Biomedical subjects

Paulo Frazão

Publications and source records attributed to Paulo Frazão.

10 recordsLinked to original sources

PubMed2006

[Inequalities in the conditions of infection control in dentistry offices in a southeastern Brazilian city].

The study analyzed infection control conditions in dentistry offices in Cariacica, Espírito Santo, Brazil. Data pertaining to interviewees, location and type of office, setting, equipment, and materials were obtained by direct observation in all the registered services and in twenty unlicensed establishments operated by "non-graduate dentists". For grouped analysis of infection control measurements in each establishment, a composite indicator based on 19 variables was developed, such that the lower its value, the better the infection control. The results referred to 113 offices. Infection control in offices of "non-graduate dentists" (xICI = 23.05, dp = 11.86) was four times worse than for private offices. Public dental care services (xICI = 16.27; dp = 6.96) occupied an intermediate position. Conditions were also four times worse in dentistry offices located in peripheral urban areas. There was a clear-cut division in sanitary conditions within dental care as a whole. A large proportion of the population depending on dental care from unlicensed dentists is exposed to increased risk of cross-infection.

Brazil↗

PubMed2006

Socio-environmental factors associated with dental occlusion in adolescents.

INTRODUCTION: Information about the distribution of malocclusion in the population and identification of factors and conditions associated with it could help researchers build models to understand its occurrence and help public-health policy makers improve interventions. The aim of this study was to assess the severity of occlusal disorders in Brazilian adolescents, 12 and 18 years old, and to investigate associations between occlusal disorders and demographic, socio-environmental, and clinical variables. METHODS: Secondary data from a cross-sectional study, including 13,801 dental occlusion status records from a probabilistic sample randomly selected from public and private schools in 131 cities in the state of São Paulo, Brazil, were analyzed according to the dental aesthetic index (DAI). The proportion of DAI scores greater than 30 were compared between ages, sexes, white and nonwhite students, urban and rural dwellers, and private and public school students; and they were compared with variables such as access to fluoridated tap water and city population, and with clinical aspects such as the care index (CI) and the decayed, missing, filled teeth (DMFT) index. Data analysis included frequency distribution calculation and multiple logistic regression modeling. RESULTS: The mean DAI score for the sample was 24.33 (SD 7.54), and 16.5% of the subjects had DAI scores of 30 or more (severe or very severe malocclusion). The rate of DAI >31 was significantly higher among 12-year-olds, nonwhites, public-school students, those from smaller municipalities, those without fluoridated tap water, and those with a CI <51%, a DMFT score >4 at age 12 years, or a DMFT score >6 at age 18 years. At age 18, fewer subjects had DAI scores >30; the components responsible for this reduction were spacing in at least 1 incisal segment, midline diastema > or =1, and anterior maxillary overjet > or =4. CONCLUSION: Some socio-environmental factors are associated with severity of malocclusion in adolescents.

Adolescent↗

PubMed2006

[Dental caries in Brazil: decline, polarization, inequality and social exclusion].

OBJECTIVE: To examine the caries situation in Brazilian schoolchildren between 1980 and 2003 and to determine the distribution of caries and access to treatment in this population group. METHODS: We employed secondary data concerning the number of decayed, missing or filled teeth (DMFT). The studies whose data were used differed in terms of study type, study design, sampling methods, and diagnostic criteria, but yielded national estimates that are considered valid for the DMFT index. Therefore, a trend analysis based on these studies was thought to be feasible. RESULTS: Analysis of DMFT values revealed a high frequency of dental caries in 1980 and a moderate frequency in the 1990s. In 2003, the DMFT index was still within the moderate range. Between 1980 and 2003, a 61.7% decrease in DMFT frequency was observed. The percentage of children with no DMFT increased from 3.7% in 1986 to 31.1% in 2003. On the other hand, in the segment of the study population least affected, the percentage of children who received care increased from 26.3 in 1986 to 34.7 in 2003, yet in the group with DMFT this percentage fell from 50.2 in 1986 to 39.3 in 2003. In the segment with DMFT >/=6, the percentage of those who received care remained stable (28%). During the study period, 60% of the dental caries were found in 20% of the study population. CONCLUSION: An important decline in DMFT was observed between 1980 and 2003, perhaps as a result of increased access to fluoridated water and toothpaste and of changes in the goals of public oral health programs. Despite the improvement, caries is unevenly distributed in the pediatric population; a small proportion of individuals carries most of the disease burden. In addition, the proportion of teeth with caries that went untreated did not change between 1980 and 2003. Reducing socioeconomic disparities and adopting public health measures that target and reach the most vulnerable groups remain a challenge for policy makers in Brazil.

Brazil↗

PubMed2004

[Dental fluorosis: comparison of two prevalence studies].

Dental fluorosis is an enamel opacity resulting from the ingestion of excessive amounts of fluoride (chronic exposure) during tooth formation. Estimation of this problem among populations exposed to fluoride sources is necessary and should be performed periodically to monitor changes in levels and patterns in the disorder. This research aimed to describe and compare two prevalence studies to estimate the occurrence of dental fluorosis in a population of schoolchildren in Ribeirão Pires, São Paulo State, Brazil, conducted in 1997 and 2000. The methods used in each study are described briefly and the results compared. Methodological aspects and implications for public health are discussed.

Adolescent↗

PubMed2004

Are severe occlusal problems more frequent in permanent than deciduous dentition?

OBJECTIVE: To determine the prevalence and severity of occlusal problems in populations at the ages of deciduous and permanent dentition and to carry out a meta-analysis to estimate the weighted odds ratio for occlusal problems comparing both groups. METHODS: Data of a probabilistic sample (n=985) of schoolchildren aged 5 and 12 from an epidemiological study in the municipality of São Paulo, Brazil, were analyzed using univariate logistic regression (MLR). Results of cross-sectional study data published in the last 70 years were examined in the meta-analysis. RESULTS: The prevalence of occlusal problems increased from 49.0% (95% CI =47.4%-50.6%) in the deciduous dentition to 71.3% (95% CI =70.3%-72.3%) in the permanent dentition (p<0.001). Dentition was the only variable significantly associated to the severity of malocclusion (OR=1.87; 95% CI =1.43-2.45; p<0.001). The variables sex, type of school and ethnic group were not significant. The meta-analysis showed that a weighted OR of 1.95 (1.91; 1.98) when compared the second dentition period with deciduous and mixed dentition. CONCLUSIONS: In planning oral health services, some activities are indicated to reduce the proportion of moderate/severe malocclusion to levels that are socially more acceptable and economically sustainable.

Adolescent↗

PubMed2004

Dental injury among Brazilian schoolchildren in the state of São Paulo.

To describe the distribution of dental trauma in Brazilian schoolchildren and its association with demographic, environmental and clinical factors. A random sample of 73 243 schoolchildren's oral examination records from private and public units, selected from 131 cities within the state of São Paulo, Brazil, was analysed. Trauma was assessed based on international methodological standards prescribed by the World Health Organization for Oral Health Surveys (1997). Proportions obtained were compared between urban and rural schools, as well as between private and public units. Oral health status indices were estimated based on the decayed, missing and filled teeth (DMFT) index - the average number of decayed, missing and filled teeth; the proportion of caries-free 5-year-old schoolchildren and anterior maxillary overjet among 12-year-old schoolchildren. The prevalence of dental trauma in anterior dentition was of 2.4, enrolling average 1.2 teeth per child. A rate of 2.4 impaired anterior teeth per thousand was obtained, upper central incisors being those that were most affected - 7.7 in every 10. Among 8- to 11-year-old children, the rates grew regularly. The proportion of dental trauma was significantly higher in boys than in girls (P < 0.01), and gender prevalence ratio was of 1.58 for boys. The results showed positive associations between dental trauma and caries-free 5-year-old schoolchildren (P = 0.003), anterior maxillary overjet > or =3 mm (P < 0.001), and private school as a socio-economic proxy indicator (P = 0.048).

Age Factors↗

PubMed2003

City-level gender differentials in the prevalence of dental caries and restorative dental treatment.

This study assesses gender differentials in the distribution of dental caries and restorative treatment at the city level in order to discuss gender inequities in health. We retrieved data for caries prevalence and dental service utilisation by 11- and 12-year-old girls and boys in 131 towns in the state of São Paulo, Brazil, 1998. We also gathered aggregate population data for these towns, and information already held by the health authority regarding the provision of dental services. Results of data analysis indicated that girls presented higher caries indices in permanent teeth than boys of the same age, concurrent with a higher utilisation of dental care. When studying aggregate data at the city level, we gathered evidence reinforcing the hypothesis that the higher prevalence of caries in girls is attributable to their earlier eruption of permanent teeth, with no significant association between this excess and indices of socio-economic status at the city level. However, indices assessing the discrepant incorporation of dental services between genders were higher in towns with a poorer profile of socio-economic status. We also observed that towns whose public health service was more effective in providing dental care presented a more equitable gender distribution of dental services. Public resources destined to dental assistance contributed to reducing inequities in oral health by allowing an incorporation of restorative dental treatment more equitably distributed between girls and boys.

Brazil↗

PubMed2003

Ethnic disparities in the prevalence of dental caries and restorative dental treatment in Brazilian children.

AIM: This study assesses disparities in the oral health status of Brazilian black and white children. PARTICIPANTS: 11- and 12-year-old schoolchildren living in 131 cities of the State of São Paulo, Brazil. METHODS: Spatial data analysis of city-level indexes of oral health, socio-economic status and provision of dental services. MAIN OUTCOME MEASURES: Ethnic ratios of the DMFT and the care index. RESULTS: White children had higher indexes of caries in permanent teeth than their black counterparts, concurrent with a higher utilisation of dental attendance. The gap of caries prevalence between black and white children was reduced in cities with a better profile of socio-economic status. Cities with higher per-capita yearly budget, expenditure in health, and provision of public dental services presented reduced indications of ethnic inequality in dental care. CONCLUSION: The knowledge of conditions associated with a lower ethnic discrepancy in the risk of caries and in the incorporation of dental services can be used to design socially appropriate dental services. An improved community dental service, higher public expenditure in health and per-capita municipal yearly budget contribute effectively to reducing inequities in oral health by allowing an incorporation of restorative dental treatment more equitably distributed between black and white children.

Black People↗

PubMed2003

The association between socioeconomic development at the town level and the distribution of dental caries in Brazilian children.

OBJECTIVE: To investigate the association between dental caries among children in the state of São Paulo, Brazil, and town-level indices of socioeconomic development. METHODS: We examined 15 385 oral-examination records from children aged 5 or 6 years old from 129 towns and cities in the state of São Paulo. We studied two outcomes: (1) the mean number of decayed, missing, and filled deciduous teeth (dmft index) and (2) the care index, which is the proportion of decayed teeth that have already been filled. The explanatory variables were the child development index, human development index, illiteracy rate among subjects older than 20 years, household income, Gini coefficient, insufficient income, fluoridated water supply, number of dentists per 10 000 inhabitants, number of dentists in the public service per 10 000 inhabitants, and number of weekly hours of dentist work in the public service per 10 000 inhabitants. Multiple linear regression models were fitted to the two outcome variables (dmft index and care index). RESULTS: The multiple linear regression analysis showed that a higher dmft index was associated with a low child development index, a high illiteracy rate, and an unfluoridated water supply. The child development index was significantly associated with the care index, and the number of dentists in the public service per 10 000 inhabitants showed borderline statistical significance. CONCLUSIONS: Our results indicate that town-level indices of socioeconomic status are significantly correlated with caries indices. Our results also emphasize the beneficial effect that fluoridating water has on reducing the prevalence of dental caries and the fact that strategies for treating and preventing oral diseases should be emphasized within the context of overall health promotion for children.

Adolescent↗

PubMed2002

Spatial analysis to identify differentials in dental needs by area-based measures.

OBJECTIVES: To examine the association between tooth decay and dental treatment needs in 5-12-year-old schoolchildren in São Paulo with area-level indicators of social development. METHODS: The present study refers to a representative sample of children from the city of São Paulo, Brazil, comprising 2491 girls and boys attending public and private schools in different areas of the city. The assessment of caries and treatment needs followed the international methodological standards prescribed by the World Health Organization. We used spatial data analysis to describe epidemiological measures distributed by small areas, and to explore hypotheses of ecological association between caries indexes and indicators of social development. RESULTS: Schoolchildren in central districts were less affected by tooth decay and presented fewer dental treatment needs when compared to those in peripheral deprived areas. At the spatial level, average family income, unemployment rate, household overcrowding, and an index of inequality of income distribution were significantly correlated with variables measuring children's caries experience. CONCLUSIONS: The heterogeneous distribution of caries indexes by areas of the city indicates higher levels of dental decay in areas of social deprivation. The delimitation of areas with increased risk of caries and greater dental treatment needs should be helpful to public health services for the formulation of policies and the targeting of resources to address these problems.

Brazil↗