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Abstract People with cognitive disabilities face multiple challenges concerning oral health and frequently show oral tissue decay because of the barriers society imposes upon them, and due to financial issues, professional and family lack of knowledge, limitations regarding access to services, lack of empowering-driven actions, among others. Positive knowledge, attitudes and practices regarding oral health, developed during the course of a lifetime, help in preserving good health. The aim of the current study is to describe oral health knowledge, attitudes and practices in people with cognitive disabilities participating in the Institutional Program for the Inclusion of People with Cognitive Disabilities in Higher Education at the University of Costa Rica (PROIN, in Spanish), during 2021. A descriptive study with mixed focus was performed; a representative sample comprised of 86 students enrolled in PROIN was used for the quantitative approach, while the qualitative approach used a criteria sample along with an opinion sample, limiting size due to information overload. The survey, along with its corresponding questionnaire and the semi-structured interview, were used as data gathering techniques. It was evidenced that certain issues need to be readdressed, such as bleeding gums, the importance of preserving dental pieces, as well, the practice of flossing, which many students expressed difficulties doing. Good attitudes were found, such as dentist visits; however, access barriers for this population must be overthrown. This article showed the importance of training professionals in disabilities as well as developing oral health promotion programs aimed at people with cognitive disabilities.

Resumen La población con discapacidad cognitiva enfrenta múltiples retos en cuanto a la salud oral, presentado comúnmente un deterioro de los tejidos orales; esto como consecuencia a las barreras impuestas por la sociedad, factores económicos, desconocimiento de los profesionales y familiares, limitaciones en el acceso a la atención, falta de acciones para fomentar su autonomía, entre otras. Los conocimientos, actitudes y prácticas favorables en salud oral ayudan a conservar una buena salud, los cuales se desarrollan a lo largo de la vida. El objetivo del presente estudio es describir los conocimientos, actitudes y prácticas de salud oral en las personas con discapacidad cognitiva que participaron en el Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica (PROIN) durante el año 2021. Se realizó un estudio descriptivo con un enfoque mixto, para el enfoque cuantitativo se utilizó una muestra representativa de 86 estudiantes matriculados en PROIN y para la parte cualitativa se utilizó una muestra por criterio con un muestreo opinático, estableciendo el tamaño por saturación de la información. Se utilizaron como técnicas de recolección de datos la encuesta con su respectivo cuestionario y la entrevista semiestructurada. Se evidenció que existen temas que se deben reforzar, como lo es el sangrado de encías, la importancia de conservar las piezas dentales, así como la práctica de uso de hilo dental, donde la mayoría de los estudiantes expresaron tener dificultades para su utilización. Además, se encontró buenas actitudes con respecto a la visita al odontólogo, sin embargo, se debe derribar barreras de acceso que se presentan para esta población. Este estudio demostró la necesidad de capacitar a los profesionales en el tema de discapacidad y desarrollar programas de promoción de la salud oral específicos para personas con discapacidad cognitiva.

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Abstract People's knowledge, attitudes, and practices related to health are built throughout life, particularly during childhood and adolescence, and they reflect the practices of their family and social circle. The aim of this study was to identify the levels of knowledge, attitudes, and practices related to oral health of first-year university students at the Paraíso Campus of the University of Costa Rica. This was done through a questionnaire of closed questions that would allow oral health educational strategies to be established in the future for this population group. For this purpose, a cross-sectional descriptive study was conducted, where 70 first-year students of the Paraíso Campus participated in the first semester of the year 2019. For data collection, a survey of 22 closed questions on knowledge, attitudes, and practices about oral health was applied, and a score on oral health knowledge was subsequently performed, based on the answers to the questions. According to the results, the level of knowledge shown about oral health is low, since the average knowledge score (7.02 points) was less than half of the maximum score (17 points). The greatest deficiency in knowledge was evidenced in topics, such as, dental biofilm, gingivitis, use of fluorides, and the role of saliva. In addition, several practices that affect the condition of the oral cavity were identified, such as harmful habits, inadequate nutrition, and poor oral hygiene habits. In this study, a general lack of knowledge was identified regarding basic concepts of oral health in young university students, who are not clear about the role of some protective or risk factors related to the main oral diseases.

Resumen Los conocimientos, actitudes y prácticas relacionados a la salud en las personas se construyen a través de la vida, particularmente durante la infancia y la adolescencia y reflejan las prácticas de su círculo familiar y social. El objetivo de este estudio fue identificar los niveles de conocimiento, las actitudes y las prácticas relacionadas a la salud bucodental en estudiantes universitarios de primer ingreso en el Recinto de Paraíso de la Universidad de Costa Rica, mediante un cuestionario de preguntas cerradas que permitirá a futuro establecer estrategias educativas en salud bucal para este grupo de población. Se trató de un estudio descriptivo transversal de tipo observacional en 70 estudiantes de primer ingreso del Recinto de Paraíso en el I semestre del año 2019. Para la recolección de datos se aplicó una encuesta de 22 preguntas cerradas sobre los conocimientos, las actitudes y las prácticas sobre la salud oral. A partir de las preguntas sobre conocimiento en salud bucal se creó un puntaje de conocimiento. Se pudo evidenciar que el nivel de conocimiento sobre la salud bucal es bajo, ya que el promedio del puntaje de conocimiento (7,02 puntos) es menos de la mitad del puntaje máximo (17 puntos). La mayor deficiencia en el conocimiento se evidenció en temas como el biofilm dental, gingivitis, uso de fluoruros y el rol de la saliva. Además, se identificaron varias prácticas que afectan la condición de la cavidad bucal, como los hábitos nocivos, una alimentación inadecuada y hábitos de higiene oral deficiente. En este estudio se identificó en general una falta de conocimiento respecto a conceptos básicos de salud bucal en personas jóvenes universitarias, quienes no tienen claro la función de algunos factores protectores o de riesgo relacionados con las principales enfermedades bucales.

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The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.

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Objetivo: Analizar las diferencias entre dos modali-dades de administración de un instrumento, autoad-ministrado o guiado por un investigador, aplicados a tutores legales de infantes de una institución educa-tiva. Materiales y Métodos: muestra de 130 tutores legales de niños/as (3 y 5 años) pertenecientes a un jardín de infantes municipal de Avellaneda. Se aplicó un instrumento de recolección de datos sobre hábi-tos de salud bucal constituido por 14 preguntas sim-ples, múltiples y cerradas. La entrega y devolución del instrumento fue a través de la institución. A los 2 meses se convocó a la misma población para comple-tar el mismo instrumento guiado por un investigador. Se evaluó: porcentajede concurrentes e instrumen-tos respondidos totalmente (modalidad autoadminis-trada), porcentaje de concurrentes que completaron el instrumento guiado y concordancia total y por res-puesta de las 2 modalidades. Se analizaron frecuen-cias y porcentajes. Para comparar la concordancia se utilizó Kappa global y Kappa de Cohen para cada pregunta. Resultados: 76,9% de tutores legales res-pondieron en la modalidad autoadministrada y 48,5% la guiada por el investigador. El 80,0% respondió la totalidad de las preguntas del instrumento autoad-ministrado. Al comparar las respuestas para ambas modalidades, no se observaron diferencias signifi-cativas en la totalidad de las mismas. Al analizar las respuestas solo 3 de las 14 preguntas tuvieron una concordancia menor (0,70). Conclusión: Para la po-blación estudiada, la forma autoadministrada tuvo mayor tasa de respuesta que la guiada por un inves-tigador, sin que se registren diferencias en las res-puestas de ambas formas de administración (AU)

Objective: Analyze the differences between two methods of administration of an instrument, self-administered or guided by a researcher, applied to legal guardians of infants in an educational institution. Materials and Methods: Population 130 legal guardians of children (3 and 5 years old) belonging to a municipal kindergarten in Avellaneda. A data collection instrument on oral health habits was applied, consisting of 14 simple, multiple, and closed questions. The delivery and return of the instrument was through the institution. After 2 months, the same population was called to complete the same instrument guided by a researcher. The following were evaluated: percentage of participants and instruments fully answered (self-administered mode), percentage of participants who completed the guided instrument. The total and response agreement of the 2 modalities was evaluated. Frequencies and percentages were analyzed. To compare agreement, global Kappa was used, and Cohen's Kappa was used for each question. Results: 76.9% of legal guardians responded to the self-administered modality and 48.5% to the one guided by the researcher. 80.0% answered all the questions of the self-administered instrument. When comparing the responses for both modalities, no significant differences were observed in all of them. When analyzing the answers, only 3 of the 14 questions had a lower agreement (0.70). Conclusion: For the population studied, the self-administered form had a higher response rate than the one guided by a researcher, with no differences recorded in the responses of both forms of administration (AU)

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Objetivo: O presente estudo teve como objetivo avaliar o perfil dos pacientes atendidos em um centro de referência de traumatismos dentários na dentição decídua, identificando as características sociodemográficas, frequência, tipos de lesões traumáticas e tratamentos realizados. Métodos:Trata-se de um estudo retrospectivo com prontuários odontológicos de crianças de 6 a 60 meses de idade atendidas na Clínica de Traumatismo na Dentição Decídua da FAO/UFMG no período de 2007 a 2019. Foram analisadas características das lesões traumáticas, da criança, atendimento imediato (2h após o trauma) e condições socioeconômicas. A análise dos dados foi realizada de maneira descritiva e consistiu na distribuição de frequência das variáveis. Resultados:Entre os 610 prontuários odontológicos, 365 crianças (59,8%) eram do sexo masculino; 335 (54,9%) tinham 3 anos de idade ou menos, 446 (73,1%) eram de baixa renda e 335 (54,9%) das mães estudaram até o ensino médio. Lesões aos tecidos duros dentários apresentaram a maior frequência em crianças com 3 anos de idade ou menos (60,4%), entretanto, após os 3 anos de idade, as lesões mais frequentes foram lesões aos tecidos de sustentação (48,0%). Dentre a classificação de lesões aos tecidos duros dentários, a trinca e/ou fratura de esmalte foi a lesão mais frequente (15,0%). A luxação intrusiva foi o trauma mais frequente nos tecidos de sustentação (11,2%) e lesão em gengiva foi mais frequente dentre lesões nos tecidos moles (9,5%). Em geral, 212 crianças (34,8%) buscaram atendimento em um intervalo menor ou igual a duas horas após o trauma. A exodontia foi o tratamento mais realizado: em casos de lesões aos tecidos de sustentação (47,1%), seguido do mantenedor de espaço (24,3%). Em tecidos duros dentários a exodontia também foi o tratamento mais frequente (50,7%), seguido de restauração e mantenedor de espaço (18,0%). Conclusão: Conclui-se que a maioria dos traumatismos dentários na dentição decídua foram em meninos com menos de 3 anos e as lesões mais comuns foram trincas/fratura de esmalte, seguidas das luxações intrusivas.

Aim: The aim of the present study was to evaluate the profile and characteristics of patients treated at a dental trauma reference center, and identifying frequency, types of traumatic injuries and treatments performed. Methods: This retrospective study was carried out with dental records of children aged 6 to 60 months attended at the Primary Dental Trauma Clinic of FAO/UFMG between 2007 and 2019. Characteristics of the child and traumatic dental injuries, immediate care (2 hours after the trauma) and socioeconomic status were analyzed. Data analysis was performed descriptively using frequency distribution. Results:Of the total of 610 dental records, 365 children (59.8%) were male; 335 (54.9%) were up to 3 years old, 446 (73.1%) were low-income and 335 (54.9%) had mothers who studied up to high school. Dental hard tissue injuries were more frequent in children aged 3 years or less (60.4%), but after 3 years of age, the most frequent injuries were supporting tissue injuries (48.0%). Among dental hard tissue injuries, enamel crack and/or fracture was the most frequent injury (15.0%). Intrusive luxation was the most frequent lesion in supporting tissues injuries (11.2%) and gingival lesions was the most frequent soft tissue injuries (9.5%). Overall, 212 children (34.8%) sought care within two hours of the injury. Extraction was the most common treatment for supporting tissue injuries (44.3%), followed by space maintainers (22.8%). In dental hard tissues injuries, extraction was also the most frequent treatment (35.8%), followed by restoration (30.2%). Conclusion: In conclusion, most traumatic dental injuries in the primary dentition occurred in boys under 3 years of age, and the most common injuries were enamel cracks/fractures, followed by intrusive luxation.

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Com o propósito de compreender a realidade do atendimento odontológico e contribuir para o planejamento do acesso a estes serviços, o presente estudo realizou uma investigação sobre a cobertura de procedimentos diagnósticos por imagem em odontologia ofertados pelo Sistema Único de Saúde no estado de Minas Gerais (SUS-MG). Foi realizada revisão de dados secundários, coletados através do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS), correlacionando-os a dados do Censo Demográfico de 2022, de modo a permitir uma análise aprofundada do panorama atual da radiologia odontológica na rede de atenção à saúde bucal do SUS-MG. Foi constatado que a macrorregião Centro foi responsável pela maioria absoluta dos procedimentos realizados no período abrangido pelo estudo, enquanto a macrorregião do Triângulo do Sul apresentou mais procedimentos por número de habitantes. A radiografia periapical/interproximal foi o exame mais solicitado até o ano de 2020, quando houve uma súbita interrupção. Desde então, a radiografia panorâmica passou a ser a mais solicitada. A desigualdade no acesso às tecnologias diagnósticas odontológicas parece ser ainda uma realidade em Minas Gerais. A disseminação de conhecimento sobre o padrão de utilização dos serviços de saúde pode impactar positivamente na diminuição da iniquidade no acesso à saúde.

In order to understand the reality of dental care and contribute to planning access to these services, this study investigated the coverage of diagnostic imaging procedures in dentistry offered by the Unified Health System in the state of Minas Gerais (SUS-MG). A review of secondary data collected through the Outpatient Information System of the Unified Health System (SIA-SUS) was carried out, correlating it with data from the 2022 Demographic Census, in order to allow an in-depth analysis of the current panorama of dental radiology in the SUS-MG oral health care network. It was found that the Central macro-region was responsible for the absolute majority of procedures carried out in the period covered by the study, while the Southern Triangle macro-region had more procedures per number of inhabitants. Periapical/interproximal radiography was the most requested exam until 2020, when there was a sudden interruption. Since then, panoramic radiography has become the most requested. Inequality in access to dental diagnostic technologies still seems to be a reality in Minas Gerais. Disseminating knowledge about the pattern of use of health services can have a positive impact on reducing inequality in access to health.

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A obesidade severa, representa um desafio significativo para a saúde pública, demandando ações coordenadas e eficazes em todos os níveis de atenção à saúde (BRASIL, 2022). Nesse sentido o mapeamento das ações, serviços e atividades da Atenção Primária à Saúde (APS), bem como a estruturação destes serviços são cruciais para uma abordagem integrada, preventiva e eficaz no enfrentamento dessa temática. Os serviços de saúde na APS possuam um enfoque multidimensional, abordando a obesidade não apenas como uma condição individual, mas como um fenômeno multifatorial que requer estratégias integradas de prevenção, diagnóstico precoce e manejo adequado. Ao identificar os serviços existentes e suas respectivas capacidades, a gestão estadual pode direcionar investimentos de forma mais eficaz e estratégica. Além disso, permite a criação de estratégias de fortalecimento, capacitação e integração entre os profissionais da APS, aprimorando o cuidado prestado aos indivíduos com obesidade e otimizando a utilização dos recursos públicos disponíveis. O inquérito foi elaborado em cinco blocos, referente as seguintes dimensões: Saúde da criança e do adolescente, saúde da pessoa adulta e idoso, procedimentos da APS, atenção e cuidado à saúde bucal e infraestrutura.

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Este documento sugere recomendações para o aprimoramento dos serviços da APS ofertados pelos municípios de Mato Grosso do Sul, em 2023. Para este fim, são apresentados gráficos com o quantitativo e percentual de serviços e/ou ofertas presentes ou não, e que foram registrados por representantes dos municípios do estado. Foram considerados serviços e ações conforme ciclos de vida (crianças, adolescentes, adultos e idosos), procedimentos da APS, atenção à saúde bucal e in- fraestrutura.

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The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

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Fundamentación: En el período de gestación el organismo de la mujer sufre modificaciones, transformaciones fisiológicas y psicológicas, además de cambios en los tejidos bucales y cambios de conducta que pueden iniciar enfermedades bucodentales o agravar las ya establecidas. Objetivo: Evaluar la efectividad del programa educativo "Sonrisas desde el vientre" en embarazadas del Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Metodología: Se realizó un estudio preexperimental, con diseño antes y después en el período de enero a junio del 2022, la población estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Se utilizaron métodos del nivel teórico, empírico (encuesta) y estadísticos. Se midió la variable conocimiento sobre salud bucodental. Resultados: Los conocimientos antes de la aplicación de programa educativo eran insuficientes (65 %), después de aplicado el programa educativo el 75 % de las embarazadas presentó conocimientos suficientes. Conclusiones: Al culminar la implementación del programa educativo "Sonrisas desde el vientre", se logró un nivel de conocimiento suficiente sobre salud bucodental en la tercera parte de las embarazadas de este hogar materno.

Background: During pregnancy, the women's body goes through many changes, physiological and psychological transformations, as well as changes in the oral cavity tissues and behavioral changes that may initiate oral diseases or aggravate the stablished ones. Objective: To evaluate the effectiveness of the educational program "Smile from the Womb" among pregnant women at the Isabel María de Valdivia Maternity Home in Sancti Spíritus. Methodology: A pre-experimental study with a before and after design was conducted from January to June 2022, the population consisted of 20 pregnant women hospitalized at Isabel María de Valdivia Maternity Home in Sancti Spíritus. Theoretical, empirical (survey) and statistical methods were used. The variable oral health knowledge was measured. Results: Before applying the educational program the knowledge was insufficient (65%), after applying the educational program 75% of pregnant women showed sufficient knowledge. Conclusions: By the end of the "Smile from the Womb" educational program, one third of the pregnant women in this maternity home had achieved a sufficient level of knowledge about oral and dental health.

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