Factors associated with clinical consequences of untreated dental caries incidence: a longitudinal study

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No. of bitstreams: 4 Dissertac??a??o Bruna Bueno_final 07.2020.pdf: 2031336 bytes, checksum: 22bc4357af32025b7d0dbaf43d4a84eb (MD5) CartaEncaminhamentoAutodepo??sito.pdf: 154600 bytes, checksum: 202d2469e58124109cca6b29c33e279e (MD5) Ata Bruna Assinada.pdf: 145306 bytes, checksum: 3a178697575bdf6eefaaa0b9f2b2ff05 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2020-06-26 FAPEAM - Funda????o de Amparo ?? Pesquisa do Estado do Amazonas The aim of this study was to investigate the association between structural determinants (socioeconomic status - SES) and intermediary determinants (frequency of dental services utilization, brushing frequency, social support, sense of coherence - SOC, belief and number of decayed teeth) in incidence of untreated dental caries sequelae, based on the WHO conceptual model of Social Determinants of Health. This longitudinal study encompassed 329 students from public schools in the eastern zone of Manaus city (Amazon, Brazil), born in 2004, with data collected from 2016 to 2018. In the baseline, socioeconomic data (parents' education, family income, number of rooms and assets), psychosocial factors (sense of coherence of parents / guardians - Sense of Coherence Scale - and beliefs in oral health of parents / guardians) and social support (Social Support Appraisal) through self-administered questionnaires for participants and those responsible. In follow-up collections, brushing frequency and the frequency of dental services utilization were obtained using standardized forms. After supervised brushing at school, students were examined to obtain the DMFT (decayed- missing- filled teeth) and PUFA (Pulpar involvement, Ulceration, Fistula and Abscess) index to investigate the incidence of sequel of untreated caries in 2 years. After data distribution, statistical analysis was performed using Structural Equation Modeling (SEM). The high incidence of the PUFA / pufa index was indirectly related to worse conditions of SES (?? = -0.019), low social support (?? = -0.038) and weak SOC of parents / guardians (??= -0.28) and directly related higher values of the decayed component of the DMFT index (?? = 0.338). A higher frequency of use of services (?? = -0.069) had a direct effect on the lower incidence of PUFA. The structural (NSE) and intermediate determinants (frequency dental services utilization, social support and decayed teeth) were directly or indirectly associated with the occurrence of clinical consequences of untreated caries. O objetivo desse estudo foi investigar a associa????o entre determinantes estruturais (n??vel socioecon??mico - NSE) e intermedi??rios (frequ??ncia do uso de servi??os odontol??gicos, frequ??ncia de escova????o, apoio social, senso de coer??ncia ??? SOC, cren??a e o n??mero de dentes cariados) na incid??ncia das sequelas da c??rie n??o tratada, tendo como base o modelo conceitual de Determinantes Sociais da Sa??de da OMS. O estudo longitudinal teve a participa????o de 329 estudantes de escolas p??blicas da zona leste de Manaus- Amazonas, nascidos em 2004, com dados coletados no per??odo de 2016 a 2018. Na linha de base foram coletados dados socioecon??micos (escolaridade dos pais, renda familiar, n??mero de c??modos e de bens), fatores psicossociais (senso de coer??ncia dos pais/respons??veis -Escala de Senso de Coer??ncia- e cren??a em sa??de bucal dos pais/respons??veis) e apoio social (Social Support Appraisal) atrav??s de question??rios autoaplic??veis para os participantes e seus respons??veis. Nas coletas de seguimento, a frequ??ncia de escova????o e a frequ??ncia do uso de servi??os odontol??gicos foram obtidas por meio de formul??rios padronizados. Ap??s escova????o supervisionada, os estudantes foram examinados em todos os tempos de coleta para obten????o dos ??ndices CPOD (n??mero de dentes Cariados, Perdidos e Obturados) e PUFA (n??mero de dentes com envolvimento Pulpar, ??lcera, F??stula e Abscesso) para investigar a incid??ncia da sequela da c??rie n??o tratada em 2 anos. Ap??s a distribui????o dos dados, a an??lise estat??stica foi realizada atrav??s da Modelagem de equa????es estruturais (MEE). A alta incid??ncia do ??ndice PUFA/pufa esteve relacionada indiretamente a piores condi????es de NSE (??= -0,019), baixo apoio social (??= -0,038) e fraco SOC dos pais/respons??veis (??= -0,28) e diretamente relacionada a maiores valores do componente cariado do ??ndice CPOD (??= 0,338). Uma maior frequ??ncia do uso de servi??os (??= -0,069) teve efeito direto na menor incid??ncia do PUFA. Os determinantes estruturais (NSE) e intermedi??rios (frequ??ncia de uso de servi??os odontol??gicos, apoio social e dentes cariados) foram associados, de forma direta ou indireta, ?? ocorr??ncia de consequ??ncias cl??nicas da c??rie n??o tratada. Os tutoriais me ajudaram muito. Plataforma simples de preencher.