to the information needs, respecting the prior knowledge of the Oral Health agents (SB). Thus, it is important to know what the professionals of the Family Health Strategy (FHS) know and how they apply the concepts of promotion in Oral Health (SB). This research has the objective of knowing how much each category of professionals from the Family Health Team (eSF) in the municipality of Platina, SP, knows and practices Oral Health (SB) and apply it in their daily activities. In this regard, we designed an open free adhesion questionnaire where the responders had full and unrestricted freedom to issue their comments, evaluations and suggestions about their personal experiences in their work with the eSF they belong. Data collection included a single team. This allowed the work with reliable data. From the quantitatively tabulated responses, including the percentage of frequency, it appears that there is a need of the agents to prepare themselves to the task of teaching and supervising all the members of the families as to the procedures of prevention, maintenance and oral health promotion. All this makes the completeness and knowledge about oral health education an effective result in the overall health of every citizen and the community
340

Perda dentária em adultos e idosos no Brasil: a influência de aspectos individuais, contextuais e geográficos / Tooth-loss in adults and the elderly in Brazil: the influence of individual, contextual and geographical features

Moreira, Rafael da Silveira 01 December 2009 (has links)
Introdução - As transições demográfica e epidemiológica vêm gerando mudanças no perfil sanitário de vários países. Dentre os vários campos da saúde, a saúde bucal expressa pela perda dentária encontra-se em situação preocupante. Objetivo - Identificar os fatores individuais e contextuais associados à perda dentária de adultos e idosos no Brasil e as características da distribuição espacial desses fatores. Métodos - Foram utilizados dados secundários do Projeto SB Brasil 2003, em que foi realizado um levantamento epidemiológico das condições de saúde bucal da população brasileira. Neste inquérito foi utilizada a técnica de amostragem probabilística por conglomerados, realizada em três estágios, totalizando 13.431 adultos entre 35 e 44 anos e 5.349 idosos entre 65 e 74 anos. A metodologia de análise empregou um modelo multinível de abordagem e a associação foi medida pela Razão de Médias e Razão de Prevalências, brutas e ajustadas. Utilizou-se a técnica de Processo Analítico Hierárquico (Analytical Hierarchy Process - AHP) e testes de dependência espacial para conhecer a distribuição espacial dos fatores associados à perda dentária. Resultados - Entre os adultos, as variáveis contextuais associadas com maior perda dentária foram: baixo número de cirurgiões-dentistas por mil habitantes (nível regional), maior número de exodontias por habitante (nível estadual) e municípios com menor porte populacional (nível municipal). As variáveis individuais associadas à perda dentária foram: maior número de pessoas por cômodo, ter consultado o cirurgião-dentista alguma vez na vida, há três anos ou mais e por motivo de dor, não ter recebido informações sobre prevenção de doenças bucais, ser do sexo feminino e a idade maior. Entre os idosos, duas análises foram feitas. Na primeira análise, as variáveis contextuais associadas ao edentulismo funcional foram as mesmas encontradas nos adultos, exceto o porte populacional. Na segunda análise, as variáveis contextuais associadas à menor necessidade de prótese total foram: maior taxa de primeira consulta odontológica programática (nível regional), da média de anos de estudo (nível estadual) e do porte municipal. Morar na área rural, maior número de pessoas por cômodo, ter tido a última consulta odontológica em serviço público, ser do sexo masculino, nãobranco e idade mais avançada foram associados à necessidade de prótese total. A análise espacial revelou áreas de risco estatisticamente significantes para a perda dentária e para a necessidade de prótese total. Conclusões - O estudo revelou os principais aspectos contextuais e individuais associados com maior perda dentária. A combinação espacial simultânea desses atributos gerou mapas de predisposição para a perda dentária e necessidade de prótese total que podem nortear as ações de Saúde Bucal Coletiva. / Introduction - The demographic and epidemiological transitions are causing changes in the health profile worldwide. Among the various areas of health care, oral health expressed by tooth loss is in a precarious situation. Objective - The objective was thus to identify the individual and contextual factors associated with tooth-loss in adults and the elderly in Brazil and the characteristics of the spatial distribution of these factors. Methods - Secondary data from the 2003 SB Brasil Project were used. This was an epidemiological survey of the oral health of the Brazilian population. The study used the technique of probability sampling by clusters, in three stages, covering 13,431 adults aged between 35 and 44 years old and 5,349 elderly individuals aged between 65 and 74 years. A multilevel analysis was employed and the degree of association was measured using the crude and adjusted mean and prevalence ratios. The Analytical Hierachy Process (AHP) technique was used to ascertain the spatial distribution of factors associated with tooth- loss, along with tests of spatial dependence. Results - Among adults, the contextual variables associated with increased tooth-loss were: a lower number of dentists per thousand inhabitants (at regional level), an increased number of tooth extractions per capita (at state level) and a smaller population size (at municipal level). The individual variables associated with tooth-loss were: a greater number of individuals living in the same room, never having consulted a dentist, having consulted a dentist three years or more ago and because of pain, not having received information on prevention of dental diseases, being female, and increased age. A further two analyses were carried out for the elderly group. In the first analysis, the contextual variables associated with functional edentulism were found to be the same in adults, with the exception of the population size. Living in rural areas and being female were associated with functional edentulism. In the second analysis, the contextual variables associated with reduced need for total prosthesis were: greater coverage of the first dental consult program (at regional level), average number of years of schooling (at state level) and population size. Living in rural areas, a greater number of individuals per room, having had the last dental consultation in the public sector, being male, non-white and of greater age were associated with the need for total prosthesis. Spatial analysis shows critical areas of risk for tooth loss. Conclusions - The study revealed the key contextual and individual aspects associated with greater tooth-loss. The combination of simultaneous spatial attributes generated maps showing the geographical predisposition to tooth loss and the need for total prosthesis that will be able to guide the work of those working in the area of Collective Oral Health.

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