Na Odontologia, existe uma grande preocupação com a formação de placa bacteriana ou biofilme devido ao seu potencial cariogênico. Essa atenção se estende à ortodontia, devido ao acúmulo de biofilme formado nos aparelhos ortodônticos, tanto nos aparelhos removíveis quanto nos aparelhos fixos. É muito comum a presença de lesões brancas após a remoção dos bráquetes, em torno de 50 a 75% dos pacientes, provocadas pela presença do biofilme. É necessário um controle químico e mecânico rigoroso, a fim de se evitar alterações irreversíveis nos dentes e periodonto. O controle mecânico se dá pela escovação adequada, pelo correto uso de fio dental e pela frequência desses hábitos, além, claro, de um acompanhamento profissional periódico. O controle químico pode ser viabilizado pelo uso de enxaguatórios bucais, nos quais residem alguns efeitos indesejáveis e contraindicações relacionadas ao uso e à idade dos pacientes. Este estudo tem como objetivo avaliar comparativamente dois enxaguatórios bucais, um de natureza comercial (Cepacol®), e outro não comercial, elaborado com extratos hidroalcoólicos das plantas Nasturtium officinale (agrião), Rosmarinus offinalis (alecrim), Tabebuia impetiginosa (ipê roxo), Achillea millefolium (mil folhas) e Plantago major (tanchagem), desenvolvido na Faculdade de Ciências Farmacêuticas/UNESP Araraquara. Foram selecionados 40 pacientes, jovens e adultos, entre 18 e 45 anos, usuários de aparelho ortodôntico corretivo (fixo), divididos em dois grupos, o grupo do Cepacol e o grupo do Enxaguatório base de plantas. Foram coletadas amostras nos períodos de 0, 7, 15 e 21 dias e analisadas observando-se as Unidades Formadoras de Colônia (UFC) de cada amostra. Houve uma queda significativa da quantidade de bactérias após o uso do Enxaguatório à base de plantas, revelando um produto de extrema utilidade no auxílio do controle do biofilme bacteriano nas superfícies dentárias. / In dentistry, there is a great concern with the formation of plaque or biofilm, due to its cariogenic potential. This attention extends to orthodontics due to the accumulation of biofilm on orthodontic appliances, removable appliances as much in the brackets. It is very common the presence of white spots after removal of the brackets, around 50 to 75% of patients, which are caused by biofilms. It takes a rigorous mechanical and chemical control in order to avoid irreversible changes in the teeth and periodontium. The mechanical control is by proper brushing, correct flossing and also the frequency of these habits, besides, of course, a periodical professional monitoring. Chemical control can be achieved by the use of mouthwashes, home to some undesirable effects and contraindications related to the use and age of patients. This study aimed to assess two mouthwashes, a commercial type (Cepacol ®) and other non-commercial, made with hydroalcoholic extracts of plants Nasturtium officinale (watercress), offinalis Rosmarinus (rosemary), Tabebuia impetiginosa ( purple ipe), Achillea millefolium (thousand leaves) and Plantago major (plantain), developed at the Faculty of Pharmaceutical Sciences / UNESP Araraquara. We selected 40 patients, young and adults between 18 and 45 years, users of orthodontic appliance (fixed), divided into two groups, the Cepacol group and the group of herbal mouthwash. Samples were collected during periods of 0, 7,15 and 21 days and analyzed by observing the Colony Forming Units (CFU) of each sample. There was a significant decrease in the amount of bacteria after using herbal mouthwash, revealing a product of the utmost use in aiding the control of bacterial biofilms on tooth surfaces.

Submitted by EDUARDA GIMENES CORRÊA null (eduarda_correa@hotmail.com) on 2018-01-24T00:00:08Z No. of bitstreams: 1 Eduarda Guimenes Correa-Doutorado.pdf: 1965109 bytes, checksum: 2abdaebab12cfb702405a46e0d12b1e7 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-01-25T16:02:35Z (GMT) No. of bitstreams: 1 correa_eg_dr_bot.pdf: 1965109 bytes, checksum: 2abdaebab12cfb702405a46e0d12b1e7 (MD5) / Made available in DSpace on 2018-01-25T16:02:35Z (GMT). No. of bitstreams: 1 correa_eg_dr_bot.pdf: 1965109 bytes, checksum: 2abdaebab12cfb702405a46e0d12b1e7 (MD5) Previous issue date: 2017-11-30 / Introdução: A Odontologia vem desenvolvendo novos conceitos de atenção precoce e manutenção da saúde, fundamentados no princípio da integralidade, capaz de transformar o cotidiano dessas práticas e o cuidado em saúde. Vislumbra-se que as práticas de promoção à saúde, quando iniciadas precocemente, capacita mães para a responsabilidade de cuidar, não só de sua saúde bucal, como também da criança, são um caminho para a melhoria da saúde. Objetivos: Levantar as condições de saúde bucal de crianças de zero a trinta e seis meses na visão da mãe; Avaliar a saúde bucal de crianças de zero a trinta e seis meses e de suas mães; Verificar a existência de associação entre índice de cárie de crianças e de suas mães; Identificar práticas de cuidados e hábitos de mães em relação á saúde bucal; Verificar se há concordância de mãe e pesquisadora acerca da saúde bucal da criança; e Conhecer o significado atribuído pela mãe ao cuidado à saúde bucal. Método: Estudo quali-quantitativo, transversal, cujos dados foram coletados por meio de questionário semiestruturado. Foi utilizado principalmente o índice Kappa para análise estatística e análise temática para os discursos qualitativos. Os dados foram coletados no primeiro semestre do ano de 2016, em uma Unidade de Saúde da Família de um município do interior paulista com amostra de 186 pessoas, sendo 93 mães e 93 crianças de ambos os sexos. Resultados: Na dimensão quantitativa verificou-se nas mães instalação de lesões de cárie moderada (43,01%) e alta (22,58%), valorização estética, preocupação em não perder elementos dentários, não pela função que exercem, mas pela dor no processo de instalação da cárie e principalmente pela alteração da estética e opinião pública. Na dimensão qualitativa revelaram-se quatro categorias: 1) Conhecendo a cárie; 2) Entendendo Saúde bucal como cuidado corporal, ausência de cárie e dor; 3) Dentes decíduos em relação aos permanentes: importância revelada pelas mães; e 4) Valorizando a estética bucal. Conclusões: Há concordância justa entre a resposta da mãe e a avaliação da pesquisadora no que concerne às condições de saúde bucal das crianças. Depreende-se que as mães, em sua maioria, conhecem o estado de saúde bucal da criança. Na avaliação de saúde bucal das crianças, a instalação de lesões de cárie ocorreu em prevalências entre moderada e alta, apresentando relação significante com a saúde bucal das mães. Por fim, no significado atribuído pelas mães ao cuidado à saúde bucal, conclui-se que estas valorizam a estética dental, muitas vezes, em detrimento da saúde oral propriamente dita, apontando para uma significação social da saúde bucal. / Introduction: Dentistry is developing new concepts of early care and health maintenance, based on integrality principle to transform daily life and health practices. Health promotion practices empower mothers to a responsibility to care child’s health including oral health. Objectives: describe the oral health conditions of children from zero to three years from mother's view; in order to evaluate the oral health of children from 0 to 36 months and of theirs mothers; To verify the relation between children and their mothers carie index; identify mothers’ oral health care and the meaning of child oral health care. Method: we used a Qualitative, cross-sectional study to collect data with a semi-structured questionnaire. We use mainly Kappa index in the study for statistical analysis and categorical analysis for qualitative discourses. The research performed at a Family Health Unit in a city from São Paulo countryside with a sample of 93 mothers and 93 children. Results: Quantitatively, we observed the presence of moderate (43.01%) and high (22.58%) carie lesions, aesthetic valorization, the tooth maintenance, because of the pain in the process Carie installation, and mainly the aesthetics and public opinion. Qualitatively, we found four categories: 1) Knowing carie, 2) Understanding oral health as body care, absence of carie and pain, 3) Deciduous teeth in relation to permanent teeth: importance revealed by mothers, 4) Valuing oral aesthetics. Conclusions:There is a fair agreement between the mother's response and the researcher's evaluation regarding the oral health conditions of the children. It is understood that mothers, for the most part, know the state of oral health of the child. In the assessment of oral health of children, caries lesions were found in moderate to high prevalence, presenting a significant relationship with the oral health of mothers. Finally, in the meaning attributed by mothers to care for oral health, it is concluded that they value dental aesthetics, often to the detriment of oral health itself, pointing to a social significance of oral health.

Made available in DSpace on 2015-05-14T12:56:07Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1184583 bytes, checksum: e7d5f827d1dea31a7b5d11cc69a3c72d (MD5) Previous issue date: 2009-12-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of the present study was to assess the oral health status of children infected with HIV virus. A prospective, observational, descriptive, case-control study was carried out in the city of João Pessoa, PB, Brazil. The sample consisted of a study group (SG) made up of 21 children infected with HIV in treatment at the Infectology Unit of the Clementino Fraga Hospital Complex and a control group (CG) of 28 children with no history of HIV infection covered by the Jardim Miramar II Family Health Program. Dental caries indices, (DMFT and deft), gingival status indices (VPI, GBA, OHI-S), resting and stimulated salivary flow and salivary buffer capacity were determined. The deft index was 3.19 ± 3.21(95%CI 1.73-4.66) in the SG and 2.54 ± 1.9 (95%CI 1.78-3.29) in the CG; the DMFT was 3.52 ± 2.6 (95%CI 2.34-4.71) in the SG and 1.32 ± 1.4 (95%CI 0.74-1.90) in the CG (p=0.002). There were statistically significant differences between groups in the decayed component for both the primary (p=0.02) and permanent (p<0.0001) dentition as well as in the filled component for the primary dentition (p<0.0001). The presence of visible biofilm was 52.9% in the SG and 47.1% in the CG (p=0.031). Gingivitis, measured by the gingival bleeding index (GBI) was absent in 57.1% of the SG and 78.5% of the CG (p=0.09). There was a difference between groups in resting saliva flow (p=0.01). There was a high frequency of caries in the SG. The most prevalent need for treatment in the SG was extraction, whereas the most prevalent treatment need in the CG was for procedures of low complexity. The organization of services is suggested for addressing this clinical demand and a health promotion program should be implemented for this population. / Este estudo teve como objetivo avaliar as condições de saúde bucal de crianças infectadas ou não pelo vírus HIV. A amostra foi composta por um grupo de estudo (GE), constituído por 21 crianças infectadas pelo HIV, atendidas no setor de infectologia do Complexo Hospitalar Clementino Fraga e por um grupo controle (GC) de 28 crianças sem história de infecção pelo HIV, atendidas no Programa de Saúde da Família Jardim Miramar II. A pesquisa é do tipo descritiva, observacional, prospectiva, e do tipo caso-controle, e foi desenvolvido em João Pessoa, PB, Brasil. Em ambos os grupos foram determinados o índice de cárie dentária (ceo-d e CPO-D), índices da condição gengival (IPV, ISG, IHO-S), além do fluxo salivar em repouso e o estimulado, e a capacidade tampão da saliva. A análise estatística foi feita através de testes de associação, como o Qui-quadrado e Exato de Fisher, além do teste de Mann-Whitney; todos com nível de significância de 95% (p<0,05). Observou-se ceo-d de 3,19 ± 3,21(IC95% 1,73 - 4,66) GE e 2,54 ± 1,9 (IC95% 1,78- 3,29) GC, já o CPO-D foi de 3,52 ± 2,6 (IC 95% 2,34 - 4,71) GE e 1,32 ± 1,4 (IC95% 0,74 - 1,90) GC (p=0,002). Em relação aos componentes verificou-se diferença estatística para o componente c cariado tanto na dentição decídua (p=0,02) como na permanente (p<0,0001) e para o componente O obturado na dentição decídua (p<0,0001). Observou-se presença de biofilme visível em 52,9% (GE) e 47,1% (GC) (p=0,031). A ausência de gengivite pelo índice de Sangramento Gengival (ISG) foi de 57,1% (GE) e 78,5% (GC) (p=0,09). Observou-se diferença entre os grupos para o fluxo salivar em repouso (p=0,01). Verificou-se alto índice de cárie nas crianças do GE. A necessidade de tratamento mais prevalente foi a extração (GE), enquanto que para o GC foi de procedimentos de baixa complexidade. As condições da saúde bucal das crianças com HIV não foram satisfatórias quando comparadas às do GC.

Submitted by FERNANDA IZAURA RODRIGUES null (nandaiza@gmail.com) on 2018-04-03T18:05:59Z No. of bitstreams: 1 dissertação fernanda izaura 03-04.pdf: 1275010 bytes, checksum: cfbfd95ed6a108ae8e796b0d8bf83780 (MD5) / Approved for entry into archive by Ana Paula Rimoli de Oliveira null (anapaula@foa.unesp.br) on 2018-04-03T18:34:52Z (GMT) No. of bitstreams: 1 rodrigues_fi_me_araca_int.pdf: 1275010 bytes, checksum: cfbfd95ed6a108ae8e796b0d8bf83780 (MD5) / Made available in DSpace on 2018-04-03T18:34:52Z (GMT). No. of bitstreams: 1 rodrigues_fi_me_araca_int.pdf: 1275010 bytes, checksum: cfbfd95ed6a108ae8e796b0d8bf83780 (MD5) Previous issue date: 2018-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A gravidez é um período no qual desenvolvimento o embrião promove significativas alterações anatômicas e fisiológicas no organismo das mulheres. Gestação de risco é aquela na qual a vida ou a saúde da mãe e/ou do feto e/ou do recém-nascido têm maiores chances de serem prejudicadas, comparando com a média da população considerada. O objetivo neste estudo foi verificar a prevalência de doença periodontal em gestantes de alto-risco e analisar a associação com as características sócio-demográficas, história médica e fatores comportamentais. Trata-se de um estudo do tipo transversal, observacional e analítico, no qual a amostra foi composta por 800 gestantes de alto risco, em qualquer fase gestacional, selecionadas no centro de referência para atenção especializada à saúde. Foram realizados entrevista, com formulário estruturado, e exame bucal, por dois examinadores calibrados (Kappa=0,89), empregando-se o índice periodontal comunitário (CPI), no ano de 2017. Foram realizados testes de associação qui-quadrado e posteriormente análise de regressão logística univariada e multivariada, ao nível de significância de 5%, para estimar odds ratios (OR) e intervalo de confiança (IC) entre as variáveis desfecho sangramento; CPI e as demais variáveis do estudo. As variáveis que obtiveram um valor de p<0,100 na análise univariada foram testadas nas análises múltiplas. Do total de gestantes, 66,9% apresentaram CPI >ou =1. Sangramento gengival esteve associado às seguintes variáveis: segundo (OR = 1,7, IC = 1,1-2,5) e terceiro trimestre de gestação (OR=1,4; IC=0,8-2,1); hipertensão arterial (OR=1,9; IC=1,4-2,7); diabetes mellitus (OR = 2,1; IC=1,3-3,3), fumo (OR=1,8; IC=1,2-2,8). Com o Odds ratio ajustado, essas mesmas variáveis mostraram significância estatística. Com relação à variável desfecho CPI, houve associação significativa com idade 35-45 anos (OR=2,0; IC=1,1-3,8); hipertensão arterial (OR=2,0; IC=1,3-3,0); fumo (OR=2,3; IC=1,4-3,8). Conclui-se que a idade avançada, hipertensão arterial, diabetes mellitus e fumo são fatores que proporcionam maiores chances de ocorrência de sangramento gengival e graus mais severos do CPI, em gestantes de alto risco. / Pregnancy is a period in which the embryo development promotes significant anatomical and physiological changes in the body of women. Risk pregnancy is one in which the life or health of the mother and / or the fetus and / or the newborn are more likely to be adiantative than the average population. The objective of this study was to verify the prevalence of periodontal disease in high-risk pregnant women and to analyze the association with socio-demographic characteristics, medical history and behavioral factors. This is a cross-sectional, observational and analytical study, in which the sample consisted of 800 high-risk pregnant women, at any gestational stage, selected at the brazilian reference center for specialized health care. Interviews were conducted using a structured form, and oral examination, by two calibrated examiners (Kappa = 0.89), with the community periodontal index (CPI) in the year 2017. Association tests, chi-square, were made at significance level of 5%. After, univariate and multivariate logistic regression analyzes were performed to estimate odds ratios (OR) and confidence interval (CI) between the outcome variables: bleeding; CPI and the other variables of the study. The variables that obtained p <0.100 in the univariate analysis were tested in the multiple analyzes. Of the total number of pregnant women, 66.9% had CPI≥ 1. Gingival bleeding was associated with the following variables: second (OR = 1.7, CI = 1.1-2.5) and third trimester of gestation (OR = 1.4; CI = 0.8-2.1); arterial hypertension (OR = 1.9, CI = 1.4-2.7); diabetes mellitus (OR = 2.1, CI = 1.3-3.3), smoking (OR = 1.8, CI = 1.2-2.8). After the adjusted odds ratio, these same variables showed statistical significance. Regarding the CPI outcome variable, there was a significant association with age 35-45 years (OR = 2.0; CI = 1,1-3,8); arterial hypertension (OR = 2.0; CI = 1.3-3.0); smoking (OR = 2.3, CI = 1.4-3.8). It was concluded that advanced age, hypertension, diabetes mellitus and smoking are factors that provide greater chances of occurrence of gingival bleeding and more severe degrees of CPI in high-risk pregnant women.

Les levures du genre Candida provoquent 70 à 90% des infections fongiques invasives chez l’Homme. Candida albicans est l’espèce de levure la plus souvent isolée et la plus pathogène au niveau de la cavité orale. Cette levure présente des facteurs de virulence multiples, notamment une capacité à modifier sa morphologie (dimorphisme), des adhésines servant à la reconnaissance de l’hôte, la sécrétion de phospholipases et d’aspartyl protéases et une capacité à former des biofilms. L’augmentation constante des infections fongiques et des résistances aux antifongiques, des effets secondaires et du coût des traitements, justifie la recherche de nouvelles molécules actives contre les biofilms impliquant des levures. Après une revue de la littérature sur les modèles de biofilms oraux, nous avons étudié l’effet d’un extrait végétal de Solidago virgaurea sur C. albicans. Une première étude a montré que l’extrait, par ailleurs dépourvu d’effet antibactérien, pouvait agir sur le champignon en : 1) empêchant la conversion de levures en hyphes, 2) inhibant la formation de biofilm, et 3) en dissociant le biofilm déjà formé. La deuxième étude visait à comprendre le mode d’action de cet extrait. Elle a montré que l’extrait de S. virgaurea inhibait l’expression de protéines impliquées dans l’adhésion et la filamentation. Par ailleurs, il exerce un effet synergique sur l’élimination du biofilm lorsqu’il est combiné à des antifongiques. L’ensemble de ces résultats positionne l’extrait de S. virgaurea en candidat prometteur pour une approche innovante du traitement topique des candidoses cutanéomuqueuses. / Candida yeast cause 70 to 90 % of human invasive fungal infections. In the oral cavity, Candida albicans is the most frequently isolated the most pathogenic species. This yeast has multiple virulence factors, including the capacity to alter its morphology (dimorphism), adhesins for host-recognition, the secretion of phospholipases and aspartyl proteases, and the ability to form biofilms. The search for new anti-biofilms drugs and, in particular, those targeting biofilm involving yeast is justified by the constantly increasing incidence of fungal infections and antifungal resistance, treatments side effects and costs. We first reviewed the literature regarding oral biofilm models. Then, we studied the effect of a Solidago virgaurea extract against C. albicans. A first study showed that this extract, which has no antibacterial effect, could act on the fungus in several ways, including: 1) inhibiting yeast-to-hypha transition, 2) inhibiting biofilm formation, and 3) disrupting existing biofilm. The second study aimed to understand the mode of action of this extract. It showed that it might act via the down-regulation of proteins involved in yeast adhesion and filamentation. Furthermore, it acted in synergy with antifungals to eliminate biofilm. Overall, these findings indicate that this S. virgaurea extract is a promising candidate for an innovative approach of superficial candidiasis topical therapy.

Orientador: Nemre Adas Saliba / Coorientadora: Cristina Berger Fadel / Banca: Renato Moreira Arcieri / Banca: Silvia Helena Venturoli Perri / Banca: Edgard Michel-Crosato / Banca: José Roberto de Magalhães Bastos / Resumo: Introdução: O acesso à informação oriunda dos inquéritos vem sendo reconhecido como um dos mais importantes recursos para o planejamento e gestão em saúde, favorecendo a tomada assertiva de decisões, subsidiando a orientação das políticas públicas de saúde e induzindo à melhora na qualidade em saúde de uma maneira mais equânime. A presente tese objetiva realizar uma análise dos fatores que determinam a condição percebida de saúde bucal e variáveis relacionadas à adesão ao autocuidado em saúde bucal na população adulta brasileira, sob base metodológica multidimensional. Metodologia: Trata-se de um estudo transversal, quantitativo, com dados provenientes de inquérito em âmbito nacional - Pesquisa Nacional de Saúde. Utilizou-se uma amostra selecionada em múltiplos estágios de 60.202 adultos, sendo representativa de todo o território brasileiro. A coleta de dados ocorreu por meio de entrevista domiciliar com profissionais previamente treinados. Considerou-se a condição percebida de saúde bucal e o indicador criado 'autocuidado em saúde bucal' como variável desfecho. Os dados foram analisados empregando-se o teste de redução de dimensionalidade e as variáveis que apresentaram relação passaram pelo teste de regressão logística. Resultados: Foram verificadas associações para a condição percebida de saúde bucal junto as variáveis: dificuldade para se alimentar (OR=5.81), avaliação do atendimento recebido durante a última consulta odontológica (OR=2.50), autopercepção da condição de s... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: The information access from surveys has been recognized as one of the most important resources for the health planning and management, favoring assertive decisionmaking, subsidizing the orientation of public health policies and inducing improvements in health quality in a more equitable way. The present thesis aims to analyze the factors which determine the perceived condition of oral health and variables related to adherence to oral health self care in the Brazilian adult population, based on a multidimensional methodology. Methodology: This is a cross-sectional, quantitative study with data arose from a national survey - National Health Survey. A sample selected in multiple stages of 60202 adults was used, as representative of the entire Brazilian territory. Data were collected through a home interview with previously trained professionals. The perceived condition of oral health and the indicator created 'self-care in oral health' were considered as a variable outcome. The data were analyzed using the dimensionality reduction test and the variables which showed a relationship were submitted to the logistic regression test. Results: Associations for oral health status were verified with the following variables: difficulty to eat (OR=5.81), evaluation of the care received during the last dental visit (OR=2.50), self-perception of the general health condition (OR=1.91), dental flossing (OR=1.88), upper dental loss (OR=1.49) and reason for the last dental surgeon'... (Complete abstract click electronic access below) / Doutor

Orientador: Nemre Adas Saliba / Coorientadora: Suzely Adas Saliba Moimaz / Banca: Symone Cristina Teixeira / Banca: Carlos Ayach / Resumo: A gravidez é um período no qual desenvolvimento o embrião promove significativas alterações anatômicas e fisiológicas no organismo das mulheres. Gestação de risco é aquela na qual a vida ou a saúde da mãe e/ou do feto e/ou do recém-nascido têm maiores chances de serem prejudicadas, comparando com a média da população considerada. O objetivo neste estudo foi verificar a prevalência de doença periodontal em gestantes de alto-risco e analisar a associação com as características sócio-demográficas, história médica e fatores comportamentais. Trata-se de um estudo do tipo transversal, observacional e analítico, no qual a amostra foi composta por 800 gestantes de alto risco, em qualquer fase gestacional, selecionadas no centro de referência para atenção especializada à saúde. Foram realizados entrevista, com formulário estruturado, e exame bucal, por dois examinadores calibrados (Kappa=0,89), empregando-se o índice periodontal comunitário (CPI), no ano de 2017. Foram realizados testes de associação qui-quadrado e posteriormente análise de regressão logística univariada e multivariada, ao nível de significância de 5%, para estimar odds ratios (OR) e intervalo de confiança (IC) entre as variáveis desfecho sangramento; CPI e as demais variáveis do estudo. As variáveis que obtiveram um valor de p<0,100 na análise univariada foram testadas nas análises múltiplas. Do total de gestantes, 66,9% apresentaram CPI >ou =1. Sangramento gengival esteve associado às seguintes variáveis: segundo (O... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Pregnancy is a period in which the embryo development promotes significant anatomical and physiological changes in the body of women. Risk pregnancy is one in which the life or health of the mother and / or the fetus and / or the newborn are more likely to be adiantative than the average population. The objective of this study was to verify the prevalence of periodontal disease in high-risk pregnant women and to analyze the association with socio-demographic characteristics, medical history and behavioral factors. This is a cross-sectional, observational and analytical study, in which the sample consisted of 800 high-risk pregnant women, at any gestational stage, selected at the brazilian reference center for specialized health care. Interviews were conducted using a structured form, and oral examination, by two calibrated examiners (Kappa = 0.89), with the community periodontal index (CPI) in the year 2017. Association tests, chi-square, were made at significance level of 5%. After, univariate and multivariate logistic regression analyzes were performed to estimate odds ratios (OR) and confidence interval (CI) between the outcome variables: bleeding; CPI and the other variables of the study. The variables that obtained p <0.100 in the univariate analysis were tested in the multiple analyzes. Of the total number of pregnant women, 66.9% had CPI≥ 1. Gingival bleeding was associated with the following variables: second (OR = 1.7, CI = 1.1-2.5) and third trimester of gestation (... (Complete abstract click electronic access below) / Mestre

A relação existente entre mudança de percepção da saúde bucal e resiliência é escassa na literatura. O objetivo deste trabalho foi descrever as dinâmicas de mudança de autopercepção relacionada à saúde bucal (melhora e piora) e avaliar os fatores determinantes destas mudanças em idosos do sul do Brasil. Uma amostra representativa de 587 pessoas, com 60 anos ou mais, residentes em Carlos Barbosa, RS, foi avaliada em 2008. O seguimento foi realizado em 2012 e foram avaliados 389 idosos. Este estudo foi aprovado pelo Comitê de Ética da Faculdade de Odontologia da UNICAMP. Os participantes responderam a um questionário sociodemográfico e de saúde geral, a Escala de Resiliência e passaram pelo exame de saúde bucal. A mudança de autopercepção relacionada à saúde bucal foi categorizada em decréscimo, estabilidade e acréscimo entre 2008 e 2012. A fim de analisar os fatores associados com as mudanças na percepção relacionada à saúde bucal em idosos independentes, utilizou-se a regressão multinomial. Os indivíduos apresentaram 21,9% de decréscimo, 48,1% permaneceram estáveis e 30% apresentaram acréscimo na mudança de autopercepção relacionada à saúde bucal. Uso dos serviços odontológicos (OR=3,28,IC=1,05-10,22) e comorbidades (OR=5,43,IC=1,17-25,18) associaram-se com melhora e renda (OR=1,89,IC=1,00-3,57) e resiliência (OR=7,70, IC=0,97-61,02) associaram-se com piora na autopercepção relacionada à saúde bucal. Conclui-se que há uma relação entre as ideias de flexibilidade e de adaptação inseridas no conceito da resiliência e a maneira como um indivíduo vê sua saúde bucal. / The existing relation between change of oral health perception and resilience is insufficient in the literature. The aim of this study was to describe the dynamics of self-perception’s change related to the oral health (improvement and decline) and to evaluate the determinants of these changes in older people of the southern of Brazil. A representative sample of 587 people aged 60 years or more, living in Carlos Barbosa, RS, was evaluated in 2008. The follow-up was made in 2012 and 389 older people were evaluated. This study was approved by the Committee of Ethics of the Faculty of Dentistry of the State University of Campinas. The participants answered an oral health and socio-demographic questionnaire, the Resilience Scale, and took an oral health exam. The change of self-perception related to the oral health was categorized as decrement, stability and increment between 2008 and 2012. In order to analyze the factors associated with the changes in the perception related to the oral health in independent living older people it was used a hierarchical analysis, made through multinomial regression. The individuals experienced 21.9% of decrement, 48.1% remain stable and 30.0% experienced increment in the change of self-perception related to the oral health. Access to the oral services (OR=3.28,CI=1.05-10.22) and co-morbidities (OR=5.43,CI=1.17-25.18) were associated with improvement, income (OR=1.89,CI=1.00-3.57) and resilience (OR=7.70, CI=0.97-61.02) was associated with the decline in the self-perception related to the oral health. It is concluded that there is a relation between the ideas of flexibility and adjustment inserted in the concept of the resilience and the manner how an individual perceives its oral health.

Reduction of oral health disparities is a worldwide goal because oral health has been shown to mimic individual and community health overall. At the end of the twentieth century, oral health made remarkable achievements; however, problems still remain in many communities around the world, especially within third world countries, such as those in South Asia. Member countries of the South-East Asia region of the World Health Organization (WHO) have stated that dental caries, tooth loss, periodontal disease, and oral cancer are some of the contending public health issues in their countries and action must be taken to reduce their numbers (WHO, 2008). The goals of this study are to determine what cultural aspects of the South Asian population aid in the increase of poor dental care in these communities. Our overall goal is to provide recommendations for a new oral health promotion program in South Asia that has been determined by understanding what cultural aspects are important in creating a successful dental care community program. As seen by the various studies, smokeless tobacco is a cultural norm in South Asia and is affecting the quality of life for many of the people there. Tobacco use is common but smokeless tobacco is becoming more prevalent in these countries. It is clear that with such statistics there is a need for governmental public programs to educate the population on the importance of proper oral care. This study analyzed the current literature to determine (i) what were the cultural aspects of South Asia that are detrimental to oral health, (ii) what is the oral health status of the individual countries found in South Asia, and lastly (iii) what aspects are necessary in creating an effective oral health program. The goal of this study is to determine what cultural aspects of the South Asian population contribute to poor dental care in these communities and to provide recommendations for a new oral health promotion program in South Asia that is strengthened by understanding what cultural aspects are important in creating a successful dental care community program. The conclusions presented here suggest an oral policy framework for the initiation of discussions aimed at designing and implementing an oral health program in their South-Asian country. Additionally, we suggest future directions once the guidelines are met. Overall, proper oral health should be enjoyed by all and this study aims to the aid the South Asian region’s governments towards moving forward in meeting those goals.

OBJECTIVE: To understand dental service utilization by frail older adults residing in a long-term care (LTC) setting in the last two years of their life. To understand the types of dental services utilized by this demographic, the frequency of utilization and determine the characteristics that may be predictors of ‘higher dental service utilization’. METHODS: A retrospective cohort study was conducted by an electronic chart review of all LTC patients at two sites who died between 11/1/2014 - 12/30/2016 and had a dental visit in the two-year period prior to death, resulting in a sample of 369 patients. Based on the number of dental appointments attended prior to death, the patients were categorized into five groups: 0,1-2,3-5,6-9 and10 or more appointments. A multivariate logistic regression model was created to identify the factors associated with higher dental service utilization. RESULT: The study found that 84% of patients who died in the study period, utilized on-site dental services in the last two years of their life. Approximately 66% had 3 or more dental appointments. Diagnostic and preventive procedures were most commonly utilized (utilized by 81% and 73% of patients respectively). Multivariate analysis suggested that dentate patients and patients wearing removable dental prosthesis were about 7 and 12 times more likely respectively to have a higher utilization of dental services (OR=6.5 and OR=11.7). Medicaid beneficiaries were more likely (OR=1.9) to have a higher utilization of dental services than the others. CONCLUSIONS: This study showed that a large percentage of frail older adults utilized dental services even in the last years of their lives when given access to these services. As people are living longer and retaining their teeth longer, there is a rising need and subsequent demand for end-of-life dental services. Certain administrative and policy implementation strategies need to be developed to provide dental services to LTC patients in the last years of their lives.