Relação entre fatores sociodemográficos, ambientais e dietéticos na experiência de cárie em crianças do Município de Carapicuíba (SP)
Data
2022-03-28
Autores
Amato, Juliana Neide 
Orientadores
Castelo, Paula Midori
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: A cárie dentária ainda é considerada um problema de saúde pública mesmo
com avanços nas medidas preventivas e curativas. O objetivo deste estudo foi avaliar
a relação entre a experiência de cárie dentária, aspectos sociodemográficos,
ambientais e dietéticos em crianças. Métodos: Um levantamento epidemiológico de
saúde bucal foi realizado entre 2014 e 2015 e incluiu 5.213 escolares de 2 a 11 anos
matriculados em 38 escolas públicas municipais de Carapicuíba (SP, Brasil). Foram
coletados dados primários quanto à experiência de cárie, avaliada por meio do índice
de dentes cariados, perdidos/esfoliados e obturados (ceo-d/CPO-D) nas escolas por
6 examinadoras calibradas e aspectos dietéticos. A análise de aspectos ambientais e
sociodemográficos das escolas foi realizada por meio de dados secundários extraídos
das bases de dados do Censo Demográfico/IBGE (2010) e do Censo Escolar (2014 e
2015) para avaliar a relação entre experiência de cárie dos escolares e fatores
sociodemográficos e ambientais dos setores censitários das escolas, bem como seus
aspectos de infraestrutura física e de recursos humanos. O estudo também abordou
a relação entre experiência de cárie e fatores dietéticos, como o consumo de alimentos
açucarados, processados e ultraprocessados, além dos hábitos de higiene bucal,
acesso a serviços de saúde, percepção dos pais/cuidadores em relação à saúde bucal
de seus filhos e acúmulo de biofilme. Resultados: Por meio de análise de
agrupamentos, foram identificados dois clusters: o “grupo mais favorecido”incluiu 33
escolas caracterizadas por maiores percentuais de crianças sem experiência de cárie,
localizadas em regiões com melhores indicadores sociodemográficos e ambientais; o
“grupo menos favorecido” incluiu 5 escolas com maior frequência de crianças com
experiência de cárie, em regiões com domicílios sem esgotamento sanitário e
abastecimento de água (consumo de água de poço não tratada e não fluoretada),
maior relação moradores/domicílio e famílias vivendo com até um salário mínimo. Foi
observado um aumento na chance de ter experiência de cárie para cada porcentagem
adicional de casas com água de poço e de famílias que vivem com até um salário
mínimo (p<0,05). O modelo logístico mostrou que o sexo feminino e a presença de
biofilme associaram-se negativa e positivamente com a cárie na primeira infância, respectivamente, e esta chance aumentou 17% para cada dia adicional de ingestão
de bebida açucarada. Nas crianças de 6 a 11 anos, a ausência de biofilme e maior
frequência de escovação estavam relacionadas ao menor índice de cárie, enquanto o
consumo de salgadinhos, bolo e biscoito foram relacionados a maior índice de cárie.
Não foi encontrada concordância entre a percepção dos pais/cuidadores sobre a
presença de cárie dentária e a necessidade de tratamento odontológico das crianças.
Conclusão: O estudo identificou um aumento nas chancesde ter experiência de cárie
em setores censitários caracterizados por casas abastecidas com água de poço,
famílias com renda de até um salário mínimo, além do consumo de bebidas
açucaradas, salgadinhos, bolos e biscoitos e presença de biofilme dentário. A falta de
concordância entre a percepção dos pais/cuidadores e a saúde bucal de seus filhos
alerta para a necessidade de ações de educação em saúde para um melhor
entendimento sobre a doença cárie e a elaboração de estratégias em saúde pública.
Objective: Dental caries is still considered a public health problem despite advances in preventive and curative measures. The aim of this study was to evaluate the relationship between caries experience, sociodemographic, environmental and dietary aspects in children. Methods: An oral health epidemiological survey conducted between 2014 and 2015 included 5,213 schoolchildren aged 2 to 11 years enrolled in 38 municipal public schools in Carapicuíba (SP, Brazil). Primary data were collected regarding caries experience, evaluated through the index of decayed, missing/exfoliated and filled teeth (ceo-d/DMFT) in schools by 6 calibrated examiners and dietary aspects. An analysis of environmental and sociodemographic aspects of schools was performed using secondary data extracted from the databases of the Demographic Census/IBGE (2010) and School Census (2014 and 2015) to assess the relationship between schoolchildren's caries experience and sociodemographic and environmental factors of the census sectors of schools as well their aspects of physical infrastructure and human resources. The study also addressed the relation between caries experience and dietary factors, such as consumption of sugary, processed and ultra-processed foods, in addition to oral hygiene habits, access to health services, parents'/caregivers' perception of their children's oral health, and biofilm accumulation. Results: By means of cluster analysis, two groups were identified: the “advantage group” included 33 schools characterized by higher percentages of children without caries experience, located in regions with better sociodemographic and environmental indicators; the “less advantage group” included 5 schools with a higher frequency of children with caries experience, located in regions with households without sanitary sewage and water supply (consumption of untreated and non-fluoridated well water), higher ratio residents/household and families that live with up to a minimum wage. An increase in the chance of having caries experience was observed for each additional percentage of homes with well water and of families living with up to one minimum wage (p<0.05). The logistic model showed that female sex and the presence of biofilm were negatively and positively associated with early childhood caries, respectively, and this chance increased by 17% for each additional day of sugary beverage intake. In children aged 6 to 11 years, the absence of biofilm and a higher frequency of brushing were related to a lower rate of caries, while the consumption of snacks, cake and cookies were related to a higher rate of caries. No agreement was found between the perception of parents/caregivers about the presence of dental caries and their children's need for dental treatment. Conclusion: The study identified an increase in the chances of having caries experience in the census sectors characterized by houses supplied with well water, families with an income of up to one minimum wage, in addition to the consumption of sugary drinks, snacks, cakes and cookies and the presence of dental biofilm. The lack of agreement between the perception of parents/caregivers and their children’s oral health highlights the need for dental health education for a better understanding of the caries disease and the development of public health strategies.
Objective: Dental caries is still considered a public health problem despite advances in preventive and curative measures. The aim of this study was to evaluate the relationship between caries experience, sociodemographic, environmental and dietary aspects in children. Methods: An oral health epidemiological survey conducted between 2014 and 2015 included 5,213 schoolchildren aged 2 to 11 years enrolled in 38 municipal public schools in Carapicuíba (SP, Brazil). Primary data were collected regarding caries experience, evaluated through the index of decayed, missing/exfoliated and filled teeth (ceo-d/DMFT) in schools by 6 calibrated examiners and dietary aspects. An analysis of environmental and sociodemographic aspects of schools was performed using secondary data extracted from the databases of the Demographic Census/IBGE (2010) and School Census (2014 and 2015) to assess the relationship between schoolchildren's caries experience and sociodemographic and environmental factors of the census sectors of schools as well their aspects of physical infrastructure and human resources. The study also addressed the relation between caries experience and dietary factors, such as consumption of sugary, processed and ultra-processed foods, in addition to oral hygiene habits, access to health services, parents'/caregivers' perception of their children's oral health, and biofilm accumulation. Results: By means of cluster analysis, two groups were identified: the “advantage group” included 33 schools characterized by higher percentages of children without caries experience, located in regions with better sociodemographic and environmental indicators; the “less advantage group” included 5 schools with a higher frequency of children with caries experience, located in regions with households without sanitary sewage and water supply (consumption of untreated and non-fluoridated well water), higher ratio residents/household and families that live with up to a minimum wage. An increase in the chance of having caries experience was observed for each additional percentage of homes with well water and of families living with up to one minimum wage (p<0.05). The logistic model showed that female sex and the presence of biofilm were negatively and positively associated with early childhood caries, respectively, and this chance increased by 17% for each additional day of sugary beverage intake. In children aged 6 to 11 years, the absence of biofilm and a higher frequency of brushing were related to a lower rate of caries, while the consumption of snacks, cake and cookies were related to a higher rate of caries. No agreement was found between the perception of parents/caregivers about the presence of dental caries and their children's need for dental treatment. Conclusion: The study identified an increase in the chances of having caries experience in the census sectors characterized by houses supplied with well water, families with an income of up to one minimum wage, in addition to the consumption of sugary drinks, snacks, cakes and cookies and the presence of dental biofilm. The lack of agreement between the perception of parents/caregivers and their children’s oral health highlights the need for dental health education for a better understanding of the caries disease and the development of public health strategies.