Abstract Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care.

Resumo Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Abstract The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Resumo Objetivou-se avaliar os cuidados em saúde bucal de crianças/adolescentes com Paralisia Cerebral (PC) segundo a gravidade, através da percepção dos pais/cuidadores. Estudo série de casos realizado em serviços de saúde de Pernambuco com 94 mães/cuidadores de sujeitos com PC entre 5 e 18 anos. Avaliaram-se fatores socioeconômicos, demográficos, cuidados em saúde bucal e uso de serviços odontológicos (SO). O Sistema de Classificação da Função Motora Grossa mostrou 67% com comprometimento motor grave. Indivíduos com PC grave tiveram frequência significantemente maior de pertencerem a famílias com renda mais baixa (89%, p < 0,001), residirem no interior (44%, p < 0,005), terem dificuldades de transporte (60%, p = 0,04) e acessibilidade aos SO (88%, p = 0,009) e maior necessidade de higiene bucal (67%, p = 0,008) realizada pelas mães (94%, p < 0,001). Apesar das barreiras de acesso aos SO, o mesmo foi facilitado para aqueles com PC grave, com uso precoce dos SO, mas com baixa oferta de dentistas e de humanização. Esses resultados informam problemas relacionados aos cuidados diários em saúde bucal, contexto de vida das famílias, de apoio institucional e de qualidade dos SO a serem enfrentados com políticas públicas socioeconômicas e de saúde integrais inclusivas e equânimes.

Abstract The aim was to evaluate the oral health care of children/adolescents with Cerebral Palsy (CP) according to severity through the perceptions of parents/caregivers. A case series study was conducted at health services in the state of Pernambuco, Brazil with 94 mothers/caregivers of subjects with CP from 5 and 18 years old. Sociodemographic factors, oral health care and use of dental services (DS) were evaluated. The Gross Motor Function Classification System showed 67% with severe motor impairment. Subjects with severe CP had significantly higher frequencies of belonging to families with lower income (89%, p < 0.001), living in the interior (44%, p < 0.005), having transportation difficulties (60%, p = 0.04), difficulty regarding access to DS (88%, p = 0.009) and a greater need for oral hygiene (67%, p = 0.008), which was performed exclusively by the caregiver (94%, p < 0.001). Despite identified access barriers, dental care was facilitated for those with severe CP, early DS use, but low availability of dentists and low degree of humanization were cited as major problems. These results reveal problems related to daily oral health care, family living context, institutional support and quality of DS that should be addressed in comprehensive, inclusive, equitable social and economic public policies.

Disfunção temporomandibular (DTM) é uma condição comum. Este estudo é parte de um grupo de pesquisa e investigou a prevalência de DTM e dor miofascial e suas associações com sexo, idade e classe socioeconômica. A amostra foi composta por 100 indivíduos, com idades entre 15 e 70 anos, usuários das Unidades de Saúde da Família, na cidade de Recife, PE. O grau de DTM foi avaliado usando os Critérios de Diagnósticos Científicos em DTM, e classe socioeconômica com o Critério de Classificação Econômica Brasil. As variáveis categóricas foram analisadas pelo teste do qui-quadrado para proporções e teste exato de Fisher para tabelas 2x2, e a análise logística binária para traçar a relação entre as variáveis independentes e dependentes. De acordo com os resultados, 42% dos indivíduos tinham DTM e 14% dor miofascial. Não houve associação estatisticamente significativa entre DTM e sexo ou classe socioeconômica, mas houve associação estatisticamente significativa com a idade e a dor miofascial foi associada com a classe socioeconômica. Considerando-se que os resultados do presente estudo devam ser confirmados em outros estudos e por causa de sua natureza piloto, a prevalência deve ser analisada com cautela.

Temporomandibular disorder (TMD) is a common condition. This study is part of a research group and it investigated the prevalence of TMD and myofascial pain and its association with gender, age and socioeconomic class. The sample comprised 100 subjects, aged 15 to 70, users of the Family Health Units' services, in the city of Recife, PE, Brazil. The TMD degree was evaluated using the Research Diagnostic Criteria for TMD and socioeconomic class by the Economic Classification Criteria Brazil. Categorical variables were analyzed by chi-square test for proportions and Fisher's exact test for 2x2 tables, and binary logistic analysis to track the relationship between the independent and dependent variables. According to the results, 42% of the subjects had TMD and 14% myofascial pain. No statistically significant association could be found between TMD and gender or socioeconomic class, but it was found to have statistically significant association with age, and myofascial pain was associated with socioeconomic class. Considering that the results of the present study should be confirmed by further studies and the fact that this was a pilot study, the prevalence must be analyzed with caution.