Fatores de risco relacionados à condição de saúde periodontal em universitários
Risk factors related to periodontal health status in undergraduate students
Souza, Carlos Henrique de C. e; Dantas-Neta, Neusa Barros; Laurentino, Joseany Barbosa; Nunes-dos-Santos, Danila Lorena; Prado Junior, Raimundo Rosendo; Mendes, Regina Ferraz
Resumo
Introdução: A doença periodontal pode ter seu início na infância e na adolescência, e progredir lentamente ao longo da vida. Em universitários, a forma mais comum e prevalente da doença é a gengivite. Objetivo: Mensurar a condição de saúde periodontal de uma amostra de universitários e verificar existência da associação com variáveis sociodemográficas e os fatores de risco envolvidos. Material e método: A amostra consistiu de 306 universitários voluntários, com idade entre 19 e 35 anos, sendo usados como indicadores de saúde bucal os índices: Índice Periodontal Comunitário (CPI) e Índice de Dentes Cariados, Perdidos e Obturados (CPO-D). Para processamento e análise dos dados, foi usado o programa SPSS versão 18.0. A classificação da condição periodontal foi dicotomizada em CPI < 3 e CPI ≥ 3. Realizou-se regressão logística bivariada e multivariada para analisar a associação entre a condição periodontal e as variáveis independentes. Resultado: A amostra consistiu de 51,3% de mulheres e 48,7% de homens, tendo a maioria renda menor do que 6 salários mínimos. Observou-se que 14,4% da amostra era livre de cárie. A pior condição periodontal foi encontrada no sextante 6 e 20,9% da amostra apresentou bolsas rasas em ao menos um sextante. Houve associação entre a condição periodontal e as variáveis: gênero, renda, nível de higiene bucal e uso do fio dental (p < 0,05); entretanto, não houve associação entre aquela e o CPO-D da amostra (p = 0,48). Conclusão: A amostra apresentou leve condição de doença periodontal, com ausência de bolsas periodontais profundas. Indivíduos do gênero feminino, de renda acima de 4 salários, com bom nível de higiene bucal e que usam o fio dental tiveram melhor condição de saúde periodontal.
Palavras-chave
Abstract
Introduction: Periodontal disease may have its onset during childhood and adolescence and slowly progress throughout life. In undergraduate students, the most common and prevalent form the disease is gingivitis. Objective: To assess the periodontal health status of a sample of undergraduate studentsand assess a possible association between the disease and socio-demographic variables, as well as the disease’s risk factors. Material and method: The sample consisted of 306 undergraduate students volunteers aged between 19 and 35 years. The oral health indices used were the CPI and DMFT. Data processing and statistical analysis was performed using SPSS version 18.0 for Windows. The classification of periodontal status was dichotomized in CPI<3 and CPI≥3. Bivariate and multivariate logistic regression analyses were carried out to evaluate the association between periodontal status and the independent variables. Result: The sample consisted of 51.3% female and 48.7% male, mostly with income less than 6 Brazilian minimum salaries. 14.4% of the sample was caries free. The worst periodontal status was in sextant #6 and 20.9% had shallow periodontal pockets in one sextant at least. There was an association between periodontal health status and gender, income, level of oral hygiene and flossing (p <0.05), but not between that and DMFT sample (p = 0.48). Conclusion: The sample showed mild periodontal disease condition, with no deep pockets. Female subjects, who earn more than 4 minimum salaries, with a good level of oral hygiene and who use dental floss had better periodontal health.
Keywords
References
1. Tanner ACR, Kent JRR,DykeTV,Sonis ST, Murray LA. Clinical and other risk indicators for early periodontitis in adults. J Periodontol. 2005;76(4):573-81. PMid:15857098 PMCid:1224718. http://dx.doi.org/10.1902/jop.2005.76.4.573
2. Coelho RDS, Gusmão ES, Jovino-Silveira RC, Caldas ADFJ. Profile of periodontal conditions in a Brazilian adult population. Oral Health Prev Dent. 2008;6(2):139-45.
3. Eick S, Pietkiewicz M, Sculean A. Oral microbiota in Swiss adolescentes. Clin Oral Invest. 2012. http://dx.doi.org/10.1007/s00784-012-0696-2
4. Brasil. Departamento de Atenção Básica, Secretaria de Atenção à Saúde, Ministério da Saúde. Projeto SB Brasil 2003. Condições de saúde bucal da população brasileira, 2002-2003. Brasília: Ministério da Saúde; 2004.
5. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. SB Brasil 2010: pesquisa nacional de saúde bucal. Brasília:Ministério da Saúde; 2011.
6. KhalifaN,Allen PF, Abu-bakr NH, Abdel-Rahman ME, Abdelghafar KO. A survey of oral health in a Sudanese population. BMC Oral Health. 2012;12:5. PMid:22364514 PMCid:3311612. http://dx.doi.org/10.1186/1472-6831-12-5
7. Vogt M, Sallum AW, Cecatti JG, Morais SS. Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reproductive Health. 2012;9(3):1-8.
8. Haas AN, Gaio EJ, Oppermann RV, Rösing CK, Albandar JM, Susin C. Pattern and rate of progression of periodontal attachment loss in an urban population of South Brazil: a 5-years population-based prospective study. J Clin Periodontol. 2012;39(1):1-9. PMid:22093104. http://dx.doi.org/10.1111/j.1600-051X.2011.01818.x
9. Oppermann RV. An overview of the epidemiology of periodontal diseases in Latin America. Braz Oral Res. 2007;21 (Spec Issue 1):8-15.
10. World Health Organization. Oral health surveys. Basic methods. 4th ed. Geneva: WHO; 1997.
11. Susin C, Haas AN, Valle PM, Oppermann RV, Albandar JM. Prevalence and risk indicators for chronic periodontitis in adolescents and young adults in south Brazil. J Clin Periodontol. 2011;38(4):326-33. PMid:21299588. http://dx.doi.org/10.1111/j.1600-051X.2011.01699.x
12. Collins J, Carpio AM, Bobadilla M, Reyes R, Gúzman I, Martínez B, et al. Prevalence of clinical attachment loss in adolescents in Santo Domingo, Dominican Republic. J Periodontol. 2005;76(9):1450-4. PMid:16171431. http://dx.doi.org/10.1902/jop.2005.76.9.1450
13. Califano JV. Research Science and Therapy Committee American Academy of Periodontology. Position paper: periodontal diseases of children and adolescents. J Periodontol. 2003;74(11):1696-704. PMid:14682670. http://dx.doi.org/10.1902/jop.2003.74.11.1696
14. Igic M, Kesic L, Lekovic V, Apostolovic M, Mihailovic D, Kostadinovic L, et al. Chronic gingivitis: the prevalence of periodontopathogens and therapy efficiency. Eur J Clin Microbiol Infect Dis. 2012. http://dx.doi.org/10.1007/s10096-011-1520-7
15. Instituto Brasileiro de Geografia e Estatística [homepage]. Sinopse do Censo Demográfico 2010 [citado em 2011 Maio 10]. Disponível em: http://www.ibge.gov.br/cidadesat/link.php?uf=pi
16. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229-35. PMid:1058834.
17. Duarte ECA. Avaliação crítica da aplicabilidade de O'Leary em relação aos índices de Greene & Vermillion e de Löe & Silness. Rev Odontol Univ São Paulo. 1994;8(4):301-7.
18. Peres MA, Peres KG, Cascaes AM, Correa MB, Demarco FF, Hallal PC, et al. Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults. J Periodontol. 2012;83(3):369-78. PMid:21859320 PMCid:3605763. http://dx.doi.org/10.1902/jop.2011.110250
19. Hermann P, Gera I, Borbely J, Fejerdy P, Madlena M. Periodontal health of an adult population in Hungary: findings of a national survey. J Clin Periodontol. 2009;36(6):449-57. PMid:19508245. http://dx.doi.org/10.1111/j.1600-051X.2009.01395.x
20. Klages U, Weber AG, Wehrbein H. Approximal plaque and gingival sulcus bleeding in routine dental care patients: relations to life stress, somatization and depression. J Clin Periodontol. 2005;32(6):575-82. PMid:15882214. http://dx.doi.org/10.1111/j.1600-051X.2005.00716.x
21. Ragghianti MS, Gregh SLA, Lauris JRP, Sant'ana ACP, Passanezi E. Influence of age, sex, plaque and smoking on periodontal conditions in a population from Bauru, Brazil. J Appl Oral Sci. 2004;12(4):273-9. PMid:20976396. http://dx.doi.org/10.1590/S1678-77572004000400004
22. Neamatollahi H, Ebrahimi M. Oral health behavior and its determinants in a group of Iranian students. Indian J Dent Res. 2010;21(1):84-8. PMid:20427913. http://dx.doi.org/10.4103/0970-9290.62820
23. Dye BA, Thornton-Evans G. A brief history of national surveillance efforts for periodontal disease in the United States. J Periodontol. 2007;78 (Suppl. 7):1373-9. PMid:17608609. http://dx.doi.org/10.1902/jop.2007.060210
24. Shiau HJ, Reynolds MA. Sex differences in destructive periodontal disease: a systematic review. J Periodontol. 2010;81(10):1379-89. PMid:20450376. http://dx.doi.org/10.1902/jop.2010.100044
25. Kırtıloglu T, Yavuz US. An assessment of oral self-care in the student population of a Turkish university. Public Health. 2006;120(10):953-7. PMid:16828129. http://dx.doi.org/10.1016/j.puhe.2006.05.006
26. Burt B. Research, Science and Therapy Committee of the American Academy of Periodontology. Epidemiology of periodontal diseases. J Periodontol. 2005;76(8):1406-19. PMid:16101377.
27. Sheiham A, Nicolau B. Evaluation of social and psychological factors in periodontal disease. Periodontol 2000. 2005;39:118-31. PMid:16135067. http://dx.doi.org/10.1111/j.1600-0757.2005.00115.x
28. Liu B, Faller LL, Klitgord N, Mazumdar V, Ghodsi M, Sommer DD, et al. Deep sequencing of the oral microbiome reveals signatures of periodontal disease. PLoS One. 2012;7(6):e37919. PMid:22675498 PMCid:3366996. http://dx.doi.org/10.1371/journal.pone.0037919
29. Matsui R, Cvitkovitch D. Acid tolerance mechanisms utilized by Streptococcus mutans. Future Microbiol. 2010;5(3):403-17. PMid:20210551 PMCid:2937171. http://dx.doi.org/10.2217/fmb.09.129
30. Costa FO, Cota LOM, Costa JE, Pordeus IA. Periodontal disease progression among young subjects with no preventive dental care: a 52-month follow-up study. J Periodontol. 2007;78 (2):198-203. PMid:17274706. http://dx.doi.org/10.1902/jop.2007.060150