RESUMO
A nonprofit private dental clinic provides free dental treatment for children up to the age of eighteen years. In order to expand its services to reach more children, a school-based sealant program using dental auxiliary personnel was organized. This paper evaluated the performance of the school-based program during 1991 by comparing the costs of the school-based program with the costs of the sealants placed in the clinic in twelve months. Costs were calculated based on 1991 expenditures, and effectiveness rates were estimated from dental literature on sealants. The cost of saving one tooth-surface from decaying within a six-year period at the school and the clinic was $65 and $42 with an average sealing time per tooth surface of 18 and 12.5 minutes, respectively. Despite the relatively lower cost of personnel, the school program cost was 35 percent higher than at the clinic. Nevertheless, if hidden costs, such as transportation, time off work, and waiting time for those attending the clinic were considered, costs could be comparable or even higher for the clinic. The main goal of this paper is to explore a methodology to compare programs of different nature, and critically evaluate the results.
Assuntos
Cárie Dentária/economia , Selantes de Fossas e Fissuras/economia , Serviços de Odontologia Escolar/economia , Absenteísmo , Criança , Análise Custo-Benefício , Auxiliares de Odontologia/economia , Cárie Dentária/prevenção & controle , Clínicas Odontológicas/economia , Custos de Cuidados de Saúde , Gastos em Saúde , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Fatores de Tempo , Meios de Transporte/economiaRESUMO
The main purpose of this study is to compare data from previous surveys to current prevalence rates of dental caries and dental fluorosis in eleven- and twelve-year-olds in a non-fluoridated Brazilian community (< 0.2 ppm F). This study also assesses the possible association between use of fluoride toothpaste and the prevalence of dental caries and dental fluorosis. The sample subjects are randomly selected schoolchildren who were examined with a dental probe and buccal mirror under natural light. The intra-examiner error was calculated, using Kappa statistics (K tau 0.85). The results showed that between 1991 and 1997 there was a 56.7 percent decrease in the prevalence of dental caries and an 80.1 percent increase in dental fluorosis. Children with dental fluorosis were 1.75 times more likely to be free of caries (OR = 1.75-CI:0.43, 6.68). Children who started using fluoride toothpaste before the age of three were 4.43 times more likely to have dental fluorosis than those who started using it after the age of three (OR = 4.43-CI:0.51, 99.61). The results of the cross-sectional surveys conducted with schoolchildren in 1991, 1995, and 1997 suggest a continuing decrease in the prevalence of dental caries and an increase in the prevalence of dental fluorosis in this nonfluoridated Brazilian town.
Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/epidemiologia , Fluoretos/uso terapêutico , Fluorose Dentária/epidemiologia , Cremes Dentais/uso terapêutico , Fatores Etários , Brasil/epidemiologia , Criança , Intervalos de Confiança , Estudos Transversais , Índice CPO , Humanos , Variações Dependentes do Observador , Razão de Chances , Prevalência , Abastecimento de ÁguaRESUMO
The main goal of the University of Texas Health Science Center (UTHSCSA) dental van programs is to provide training in delivering care to diverse segments of the population. The UTHSCSA is the Academic Health Center for all of South Texas, a region with 25% of the State's population and 60% Hispanic. About 60% of the region's counties are federally designated dental health personnel shortage areas. Interdepartmental efforts with the participation of dental hygiene, community dentistry, oral diagnosis, periodontics and general practice carried out two programs during the 1994-95 academic year. At the Saint Philip of Jesus Clinic, a charity clinic, and at the Willows Development Center for Severely and Profoundly Mentally Retarded, the dental van was used to provide preventive and restorative care. A questionnaire to measure the value of the programs indicated that students perceived them as important educational activities which increased their confidence in treating persons in the community, especially persons with disabilities. Program output was quantitatively assessed. An average of 8 preventive procedures, 7 fillings, 2 sealants and 1 extraction or referral were provided each working day. Eighty patients were seen at the Saint Philip Clinic (2.5 visits per patient) and 130 patients were seen at the Willows Development Center. Overall, 80 students and 6 faculty participated in providing screening, treatment and referral services. Dental van programs promote access to dental care and increase the visibility of dental schools within the university and community. Current tendencies to halt new program initiatives and phase out existing programs due to shifting financial priorities should be carefully considered in view of the 1995 Institute of Medicine (IOM) report on the future of dental education.
Assuntos
Assistência Odontológica , Educação em Odontologia , Unidades Móveis de Saúde , Atitude , Centros Comunitários de Saúde , Relações Comunidade-Instituição , Atenção à Saúde , Assistência Odontológica para a Pessoa com Deficiência , Profilaxia Dentária , Restauração Dentária Permanente , Recursos Humanos em Odontologia , Acessibilidade aos Serviços de Saúde , Humanos , Área Carente de Assistência Médica , Higiene Bucal , Equipe de Assistência ao Paciente , Selantes de Fossas e Fissuras/uso terapêutico , Avaliação de Programas e Projetos de Saúde , Radiografia Dentária , Estudantes de Odontologia , Texas , Extração DentáriaRESUMO
PURPOSE: To evaluate the incidence of occlusal caries and the rates of retention using Variglass VLC (polyacid-modified resin) as an occlusal sealant. MATERIALS AND METHODS: The sample consisted of 185 school children (6-8 yr-old), with sound unsealed permanent first molars. Sealants were applied on the upper and lower first molars from a randomly chosen hemiarch (N=370 teeth). The follow-up was conducted at 6, 12 and 48 months examining 343 (93%), 290 (78%) and 187 (51%) teeth, respectively. RESULTS: After 48 months, total retention of the material was noted in only 5% of the teeth. The presence of sealant in 2/3 and 1/3 of the pit extension was verified in 8% and 14% of the teeth, respectively, while 73% of the sealed teeth had no sealant present on the occlusal surface. Caries incidence, measured by the presence of dental caries and restorations, was 16% representing an annual increase of 4%.
Assuntos
Compômeros/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Resinas Acrílicas/uso terapêutico , Criança , Índice CPO , Colagem Dentária , Cárie Dentária/etiologia , Restauração Dentária Permanente , Seguimentos , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Dente Molar , Estatística como AssuntoRESUMO
PURPOSE: To assess the retention and caries incidence of Vitremer (resin-modified glass ionomer) and Ketac-bond (conventional glass ionomer cement), used as occlusal sealants, after 6 and 12 months placement. MATERIALS AND METHODS: The sample consisted of 200 school children, 6-8 years old with sound and unsealed permanent first molars. They were divided into three groups: (a) control group (n = 432 teeth); (b) Vitremer experimental group (n = 200 teeth), and (c) Ketac-Bond experimental group (n = 200 teeth). In the experimental groups, Vitremer was applied on teeth 16 and 46 whereas Ketac-Bond was applied on 26 and 36. RESULTS: The total retention rates for Vitremer after 6 and 12 months were 59% and 36%, respectively. For Ketac-Bond, the total retention rates were 24% and 15%, respectively. No dental caries was recorded during the 12 months for both experimental groups. When effectiveness was measured by sealant retention, there was a significant difference between Vitremer and Ketac-Bond after 6 (P < 0.01) and 12 months (P < 0.05). When effectiveness was measured by caries prevention, no significant difference was found between experimental groups, even when the sealants were partially or totally lost. There was no development of carious lesions after 1-year placement of sealants, but there was a significant difference between experimental and control groups (P < 0.01).