Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject’s education, subject’s income, subject’s occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries.

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I², and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]).

O trabalho objetivou identificar as ações desenvolvidas pelo Agente Comunitário de Saúde (ACS) vinculado à Saúde da Família de Montes Claros, MG, Brasil. A pesquisa foi conduzida no âmbito do Programa de Educação pelo Trabalho para a Saúde-PET-Saúde, 2010-2012. Estudo quantitativo e censitário com 241 Agentes. A maioria realiza o cadastro e visita familiar, identifica as famílias de risco e informa à equipe, orienta quanto ao uso dos serviços de saúde, encaminha e agenda consultas/exames, realiza educação em saúde e participa de reflexão do trabalho em equipe. Uma parcela auxilia no ambiente clínico. Ao associar as atividades com a condição de ter capacitado para a função, somente o encaminhamento para a consulta e a educação em saúde foram associados à qualificação profissional. A maioria dos que realizam a educação em saúde e fazem encaminhamentos se sente preparada para a função. O ACS é o elemento nuclear das ações em saúde, mas as dimensões de atuação exigem investimentos na instumentalização adequada do profissional e na manutenção da qualidade do processo de trabalho executado por ele, em atividades de supervisão e de reflexão em equipe. Assim, o ACS poderá assumir a corresponsabilidade com a Atenção básica, integrado ao sistema de administração de saúde.

Resumo Objetivou-se conhecer a prevalência e os fatores associados à fragilidade em idosos na Atenção Primária à Saúde. Trata-se de estudo transversal realizado com1750 idosos no Sudeste do Brasil. Utilizou-se para coleta o Brazilian Older Americans Resources and Services MultiDimensional Function Assessment Questionnaire (BOMFAQ) e o Índice de Vulnerabilidade Clínico-funcional (IVCF-20). Realizaram-se as análises descritivas e bivariadas, seguidas da análise regressão de Poisson, com variância robusta, para obtenção de razões de prevalência ajustadas. O IVCF-20 identificou 357 idosos frágeis (20,1%). As variáveis estatisticamente associadas à fragilidade após análise múltipla foram: estado civil (RP = 1,05; IC95% = 1,02-1,07), escolaridade (RP = 1,05; IC95% = 1,03-1,08), polipatologia (RP = 1,05; IC95% = 1,01-1,09), polifarmácia (RP = 1,21; IC95% = 1,17-1,26), transtorno mental (RP = 1,16; IC95% = 1,12-1,21), comprometimento cognitivo (RP = 1,71; IC95% = 1,57-1,86), comprometimento de atividades de vida diária (RP = 1,12; IC95% = 1,09-1,14), quedas (RP = 1,06; IC95% = 1,03-1,10), internação (RP = 1,39; IC95% = 1,27-1,52) e incontinência urinária, autopercepção da saúde. Concluiu-se que a significante prevalência de fragilidade do estudo reitera a necessidade de abordagem multidimensional do idoso.

OBJECTIVE: To estimate the prevalence of robustness among older adults assisted in primary health care and identify factors in successful aging. METHODS: This is a cross-sectional study conducted with older adults in Northern Minas Gerais, Brazil. Two questionnaires were used for data collection: the Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire (BOMFAQ) and the Clinical-Functional Vulnerability Index IVCF-20). The adjusted prevalence ratios were obtained by robust Poisson regression. Statistical analysis was performed for older adults in general (60 to 107 years) and stratified by age: from 60 to 79 years and 80 years or more. RESULTS: A total of 1,750 older adults aged 60 to 107 years participated; between them, 48.7% were robust. Older adults aged 60 to 79 years (n = 1,421) and 80 years or more (n = 329) had a prevalence of robustness of 55.4% and 19.3%, respectively. Some factors associated with successful aging were: positive self-perception of health, dancing habits, walking habits, absence of cognitive impairment, absence of depressive symptoms and polypathology, as well as daily life independence. After adjustment by age, the absence of polypathology and independence for activities of daily living stand out for robustness between 60 and 79 years; in those aged 80 years and over, independence for activities of daily living and dance practice presented greater strength of association. CONCLUSION: The prevalence of robust older adults in primary care is considered satisfactory for the older population in general but decreases with age and is associated with the absence of diseases and disabilities. These results denote the need to redesign the health care system, focusing on promoting and preventing clinical-functional vulnerability.

In recent decades, studies in the field of public health have increasingly focused on social determinants that affect the health-illness process. The epidemiological perspective considers oral health to be a reflection of socioeconomic and environmental aspects, and it is particularly influenced by the social context. The aim of the present study was to assess the association between the severity of dental caries among adults aged 35 to 44 years and characteristics on the different levels at which the determinants of caries operate (individual, social structure and social context).