Implementação e avaliação de uma intervenção para promoção da saúde bucal de crianças no contexto da atenção primária.

Abstract

In childhood, caries remains one of the most common diseases, infants and children continue to be frequently affected, known as early childhood caries. Despite the overall reduction in its prevalence, caries is still considered a public health problem that affects approximately 60% of children in Brazil. Although it is a behavioral disease, dental caries can be prevented or controlled through the use of modifiable behaviors, including brushing twice a day with fluoride, controlling sugar consumption and regular visits to the dentist.With the objective of promoting the oral health of children from 0 to 5 years old, belonging to families registered in Basic Health Units of the Unified Health System, in the city of Pelotas, Rio Grande do Sul, a randomized controlled trial was developed. Intervention is culturally appropriate to prevent caries in children by changing target behaviors. It is composed of multiple strategies of health promotion and communication with views at three levels: community, organizational and interpersonal / intrapersonal. The Basic Health Units that met the inclusion criteria became eligible to participate in the study, and following a randomization scheme in pairs and by geographic location, the control group was composed of two UBS and the other two the intervention group.Through the application of questionnaires, the outcomes evaluated were knowledge of the primary caregiver on oral health, improvement of oral hygiene practices, reduction of sugar consumption and use of the dental service. The analysis of difference between the groups after the intervention was estimated from the Pearson's Chi-square test and Student's T test, the impact of the intervention was assessed from the change rates of the outcomes according to the relative risks and differences Absolute percentages. Of the 344 children recruited at the start of the study, 91% were assessed in followup, 152 in the intervention group and 161 in the control group. The main reason for loss was a change of city. After the intervention, there were positive and significant changes in favor of the intervention group, in three of the four outcomes evaluated: caregiver knowledge about oral health, improvements in oral hygiene practices and use of the dental service. The outcome related to sugar consumption presented favorable indicators for the intervention group, but the differences found were not statistically significant. The proposed intervention is possible for development in the health services, the results point to an effective improvement in the change of behaviors favorable to oral health and can be an important indicator of this intervention for the reduction of caries in early childhood.