Hipersensibilidade dentinária (HSD) é caracterizada como uma dor dentária curta e aguda, causada em resposta a estímulos térmicos, evaporativos, táteis ou osmóticos, e que não pode ser atribuída a qualquer outro tipo de patologia. A epidemiologia da HSD ainda é pouco estuda em nível populacional. O objetivo desta dissertação foi abordar a epidemiologia da HSD através da revisão crítica da literatura e da apresentação de um estudo de base populacional sobre prevalência, extensão e indicadores de risco para essa condição.Uma amostra representativa de 1023 habitantes adultos, com mais de 35 anos de idade, residentes em Porto Alegre foi obtida através de uma amostragem probabilística proporcional estratificada de múltiplo-estágio. Os participantes do estudo responderam a um questionário estruturado a respeito de dados sociodemográficos e comportamentais e receberam um exame clínico para diagnóstico de HSD térmico (jato de ar) e tátil (sonda) aplicados na superfície vestibular de todos os dentes presentes. Comandos analíticos que consideram a amostra complexa foram utilizados para gerar estimativas em modelos de risco multivariados. Aproximadamente um terço da população foi diagnosticada com HSD (jato de ar = 33,4% / sonda = 34,2%). Dentre os indivíduos que apresentaram HSD, em média 2 a 3 dentes apresentaram HSD. Os dentes mais afetados com HSD foram pré-molares superiores, molares superiores e pré-molares inferiores. Recessão gengival foi fator determinante para a ocorrência de HSD e foi modelada separadamente das demais variáveis. Mulheres, indivíduos mais jovens, fumantes, de melhor nível educacional e aqueles que relatam tratamento periodontal tiveram significativamente mais chance de HSD. Conclui-se que a prevalência e de HSD encontrada na população estudada é alta, porém com um número pequeno de dentes afetados. A ocorrência de HSD está associada a fatores comportamentais e sociodemográficos importantes, para os quais se podem estabelecer estratégias preventivas em nível individual e populacional. / Dentine hypersensitivity (DH) is characterized by an acute and short dental pain in response to thermal, evaporative, tactile and osmotic stimuli, which cannot be attributed to any other type of pathology. The epidemiology of DH is still little studied on the population level. The aim of this thesis was to assess the epidemiology of DH by conducting a critical appraisal of the literature and presenting the findings of a population-based study about the prevalence, extent and risk indicators of this condition. A representative sample of 1,023 adult 35 years and older inhabitants of Porto Alegre was obtained using a multistage, stratified, proportional to size, probability sampling strategy. Participants answered a structured questionnaire about sociodemographic and behavioral variables and were submitted to a clinical examination to diagnose DH using a blast of air and a manual probe on the buccal surfaceof all present teeth. Analytical commands that take into consideration the complex sampling design were used to generate estimates and multivariable risk models. Approximately one third of the population was diagnosed with DH (air blast= 33.4% and probe= 34.2%). Among individuals with DH, in average 2 to 3 teeth were affected by DH. The teeth most affected by DH were maxillary premolars and molars, followed by mandibular premolars. Gingival recession was a determinant factor for the occurrence of DH and was modeled separately from the other variables. Females, younger individuals, smokers, individuals of higher education and those reporting positive history of periodontal treatment had significantly higher chances of DH. It can be concluded that the prevalence of DH found in the studied population is high, although with few teeth affected. The occurrence of DH is associated with important sociodemographic and behavioral factors for which preventive strategies may be established on individual and population levels.

Hipersensibilidade dentinária (HSD) é caracterizada como uma dor dentária curta e aguda, causada em resposta a estímulos térmicos, evaporativos, táteis ou osmóticos, e que não pode ser atribuída a qualquer outro tipo de patologia. A epidemiologia da HSD ainda é pouco estuda em nível populacional. O objetivo desta dissertação foi abordar a epidemiologia da HSD através da revisão crítica da literatura e da apresentação de um estudo de base populacional sobre prevalência, extensão e indicadores de risco para essa condição.Uma amostra representativa de 1023 habitantes adultos, com mais de 35 anos de idade, residentes em Porto Alegre foi obtida através de uma amostragem probabilística proporcional estratificada de múltiplo-estágio. Os participantes do estudo responderam a um questionário estruturado a respeito de dados sociodemográficos e comportamentais e receberam um exame clínico para diagnóstico de HSD térmico (jato de ar) e tátil (sonda) aplicados na superfície vestibular de todos os dentes presentes. Comandos analíticos que consideram a amostra complexa foram utilizados para gerar estimativas em modelos de risco multivariados. Aproximadamente um terço da população foi diagnosticada com HSD (jato de ar = 33,4% / sonda = 34,2%). Dentre os indivíduos que apresentaram HSD, em média 2 a 3 dentes apresentaram HSD. Os dentes mais afetados com HSD foram pré-molares superiores, molares superiores e pré-molares inferiores. Recessão gengival foi fator determinante para a ocorrência de HSD e foi modelada separadamente das demais variáveis. Mulheres, indivíduos mais jovens, fumantes, de melhor nível educacional e aqueles que relatam tratamento periodontal tiveram significativamente mais chance de HSD. Conclui-se que a prevalência e de HSD encontrada na população estudada é alta, porém com um número pequeno de dentes afetados. A ocorrência de HSD está associada a fatores comportamentais e sociodemográficos importantes, para os quais se podem estabelecer estratégias preventivas em nível individual e populacional. / Dentine hypersensitivity (DH) is characterized by an acute and short dental pain in response to thermal, evaporative, tactile and osmotic stimuli, which cannot be attributed to any other type of pathology. The epidemiology of DH is still little studied on the population level. The aim of this thesis was to assess the epidemiology of DH by conducting a critical appraisal of the literature and presenting the findings of a population-based study about the prevalence, extent and risk indicators of this condition. A representative sample of 1,023 adult 35 years and older inhabitants of Porto Alegre was obtained using a multistage, stratified, proportional to size, probability sampling strategy. Participants answered a structured questionnaire about sociodemographic and behavioral variables and were submitted to a clinical examination to diagnose DH using a blast of air and a manual probe on the buccal surfaceof all present teeth. Analytical commands that take into consideration the complex sampling design were used to generate estimates and multivariable risk models. Approximately one third of the population was diagnosed with DH (air blast= 33.4% and probe= 34.2%). Among individuals with DH, in average 2 to 3 teeth were affected by DH. The teeth most affected by DH were maxillary premolars and molars, followed by mandibular premolars. Gingival recession was a determinant factor for the occurrence of DH and was modeled separately from the other variables. Females, younger individuals, smokers, individuals of higher education and those reporting positive history of periodontal treatment had significantly higher chances of DH. It can be concluded that the prevalence of DH found in the studied population is high, although with few teeth affected. The occurrence of DH is associated with important sociodemographic and behavioral factors for which preventive strategies may be established on individual and population levels.

Hipersensibilidade dentinária (HSD) é caracterizada como uma dor dentária curta e aguda, causada em resposta a estímulos térmicos, evaporativos, táteis ou osmóticos, e que não pode ser atribuída a qualquer outro tipo de patologia. A epidemiologia da HSD ainda é pouco estuda em nível populacional. O objetivo desta dissertação foi abordar a epidemiologia da HSD através da revisão crítica da literatura e da apresentação de um estudo de base populacional sobre prevalência, extensão e indicadores de risco para essa condição.Uma amostra representativa de 1023 habitantes adultos, com mais de 35 anos de idade, residentes em Porto Alegre foi obtida através de uma amostragem probabilística proporcional estratificada de múltiplo-estágio. Os participantes do estudo responderam a um questionário estruturado a respeito de dados sociodemográficos e comportamentais e receberam um exame clínico para diagnóstico de HSD térmico (jato de ar) e tátil (sonda) aplicados na superfície vestibular de todos os dentes presentes. Comandos analíticos que consideram a amostra complexa foram utilizados para gerar estimativas em modelos de risco multivariados. Aproximadamente um terço da população foi diagnosticada com HSD (jato de ar = 33,4% / sonda = 34,2%). Dentre os indivíduos que apresentaram HSD, em média 2 a 3 dentes apresentaram HSD. Os dentes mais afetados com HSD foram pré-molares superiores, molares superiores e pré-molares inferiores. Recessão gengival foi fator determinante para a ocorrência de HSD e foi modelada separadamente das demais variáveis. Mulheres, indivíduos mais jovens, fumantes, de melhor nível educacional e aqueles que relatam tratamento periodontal tiveram significativamente mais chance de HSD. Conclui-se que a prevalência e de HSD encontrada na população estudada é alta, porém com um número pequeno de dentes afetados. A ocorrência de HSD está associada a fatores comportamentais e sociodemográficos importantes, para os quais se podem estabelecer estratégias preventivas em nível individual e populacional. / Dentine hypersensitivity (DH) is characterized by an acute and short dental pain in response to thermal, evaporative, tactile and osmotic stimuli, which cannot be attributed to any other type of pathology. The epidemiology of DH is still little studied on the population level. The aim of this thesis was to assess the epidemiology of DH by conducting a critical appraisal of the literature and presenting the findings of a population-based study about the prevalence, extent and risk indicators of this condition. A representative sample of 1,023 adult 35 years and older inhabitants of Porto Alegre was obtained using a multistage, stratified, proportional to size, probability sampling strategy. Participants answered a structured questionnaire about sociodemographic and behavioral variables and were submitted to a clinical examination to diagnose DH using a blast of air and a manual probe on the buccal surfaceof all present teeth. Analytical commands that take into consideration the complex sampling design were used to generate estimates and multivariable risk models. Approximately one third of the population was diagnosed with DH (air blast= 33.4% and probe= 34.2%). Among individuals with DH, in average 2 to 3 teeth were affected by DH. The teeth most affected by DH were maxillary premolars and molars, followed by mandibular premolars. Gingival recession was a determinant factor for the occurrence of DH and was modeled separately from the other variables. Females, younger individuals, smokers, individuals of higher education and those reporting positive history of periodontal treatment had significantly higher chances of DH. It can be concluded that the prevalence of DH found in the studied population is high, although with few teeth affected. The occurrence of DH is associated with important sociodemographic and behavioral factors for which preventive strategies may be established on individual and population levels.

This study aimed to investigate the relationship between oral pain, seeking treatment, treatment need and self-perceived dental impact in people ages 50 to 74 years in three sanitary districts of Porto Alegre. Cross-sectional study of people in Porto Alegre with 720 individuals, aged between 50 and 74 years living in three sanitary districts. The impacts of dental and sociodemographic data were collected through structured interviews. The Oral Impacts on Daily Performances - OIDP developed by Adulyanon, Vourapukjaru and Sheiham (1996) was used to measure the impacts. The data were analyzed using Poisson regression. The prevalence of pain in this population were 32.8% and was present in 32.5% of those reporting some impact on dental care, and daily activities more often associated with the prevalence of pain: Talking (37.6%), clean their teeth and gums (37.0%) and enjoy being with people (% 36.5) and with severe pain: Work (% 14.8), enjoy socializing with people (% 11.6) and rest (%11.1). The outcome variables significantly associated with high impact were seeking treatment in the last year [PR 0.72 (0.54 to 0.96)] and reasons for visiting a dentist because of pain [PR 1.75 (1.18 to 2, 61)]. These results serve as an aid in formulating public health policies, focusing on services for adults and the elderly, further studies are needed to establish causal relationship between dental pain and impact dental conditions and dental predictors of impact. / Este estudo teve como objetivo principal investigar a relação entre dor bucal, procura por atendimento, necessidade de tratamento auto-percebida e o impacto odontológico em pessoas em idades entre 50 e 74 anos de três distritos sanitários de Porto Alegre. Estudo analítico transversal de base populacional no município de Porto Alegre com 720 indivíduos, com idades entre 50 e 74 anos, residentes em três distritos sanitários. Os impactos odontológicos e os dados sociodemográficos foram coletados por meio de entrevistas estruturadas. O Oral Impacts on Daily Performances OIDP, desenvolvido por Adulyanon, Vourapukjaru, e Sheiham (1996) foi utilizado para medir os impactos. As informações foram analisadas através de regressão de Poisson. A prevalência de dor na população estudada foi 32,8% e esteve presente em 32,5% dos indivíduos que referiram algum impacto odontológico, sendo as atividades diárias mais frequentemente associadas com a prevalência de dor: Falar (37,6%), limpar seu dentes e gengivas (37,0%) e aproveitar o convívio com as pessoas (36,5%); e com dor severa: Trabalhar (14,8%), aproveitar o convívio com as pessoas (11,6%) e descansar (11,1%). As variáveis associadas significativamente ao desfecho impacto alto foram, procura por atendimento no último ano [RP 0,72 (0,54-0,96)] e motivos da consulta odontológica por dor [RP 1,75 (1,18-2,61)]. Os resultados deste trabalho servem como meio auxiliar na formulação de políticas públicas de saúde, voltadas ao atendimento de adultos e idosos, novos estudos são necessários para estabelecer relação causal entre dor dentária e o impacto odontológico, assim como das condições preditoras de impacto odontológico.

Indiana University-Purdue University Indianapolis (IUPUI) / Although complex phenomena such as oral diseases can be studied using generalizable conceptual frameworks, the differences in the underlying influences across countries necessitate adaptation of existing oral health frameworks to the specific conditions in each country. The aim of this dissertation was to investigate distal (indirect) and proximal (direct) influences of oral health and their interactions with both self-reported oral pain (OP) and self-rated oral health status (SROH) in Saudi Arabia (SA). Two secondary data analyses were conducted utilizing data from the national demographic and health survey (DHS) of SA in 2017. The objective of the first study was to describe the study design, and the distal and proximal influences reported in the 2017 SA DHS. The objective of second study was to explore associations between proximal and distal factors that affect OP and SROH, using the adapted framework. Path analysis modeling was used to estimate direct, indirect, and total effects. The 2017 SA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ catchment areas as the primary sampling unit. The final analysis included 29,274 adults, 9910 adolescents, and 11653 children. OP in the past year was experienced in 39% in children and, 48.5% for the adolescents, and 47.1% in adults. The proportion of respondents who reported good, very good, or excellent self-rated oral health status was 92.9 % in children, 87.1% in both adolescents and adults. In children group, OP was linked to less tooth brushing, more dental visits and less dental routine examination, while less favorable SROH was linked to less tooth brushing, more dental visits and sweets consumption. In adolescents and adults groups, OP and less favorable SROH were linked to more dental visits, complaint dental visits, less tooth brushing. Many distal influences showed significant effects (direct, indirect, and total) on OP and SROH; however, differences existed among the three age groups. The studies suggest that future investigations should focus on why Saudi residents perceive their oral health positively while the prevalence of negative oral health influences and OP was high.

<h1>Abstract</h1><p><strong>Background: </strong>Pain is usually common patients who undergo high-dose treatment in combination with HSCT. Pain is usually associated with side effects as for example mucositis. The purpose of this study was to examine patients’ experiences of pain in relation to stemcellstransplantation. The purpose was also to examine how patients experience that they have been treated by the personnel regarding their pain, and also if the pain relief correspond to the patients expectations.</p><p><strong>Method: </strong>The study is a descriptive, longitudinal study. Eight patients who underwent HSCT were interviewed. The study implemented in three parts, whereof two interviews and one questionnaire. The interview material was analyzed by means of content analysis.</p><p><strong>Results: </strong>The result shows that five of eight patients experienced pain during HSCT treatment. Three of these informants experienced pain in their mouth, their head and in their stomach. This is usually commonly side effects of the treatment. Back pain occurs in two of the patients and this pain hasn’t proceeded during the treatment.</p><p>Three informants did not experience any pain at all during the time of nursing. The result even shows that the all of the informants had experienced a well refutation of the personnel in terms of their pain. All informants reported that it was important to be well pain relieved. Those informants who had pain during their treatment were very satisfied with the pain relief they have got.</p><p><strong> </strong></p><p><strong>Keywords: </strong>stem cell transplantation, oral pain, pain treatment, oral mucositis, satisfaction with care.</p> / <p> </p><h1>Sammanfattning</h1><p><strong>Bakgrund och syfte: </strong>Smärta är vanligt förekommande bland patienter som genomgår högdosbehandling i kombination med HSCT. Smärta är vanligtvis förknippad med biverkningar som t ex mucosit. Syftet med denna studie var att undersöka patienters upplevelse av smärta i samband med stamcellstransplantation. Syftet är även att undersöka hur patienterna upplever att de blir bemötta av personalen angående sin smärta, samt om smärtlindringen motsvarar patientens förväntningar.</p><p><strong>Metod:</strong> Studien är en deskriptiv, longitudinell studie. Åtta patienter som skulle genomgå stamcellstransplantation intervjuades. Studien genomfördes i tre delar, varav två intervjuer och ett frågeformulär. Intervjumaterialet analyserades med innehållsanalys.</p><p><strong>Resultat:</strong> Resultatet visar att fem av åtta patienter upplevde smärta i samband med HSCT. Tre av dessa informanter upplevde smärtor i munnen, huvudet och i magen. Ryggsmärta förekom hos två av informanterna och denna smärta hade inte uppstått i samband med behandlingen. Tre informanter upplevde ingen smärta alls under hela vårdtiden. Resultatet visar även att samtliga informanter upplevt ett bra bemötande av personalen vad gäller deras smärta. Alla informanter uppgav att det var viktigt att vara bra smärtlindrad. De informanter som hade smärta under behandlingen var mycket nöjda med den smärtlindring de fick.</p><p><strong> </strong></p><p><strong>Nyckelord: </strong>stamcellstransplantation, oral smärta, smärtbehandling, oral mucosit, tillfredsställelse med vård.</p>

Abstract Background: Pain is usually common patients who undergo high-dose treatment in combination with HSCT. Pain is usually associated with side effects as for example mucositis. The purpose of this study was to examine patients’ experiences of pain in relation to stemcellstransplantation. The purpose was also to examine how patients experience that they have been treated by the personnel regarding their pain, and also if the pain relief correspond to the patients expectations. Method: The study is a descriptive, longitudinal study. Eight patients who underwent HSCT were interviewed. The study implemented in three parts, whereof two interviews and one questionnaire. The interview material was analyzed by means of content analysis. Results: The result shows that five of eight patients experienced pain during HSCT treatment. Three of these informants experienced pain in their mouth, their head and in their stomach. This is usually commonly side effects of the treatment. Back pain occurs in two of the patients and this pain hasn’t proceeded during the treatment. Three informants did not experience any pain at all during the time of nursing. The result even shows that the all of the informants had experienced a well refutation of the personnel in terms of their pain. All informants reported that it was important to be well pain relieved. Those informants who had pain during their treatment were very satisfied with the pain relief they have got.   Keywords: stem cell transplantation, oral pain, pain treatment, oral mucositis, satisfaction with care. / Sammanfattning Bakgrund och syfte: Smärta är vanligt förekommande bland patienter som genomgår högdosbehandling i kombination med HSCT. Smärta är vanligtvis förknippad med biverkningar som t ex mucosit. Syftet med denna studie var att undersöka patienters upplevelse av smärta i samband med stamcellstransplantation. Syftet är även att undersöka hur patienterna upplever att de blir bemötta av personalen angående sin smärta, samt om smärtlindringen motsvarar patientens förväntningar. Metod: Studien är en deskriptiv, longitudinell studie. Åtta patienter som skulle genomgå stamcellstransplantation intervjuades. Studien genomfördes i tre delar, varav två intervjuer och ett frågeformulär. Intervjumaterialet analyserades med innehållsanalys. Resultat: Resultatet visar att fem av åtta patienter upplevde smärta i samband med HSCT. Tre av dessa informanter upplevde smärtor i munnen, huvudet och i magen. Ryggsmärta förekom hos två av informanterna och denna smärta hade inte uppstått i samband med behandlingen. Tre informanter upplevde ingen smärta alls under hela vårdtiden. Resultatet visar även att samtliga informanter upplevt ett bra bemötande av personalen vad gäller deras smärta. Alla informanter uppgav att det var viktigt att vara bra smärtlindrad. De informanter som hade smärta under behandlingen var mycket nöjda med den smärtlindring de fick.   Nyckelord: stamcellstransplantation, oral smärta, smärtbehandling, oral mucosit, tillfredsställelse med vård.

Philosophiae Doctor - PhD / Validation of the OHIP-14 for a South African adult population using CFA resulted in a 12-item scale (OHIP-12) with excellent reliability (α =0.94), but the structural pathway varied across the socio-economic groups. The prevalence of oral pain was 19.4%, and varied significantly only across area-level SEP. Cost of care over the six months was estimated at about one billion Rand. Of those residing in the lowest SEP areas, 20.8% reported that they “did nothing” to relieve their last pain episode. Oral pain resulted in an average of two days lost per person from work/school over a six months period. The prevalence of OHIP was 16.2%. Those who had never visited a dental clinic had significantly better OHRQoL and less pain experience compared to those who previously visited a dental clinic. Both individual-level and area-level SEP were associated with OHRQoL in the bi-variate analysis, but these effects did not remain significant in multivariable-adjusted analysis. In particular, the respondents‟ race completely attenuated the effect of individual-level SEP on OHRQoL, while the experience of oral pain in the past six months completely attenuated the effect of area-level SEP on OHRQoL. Both absolute and relative inequality in oral health among the South African adult population was greater in the highest SEP areas than in the areas of lowest SEP