Aim To analyze associations between sociodemographic factors, self-perception, self-care practices in health with Oral Health Literacy (OHL) levels among users of Primary Health Care (PHC). Methods A cross-sectional and analytical study was performed in Piracicaba (São Paulo), Brazil, in 2018, with a convenience sample of users of PHC that were aged over 18 years. Data were collected with a questionnaire by a trained dentist in two Family Health Units. The outcome variable was OHL, measured by the OHLA-B instrument, which was dichotomized by median into low (≤8 point) and high (>8 point). The independent variables were sociodemographic conditions (age, sex, self-declared skin color, and education), self-perceived oral health and self-care practices in health (tooth brushing frequency, smoking habits, reason for the last visit to the dentist, and source of health information search). Unadjusted and adjusted analyses were performed between OHL and independent variables for multiple logistic regression model (p≤0.05). Results The sample consisted of 450 adults. A total of 54.7% had a low OHL. After adjusting for sex and age, OHL was associated with skin color (OR=0.57; 95%CI=0.37-085), educational level (OR=4.92; 95%CI=3.16-7.79), health information from health professionals (OR=2.40; 95%CI=1.42-4.16) and internet (OR=2.88; 95%CI=1.59-5.32), toothbrushing >1 time a day (OR=3.23; 95%CI=1.27-9.92) and smokers (OR=0.42; 95%CI=0.23-0.73). After adjusting for sex, age and income, OHL was associated with (OR=0.63; 95%CI=0.41-096), educational level (OR=4.06; 95%CI=2.57-6.51) and smokers (OR=0.48; 95%CI=0.26-0.84). Conclusions Low OHL was associated with socioeconomic factors, source of information and smoking. This fact highlights the importance of health professionals to promote OHL. factors selfperception, selfperception self perception, perception self-perception selfcare care (OHL PHC. . (PHC) crosssectional cross sectional São Paulo, Paulo , Paulo) Brazil 2018 1 years Units OHLAB OHLA B instrument ≤8 8 (≤ point >8 (> point. (age selfdeclared declared education, education education) selfperceived perceived tooth frequency habits search. search search) p≤0.05. p005 p p≤0.05 0 05 (p≤0.05) 45 adults 547 54 7 54.7 OR=0.57 OR057 OR 57 (OR=0.57 95%CI=0.37085, 95CI037085 CI 95%CI=0.37 085 95 37 95%CI=0.37-085) OR=4.92 OR492 4 92 (OR=4.92 95%CI=3.167.79, 95CI316779 95%CI=3.16 7.79 3 16 79 95%CI=3.16-7.79) OR=2.40 OR240 2 40 (OR=2.40 95%CI=1.424.16 95CI142416 95%CI=1.42 4.16 42 95%CI=1.42-4.16 OR=2.88 OR288 88 (OR=2.88 95%CI=1.595.32, 95CI159532 95%CI=1.59 5.32 59 5 32 95%CI=1.59-5.32) > OR=3.23 OR323 23 (OR=3.23 95%CI=1.279.92 95CI127992 95%CI=1.27 9.92 27 9 95%CI=1.27-9.92 OR=0.42 OR042 (OR=0.42 95%CI=0.230.73. 95CI023073 95%CI=0.23 0.73 73 95%CI=0.23-0.73) income OR=0.63 OR063 63 (OR=0.63 95%CI=0.41096, 95CI041096 95%CI=0.41 096 41 95%CI=0.41-096) OR=4.06 OR406 06 (OR=4.06 95%CI=2.576.51 95CI257651 95%CI=2.57 6.51 6 51 95%CI=2.57-6.51 OR=0.48 OR048 48 (OR=0.48 95%CI=0.260.84. 95CI026084 95%CI=0.26 0.84 26 84 95%CI=0.26-0.84) (PHC 201 ≤ ( p00 p≤0.0 (p≤0.05 54. OR=0.5 OR05 (OR=0.5 37085 95%CI=0.37085 95CI03708 95CI037 95%CI=0.3 08 95%CI=0.37-085 OR=4.9 OR49 (OR=4.9 167 95%CI=3.167.79 95CI31677 95CI316 95%CI=3.1 779 7.7 95%CI=3.16-7.79 OR=2.4 OR24 (OR=2.4 424 95%CI=1.424.1 95CI14241 95CI142 95%CI=1.4 416 4.1 95%CI=1.42-4.1 OR=2.8 OR28 (OR=2.8 595 95%CI=1.595.32 95CI15953 95CI159 95%CI=1.5 532 5.3 95%CI=1.59-5.32 OR=3.2 OR32 (OR=3.2 279 95%CI=1.279.9 95CI12799 95CI127 95%CI=1.2 992 9.9 95%CI=1.27-9.9 OR=0.4 OR04 (OR=0.4 230 95%CI=0.230.73 95CI02307 95CI023 95%CI=0.2 073 0.7 95%CI=0.23-0.73 OR=0.6 OR06 (OR=0.6 41096 95%CI=0.41096 95CI04109 95CI041 95%CI=0.4 09 95%CI=0.41-096 OR=4.0 OR40 (OR=4.0 576 95%CI=2.576.5 95CI25765 95CI257 95%CI=2.5 651 6.5 95%CI=2.57-6.5 260 95%CI=0.260.84 95CI02608 95CI026 084 0.8 95%CI=0.26-0.84 20 p0 p≤0. (p≤0.0 OR=0. OR0 (OR=0. 3708 95%CI=0.3708 95CI0370 95CI03 95%CI=0. 95%CI=0.37-08 OR=4. OR4 (OR=4. 95%CI=3.167.7 95CI3167 95CI31 95%CI=3. 77 7. 95%CI=3.16-7.7 OR=2. OR2 (OR=2. 95%CI=1.424. 95CI1424 95CI14 95%CI=1. 4. 95%CI=1.42-4. 95%CI=1.595.3 95CI1595 95CI15 53 5. 95%CI=1.59-5.3 OR=3. OR3 (OR=3. 95%CI=1.279. 95CI1279 95CI12 99 9. 95%CI=1.27-9. 95%CI=0.230.7 95CI0230 95CI02 07 0. 95%CI=0.23-0.7 4109 95%CI=0.4109 95CI0410 95CI04 95%CI=0.41-09 95%CI=2.576. 95CI2576 95CI25 95%CI=2. 65 6. 95%CI=2.57-6. 95%CI=0.260.8 95CI0260 95%CI=0.26-0.8 p≤0 (p≤0. OR=0 (OR=0 370 95%CI=0.370 95CI0 95%CI=0 95%CI=0.37-0 OR=4 (OR=4 95%CI=3.167. 95CI3 95%CI=3 95%CI=3.16-7. OR=2 (OR=2 95%CI=1.424 95CI1 95%CI=1 95%CI=1.42-4 95%CI=1.595. 95%CI=1.59-5. OR=3 (OR=3 95%CI=1.279 95%CI=1.27-9 95%CI=0.230. 95%CI=0.23-0. 410 95%CI=0.410 95%CI=0.41-0 95%CI=2.576 95CI2 95%CI=2 95%CI=2.57-6 95%CI=0.260. 95%CI=0.26-0. p≤ (p≤0 OR= (OR= 95CI 95%CI= 95%CI=0.37- 95%CI=3.167 95%CI=3.16-7 95%CI=1.42- 95%CI=1.595 95%CI=1.59-5 95%CI=1.27- 95%CI=0.230 95%CI=0.23-0 95%CI=0.41- 95%CI=2.57- 95%CI=0.260 95%CI=0.26-0 (p≤ (OR 95%CI 95%CI=3.16- 95%CI=1.59- 95%CI=0.23- 95%CI=0.26- (p

Abstract This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes “tooth loss” and “reason for the last dental appointment” were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.

Objetivo: investigar as propriedades psicométricas da versão adaptada ao português do Brasil do questionário de letramento em saúde European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) em adultos brasileiros. Método: o instrumento foi traduzido e pré-testado em uma amostra de 50 indivíduos. Em seguida, ele foi aplicado em uma amostra com 783 indivíduos adultos. Os dados passaram por um processo adequado de testagem das propriedades, com a combinação de técnicas da Análise Fatorial Exploratória, Análise Fatorial Confirmatória e Teoria de Resposta ao Item. Para a avaliação da confiabilidade, foram utilizados os indicadores de alfa de Cronbach e o Ômega de McDonald. Foi aplicada a validação cruzada com análise integral dos dados. Resultados: a maioria dos participantes era do sexo feminino (68,1%), com idade média de 38,6 (dp=14,5) anos e 33,5% estudaram até o ensino fundamental. Os resultados indicaram um modelo unidimensional com variância explicada de 71,23%, níveis de cargas fatoriais, comunalidades e discriminação do item adequados, bem como estabilidade e a replicabilidade do instrumento para outras populações. Conclusão: a versão brasileira do HLS-EU-Q6 indicou que o instrumento está adequado para aplicação de forma indiscriminada na população a que se destina para aferir os níveis de letramento em saúde.

Objective: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. Method: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. Results: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. Conclusion: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Objetivo: investigar las propiedades psicométricas de la versión en portugués brasileño del cuestionario de alfabetización en salud European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) en adultos brasileños. Método: el instrumento fue traducido y probado primero en una muestra de 50 individuos. Luego, se aplicó a una muestra de 783 individuos adultos. Los datos pasaron por un proceso adecuado de prueba de las propiedades, con la combinación de técnicas de Análisis Factorial Exploratorio, Análisis Factorial Confirmatorio y Teoría de Respuesta al Ítem. Para evaluar la confiabilidad se utilizaron los indicadores alfa de Cronbach y Omega de McDonald's. Se aplicó validación cruzada con análisis de datos completo. Resultados: la mayoría de los participantes era de sexo femenino (68,1%), con una edad media de 38,6 (dt = 14,5) años y el 33,5% cursó hasta la educación primaria. Los resultados indicaron un modelo unidimensional con una varianza explicada de 71,23%, niveles adecuados de carga factorial, comunalidades y discriminación de ítems, así como estabilidad y replicabilidad del instrumento a otras poblaciones. Conclusión: la versión brasileña de HLS-EU-Q6 indicó que el instrumento es apto para su aplicación indiscriminada en la población a la que se destina para evaluar los niveles de alfabetización en salud.

Resumo Objetivo Avaliar as repercussões da pandemia de COVID-19 nos procedimentos realizados por um serviço público odontológico de urgência (SPOU). Métodos Estudo transversal, utilizando-se dados do SPOU de Piracicaba, SP, Brasil, relativos a dois períodos, anterior (fevereiro e março de 2020) e durante a pandemia (março e abril de 2020). Diferenças no perfil de atendimentos, entre os períodos pré-COVID-19 e COVID-19 selecionados, de acordo com sexo, idade e procedimentos odontológicos, foram analisadas pelo teste qui-quadrado de Pearson. Também foi calculado o tamanho do efeito Cramer's V. Resultados Houve redução de 51% no número de atendimentos, entre o período anterior (n=824) e o período da pandemia de COVID-19 observado (n=404). O percentual de exodontias reduziu-se, de 14,7 para 8,9%, enquanto o de selamento provisório de cavidades aumentou de 22,9 para 33,2%, entre ambos períodos. Conclusão A pandemia de COVID-19 repercutiu na quantidade e no padrão de procedimentos realizados pelo serviço odontológico de urgência do município.

Abstract Objective To evaluate the repercussions of the COVID-19 pandemic on procedures performed by a public urgent dental care service (PUDS). Methods This was a cross-sectional study, using data from the PUDS in Piracicaba, SP, Brazil, prior to the pandemic (February-March 2020) and during the pandemic (March-April 2020). Differences in the care profile between the pre-COVID-19 period and the COVID-19 period, according to sex, age and dental procedures were analyzed using Pearson’s Chi-square test. Effect size was also measured using Cramer’s V. Results There was a 51% reduction in the number of visits between the pre-COVID-19 period (n=824) and the COVID-19 period (n=404). The percentage of extractions reduced from 14.7% to 8.9%, while the percentage of temporary cavity fillings increased from 22.9% to 33.2%, between the two periods. Conclusion The COVID-19 pandemic had repercussions on the amount and pattern of procedures performed at the city’s urgent dental care service.

Resumen Objetivo Evaluar el impacto de la pandemia COVID-19 en los procedimientos realizados por un servicio de odontología pública de emergencia (SOPE). Métodos Estudio transversal, utilizando datos del SOPE de Piracicaba, SP, Brasil, para los períodos anteriores (febrero y marzo 2020) y durante la pandemia (marzo y abril 2020). Las diferencias en el perfil de atención entre los períodos Pre-COVID-19 y COVID-19, según sexo, edad y procedimientos dentales, se analizaron mediante la prueba Chi-cuadrado de Pearson. También se calculó el tamaño del efecto de Cramer V. Resultados Hubo una reducción del 51% en el número de visitas entre el período anterior (n=824) y el período de la pandemia de COVID-19 (n=404). El porcentaje de extracciones se redujo del 14,7% al 8,9%, mientras que el porcentaje de sellado provisional de cavidades aumentó del 22,9% al 33,2%, entre estos períodos. Conclusión La pandemia de COVID-19 afectó la cantidad y patrón de procedimientos realizados en el servicio de odontología de emergencia de la ciudad.

Resumo Objetivo Avaliar as repercussões da pandemia de COVID-19 nos procedimentos realizados por um serviço público odontológico de urgência (SPOU). Métodos Estudo transversal, utilizando-se dados do SPOU de Piracicaba, SP, Brasil, relativos a dois períodos, anterior (fevereiro e março de 2020) e durante a pandemia (março e abril de 2020). Diferenças no perfil de atendimentos, entre os períodos pré-COVID-19 e COVID-19 selecionados, de acordo com sexo, idade e procedimentos odontológicos, foram analisadas pelo teste qui-quadrado de Pearson. Também foi calculado o tamanho do efeito Cramer's V. Resultados Houve redução de 51% no número de atendimentos, entre o período anterior (n=824) e o período da pandemia de COVID-19 observado (n=404). O percentual de exodontias reduziu-se, de 14,7 para 8,9%, enquanto o de selamento provisório de cavidades aumentou de 22,9 para 33,2%, entre ambos períodos. Conclusão A pandemia de COVID-19 repercutiu na quantidade e no padrão de procedimentos realizados pelo serviço odontológico de urgência do município.

Abstract Objective To evaluate the repercussions of the COVID-19 pandemic on procedures performed by a public urgent dental care service (PUDS). Methods This was a cross-sectional study, using data from the PUDS in Piracicaba, SP, Brazil, prior to the pandemic (February-March 2020) and during the pandemic (March-April 2020). Differences in the care profile between the pre-COVID-19 period and the COVID-19 period, according to sex, age and dental procedures were analyzed using Pearson’s Chi-square test. Effect size was also measured using Cramer’s V. Results There was a 51% reduction in the number of visits between the pre-COVID-19 period (n=824) and the COVID-19 period (n=404). The percentage of extractions reduced from 14.7% to 8.9%, while the percentage of temporary cavity fillings increased from 22.9% to 33.2%, between the two periods. Conclusion The COVID-19 pandemic had repercussions on the amount and pattern of procedures performed at the city’s urgent dental care service.

Resumen Objetivo Evaluar el impacto de la pandemia COVID-19 en los procedimientos realizados por un servicio de odontología pública de emergencia (SOPE). Métodos Estudio transversal, utilizando datos del SOPE de Piracicaba, SP, Brasil, para los períodos anteriores (febrero y marzo 2020) y durante la pandemia (marzo y abril 2020). Las diferencias en el perfil de atención entre los períodos Pre-COVID-19 y COVID-19, según sexo, edad y procedimientos dentales, se analizaron mediante la prueba Chi-cuadrado de Pearson. También se calculó el tamaño del efecto de Cramer V. Resultados Hubo una reducción del 51% en el número de visitas entre el período anterior (n=824) y el período de la pandemia de COVID-19 (n=404). El porcentaje de extracciones se redujo del 14,7% al 8,9%, mientras que el porcentaje de sellado provisional de cavidades aumentó del 22,9% al 33,2%, entre estos períodos. Conclusión La pandemia de COVID-19 afectó la cantidad y patrón de procedimientos realizados en el servicio de odontología de emergencia de la ciudad.

Resumo O objetivo deste estudo foi realizar a adaptação transcultural e validação da “Escala de Autoeficácia para escovação dentária noturna” em uma população de adultos brasileiros. A tradução e a adaptação transcultural para a língua portuguesa foram realizadas de acordo com padrões recomendados na literatura. A validade de construto foi realizada por meio de análises fatoriais exploratória e confirmatória em uma amostra de 198 adultos. A confiabilidade do instrumento foi aferida pelos índices Alpha e Ômega. O modelo foi observado como unidimensional para todos os indicadores, com variância explicada de 85,7%, cargas fatoriais entre 0,85 e 0,91 e comunalidades entre 0,72 e 0,83. Os índices de ajuste do modelo apresentados pela análise confirmatória estiveram entre 0,98 e 0,99, com cargas fatoriais entre 0,85 e 0,93 e valores de regressão entre 0,69 e 0,84, indicando a qualidade do instrumento. Para a confiabilidade do instrumento, os valores de Alpha e Ômega apresentaram índices idênticos de 0,95, mostrando altos níveis de confiabilidade do modelo. O índice de replicabilidade G-H foi de 0,96, indicando a estabilidade da solução em outros contextos e amostras. Concluímos que todos os indicadores representaram excelentes evidências de validade da “Escala de Autoeficácia para Escovação Dentária Noturna”.

Abstract This study aims to perform cross-cultural adaptation and validation of the “Self-efficacy scale to brush teeth at night” with a Brazilian adult population. Translation and cross-cultural adaptation to the Brazilian-Portuguese language were done according to the stages recommended in the literature. Construct validity was carried out by mean of exploratory and confirmatory factorial analysis in a sample of 198 adult subjects. The reliability of the instrument was measured by Alpha and Omega indices. The model was observed to have been established as one-dimensional for all indicators, with explained variance of 85.7%; factorial loads between 0.85 and 0.91; and with communalities between 0.72 and 0.83. The goodness of fit of the model shown by the confirmatory model were between 0.98 and 0.99; with factorial loads between 0.85 and 0.93, and regression values between 0.69 and 0.84, all above the minimum indices established for instrument quality. For reliability, the Alpha and Omega values had identical indices of 0.95 showing high levels of reliability of the model. The G-H index replicability was 0.96, indicating the stability of solution in other contexts and samples. We concluded that all indicators represented excellent evidence of scale validity to measure self-efficacy to brush teeth at night.

Resumo O objetivo deste estudo foi realizar a adaptação transcultural e validação da “Escala de Autoeficácia para escovação dentária noturna” em uma população de adultos brasileiros. A tradução e a adaptação transcultural para a língua portuguesa foram realizadas de acordo com padrões recomendados na literatura. A validade de construto foi realizada por meio de análises fatoriais exploratória e confirmatória em uma amostra de 198 adultos. A confiabilidade do instrumento foi aferida pelos índices Alpha e Ômega. O modelo foi observado como unidimensional para todos os indicadores, com variância explicada de 85,7%, cargas fatoriais entre 0,85 e 0,91 e comunalidades entre 0,72 e 0,83. Os índices de ajuste do modelo apresentados pela análise confirmatória estiveram entre 0,98 e 0,99, com cargas fatoriais entre 0,85 e 0,93 e valores de regressão entre 0,69 e 0,84, indicando a qualidade do instrumento. Para a confiabilidade do instrumento, os valores de Alpha e Ômega apresentaram índices idênticos de 0,95, mostrando altos níveis de confiabilidade do modelo. O índice de replicabilidade G-H foi de 0,96, indicando a estabilidade da solução em outros contextos e amostras. Concluímos que todos os indicadores representaram excelentes evidências de validade da “Escala de Autoeficácia para Escovação Dentária Noturna”.

Abstract This study aims to perform cross-cultural adaptation and validation of the “Self-efficacy scale to brush teeth at night” with a Brazilian adult population. Translation and cross-cultural adaptation to the Brazilian-Portuguese language were done according to the stages recommended in the literature. Construct validity was carried out by mean of exploratory and confirmatory factorial analysis in a sample of 198 adult subjects. The reliability of the instrument was measured by Alpha and Omega indices. The model was observed to have been established as one-dimensional for all indicators, with explained variance of 85.7%; factorial loads between 0.85 and 0.91; and with communalities between 0.72 and 0.83. The goodness of fit of the model shown by the confirmatory model were between 0.98 and 0.99; with factorial loads between 0.85 and 0.93, and regression values between 0.69 and 0.84, all above the minimum indices established for instrument quality. For reliability, the Alpha and Omega values had identical indices of 0.95 showing high levels of reliability of the model. The G-H index replicability was 0.96, indicating the stability of solution in other contexts and samples. We concluded that all indicators represented excellent evidence of scale validity to measure self-efficacy to brush teeth at night.