The aim of the present study was determine the prevalence and factors associated with dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy (CP). This is a cross-sectional study conducted with 80 patients ranging in age from 2 to 18 years old. Oral exams were conducted by an examiner with records of DMFT, dmft, Gingival Bleeding Index (GBI) and Community Periodontal Index (CPI). The statistical analysis used Poisson Regression with robust variance estimation (α = 0.05). The prevalence of dental caries was 59.3%, with DMFT and mean dmft of 1.71 ± 2.42 and 2.22 ± 3.23, respectively. The mean GBI was 22.44%, and in the CPI, the prevalence of gingival bleeding, calculus, shallow and deep pockets were 94.73%, 79.62%, 12.90% and 3.22%, respectively. The caregiver’s educational level of less than eight years were associated with the dental caries experience (PR = 1.439; 95%CI = 1.09–1.89). The periodontal alterations were associated with female sex (PR = 0.82; 95%CI = 0.69–0.97), caregiver’s educational level of less than eight years (PR = 1.15; 95%CI = 1.03–1.29), poor oral perception (PR = 0.89; 95%CI = 0.80–0.98), serious communication problem (PR = 0.87; 95%CI = 0.76–0.99) and athetoid type of CP (PR = 0.85; 95%CI = 0.75–0.97). The patients with CP presented high dental caries experience and periodontal alterations, which were associated with their demographic, socioeconomic, oral health perception and systemic information.
The prevalence of dental trauma was high, but not associated with clinical variables and evaluated socioeconomic indicators.
Avaliar o acesso e identificar as barreiras ao cuidado em Saúde Bucal de Crianças com Deficiência Motora (CDM) em João Pessoa-PB, a partir das perspectivas de seus cuidadores. Metodologia: Utilizou-se abordagem indutiva, procedimento descritivo e técnica de observação direta intensiva, por meio de entrevista. Participaram do estudo 43 dos 59 cuidadores de CDM de 0-12 anos identificados, selecionados por conveniência. As entrevistas, gravadas em áudio, foram transcritas e analisadas descritivamente e qualitativamente (técnica do Discurso do Sujeito Coletivo-DSC). Resultados: Segundo relato dos cuidadores, o diagnóstico das crianças foi Paralisia Cerebral (86%; n=36), Hidrocefalia (4%; n=2), Mielomenigocele (2%; n=2), Síndrome de West (2%; n=1), Síndrome de Down (2%; n=1) e Síndrome de Rett (2%; n=1). O acesso ao dentista foi obtido por 69% (n=30) das crianças, sendo 50% (n=15) no setor privado. Dificuldades para obter o acesso foram encontradas por 65% (n=28), entre elas, baixa oferta de dentistas para atender pacientes especiais (75%; n=21), demora no agendamento (18%; n=5) e indisponibilidade de realizar o procedimento com anestesia geral (7%; n=2). O DSC obtido da percepção sobre o cuidado em saúde bucal foi: O cuidado em Saúde Bucal é medidas de prevenção, promoção e controle, através da higienização e eliminação de hábitos deletérios, além do acompanhamento periódico com o dentista. Conclusão: A partir da percepção do cuidador, o acesso ao cuidado em saúde bucal das CDM é difícil, apresentando como barreiras: baixa oferta de dentistas para atender pacientes especiais, demora no agendamento e necessidade de anestesia geral. Acesso aos Serviços de Saúde. Saúde bucal. Pessoas com necessidades especiais. Objective: To evaluate the access and identify obstacles for oral health care of Children with Motor Disability (CMD) in the city of Joao Pessoa-PB, from caregivers' perspectives. Methods: It was employed an inductive approach, descriptive procedure and intensive direct observation technique by means of interview. The study encompassed 43 out of the 59 caregivers of identified CMD aged 0-12 years, selected by convenience. Audiorecorded interviews were transcripted and analyzed descriptively and qualitatively (Collective Subject Discourse technique-CSD). Results: According to caregivers' reports, children's diagnoses were cerebral palsy (86%; n=36), hydrocephaly (4%; n=2), spina bifida (2%; n=2); West syndrome (2%; n=1), Down syndrome (2%; n=1) and Rett syndrome (2%; n=1). The access to dentist was achieved by 69% (n=30) children, from which 50% (n=15) was in the private practice. Difficulties in getting access were found by 65% (n=28); among those, are: low supply of dentists to support disabled patients (75%; n=21), delay in scheduling (18%; n=5) and unavailability to perform the procedure without general anesthesia (7%; n=2). The CSD gathered from the perception on oral health was: Oral health care is measures for prevention, promotion and control, through cleansing and elimination of harmful habits, besides be...
OBJECTIVE To investigate the association between C-reactive protein (CRP) and high blood pressure (BP) in overweight or obese children and adolescents. METHODS Cross-sectional study with 184 overweight or obese children and adolescents aged from two to 18 years old, from April, 2009 to April, 2010. The classification of nutritional status used the body mass index (BMI). Based on the Centers for Disease Control and Prevention curve, individuals were classified as: overweight (BMI between the 85th-95th percentiles), obesity (BMI between 95th-97th percentiles) and severe obesity (BMI >97th percentile). Abnormal values were considered for systolic BP (SBP) and/or diastolic (DBP) if ≥90th percentile of the BP curve recommended for children and adolescents in the V Brazilian Guidelines on Hypertension, for waist circumference (WC) if ≥90th percentile of the curve established by the National Cholesterol Education Program, and for high sensitive CRP (hs-CRP) if >3mg/dL. To evaluate the association of inadequate values of CRP and the studied groups, chi-square test and analysis of variance were applied, using the Statistical Package for the Social Sciences version 17.0 and adopting a significance level of 5%. RESULTS Among the evaluated sample, 66.3% were female, 63.5%, non-white, 64.1% had severe obesity, 78.3% had altered WC and 70.6% presented high BP. There was a significant association of CRP high levels with altered WC and BMI ≥97th percentile. In adolescents, high CRP was related to high SBP. CRP mean values were higher in individuals with elevated SBP. CONCLUSIONS Inadequate values of hs-CRP were associated with severe obesity and high SBP in the studied population. These markers can be used to identify children and adolescents at higher risk for developing atherosclerosis.
Individuals with CP had low HRQoL and OHRQoL scores. The impact on HRQoL was shown to be associated with gender, health perception. and communication skills. Regarding OHRQoL, the presence of impact was associated with age, gastroesophageal reflux, dental caries. and periodontal diseases.
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