Oral Health Access and Early Caries in Childhood in a Primary Care Service in Southern Brazil: A Cross-Sectional Study

Lucas Eduardo  Jardim; Mayara Rodrigues  Pereira; Márcia Cançado  Figueiredo; Daniel Demétrio  Faustino-Silva

Authors

Lucas Eduardo Jardim
Mayara Rodrigues Pereira
Márcia Cançado Figueiredo
Daniel Demétrio Faustino-Silva

Keywords:

Dental Caries, Child, Primary Health Care, Health Services Accessibility, Oral Health

Abstract

Objective: To evaluate the prevalence of early childhood caries and its association with Child's Programmatic Action dental visits in a Primary Care Service. Material and Methods: A cross-sectional analytical study was carried out at the Health Centers of the Grupo HospitalarConceição Community Health Service in Porto Alegre, RS, Brazil. Mothers answered a questionnaire containing socioeconomic data, eating habits and oral care of their children. Caries examination was performed by two examiners calibrated using WHO criteria. Results: Eighty-one children with mean age of 58.8 (SD=4.8) months were evaluated, 58% were male. Caries prevalence was 43%, with mean dmft = 1.7 and mean dmfs = 3.09. In the multivariate analysis, there was a statistically significant association of caries with maternal schooling (PR=1.31, 95%CI=1.06-1.62, p=0.012), family income (PR=0.93, 95% CI=0.90-0.97, p<0.001), adequacy of the number of childcare visits (PR=0.68, 95%CI=0.54–0.86, p=0.001) and number of visits to the dentist (PR=1.04, 95%CI=1.01-1.06, p=0.001). Conclusion: Ensuring access to childcare and early dental consultation, while the family context is disregarded, does not seem to be enough to reduce caries. It is necessary to think of non-conventional oral health promotion strategies in Primary Health Care taking into account the territory and social determinants since changes to eating and oral hygiene habits and behaviors are still a challenge to the control of childhood caries.

References

American Academy of Pediatric Dentistry (AAPD). Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Reference Manual 206/2017; 38(6):52-54.

Graves CE, Berkowitz RJ, Proskin HM, Chase I, Weinstein P, Billings R. Clinical outcomes for early childhood caries: influence of aggressive dental surgery. J Dent Child 2004; 71(2):114-7.

Brasil. Ministério da Saúde. Projeto SB Brasil 2003: Condições de Saúde Bucal da População Brasileira 2002-2003. Brasil. 2004. [In Portuguese]

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Secretaria de Vigilância em Saúde. Departamento de Atenção Básica. Coordenação Geral de Saúde Bucal. SB Brasil 2010 – Resultados Principais; Brasília, 2011. [In Portuguese]

Narvai PC, Antunes JLF, Moysés SJ, Frazão P, Peres MA, Peres KG, de Souza MLR, Roncalli AG. Scientific validity of epidemiological knowledge based on data from the Brazilian Oral Health Survey (SB Brazil 2003. Cad Saúde Pública 2010; 26(4):647-70. https://doi.org/10.1590/s0102-311x2010000400002

Sheiham A, Alexander D, Cohen L, Marinho V, Moysés S, Petersen PE, et al. Global oral health inequalities: task group – implementation and delivery of oral health strategies. Adv Dent Res 2011; 23(2):259-67. https://doi.org/10.1177/0022034511402084

International Association of Paediatric Dentistry. Early Childhood Caries: IAPD Bangkok Declaration. Int J Paediatr Dent 2019; 29(3):384-6. https://doi.org/10.1111/ipd.12490

Roncalli AG, Silva NN, Nascimento AC, Freitas CHSM, Casotti E, Peres KG, et al. Relevant methodological issues from the SBBrasil 2010 Project for national health surveys. Cad. Saúde Pública 2012; 28(Suppl):40-57. https://doi.org/10.1590/S0102-311X2012001300006

Listl S, Galloway J, Mossey PA, Marcenes W. Global economic impact of dental diseases. J Dent Res 2015; 94(10):1355-61. https://doi.org/10.1177/0022034515602879

Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and meta regression. J Dent Res 2015; 94(5):650-58. https://doi.org/10.1177/0022034515573272

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Saúde Bucal. Brasília – (Cadernos de Atenção Básica, n. 17) (Série A. Normas e Manuais Técnicos); 2006. [In Portuguese]

Brasil. Ministério da Saúde. Grupo Hospitalar Conceição. Gerência de Saúde Comunitária. A saúde bucal da criança de 0 a 12 anos. Atenção à saúde da criança de 0 a 12 anos. Porto Alegre: Hospital Nossa Senhora da Conceição, 2008. p.111-118. [In Portuguese]

Brasil. Ministério da Saúde. Grupo Hospitalar Conceição. Gerência de Saúde Comunitária. A saúde bucal da criança de 0 a 12 anos. Atenção à saúde da criança de 0 a 12 anos. 2nd. ed. Porto Alegre: Hospital Nossa Senhora da Conceição, 2014. p.133-148. [In Portuguese]

Gradella CMF, Oliveira LB, Ardenghi TM, Bonecker M. Caries Epidemiology in children aged 5-59 months-old in the city of Macapá, State of Amapá, Brazil. RGO 2007; 55(4):329-34.

Piovesan C, Moro BLP, Lara JS, Ardenghi TM, Guedes RS, Haddad AE, et al. Laboratorial training ofexaminers for using a visual caries detection system in epidemiologicalsurveys. BMC Oral Health 2013; 13:49. https://doi.org/10.1186/1472-6831-13-49

Cericato GO, Garbin D, Fernandes APS. Surgeon-dentist insertion in the Family Health Program: a critical revision on the actions and evaluation methods of the Oral Health Team. RFO 2007; 12(3):18-23.

Pauleto ARC, Pereira MLT, Cyrino EG. Oral health: a critical review about educative programmes for students. Ciênc Saúde Coletiva 2004; 9(1):121-30. https://doi.org/10.1590/S1413-81232004000100012

Cascaes AM, Bieleman RM, Clark VL, Barros AJD. Effectivenessofmotivationalinterviewingatimproving oral health: a systematic review. Rev Saúde Pública 2014; 48(1):142-53. https://doi.org/10.1590/s0034-8910.2014048004616

Gao X, Lo EC, Kot SC, Chan KC. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodontol 2014; 85(3):426-37. https://doi.org/10.1902/jop.2013.130205

Colvara BC, Faustino-Silva DD, Meyer E, Hugo FN, Hilgert JB, Celeste RK. Motivational interviewing in preventing early childhood caries in primary healthcare: a community-based randomized cluster trial. J Pediatr 2018; 201(10):190-5. https://doi.org/1016/j.jpeds.2018.05.016

Moynihan P, Tanner LM, Holmes RD, Hillier-Brown F, Mashayekhi A, Kelly SAM, et al. Systematic review of evidence pertaining to factors that modify risk of early childhood caries. JDR Clin Trans Res. 2019 Jul;4(3):202-216. https://doi.org/10.1177/2380084418824262

Ardenghi TM, Piovesan C, Antunes JLF. Inequalities in untreated dental caries prevalence in preschool children in Brazil. Rev Saúde Pública 2013; 47(Suppl3):129-37. https://doi.org/10.1590/S0034-8910.2013047004352

Catani DB, Meirelles MPMR, Sousa MLR. Dental caries and social determinants of health in scholars at Piracicaba - SP. Rev Odontol UNESP 2010; 39(6):344-50.

Noro LRA, Roncalli AG, Mendes Júnior FIR, Lima KC. Use of dental care by children and associated factors in Sobral, Ceará State, Brazil. Cad Saúde Pública 2008; 24(7):1509-16. https://doi.org/10.1590/S0102-311X2008000700005

Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent 2019; 29(3):238-48. https://doi.org/10.1111/ipd.12484

Kirthiga M, Murugan M, Saikia A, Kirubakaran R. Risk factors for early childhood caries: a systematic review and meta-analysis of case control and cohort studies. Pediatr Dent 2019; 41(2):95-112.

Machado APS, Brunetto S, Faustino-Silva DD. Report of joint service experience dentistry and nutrition for children 0-36 months in a basic health unit in the city of Porto Alegre-RS. Rev Fac Odontol Porto Alegre 2011; 52(1/3):49-55. https://doi.org/10.22456/2177-0018.27537

Garbin CAS, Saliba NA, Moimaz SAS, Santos KT. O papel das universidades na formação de profissionais na área da Saúde. Rev ABENO 2006; 6(1):6-10. [In Portuguese]

Pereira DQ, Pereira JCM, Assis MMA. The odontological practice in the Basic Health Units in Feira de Santana, Bahia, in the health municipalization process: individual, autonomous, curative and technical activities. Ciênc Saúde Coletiva 2003; 8(2):599-609. https://doi.org/10.1590/S1413-81232003000200020

Reis ML, Luvison IR, Faustino-Silva DD. Oral health knowledge, attitudes, and practices of doctors and nurses in the PHC of children. RFO UPF 2015; 20(2):164-71.