Text in Afrikaans / Die tydruimtelike variasie in die fluoriedinhoud vannatuurlike drinkwater en in die voorkoms van tandfluorose, die verband tussen hierdie veranderlikes asook hulle kovariasie is op 'n hoe resolusievlak in geselekteerde endemiese gebiede ondersoek. Die drie studiegebiede verskil grootliks van mekaar wat sommige fisies- en menslik-geografiese kenmerke betref, maar ondergrondse water was oral die belangrikste bron van drinkwater. Ioonspesifieke analise en laboratoriumtegnieke is gebruik om die fluoriedinhoud van die drinkwater uit 517 bronne te bepaal. Die tande van 3 068 kinders is klinies en fotografies ondersoek. Die erkende Tooth Fluorosis Index en die indeks van Dean is gebruik om die voorkoms van fluorose te beskryf. Grafiese tegnieke, beskrywende statistieke en nieparametriese analise van variansietoetse is gebruik om die voorkoms en tydruimtelike variasiepatrone van die sleutelveranderlikes in elke studiegebied, asook die verskillende ruimtelike eenhede binne die studiegebiede, te beskryf. Die verband tussen die sleutelveranderlikes asook hul intra- en interareale kovariasie is ontleed. Daar is gevind dat die fluoriedinhoud van die ondergrondse water in die Pilanesberg- en Hammanskraal-studiegebied relatief hoog tot hoog is en die in die Vrystaat-studiegebied relatief laag. Ruimtelike veranderlikheid met groot verskille oor klein afstande kenmerk die fluoriedinhoud van ondergrondse water ongeag die gesteentes waaruit dit onttrek word. Middelwaardes bied ontoereikende beskrywings van die fluoriedgehalte van die drinkwater. Die skep van nuwe drinkwaterbronne veroorsaak langtermynvariasie in die fluoriedinhoud van die beskikbare drinkwater. Fluoroseprevalensie in die studiegebiede bet van 62% tot 87% gewissel, met meer ernstige aantasting in die Pilanesberg- en Hammanskraal-gebied as in die Suid-Vrystaat. Beduidende intra-areale ruimtelike variasie is 'n wesenlike kenmerk van die voorkoms van fluorose in al drie studiegebiede. In alle gevalle het die variasiepatroon in die fluoriedinhoud van die drinkwater die in die voorkoms van fluorose slegs gedeeltelik verklaar. Sporadiese en/of periodieke kortstondige blootstelling aan hoe fluoriedkonsentrasies lei tot emstige aantasting ten spyte van die gereelde gebruik van water met 'n laefluoriedinhoud. Ligte fluorose ontwikkel geredelik in assosiasie met <0,5 mgF-/l en matige fluorose in assossiasie met 0,5-0,7 mgF-/l, die optimum konsentrasieinterval vir fluoridasie in Suid-Afrika. / The spatiotemporal variation in the fluoride content of natural drinking water and the occurrence of dental fluorosis, the relation between these variables as well as their covariation were investigated at a high resolution level in selected endemic areas. Groundwater was the most important source of drinking water in all three study areas, but they differed markedly in respect of some physical and human geographical characteristics. Ion specific analysis and laboratory techniques were used to determine the fluoride content of the water from 517 sources. The teeth of 3 068 children were examined clinically and photographically. The fluorosis was scored according to the Tooth Fluorosis Index and Dean's classification. Graphical techniques, descriptive statistics and nonparametric analysis of variance were used to describe the occurrence and variation patterns of the key variables in the different spatial units is each study area. The relation between the variables as well as their intra and interareal covariation were analysed. The fluoride content of the groundwater in the Pilanesberg and Hammanskraal areas was relatively high to high; in the southern Free State it was relatively low. Spatial variability and significant differences over small distances typify the fluoride content of the groundwater, irrespective of the aquifer. Central statistics inadequately describe the fluoride quality of the natural drinking water. The development of new water sources causes long term variation in the fluoride content of the available drinking water. Fluorosis prevalence varied form 62% to 87%, with more severe fluorosis in Pilanesberg and Hammanskraal than in the southern Free State. Significant intra-areal spatial variation is an attribute of fluorosis in all three study areas. In all cases the variation pattern in the fluoride content of the drinking water partly explained the spatial pattern in the occurrence of fluorosis. Sporadic and/or periodic brief exposure to high fluoride concentrations leads to severe fluorosis despite regul~ usage of water with a low fluoride content. Mild fluorosis readily develops in association with <0,5 mgF-1~ and medium fluorosis in association with 0,5-0,7 mgF-/l, the optimum concentration interval for fluoridation in South Africa. / Geography / D. Phil. (Geografie)

Introdução - A quantidade de flúor ingerida, proveniente de todas as fontes, durante o período crítico de formação dos dentes, é o principal fator de risco para a fluorose dentária. Dentre estas fontes estão a água fluoretada, o dentifrício fluoretado e os alimentos, bebidas, fórmulas e suplementos infantis. Considerando-se que a fluorose dentária tem aumentado em todas as regiões é importante avaliar, além da água e do dentifrício, também a contribuição diária do consumo alimentar das crianças e a concentração de flúor nesses itens alimentares para a ingestão de flúor. Objetivo - Descrever o consumo alimentar de crianças de 2 a 6 anos, com relação ao flúor. Métodos - Foram avaliadas 379 crianças, de 2 a 6 anos, faixa etária de risco para fluorose, residentes em Bauru - São Paulo, município com fluoretação artificial da água de abastecimento público. A amostragem foi estratificada por setor, baseando-se no Plano Diretor do Município. O consumo alimentar foi avaliado pelo Questionário de Freqüência Alimentar Semiquantitativo, aplicado aos pais ou responsáveis, e a concentração de flúor nos itens alimentares a partir de análises laboratoriais. As crianças foram classificadas quanto à ingestão diária de f1úor de acordo com a Dietary Reference Intakes. Resultados - Dentre os 70 itens alimentares, o arroz, a água de abastecimento público e o leite foram os mais consumidos; o chá preto, o leite em pó de soja diluído com água de abastecimento público e o biscoito Danyt\'s® apresentaram maior concentração de flúor; a água de abastecimento público, o refrigerante Coca-Cola® e a batata frita representaram maior contribuição diária para ingestão de flúor. Os itens alimentares mais consumidos apresentaram, em média (±DP), concentração de flúor (0,015 ± 0,028 mgF/porção) significantemente menor (p = 0,03) que os menos consumidos (0,107 ± 0,162 mgF/porção). Os itens alimentares com maior concentração de flúor contribuíram significantemente (p < 0,001) para a ingestão do halogênio (0,018 ± 0,037 mgF/dia). A média da ingestão de flúor por meio dos alimentos sólidos e líquidos, da água e da escovação foi de 0,017 ± 0,016; 0,011 ± 0,004 e 0,036 ± 0,028 mgF/kg peso/dia, respectivamente, totalizando 0,064 ± 0,035 mgF/kg peso/dia. Das 379 crianças, 31,2% apresentaram risco de fluorose. O dentifrício e os itens alimentares (sólidos, água e outros líquidos) contribuíram com 57% e 43%, respectivamente, para a ingestão de flúor. Conclusão - O dentifrício foi a principal fonte para a ingestão de f1úor pelas crianças, porém, a concentração desse halogênio nos itens alimentares contribuiu significantemente para a ingestão, representando risco para f1uorose dentária. / The quantity of fluoride ingested, deriving from all sources, during the critical period of formation of the teeth, is the main factor of risk for the dental fluorosis. Among this sources, we have the fluoridated water, the fluoridated dentifrice and the food, drinks, chemical formula and the infant supplements. Taking into consideration that the dental fluorosis has increased in all regions, it is important to evaluate it, besides the water and the dentifrice, the daily contribution of children\'s food consumption and the concentration of fluoride in these food items for the ingestion of fluoride. Objective - Describe the food consumption of children from 2 to 6 years old, relationg to fluoride. Methods - 379 children were evaluated at risking ages for fluorosis, residents in Bauru - São Paulo, district with artificial f1uoridation. The sampling was stratified by sector, based on the Director\'s Plan of the District. The food intake was evaluated by the Food Frequency Semiquantitative Questionnaire, applied on parents or responsable one, and the concentration of fluoride on the food items from analyses in laboraties. The children were classified based on theis daily ingestion of fluoride according to the Dietary Reference Intakes. Results - Among the 70 food items, rice, public water supply and the milk were the most consumed ones; the black tea, the soybean powdered milk diluted in public water and the biscuit Danyt\'s® presented the gratest daily contribution for the ingestion of fluoride. The most consumed food items present, in average (± DP), concentration of fluoride (0,015 ± 0,028 mg F / portion), significantly lower (p = 0,03) that the less consumed (0,107 ± 0,162 mgF/portion). The food items with the greatest concentration of fluoride contributed significantly (p < 0,001) for the ingestion of the mineral (0,018 ± 0,037 mgF/day). The average amount of fluoride ingestion taken from the solid food and the liquid ones (except water) coming from the water and the teeth brushing was 0,017 ± 0,016; 0,011 ± 0,004 and 0,036 ± 0,028 mgF/kg weight/day, respectively, totalizing 0,064 ± 0,035 mgF/kg weight/dia. 31,2% of the 379 children presented risk of fluorosis. The dentifrice and the food items (solid, water and other liquids) contributed with 57% and 43%, respectively, for the ingestion of fluoride. Conclusion - The dentifrice was the main source for the ingestion of fluoride, by the children, however, the concentration of this mineral in food items contributed significantly for the ingestion by the children, representing risk for dental fluorosis.

Introdução - A quantidade de flúor ingerida, proveniente de todas as fontes, durante o período crítico de formação dos dentes, é o principal fator de risco para a fluorose dentária. Dentre estas fontes estão a água fluoretada, o dentifrício fluoretado e os alimentos, bebidas, fórmulas e suplementos infantis. Considerando-se que a fluorose dentária tem aumentado em todas as regiões é importante avaliar, além da água e do dentifrício, também a contribuição diária do consumo alimentar das crianças e a concentração de flúor nesses itens alimentares para a ingestão de flúor. Objetivo - Descrever o consumo alimentar de crianças de 2 a 6 anos, com relação ao flúor. Métodos - Foram avaliadas 379 crianças, de 2 a 6 anos, faixa etária de risco para fluorose, residentes em Bauru - São Paulo, município com fluoretação artificial da água de abastecimento público. A amostragem foi estratificada por setor, baseando-se no Plano Diretor do Município. O consumo alimentar foi avaliado pelo Questionário de Freqüência Alimentar Semiquantitativo, aplicado aos pais ou responsáveis, e a concentração de flúor nos itens alimentares a partir de análises laboratoriais. As crianças foram classificadas quanto à ingestão diária de f1úor de acordo com a Dietary Reference Intakes. Resultados - Dentre os 70 itens alimentares, o arroz, a água de abastecimento público e o leite foram os mais consumidos; o chá preto, o leite em pó de soja diluído com água de abastecimento público e o biscoito Danyt\'s® apresentaram maior concentração de flúor; a água de abastecimento público, o refrigerante Coca-Cola® e a batata frita representaram maior contribuição diária para ingestão de flúor. Os itens alimentares mais consumidos apresentaram, em média (±DP), concentração de flúor (0,015 ± 0,028 mgF/porção) significantemente menor (p = 0,03) que os menos consumidos (0,107 ± 0,162 mgF/porção). Os itens alimentares com maior concentração de flúor contribuíram significantemente (p < 0,001) para a ingestão do halogênio (0,018 ± 0,037 mgF/dia). A média da ingestão de flúor por meio dos alimentos sólidos e líquidos, da água e da escovação foi de 0,017 ± 0,016; 0,011 ± 0,004 e 0,036 ± 0,028 mgF/kg peso/dia, respectivamente, totalizando 0,064 ± 0,035 mgF/kg peso/dia. Das 379 crianças, 31,2% apresentaram risco de fluorose. O dentifrício e os itens alimentares (sólidos, água e outros líquidos) contribuíram com 57% e 43%, respectivamente, para a ingestão de flúor. Conclusão - O dentifrício foi a principal fonte para a ingestão de f1úor pelas crianças, porém, a concentração desse halogênio nos itens alimentares contribuiu significantemente para a ingestão, representando risco para f1uorose dentária. / The quantity of fluoride ingested, deriving from all sources, during the critical period of formation of the teeth, is the main factor of risk for the dental fluorosis. Among this sources, we have the fluoridated water, the fluoridated dentifrice and the food, drinks, chemical formula and the infant supplements. Taking into consideration that the dental fluorosis has increased in all regions, it is important to evaluate it, besides the water and the dentifrice, the daily contribution of children\'s food consumption and the concentration of fluoride in these food items for the ingestion of fluoride. Objective - Describe the food consumption of children from 2 to 6 years old, relationg to fluoride. Methods - 379 children were evaluated at risking ages for fluorosis, residents in Bauru - São Paulo, district with artificial f1uoridation. The sampling was stratified by sector, based on the Director\'s Plan of the District. The food intake was evaluated by the Food Frequency Semiquantitative Questionnaire, applied on parents or responsable one, and the concentration of fluoride on the food items from analyses in laboraties. The children were classified based on theis daily ingestion of fluoride according to the Dietary Reference Intakes. Results - Among the 70 food items, rice, public water supply and the milk were the most consumed ones; the black tea, the soybean powdered milk diluted in public water and the biscuit Danyt\'s® presented the gratest daily contribution for the ingestion of fluoride. The most consumed food items present, in average (± DP), concentration of fluoride (0,015 ± 0,028 mg F / portion), significantly lower (p = 0,03) that the less consumed (0,107 ± 0,162 mgF/portion). The food items with the greatest concentration of fluoride contributed significantly (p < 0,001) for the ingestion of the mineral (0,018 ± 0,037 mgF/day). The average amount of fluoride ingestion taken from the solid food and the liquid ones (except water) coming from the water and the teeth brushing was 0,017 ± 0,016; 0,011 ± 0,004 and 0,036 ± 0,028 mgF/kg weight/day, respectively, totalizing 0,064 ± 0,035 mgF/kg weight/dia. 31,2% of the 379 children presented risk of fluorosis. The dentifrice and the food items (solid, water and other liquids) contributed with 57% and 43%, respectively, for the ingestion of fluoride. Conclusion - The dentifrice was the main source for the ingestion of fluoride, by the children, however, the concentration of this mineral in food items contributed significantly for the ingestion by the children, representing risk for dental fluorosis.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O incremento na incidÃncia da fluorose dentÃria ocorrido nos Ãltimos tempos, à motivo de preocupaÃÃo dos epidemiologistas em nÃvel nacional e internacional. A diferenciaÃÃo entre as alteraÃÃes do esmalte fluorÃtico e nÃo fluorÃtico leva a importantes decisÃes em epidemiologia e saÃde pÃblica bucal. O objetivo deste estudo à investigar a capacidade dos cirurgiÃes-dentistas do serviÃo pÃblico de saÃde no municÃpio de Fortaleza, em diagnosticar a fluorose dentÃria, frente Ãs diversas afecÃÃes do esmalte dentÃrio, seus graus de severidade e a conduta terapÃutica apropriada a cada caso. Utilizou-se para isso um questionÃrio com questÃes semi-estruturadas, o qual foi aplicado a 200 cirurgiÃes-dentistas, de um universo de 527 profissionais do serviÃo pÃblico de saÃde de Fortaleza. O questionÃrio foi aplicado no local de trabalho dos participantes, cujas respostas se basearam na apresentaÃÃo de 20 fotografias digitalizadas de dentes com alteraÃÃes prÃprias do esmalte. A presenÃa ou ausÃncia de fluorose dentÃria e seus graus de severidade foram determinados pelo Ãndice de Dean. NÃo foram detectadas diferenÃas significativas no nÃvel de acerto do grau de fluorose, quando os respondentes foram classificados segundo a instituiÃÃo de graduaÃÃo (p>0,05). No entanto, aqueles profissionais menos experientes apresentaram melhor desempenho (p<0,05), tanto no diagnÃstico de fluorose, quanto na conduta mas nÃo no grau de severidade da doenÃa. Os profissionais gerenciados pela Secretaria Municipal de SaÃde obtiveram desempenho superior aos gerenciados pelo Estado, em todas as percepÃÃes do teste. Quanto ao agrupamento da amostra por especialidades, nenhuma diferenÃa significativa (p>0,05) foi encontrada entre os Grupos. A mÃdia de acertos no diagnÃstico diferencial da fluorose dentÃria foi de 7,70  0,15. Valores inferiores a 30% de acertos foram obtidos no diagnÃstico do grau de severidade da fluorose, destacando-se as formas mais graves como de maior percentual de acerto. A maioria (90%) dos respondentes admitiram ter sentido dificuldades no diagnÃstico da fluorose, apesar de 75% ter recebido informaÃÃo acerca do assunto no curso de graduaÃÃo, porÃm consideraram escassa e deficiente (79,5%). A mÃdia de acertos da conduta clÃnica foi considerada muito baixa (2,71  0,76). Cerca de 70% dos inquiridos solicitaram curso de capacitaÃÃo acerca do diagnÃstico diferencial da fluorose dentÃria. A partir desses resultados, conclui-se que os cirurgiÃes-dentistas que atuam no serviÃo pÃblico de saÃde de Fortaleza apresentaram um baixo nÃvel de conhecimento e falta de preparo adequado para o diagnÃstico da fluorose dentÃria, a percepÃÃo dos seus graus de severidade e definiÃÃo da conduta clÃnica apropriada. Sugere-se que estudos mais abrangentes sejam conduzidos a fim de identificar as carÃncias do setor pÃblico de saÃde, em todos os nÃveis de atenÃÃo / Increasing levels of dental fluorosis are a major concern to public health authorities. The ability to discriminate fluorosis from other enamel modifications is an important factor to support decision makers in epidemiology and oral health. The main objective of this research is to investigate the ability of the odontologists working for the public health services in Fortaleza, to discriminate fluorosis from other enamel alterations, the severity of the disease and the correct clinical approach. Two hundred dentists out of 527 professionals of the public health services answered a semi-structured survey, based on the evaluation of 20 digitalized pictures showing enamel modifications. The presence or absence of fluorosis, as well as the severity of the disease were determined according to the Deanâs index. We were unable to detect an effect of the school of graduation (p>0.05) on the ability to diagnose fluorosis. However, the youngest, less experienced dentists performed better (p<0.05) for both fluorosis diagnosis and to determine to adequate clinical approach for each case. Also, odontologists working in the city health services were more likely to get higher scores compared to the ones working for the state services, with an average of correct answers for differential diagnosis of 7.70  0.15. Although a few subjects achieved less than 30% of correct answers, pictures displaying more severe cases of fluorosis were more likely to result in correctly answered questions. The vast majority (90%) of the subjects reported to have a poor ability do diagnose fluorosis, although 75% had received information about that disease during undergraduation. The odontologists also displayed a very poor performance (2,71  0,76) in defining the best clinical approach, and about 70% of them asked for specific training for correctly diagnose dental fluorosis. Based on the above results, we conclude that most dental surgeons working for the public health services in Fortaleza displayed a poor knowledge about dental fluorosis and lack an adequate training to diagnose and treat that disease. Similar researchs in other regions of Ceara should be performed in order to better identify the deficiencies of the public health services, at different levels

Text in Afrikaans / Die tydruimtelike variasie in die fluoriedinhoud vannatuurlike drinkwater en in die voorkoms van tandfluorose, die verband tussen hierdie veranderlikes asook hulle kovariasie is op 'n hoe resolusievlak in geselekteerde endemiese gebiede ondersoek. Die drie studiegebiede verskil grootliks van mekaar wat sommige fisies- en menslik-geografiese kenmerke betref, maar ondergrondse water was oral die belangrikste bron van drinkwater. Ioonspesifieke analise en laboratoriumtegnieke is gebruik om die fluoriedinhoud van die drinkwater uit 517 bronne te bepaal. Die tande van 3 068 kinders is klinies en fotografies ondersoek. Die erkende Tooth Fluorosis Index en die indeks van Dean is gebruik om die voorkoms van fluorose te beskryf. Grafiese tegnieke, beskrywende statistieke en nieparametriese analise van variansietoetse is gebruik om die voorkoms en tydruimtelike variasiepatrone van die sleutelveranderlikes in elke studiegebied, asook die verskillende ruimtelike eenhede binne die studiegebiede, te beskryf. Die verband tussen die sleutelveranderlikes asook hul intra- en interareale kovariasie is ontleed. Daar is gevind dat die fluoriedinhoud van die ondergrondse water in die Pilanesberg- en Hammanskraal-studiegebied relatief hoog tot hoog is en die in die Vrystaat-studiegebied relatief laag. Ruimtelike veranderlikheid met groot verskille oor klein afstande kenmerk die fluoriedinhoud van ondergrondse water ongeag die gesteentes waaruit dit onttrek word. Middelwaardes bied ontoereikende beskrywings van die fluoriedgehalte van die drinkwater. Die skep van nuwe drinkwaterbronne veroorsaak langtermynvariasie in die fluoriedinhoud van die beskikbare drinkwater. Fluoroseprevalensie in die studiegebiede bet van 62% tot 87% gewissel, met meer ernstige aantasting in die Pilanesberg- en Hammanskraal-gebied as in die Suid-Vrystaat. Beduidende intra-areale ruimtelike variasie is 'n wesenlike kenmerk van die voorkoms van fluorose in al drie studiegebiede. In alle gevalle het die variasiepatroon in die fluoriedinhoud van die drinkwater die in die voorkoms van fluorose slegs gedeeltelik verklaar. Sporadiese en/of periodieke kortstondige blootstelling aan hoe fluoriedkonsentrasies lei tot emstige aantasting ten spyte van die gereelde gebruik van water met 'n laefluoriedinhoud. Ligte fluorose ontwikkel geredelik in assosiasie met <0,5 mgF-/l en matige fluorose in assossiasie met 0,5-0,7 mgF-/l, die optimum konsentrasieinterval vir fluoridasie in Suid-Afrika. / The spatiotemporal variation in the fluoride content of natural drinking water and the occurrence of dental fluorosis, the relation between these variables as well as their covariation were investigated at a high resolution level in selected endemic areas. Groundwater was the most important source of drinking water in all three study areas, but they differed markedly in respect of some physical and human geographical characteristics. Ion specific analysis and laboratory techniques were used to determine the fluoride content of the water from 517 sources. The teeth of 3 068 children were examined clinically and photographically. The fluorosis was scored according to the Tooth Fluorosis Index and Dean's classification. Graphical techniques, descriptive statistics and nonparametric analysis of variance were used to describe the occurrence and variation patterns of the key variables in the different spatial units is each study area. The relation between the variables as well as their intra and interareal covariation were analysed. The fluoride content of the groundwater in the Pilanesberg and Hammanskraal areas was relatively high to high; in the southern Free State it was relatively low. Spatial variability and significant differences over small distances typify the fluoride content of the groundwater, irrespective of the aquifer. Central statistics inadequately describe the fluoride quality of the natural drinking water. The development of new water sources causes long term variation in the fluoride content of the available drinking water. Fluorosis prevalence varied form 62% to 87%, with more severe fluorosis in Pilanesberg and Hammanskraal than in the southern Free State. Significant intra-areal spatial variation is an attribute of fluorosis in all three study areas. In all cases the variation pattern in the fluoride content of the drinking water partly explained the spatial pattern in the occurrence of fluorosis. Sporadic and/or periodic brief exposure to high fluoride concentrations leads to severe fluorosis despite regul~ usage of water with a low fluoride content. Mild fluorosis readily develops in association with <0,5 mgF-1~ and medium fluorosis in association with 0,5-0,7 mgF-/l, the optimum concentration interval for fluoridation in South Africa. / Geography / D. Phil. (Geografie)

Made available in DSpace on 2014-06-11T19:33:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-07-28Bitstream added on 2014-06-13T19:43:56Z : No. of bitstreams: 1 casotti_ca_dr_araca.pdf: 660013 bytes, checksum: c630d7bb4fdb85d40a30ec52f8e05ca2 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A fluoretação da água de abastecimento público é reconhecida como uma das principais estratégias de saúde pública para prevenir a cárie dentária. A cidade de Baixo Guandu, localizada no Estado do Espírito Santo, Brasil, foi a primeira a implantar o método. Foi objetivo do presente estudo avaliar o impacto que a fluoretação artificial da água proporcionou à saúde bucal de indivíduos com idade de 5, 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos, que sempre viveram e consumiram exclusivamente água da rede de abastecimento público dos municípios de Baixo Guandu onde a fluoretação ocorre há 52 anos e Itarana, onde o método foi implantado há 3 anos. A metodologia, os códigos e os critérios adotados foram os recomendados pela Organização Mundial da Saúde (OMS), com a inserção dos grupos etários de 20 a 34 e 45 a 56 anos. Inicialmente foram identificados os moradores permanentes das duas cidades, as quais foram examinados no domicílio, com auxílio de espelho bucal e sonda periodontal CPI. Previamente à realização do estudo, o examinador passou por uma oficina de calibração e treinamento para a padronização dos diagnósticos da cárie dentária, fluorose dentária, perda dentária e uso e necessidade de prótese, em indivíduos com grupos etários semelhantes aos do estudo. Para o cálculo da concordância kappa intra-examinador, 10% dos indivíduos foram reexaminados, sendo os resultados obtidos para a cárie dentária 0,95; fluorose dentária 0,91; perda dentária 1 e o uso e necessidade de prótese 1. No total foram examinados 1588 moradores sendo 1129 (71,1%) de Baixo Guandu e 459 (28,9%) de Itarana. Foram utilizados os testes estatísticos Qui-quadrado, Fisher, Mann Whitney e de proporções com nível de significância de 5%. As médias do ceod aos 5 anos e CPOD aos 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos foram, respectivamente, em Baixo Guandu... / The water fluoridation in the public supply is recognized as one of the main public health strategies to prevent dental caries. Baixo Guandu-ES was the first city to introduce this method in Brazil. The objective of the present study was to evaluate the impact that the artificial fluoridation of the water brought to the oral health of subjects in the age of 5, 12, 15 to 19, 20 to 34,35 to 44 and 45 to 56 years, that have always lived and consumed exclusively the water from the public supply of the city of Baixo Guandu for 52 years and Itarana where the method was introduced 3 years ago. The methodology, the codes and criteria adopted were recommended by the World Health Organization (WHO), with the insertion of age groups of 20 to 34 and 45 to 56 years. Initially the identification of the permanent inhabitants of both cities, was realized and they were locally examined with the aid of plan oral mirrors number 5 and CPI periodontal probes. Previously to this study, the examiner went through a calibrator's workshop and training for the diagnosis of dental caries, dental fluorosis, tooth loss, the use and need of prosthesis with age groups similar to the ones in the study. In order to have the Kappa's intra-examiner calculated, 10% of the individuals were re-examined and the obtained result for dental caries was 0.95; for dental fluorosis 0.91; for dental loss, and for the use and need for prosthesis 1. A total of 1588 inhabitants were examined, of those 1129 (71.1%) of Baixo Guandu and 459 (29.9%) of Itarana. The Chi-square, Fisher's, Mann-Whitney's and the Proportions tests with level of significance of 5% were used to verify the significant statistic of the results. The mean dmft for 5 year old subjects and DMFT for 12, 15 to 19, 20 to 34, 35 to 44 and 45 to 56 subjects were respectively in Baixo Guandu 2.32; 1,55; 3.48; 7.69; 13,85 and 16.49 and ...(Complete abstract, click electronic address below)

Orientador: Nemre Adas Saliba / Banca: Edgard Michel Crosato / Banca: Beatriz Unfer / Banca: Rogério Moreira Arcieri / Banca: Renato Herman Sundfeld / Resumo: A fluoretação da água de abastecimento público é reconhecida como uma das principais estratégias de saúde pública para prevenir a cárie dentária. A cidade de Baixo Guandu, localizada no Estado do Espírito Santo, Brasil, foi a primeira a implantar o método. Foi objetivo do presente estudo avaliar o impacto que a fluoretação artificial da água proporcionou à saúde bucal de indivíduos com idade de 5, 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos, que sempre viveram e consumiram exclusivamente água da rede de abastecimento público dos municípios de Baixo Guandu onde a fluoretação ocorre há 52 anos e Itarana, onde o método foi implantado há 3 anos. A metodologia, os códigos e os critérios adotados foram os recomendados pela Organização Mundial da Saúde (OMS), com a inserção dos grupos etários de 20 a 34 e 45 a 56 anos. Inicialmente foram identificados os moradores permanentes das duas cidades, as quais foram examinados no domicílio, com auxílio de espelho bucal e sonda periodontal CPI. Previamente à realização do estudo, o examinador passou por uma oficina de calibração e treinamento para a padronização dos diagnósticos da cárie dentária, fluorose dentária, perda dentária e uso e necessidade de prótese, em indivíduos com grupos etários semelhantes aos do estudo. Para o cálculo da concordância kappa intra-examinador, 10% dos indivíduos foram reexaminados, sendo os resultados obtidos para a cárie dentária 0,95; fluorose dentária 0,91; perda dentária 1 e o uso e necessidade de prótese 1. No total foram examinados 1588 moradores sendo 1129 (71,1%) de Baixo Guandu e 459 (28,9%) de Itarana. Foram utilizados os testes estatísticos Qui-quadrado, Fisher, Mann Whitney e de proporções com nível de significância de 5%. As médias do ceod aos 5 anos e CPOD aos 12, 15 a 19, 20 a 34, 35 a 44 e 45 a 56 anos foram, respectivamente, em Baixo Guandu ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The water fluoridation in the public supply is recognized as one of the main public health strategies to prevent dental caries. Baixo Guandu-ES was the first city to introduce this method in Brazil. The objective of the present study was to evaluate the impact that the artificial fluoridation of the water brought to the oral health of subjects in the age of 5, 12, 15 to 19, 20 to 34,35 to 44 and 45 to 56 years, that have always lived and consumed exclusively the water from the public supply of the city of Baixo Guandu for 52 years and Itarana where the method was introduced 3 years ago. The methodology, the codes and criteria adopted were recommended by the World Health Organization (WHO), with the insertion of age groups of 20 to 34 and 45 to 56 years. Initially the identification of the permanent inhabitants of both cities, was realized and they were locally examined with the aid of plan oral mirrors number 5 and CPI periodontal probes. Previously to this study, the examiner went through a calibrator's workshop and training for the diagnosis of dental caries, dental fluorosis, tooth loss, the use and need of prosthesis with age groups similar to the ones in the study. In order to have the Kappa's intra-examiner calculated, 10% of the individuals were re-examined and the obtained result for dental caries was 0.95; for dental fluorosis 0.91; for dental loss, and for the use and need for prosthesis 1. A total of 1588 inhabitants were examined, of those 1129 (71.1%) of Baixo Guandu and 459 (29.9%) of Itarana. The Chi-square, Fisher's, Mann-Whitney's and the Proportions tests with level of significance of 5% were used to verify the significant statistic of the results. The mean dmft for 5 year old subjects and DMFT for 12, 15 to 19, 20 to 34, 35 to 44 and 45 to 56 subjects were respectively in Baixo Guandu 2.32; 1,55; 3.48; 7.69; 13,85 and 16.49 and ...(Complete abstract, click electronic address below) / Doutor