Abstract The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services’ characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services’ characteristics.

Abstract This study aimed to describe the structure of oral health services in primary health care in Brazil with centers participating in the second cycle of the ‘National Program for Improving Access and Quality of Primary Care’ (PMAQ-AB), the largest health service evaluation program ever instituted in the country. This cross-sectional study evaluated 16,202 oral health services, regarding 22 pieces of dental equipment and 25 dental supplies. The presence of each piece of equipment/dental supply generated a score for services. The sum of these scores was compared among different regions in Brazil. Quantitative data were described by quartiles and categorical data by frequencies, using the SPSS, version 25. Most of the evaluated centers presented adequate equipment in good using conditions and sufficient dental supplies for primary oral health care. Data also showed a lack of some equipment, such as X-rays, bicarbonate jet, and ultrasound devices, while for dental supplies, a lack of amalgam (capsule and manual preparation), anesthesia without vasoconstrictors, and intracanal medication was found. The services presented a median of 14 pieces of equipment and 22 dental supplies. Of the Brazilian regions, the South presented the highest median, while the North and Northeast regions presented the lowest one. The oral health services presented dental offices with good availability of equipment and dental supplies to perform clinical activities. However, differences in the structure of services among the Brazilian regions was still observed.

ABSTRACT Objective: To describe dental findings of kidney and liver, pre and post-transplant patients of an oral health care service from a Brazilian Southeast state. Material and Methods: A descriptive cross-sectional study was developed with a sample of patients attending the oral health care program for transplantation of Universidade Federal de Minas Gerais. Participants were divided into two groups according to the kind of transplantation-kidney or liver. Characteristics of the sample, sex (male/female), age (18-44; 45-54; 55-80), living region (Belo Horizonte, or outside), phase of transplantation (pre-Tx or post-Tx), and self-report of diabetes mellitus and hypertension were presented by frequencies. Dental caries experienced was measured by Decayed, Missing and Filled-Teeth (DMF-T) index. Results: 185 patients, kidney (46; 24.9%), and liver (139; 75.1%) were included. Mean DMFT was 18.3 (20.0). DMFT scores of males (18.7; 20.0), females (17.2; 18.0), pre-transplanted (18.3; 20.0), and post-transplanted (18.1; 20.0) were similar. The liver transplantation group (19.3; 20.0) showed higher caries experience comparing to kidney´s (15.2; 17.0). Conclusion: Dental caries experience was high in kidney and liver patients under transplantation therapy. This highlights the demand for treatment need in this population.

Abstract This study investigated the factors associated with new carious lesions in one-to five-year-old children with developmental disabilities. This was a retrospective cohort that evaluated 64 dental charts of individuals with caries or fillings in their first dental appointment. The dependent variable was the occurrence of a new carious lesion or restoration. Gender, age, mother’s education, sugar consumption, oral hygiene, mouth breathing, reports of xerostomia, gingival status, use of psychotropic drugs, use of asthma drugs, history of asthma, bronchitis, reflux or seizures and having at least one sibling were covariates. Cox proportional hazards regression model was used to estimate the raw and adjusted hazard ratios with their respective 95% confidence interval. The average time that individuals remained free of dental caries/restoration was 79.49 months (95%CI: 64.37 to 92.61). Increase in sucrose consumption increased the rate of caries recurrence (HR = 1.16; 95%CI: 1.04 to 1.30). Individuals who had poor oral hygiene had higher rate of new dental caries (HR = 3.88; 95%CI: 1.22 to 12.37) compared to those with good oral hygiene. The presence of mouth breathing decreased the rate of recurrence of the disease when compared to the nasal breathing (HR = 0.32; 95%CI: 0.15 to 0.70). Oral health-related behaviors and nasal respiration influenced the rate of dental caries recurrence in individuals with developmental disabilities.

Abstract This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

Resumo Esse estudo avaliou os fatores individuais e contextuais associados às necessidades de tratamento odontológico especializado na população de 35 a 44 anos no estado de Minas Gerais. Foram utilizados dados secundários referentes à saúde bucal de adultos, obtidos no levantamento epidemiológico da Pesquisa das Condições de Saúde Bucal da população mineira e de dados municipais, obtidos de bancos de dados públicos. Foi realizada análise multinível para avaliar a associação de variáveis independentes individuais e contextuais com ausência ou presença de necessidades de tratamento odontológico na atenção secundária da rede de saúde bucal. Os indivíduos com maior renda (OR 0,53; IC95% 0,31-0,93) e com maior acesso aos cuidados em saúde bucal, que caracterizam a cobertura de primeira consulta da atenção primária (OR 0,94; IC95% 0,90-0,99) apresentaram menor necessidade de tratamento odontológico na atenção secundária. A renda e o acesso aos cuidados em saúde bucal estão relacionados às necessidades de tratamento odontológico especializado em Minas Gerais.

Resumo Esse estudo avaliou os fatores individuais e contextuais associados às necessidades de tratamento odontológico especializado na população de 35 a 44 anos no estado de Minas Gerais. Foram utilizados dados secundários referentes à saúde bucal de adultos, obtidos no levantamento epidemiológico da Pesquisa das Condições de Saúde Bucal da população mineira e de dados municipais, obtidos de bancos de dados públicos. Foi realizada análise multinível para avaliar a associação de variáveis independentes individuais e contextuais com ausência ou presença de necessidades de tratamento odontológico na atenção secundária da rede de saúde bucal. Os indivíduos com maior renda (OR 0,53; IC95% 0,31-0,93) e com maior acesso aos cuidados em saúde bucal, que caracterizam a cobertura de primeira consulta da atenção primária (OR 0,94; IC95% 0,90-0,99) apresentaram menor necessidade de tratamento odontológico na atenção secundária. A renda e o acesso aos cuidados em saúde bucal estão relacionados às necessidades de tratamento odontológico especializado em Minas Gerais.

Abstract This study evaluated the individual and contextual factors associated with the specialised dental treatment needs of a population of adults aged 35 to 44 years old in the state of Minas Gerais. The individual variables were obtained from the database of the SB Minas Gerais project - a survey of oral health status of the population of Minas Gerais, Brazil. The variables at the municipal level were derived from any available public databases related to oral health services. A multilevel analysis was performed to evaluate the association of independent individuals and contextual variables with or without dental treatment needs in the secondary care of the oral health network. Individuals with a higher income (OR 0.53; CI95% 0.31-0.93) and with greater access to oral health care (OR 0.94; CI95% 0.90-0.99) had less secondary care treatment needs. Income and access to oral health care are related to the needs of specialised dental treatment in Minas Gerais.

ABSTRACT OBJECTIVE To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument’s main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of “risks” and “main message” were unclear and needed to be revised. CONCLUSION The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.

Abstract The aim of this study was to evaluate the factors associated with toothache in the adult population of Minas Gerais, Brazil. Individual data from a population sample (age 35 to 44 years) were collected from a secondary database of the SB Minas survey. Sampling was carried out by clusters and with multiple drawing stages. The eligibility criteria were to reside in areas chosen for the research, be within the age group, and accept to participate in the research. The individual variables assessed by a questionnaire and dental exams were sex, income, race/skin color, root caries, periodontal condition, need for dental treatment, and last dental appointment. The contextual variables, assessed by municipal indexes, were Human Development Index (HDI), illiteracy, unemployment, half minimum wage, quarter minimum wage, oral health team coverage, access to individual health care, and supervised tooth brushing average. The dependent variable was toothache in the past six months. A descriptive analysis was made using the Statistical Package for the Social Sciences and Hierarchical Linear and Nonlinear Modeling Software was used to perform the multilevel analyses for individual and contextual levels. An association was found between toothache and low income (OR = 2.00; 95%CI = 1.32–3.13), dental caries (OR = 1.86; 95%CI = 1.22–2.86), periodontal condition, and living on a quarter of the minimum wage or less (OR = 1.03; 95%CI = 1.00–1.08). Clinical and social factors were associated with toothache, reinforcing the need to improve public polices in oral health focused on the adult population.

Abstract The aim of this study was to evaluate the association between number of cavitated dental caries in adolescents and family cohesion, drug use, sociodemographic factors and visits to the dentist. A cross-sectional study was conducted with 746 adolescents aged 15 to 19 years from Campina Grande, Brazil. The parents answered a questionnaire addressing sociodemographic data, and the adolescents answered questionnaires on drug use, type of family cohesion and visits to the dentist. Two examiners underwent training and calibration exercises (K > 0.80) to diagnose dental caries using the Nyvad criteria. A directed acyclic graph was created to select the variables to be controlled in the statistical model. Associations between the independent variables and the outcome were determined using robust Poisson Regression analysis for complex samples (α = 5%). Rate ratios (RR) and 95% confidence intervals (CI) were calculated. The prevalence of dental caries and cavitated lesions among the adolescents was 92.8% and 41.6%, respectively. The following variables remained associated with the number of cavitated lesions in the multivariate analysis: disengaged (RR: 6.30; 95%CI: 1.24–31.88; p = 0.028 ), separated (RR: 4.80; 95%CI: 1.03–22.35; p = 0.046) and connected (RR: 5.23; 95%CI: 1.27–21.59; p = 0.024) levels of family cohesion, and high social class (RR: 0.55; 95%CI: 0.39–0.76; p = 0.001). In conclusion, this paper posits that adolescents with a lower socioeconomic status, and those whose family cohesion was classified as disengaged, separated or connected, had a larger number of cavitated lesions.

Abstract Objective: To describe and analyze the availability and factors related to the presence of analgesics and non-steroidal anti-inflammatory drugs in the Brazilian public primary healthcare system. Material and Methods: This was a cross-sectional study that evaluated 17,903 health units that participated in the National Program for Primary Care Access and Quality Improvement (2013-2014). The dependent variable was defined as the presence of metamizole, ibuprofen, and acetaminophen in a sufficient amount. The independent variables included the type of primary health care unit, the presence of a medication disposal area, the number of physicians, nurses, and dental practitioners; and the number of primary care units with family and oral health teams. For statistical analysis, unadjusted and adjusted Odds Ratio (OR) (95% CI) were presented. Results: The three medicines were available in 62.4% of the units. Regarding Health Clinics, the Basic Health Units (OR= 1.31, CI95% 1.18-1.44), Polyclinic (OR= 2.00, 95% CI, 1.15 -3.48), and others (OR= 1.37; 95% CI 1.14-1.63) had higher chances of availability of all three drugs. The presence of a disposal area (OR = 1.64, 95% CI 1.51-1.77) and the number of physicians (OR= 1.04, 95% CI 1.00-1.08), nurses (OR= 1.08, 95% CI 1.03- 1.13), and dental practitioners (OR= 1.09, 95% CI 1.04-1.14) increased the availability odds of the analyzed drugs in the service. Conclusion: The structure of the healthcare units and the higher number of professionals were positively associated with the availability of these drugs.

ABSTRACT OBJECTIVE Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87–0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS The following variables remained associated with better OHL: high mother’s schooling level (RR = 1.07; 95%CI: 1.03–1.12), high income (RR = 1.04; 95%CI: 1.01–1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01–1.10), married parents (RR = 1.04; 95%CI: 1.01–1.09), “enmeshed” family cohesion (RR = 1.21; 95%CI: 1.12–1.30), “structured” (RR = 1.06; 95%CI: 1.01–1.12) or “rigid” (RR = 1.11; 95%CI: 1.04–1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01–1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03–1.13). CONCLUSION Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

Abstract Objective: To analyze the association between water sanitation and living conditions and dental caries in Brazilian schoolchildren. Material and Methods: A list containing names of children enrolled in 18 urban public schools was obtained. Then, data registered by community health agents from the family health strategy were consulted, aiming to obtain information about socio-environmental variables such as house type, number of rooms in the house, water supply, water treatment, waste, feces and urine disposal. For sample calculation, 95% confidence level, 80% test power and 5% error rate were used A total of 199 5-year-old and 137 12-year-old schoolchildren participated in the research. For examinations, World Health Organization recommendations for epidemiological surveys of dental caries were followed. Results: For 5-year-old children, dental caries prevalence was related to municipality of origin, water supply system and sewage system. For 12-year-old children, untreated water and waste collection were related to higher dental caries rates. Conclusion: Dental caries was associated to house type and water sanitation.

Abstract Objective: To investigate the impact of inadequate prostheses on older adult’s quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher’s exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.

ABSTRACT OBJECTIVE Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents. METHODS Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87–0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study. RESULTS The following variables remained associated with better OHL: high mother’s schooling level (RR = 1.07; 95%CI: 1.03–1.12), high income (RR = 1.04; 95%CI: 1.01–1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01–1.10), married parents (RR = 1.04; 95%CI: 1.01–1.09), “enmeshed” family cohesion (RR = 1.21; 95%CI: 1.12–1.30), “structured” (RR = 1.06; 95%CI: 1.01–1.12) or “rigid” (RR = 1.11; 95%CI: 1.04–1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01–1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03–1.13). CONCLUSION Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

ABSTRACT OBJECTIVE To perform a cross-cultural adaptation of the Clear Communication Index instrument from the Centers for Disease Control and Prevention (CDC-CCI) from English to Brazilian Portuguese. METHODS This study comprised initial discussion about the conceptual equivalence of the instrument by a committee formed by experts on health education. We performed translations, synthesis of translations, back-translations, revision by the committee, and linguistic revision. Semantic equivalence was obtained by analyzing the referential and general meaning of each item by the committee, resulting in a pre-final version of the instrument. Subsequently, thirty professionals with health sciences degrees performed a pre-test. These professionals used the pre-final version of the instrument to assess a health education material. A questionnaire was applied to evaluate the acceptability of the instrument, the understanding of each of the 20 items, as well as the individual and professional variables. We analyzed the scores attributed to the health education material, the variables related to healthcare professionals, the proportions of the acceptability of the instrument, and the comprehension of each item. RESULTS After we obtained the conceptual equivalence of the instrument, the committee of experts, the instrument’s main author, and the linguist produced the pre-final version using two translations, a synthesis of the translations, and two back-translations. A general equivalence was maintained in 15 of the 20 items (75%), four of the items were slightly altered (20%), and one item was very altered (5%). Nineteen items presented referential equivalence or near equivalence (95%). We then carried out with the pre-test, in which the professionals used the pre-final version. Two items in the domains of “risks” and “main message” were unclear and needed to be revised. CONCLUSION The process of cross-cultural adaptation of the Clear Communication Index provided an adapted version to the Brazilian Portuguese language.