Made available in DSpace on 2011-05-04T12:42:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / Objetivo: O objetivo desta tese foi descrever as condições de saúde bucal e analisar os fatores associados ao processo saúde-doença, em duas populações rurais ribeirinhas do município de Coari-AM. A hipótese de que a distância geográfica do centro urbano influencia os desfechos de saúde bucal em populações remotas foi testada. Métodos: As comunidades ribeirinhas foram selecionadas com base no critério de localização: uma deveria ser a mais próxima da sede do município (Comunidade de Isidoro) e a outra a mais distante (Comunidade de LauroSodré). Um estudo de corte transversal foi conduzido, seguindo os critérios da OMS para pesquisas epidemiológicas em saúde bucal. O estudo incluiu indivíduos de 1 a 75 anos, e os grupos etários para análise incluíram os preconizados pela OMS. Os desfechos clínicos foram: cárie para dentição decídua (ceo-d) e permanente (CPO-D), condição periodontal de acordo com os índices CPI, PIP e de sangramento gengival, e lesões de tecido mole. As variáveis analisadas foram: local de residência, dados socioeconômicos, hábitos de higiene e dieta. Adicionalmente, foram aplicados questionários estruturados a indivíduos acima de 18 anos, e entrevistas semi-estruturadas a informantes-chave para se obter dados sobre freqüência de uso dos serviços odontológicos / Objective: The aim of this thesis was to evaluate oral health conditions and to analyze factors associated with the health-disease process in two rural riverine populations located in the Amazonas state (Brazil). The hypothesis that the geographical distance from urban centers influences oral health outcomes in remote populations, has been tested. Methods: The riverine communities were selected based on the location criteria: one was the nearest from the administrative center of the town (Isidoro Community), and the other was the farther (Lauro Sodré Community). A cross-sectional study was conducted following the WHO guidelines for epidemiological surveys in oral health. The study covered population aged from 1 to 75 years, and the age groups for analysis included the WHO pattern. The clinical outcomes were: dental caries for deciduous (dmf-t) and permanent (DMF-T) teeth, periodontal condition according to the CPI and PIP indexes and to gingival bleeding, and soft tissue lesions. The variables analyzed were: place of residence, socioeconomic data, oral hygiene habits and diet. Additionally, structured questionnaires were applied to individuals above 18 years-old and semi-structured interviews were led with key-informants to obtain data about the frequency of use of dental health services. The OHIP-14 was validated and applied to individuals above 18 years-old for the description of oral health impacts. Bivariate and multivariate analyses were performed for the comparison of the two communities. Results: 136 individuals in Isidoro and 242 individuals in Lauro Sodré were examined. The farther community (Lauro Sodré) presented more caries, a higher prevalence of edentate persons, more time in between since their last dental visit, and more negative impacts of oral health than the nearest community. For the DMF-T outcome, when socioeconomic, hygiene and diet variables were controlled in the multivariate analyses, only place of residence and age remained significant. The psychometric properties of the OHIP-14 was good (ICC=0,97 and Cronbach s alpha=0,89). Conclusions: The prevalence of untreated caries, oral pain, edentulism and oral health negative impacts were high for the riverines, especially for those who live further distant from the urban center. Additionally, the limited access to dental health services for these populations points to the need for imminent deployment of broad measures of health promotion, along with greater availability of services.