Greater access to information on how to prevent oral cancer among
                    elderly using primary health care

Martins, Andréa Maria Eleutério de Barros Lima; Barreto, Sandhi Maria; Santos-Neto, Pedro Eleutério dos; Sá, Maria Aparecida Barbosa de; Souza, João Gabriel Silva; Haikal, Desireé Sant’Ana; Ferreira, Efigenia Ferreira e; Pordeus, Isabela Almeida

doi:10.1590/1413-81232015207.15272014

Andréa Maria Eleutério de Barros Lima Martins

Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros. Av. Dr. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil. martins. andreamebl@gmail.com

Sandhi Maria Barreto

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais

Pedro Eleutério dos Santos-Neto

Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros. Av. Dr. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil. martins. andreamebl@gmail.com

Maria Aparecida Barbosa de Sá

Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros. Av. Dr. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil. martins. andreamebl@gmail.com

João Gabriel Silva Souza

Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas

Desireé Sant’Ana Haikal

Departamento de Odontologia, Centro de Ciências Básicas e da Saúde, Universidade Estadual de Montes Claros. Av. Dr. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil. martins. andreamebl@gmail.com

Efigenia Ferreira e Ferreira

Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal de Minas Gerais

Isabela Almeida Pordeus

Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal de Minas Gerais

Collaborations

AMEBL Martins, IA Pordeus, EF Ferreira e SM Barreto participated in the conception and design, analysis, interpretation of data and writing of the manuscript. DS Haikal, PE Santos-Neto, MAB Sá and JGS Souza participated in the collection, analysis and interpretation of the data, as well as in the writing of the manuscript.

				n	%	%^a a Estimated values corrected for design effect.	Standard error	Deff
Access to health-related information
	Access to information on how to prevent oral cancer^b b Variation in n = 492 due to loss of information.
		No		201	40.9	41.1	5,5
		Yes		291	59.1	58.9		6.891
Personal determinants
	Age range (in years)
		69 to 74		209	42.5	41.5	2,6
		65 to 68		283	57.5	58.5		1.495
	Self-declared race^b b Variation in n = 492 due to loss of information.						3,7
		Brown ”mixed”		232	47.3	45.4	2,2	2.949
		Black		70	14.3	16.1	0,4	1.903
		Indigenous		2	0.4	0.5	0,5	1.653
		Asian “yellow”		5	1.0	0.9	4,7	1.319
		White		182	37.1	37.1		5.133
	Sex
		Male		231	47.0	47.8	2,7
		Female		261	53.0	52.2		1.645
	Marital status
		Single/Widowed/Divorced		170	34.6	30.8	3,4
		Married/Stable union		322	65.4	69.2		2.972
	Schooling (years of study)
		0 to 4		285	57.9	59.1	5,2
		5 and above		207	42.1	40.9		3.958
	Per capita monthly income in number of minimum wages^b b Variation in n = 492 due to loss of information. , ^c c Based on the minimum wage in 2008. R$ 415.00.
		1 or less		310	65.1	66.8	4,0
		More than 1		166	34.9	33.2		3.842
Health services/health costs
	Dental service used^b b Variation in n = 492 due to loss of information.
		Supplemental or private services		360	73.5	72.1	4,4
		Governamental or philanthropic services		130	26.5	27.9		5.229
	Residence registered in the FHS
		No		242	49.2	43.6	8,4
		Yes		250	50.8	56.4		15.885
	Time since last dental visit (years)
		1 or more		360	73.2	72.9	2,8
		Less than 1		132	26.8	27.1		2.112
	Motive for use of dental service^b b Variation in n = 492 due to loss of information.
		Appointment for treatment		296	60.4	62.9	3,6
		Regularly scheduled check-up		194	39.6	37.1		2.994
Health behaviors (related)
	Past or present tobacco habit
		Yes		175	35.6	36.4	3,2
		No		317	64.4	63.6		2.500
	Past or present alcohol habit^b b Variation in n = 492 due to loss of information.
		Yes		188	38.2	39.9	2,7
		No		304	61.8	60.1		1.718
	Oral self-exam
		No		391	79.5	77.6	2,9
		Yes		101	20.5	22.4		2.604
Health outcomes
	Reported general health
		Presence of chronic disease^b b Variation in n = 492 due to loss of information.
		Yes		405	82.3	79.7
		No		87	17.7	20.3	3,2	3.520
	Use of medications
		Yes		344	69.9	68.7
		No		148	30.1	31.3	2,8	1.942
Normative conditions of oral health
	Alterations in the soft tissues^b b Variation in n = 492 due to loss of information.
		Yes		81	17.1	16.5
		No		393	82.9	83.5	2,4	2.193
	Use of removable prostheses
		No		94	19.1	17.7
		Yes		398	80.9	82.3	2,9	3.170
Subjective conditions of health…
		… Self-reported need for dental treatment^b b Variation in n = 492 due to loss of information.
			Yes	278	56.7	59.7
			No	212	43.3	40.3	3,9	3.489
		… Pain in teeth over the past six months^b b Variation in n = 492 due to loss of information.
			Yes	125	25.6	25.2
			Noo	364	74.4	74.8	2,8	2.229
		… Discomfort in the mouth. head or neck
			Yes	98	19.9	19.2
			No	394	80.1	80.8	2,6	2.360
	OHIP^b b Variation in n = 492 due to loss of information.
		Impact		92	18.7	17.8
		No impact		399	81.3	82.2	2,0	1.568

Access				No %^a a Estimated values corrected for design effect.	Yes % ^a a Estimated values corrected for design effect.	OR^a a Estimated values corrected for design effect.	CI 95%^a a Estimated values corrected for design effect.	P	Standard error	Deff
Personal determinants
	Age (in years)
		69-74		60.6	39.4	1.00
		65-68		57.8	42.2	1.12	0.70-1.79	0.607	0.23	1,69
	Self-declared race^b b Variation in n = 492 due to loss of information.
		Brown “mixed”/ Black/ Indigenous		51.2	48.8	1.00
		White/ Asian “yellow”		71.7	28.3	0.41	0.23-0.71	0.002	0.27	2,11
	Sex
		Male		59.4	40.6	1.00
		Female		58.5	41.5	1.03	063-1.70	0.876	0.24	2,00
	Marital status
		Single/Widowed/Divorced		54.4	45.6	1.00
		Married/stable union		61.0	39.0	0.76	0.54-1.07	0.118	0.16	0,80
	Schooling (years of study)
		0 to 4 years		65.0	35.0	1.00
		5 and above		50.1	49.9	1.85	1.06-3.22	0.030	0.27	2,40
	Per capita monthly income (number of minimum wages)^b b Variation in n = 492 due to loss of information. , ^c c Based on the minimum wage in 2008. R$ 415.00.
		1 or less		63.8	36.2	1.00	1.05-2.78	0.030	0.23	1,64
		More than 1		50.6	49.4	1.71
Use of health services/ health expenditures
	Dental service used ^b b Variation in n = 492 due to loss of information.
		Supplemental or private services		59.2	40.8	1.00				2,75
		Governamental or philanthropic services		58.3	41.7	1.03	0.54-1.98	0.905	0.32
	Residence registered in the FHS
		No		72.7	27.3	1.00				4,86
		Yes		48.3	51.7	2.85	1.25-6.49	0.014	0.40
	Time since last dental visit (years)
		1 or more		57.6	42.4	1.00				2,16
		Less than 1		62.6	37.4	0.81	0.45-1.45	0.471	0.29
	Motive for use of dental service ^b b Variation in n = 492 due to loss of information.
		Appointment for treatment		57.6	42.4	1.00				1,53
		Regularly scheduled check-up		60.7	39.3	0.88	0.56-1.38	0.570	0.22
Health-related behaviors
	Past or present tobacco habit
		Yes		69.7	30.3	1.00				1,43
		No		52.8	47.2	2.05	1.30-3.23	0.003	0.22
	Past or present alcohol habit ^b b Variation in n = 492 due to loss of information.
		Yes		60.3	39.7	1.00				2,33
		No		58.1	41.9	1.09	0.63-1.89	0.738	0.27
	Oral self-exam
		No		68.3	31.7	1.00				1,94
		Yes		26.4	73.6	5.99	3.14-11.44	0.000	0.32
Health outcomes
	Reported general health
		Presence of chronic disease b
			Yes	61.1	38.9	1.00	0.79-2.99	0.199	0.32	2,38
			No	50.5	49.5	1.53
		Use of medications
			Yes	58.7	41.30	1.00	0.53-1.75	0.919	0.29	2,45
			No	59.4	40.6	0.97
Normative conditions of oral health
	Alterations in the soft tissuesb
		Yes		72.0	28.0	1.00	1.00-4.14	0.048	0.35	1,86
		No		55.7	44.3	2.04
	Use of removable prostheses
		No		69.7	30.3	1.00	0.24-1.34	0.190	0.42	3,13
		Yes		56.6	43.4	0.56
Subjective conditions of health…
		… Self-reported need for dental treatmentb
			Yes	63.3	36.7	1.00	0.77-2.43	0.264	0.28
			No	55.5	44.5	1.37				2,50
		… Pain in teeth over the past six monthsb
			Yes	58.4	41.6	1.00	0.59-1.58	0.906	0.24
			Noo	59.1	40.9	0.97				1,44
		… Discomfort in the mouth. head or neck
			Yes	75.2	24.8	1.00	1.40-4.38	0.003	0.28
			No	55.1	44.9	2.47				1,33
	OHIPb
		Impact		71.9	28.1	1.00	1.00-3.91	0.047	0.33
		No impact		56.3	43.7	1.98				1,89

				OR	CI 95%	p
Personal determinants
	Per capita monthly income (number of minimum wages)^b,c
		1 or less		1.00
		More than 1		2.016	1.182-3.437	0.011
Health services/ health costs
	Residence registered in the FHS
		No		1.00
		Yes		3.137	1.353 −7.277	0.009
Health-related behaviors
	Past or present tobacco habit
		Yes		1.00
		No		2.005	1.161-3.461	0.014
	Oral self-exam
		No		1.00
		Ye s		6.350	3.462 −11.646	0.000
Health outcomes
	Reported general health
		Discomfort in the mouth, head or neck
			Yes	1.00
			No	2.063	1.021 – 4.170	0.044

[1] Collaborations

AMEBL Martins, IA Pordeus, EF Ferreira e SM Barreto participated in the conception and design, analysis, interpretation of data and writing of the manuscript. DS Haikal, PE Santos-Neto, MAB Sá and JGS Souza participated in the collection, analysis and interpretation of the data, as well as in the writing of the manuscript.

Brasil

Brasil

Greater access to information on how to prevent oral cancer among elderly using primary health care

Abstract