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- Prevalência de retenções dentárias nos utentes adultos da Clínica Universitária da Universidade Católica PortuguesaPublication . Couto, Patrícia; Couto, João; Pereira, Miguel; Borges, Tiago; Almeida, BrunoObjetivos: Verificar a prevalência das anomalias de erupção dentária na população da clínica dentária universitária, bem como a sua caracterização. Métodos: Realizou‐se um estudo retrospetivo e observacional através da análise de 2.977 radiografias panorâmicas, correspondentes aos pacientes adultos que vieram à Clínica Dentária Universitária da Universidade Católica Portuguesa de Viseu, no período de 2011‐2013. Selecionaram‐se todos os processos que preenchiam os critérios de inclusão e analisaram‐se segundo variáveis como: género, idade, classificação de Winter, classificação de Pell & Gregory, características anatómicas das raízes e sua relação com o canal mandibular, localização e orientação, quer tridimensional quer no plano sagital, e comorbilidades associadas à retenção. Resultados: De entre os vários resultados evidenciados podemos salientar: que 16,6% da população em estudo apresenta dentes retidos; que os terceiros molares inferiores foram o grupo de dentes que se encontrou mais frequentemente retido; que a posição mais comum de retenção dos terceiros molares foi a vertical e a IIA de Pell e Gregory; que o nervo alveolar inferior se apresentava numa relação de proximidade com as raízes dos terceiros molares em cerca de 45% dos casos; que a retenção do canino por palatino é muito mais comum que a retenção por vestibular; e que são raros os casos que se encontram de transmigração. Conclusões: Apesar das limitações da ortopantomografia, esta constitui um exame de grande importância para o diagnóstico inicial e avaliação de dentes retidos, que permite obter resultados de prevalências bastante fiáveis.
- Oral health-related quality of life of Portuguese adults with mild intellectual disabilitiesPublication . Couto, Patrícia; Pereira, Paulo Almeida; Nunes, Manuel; Mendes, Rui AmaralIndividuals with disabilities are regarded as a highly vulnerable population group, particularly as far as oral health is concern. However, few studies have assessed the impact of the oral condition on the quality of life of these individuals. Therefore, the aim of this study is to expand knowledge on the oral health status of the Portuguese adults with mild intellectual disability, and to assess how the patient’s oral health is related to their quality of life. A sample of 240 adults with mild intellectual disabilities linked to the Portuguese Federation for Intellectual Disability, were interviewed using a previously validated version of the Oral Health Impact Profile. An oral health examination was also conducted using three oral health indexes: Clinical Oral Health Index (COHI); Clinical Oral Care Needs Index (COCNI) and the Clinical Oral Prevention Index (COPI). Sociodemographic characteristics and dental health factors were also collected, following statistical analysis. More than half of the individuals (54,9%) presented one or more problems of major to severe impact on health (COHI level 2); only 4,6% of the individuals do not need treatment or examination (COCNI level 0) and 85% of the study sample needs measures of educational or preventive action (COPI level 1). In 76,9% of the participants, oral health had impact on the quality of life. The most affected dimensions of life were physical pain with 61,9%, followed by psychological discomfort and psychological disability with 45,1% and 45%, respectively. With relation to oral health factors and sociodemographic variables it was verified that fewer teeth and higher self-perception of need for dental treatment had a negative impact on the quality of life. On the other hand, institutionalization and an increase in at least one category in the self-perception of the oral health status had a positive impact on the quality of life. Given the high burden of oral disease and the considerable impact on quality of life found in this study, the establishment of guidelines to improve the oral health and quality of life of these individuals should be regarded as imperative.
- Validation of a Portuguese version of the Oral Health Impact Profile adapted to people with mild intellectual disabilities (OHIP-14-MID-PT)Publication . Couto, Patrícia; Pereira, Paulo Almeida; Nunes, Manuel; Mendes, Rui AmaralBackground The purpose of this study is to develop a Portuguese version of the Oral Health Impact Profile (OHIP-14) and validate it for people with mild intellectual disability (OHIP-14-MID-PT). Methods The Portuguese version of the questionnaire was drawn up from the original English version, following internationally defined guidelines. Interviews were conducted with 240 individuals living in (or attending) institutions of the central region of Portugal that are affiliated with Humanitas (Portuguese Federation for Intellectual Disability) to measure oral health related quality of life (OHRQoL). The interview also included a sociodemographic and oral health questionnaire followed by an intraoral examination. Two types of reliability were analyzed: test-retest (ICC) and internal consistency (Cronbach’s α, inter-item and item-total correlations). Convergent and divergent validities were also assessed, and a confirmatory factor analysis was performed using the maximum likelihood method. Results The OHIP-14-MID-PT presented high reliability (ICC = 0.999; Cronbach’s α = 0.922). The inter-item correlation coefficient ranged from 0.277 to 0.749, and the item-total correlation coefficient varied between 0.529 and 0.718. Lower OHIP-14-MID-PT total scores were significantly associated with: a self-perception of better oral health status (r = -0.545, p<0,001) and reduced need for dental treatment (U = 2366.5, p<0,001), more natural teeth (χ2 = 29.74, p<0,001) and better results in the clinical oral health index (COHI) (χ2 = 18.50, p<0,001); the results support the convergent and divergent validities of the questionnaire. Conclusions OHIP-14-MID-PT has proved to be a consistent, valid and reliable instrument with good psychometric properties to determine the impact of oral health on quality of life in adults with mild intellectual disabilities in Portugal.
- Self-perceived oral health assessment of institutionalized elderly of ViseuPublication . Veiga, N.; Couto, P.; Ribeiro, A.; Varelas, C.; Santos, I.; Pinto, M.; Coelho, I.Background: Self-perception of oral health is a multidimensional measure that, reflects the subjective experience of individuals about their physical and psychosocial well-being, determines the search for prevention and dental treatments.Objective: The assessment of the self-perception of oral health status of institutionalized elderly through the Geriatric Oral Health Assessment Index (GOHAI) and the verification of the association between the GOHAI and the various socio-demographic variables and oral health behaviors analyzed. Participants and methods: With this study we intended to conduct a cross-sectional observational epidemiological study with institutionalized elderly. Data were collected from a sample of 56 institutionalized elderly of the Mariana Seixas Foundation and the Viscondessa São Caetano Nursing Home in Viseu, Portugal. For this we used a questionnaire that allows to evaluate the self-perception of oral health, the Geriatric Oral Health Assessment Index (GOHAI). Results: It was found that the elderly generally favorably assessed their oral health, with 42.9% of the participants having a high self-perception of their oral health (values between 34-36); 28.6% have a moderate perception (values between 30-33) and the same percentage of individuals (28.6%) have a low perception (values below 30) of their oral health. The GOHAI scores obtained are associated with gender, educational level and oral health behaviors. Conclusion: Literacy can influence the level of self-perception of oral health. Therefore, the development of measures to assess oral health status is essential for the evolution of scientific knowledge based on geriatric dentistry in order to determine oral health promotion strategies among the institutionalized elderly.
- The influence of population aging in public healthPublication . Veiga, Nélio; Couto, Patrícia; Fernandes, Adélia; Oliveira, Alexia; Gomes, Daniela; Santos, Daniela; Amaral, Odete; Pereira, Carlos; Pereira, Pedro; Coelho, InêsIntroduction: Population aging is one of the greatest challenges in contemporary public health. Thus, one of the consequences of this dynamic is a greater demand for health services. The aim of the present research consists in explaining the main topics that justify the fact that the increase of population-aging worldwide influences public health strategies applied. Materials and methods: To carry out this review article the search strategies included electronic databases, such as PubMed, Cochrane Library and Science Direct, reference lists of articles, and selected textbooks. Articles and textbooks used in this study were mainly reached by using the following keywords: “Public health”; “Population-ageing “; “Global Aging”; “Elderly” and “Health”. Selection criteria included articles published from 1985 to the present year of 2018. At the end of the search, 11 scientific articles were selected. Results and Discussion: The physical / biological, psychological and social changes associated with the elderly leads to decrease of health, withdrawal from the labor market and several unfavorable situations, which cannot be controlled. In this context, the elderly seek to find support in the family, neighborhood, friends and institutions that will influence their quality of life. Therefore, the path of Public Health has three essential points: first, health promotion and primary prevention, which requires a lot of health education to develop healthy living habits and improve understanding of the aging process; secondly, appropriate health treatments, including professionals trained in Geriatrics and Gerontology, aiming at early diagnosis and interdisciplinary administration of diseases, seeking to preserve functional capacity; and finally, the rehabilitation of the functions committed, aiming at functional independence and mental autonomy, in any type of incapacity or limitation. Conclusions: Aging is a challenge to be integrated by Public Health and the vulnerability inherent in the elderly should never be seen in a unique way. Thus, we believe in the importance of different forms of support, not only in terms of assistance, clinical treatment and rehabilitation, but also in the implementation of public policies and disease prevention actions, as well as health promotion of the population of integral form.
- Oral health behaviour perception scale applied among a sample of Portuguese adolescentsPublication . Amaral, Odete; Couto, Patrícia; Coelho, Inês; Correia, Maria José; Veiga, Nélio JorgeIntroduction: The application of a scale can be particularly useful for the epidemiological studies comparing different populations and for analysis of the influence of distinct aspects of oral health on the development of certain health conditions. The aim of this study consists in the creation of a scale to classify the level of perception of the oral health behaviors applicable to a sample of Portuguese adolescents. Material and Methods: An observational cross-sectional study was designed with a total of 649 adolescents between the ages of 12 and 18 years old from five public schools in the Viseu and Guarda districts, in Portugal. Data was collected by the application of a self-administered questionnaire and, after analysis of data collection, the newly Universidade Católica Portuguesa (UCP) oral health perception scale was created. Statistical analysis was performed using SPSS-IBM software version 24.0 (IBM SPSS, Chicago, Il., USA). In the descriptive statistical analysis, absolute and descriptive frequencies were used for variables with nominal measurement level, mean as a measure of central tendency and standard deviation as a measure of dispersion for interval variables. Results: Oral health behaviors perception respecting the assumptions defined by the present scale has been elaborated. The result showed that 67% of the sample presented a poor perception of their oral health behaviors, 23.9% intermediate/sufficient, while 8.2% refer having good perception, respecting the assumptions defined for the elaboration of the present scale. Conclusion: For this purpose, through the scale to classify the level of oral health behaviors applicable to the sample of portuguese adolescents, it is possible to compare the data of several samples and understand what are the most frequent oral or eating habits among adolescents.
- Assessment of oral health care among the institutionalized elderly caregiversPublication . Tavares, Maria; Monteiro, Ana; Dias, Cristiana; Fonseca, Inês; Bornes, Rita; Couto, Patrícia Sofia Soares; Veiga, Nélio JorgeIntroduction: The importance of oral hygiene among the elderly cannot be overlooked, providing physical and psychological well-being, increasing self-esteem and maintaining general health, based on the relationship between oral health and general health. Objectives: The aim of this study consisted of the assessment of the oral health care developed by the caregivers towards their institutionalized elderly in order to understand the necessities of the elderly people and their caregivers. Design and Methods: A cross-sectional study was developed based on a convenience sample that included a final sample of 17 caregivers of institutionalized individuals with 65 years of age or over. It was collected information based on oral hygiene habits, oral health problems, and the role of caregivers in this population and general assessment of oral health status. A questionnaire was developed and applied in the form of an interview directly to the caregivers of the nursing homes Viscondessa São Caetano and Mariana Seixas Foundation in Viseu, Portugal. Results: When asked, caregivers reported that it is rare that the elderly complain of pain or discomfort caused by oral/dental problems. This can also be explained due to the difficulty of communication and the level of dementia that the elderly may present. Regarding dental prostheses, the caregivers considered that the elderly only sometimes or rarely it is that they sanitize them well, which demonstrates the clear need to define better primary prevention strategies for this specific population, passing mainly by oral health education and promotion among the caregivers. They also mentioned that they almost always remove the prosthesis to sleep, which a satisfactory point is considering that the nocturnal rest of the prosthesis consists of a way to avoid the appearance of pathologies such as prosthetic stomatitis. Conclusions: Oral health training is necessary in the elderly and their caregivers, and greater support is also needed when they perform oral hygiene in order to improve their general condition oral health. It is important to highlight the positive fact that the elderly, increasingly, do the nocturnal rest of the dental prosthesis.
- Estudo comparativo de comportamentos e autoperceção em saúde oral de populações adultas com e sem deficiência intelectualPublication . Martins, Inês; Veiga, Nélio; Correia, Maria; Coelho, Inês; Couto, PatríciaObjetivos: Comparar os comportamentos de saúde oral e a autoperceção da necessidade de tratamento em populações adultas com e sem deficiência intelectual. Métodos: Foi realizado um estudo de prevalência numa amostra de conveniência de 480 indivíduos com idades compreendidas entre os 18-64 anos (240 indivíduos com deficiência intelectual leve filiados na HUMANITAS e 240 sem deficiência, utentes da Clínica Universitária da Universidade Católica Portuguesa), através da aplicação de um questionário sociodemográfico e de saúde oral onde se pretende avaliar: número de dentes naturais; frequência e técnicas de higienização; periodicidade e motivo das consultas médico-dentárias; autoperceção da condição oral e necessidade de tratamentos. A análise estatística foi realizada no software SPSS versão 22.0, com recurso aos testes estatísticos Qui-Quadrado e Mann-Whitney. Resultados: Relativamente à condição oral da população com deficiência verificou-se que 32,9% dos indivíduos tinha menos de 20 dentes, valor este superior ao da população sem deficiência (10%). Também a percentagem de higienização oral diária foi inferior na população com deficiência (79,6% vs 94,2%), assim como o uso de fio dentário (7,1% vs 47,1%) ou elixir (24,1% vs 49,2%). Verificámos ainda nos indivíduos com deficiência uma menor percentagem de consultas médico-dentárias nos últimos 6 meses (28,4% vs 59,2%), especialmente por motivo de rotina (18,8% vs 46,3%), uma maior autoperceção da necessidade de tratamento (75,2% vs 56,7%), e uma autoperceção menos favorável da condição oral, já que menos de metade (37,4% vs 56,2%) da amostra descreveu a sua condição oral como boa ou superior. Conclusões: Apesar dos fracos resultados gerais obtidos em ambas as populações, os comportamentos de saúde oral da população com deficiência intelectual são inferiores aos da população sem deficiência. Assim, a formação dos profissionais de saúde, dos cuidadores e a implementação de programas públicos de saúde oral são essenciais para melhorar a saúde oral destes indivíduos.
- Cárie dentária e materiais restauradores em população de Clínica UniversitáriaPublication . Couto, Patrícia; Coelho, Pedro Francisco Ferreira; Rio, RuteObjetivos: A cárie dentária é a doença mais prevalente na cavidade oral. O seus factores etiológicos são variáveis, sendo esta patologia mais prevalente nos países desenvolvidos. Ao longo dos últimos anos, a prevalência de cárie em Portugal tem vindo a diminuir, revelando uma melhoria na saúde oral. Contudo, a cárie dentária continua presente e nem todos os pacientes revelam cuidados com a sua higiene oral. Deste modo, este trabalho pretende analisar a prevalência de cárie dentária e do material restaurador utilizado; classificar a lesão de cárie através das faces dentárias envolvidas e determinar os tecidos envolvidos na mesma, em pacientes da Clínica Universitária da Universidade Católica Portuguesa, do Centro Regional das Beiras, em Viseu. Materiais e métodos: Para determinar as variáveis anteriormente referidas recorreu-se à análise da história clínica e dos resultados do exame físico. Foram recolhidos dados como o número de cáries presentes, os dentes que se encontravam cariados, a classificação da extensão da lesão de cárie e as restaurações presentes, utilizando uma amostra constituída por pacientes, atendidos de Novembro de 2012 até Março de 2013, na Clínica Universitária da Universidade Católica Portuguesa. Resultados: Os resultados preliminares do estudo demonstram que, em média, os pacientes possuem 5.7 ± 4.3 dentes cariados e 2.7 ± 3.3 dentes restaurados. Foram encontrados mais casos de cáries de Classe I de acordo com a Classificação de Black. No lado oposto podemos encontrar as cáries de classe IV segundo a mesma classificação. Relativamente ao processo restaurador, a maioria das restaurações efectuadas aquando da realização do exame clínico foram realizadas em compósito. Conclusões: Os resultados obtidos na amostragem demonstram a necessidade premente de um maior auxílio e cuidado na saúde oral dos pacientes, numa simbiose entre as Universidades e a Sociedade em geral, de forma a conseguir promover uma melhor qualidade de vida e diminuir a prevalência de cárie dentária.
- Dental caries and oral health behavior assessments among Portuguese adolescentsPublication . Veiga, Nélio Jorge; Cecchi, Maria Helena Ribeiro de; Martins, Johnny; Cunha, Inara Pereira da; Meneghim, Marcelo de Castro; Correia, Maria José; Couto, PatríciaIntroduction: Adolescents have a high risk of developing caries in Portugal. The present study is designed to assess dental caries experience among the adolescents by the application of DMFT index, characterize the oral health risk factors and to determine the association between caries experience and socio-demographic variables. The characterization of the oral health behaviors of adolescents of the central region of Portugal will help in the development of specific oral health education strategies to improve oral health among the local communities. Material and methods: A cross-sectional study was conducted among a convenient sample of 694 adolescents aged 12 to 18 years attending public schools in two Portuguese districts using a structured questionnaire designed to investigate oral health and behavior of participants. In addition, a clinical examination was carried out noting the decayed, missing and filled teeth. A descriptive analysis of the variables was performed using the Chi-square, Mann-Whitney and Kruskal-Wallis tests (p<0.05). A multivariate analysis was applied for analysis of the association between variables. Results: The mean DMFT index score of 2.91±2.9 was obtained. Of the total sample, 73% consumed sugary food daily, 50.1% considered having good oral health and 70.8% did not report pain in the last 12 months. Most adolescents (79.4%) brushed their teeth daily and 60% did not use dental floss. Of the total sample, 96.4% had a dental appointment in the last 12 months, 46.4% of which was for preventive purposes. Applying the Chi-square statistical test, we verified that the adolescents who brush their teeth daily presented a good perception about their oral health (p<0.001), the DMFT index scores were associated with the residence area (p=0.01) and the presence of dental caries was associated with the perception of oral health (p=0.049) and sugary food intake (p=0.029).Conclusion: Portuguese adolescents presented a low DMFT index. The DMFT index was associated with residence area, perception of oral health and sugary food intake. Daily toothbrushing was associated with self-perception of oral health. It is suggested that oral health promotion and prevention programs should aim to reduce the risks of oral disease development.