Carlos Pereira, 46 years old with a doctorate from the Faculty of Medicine, University of Porto, dentist, professor at the School of Health of Viseu (ESSV) coordinated a study on the oral health of young people in the Centre Region. Natural Sátão, began her career in nursing, but the passion for oral health was stronger, becoming the first doctorate in ESSV. Viseu chose to live, but opted for the hometown to open an office. I knew that the mouths of most of the Portuguese is a serious problem, but the results of the study coordinated still managed to surprise: it is amazing that 20 percent of teens have no idea of what the dental floss.
-How does the opportunity to conduct this study with young people between 12 and 18 in the Center?
-The idea of developing this study arose from the lack of evidence, evidence, hard data on this phenomenon we have studied. We had no data on population and in the case of adolescents on how they performed their oral hygiene, the number of times they visited the dentist, and because we do not, this was the most important motivation.
-The lack of hard data was a barrier?
-It is impossible to plan care, a care plan is based not know the most basic data of this phenomenon, about which we can intervene.
-Party with the idea that the situation was not good and you need to achieve on the ground?
-We had the notion that the scenery was not encouraging. That is to say that the scene did not surprise us. Who makes clinical faced every day with this issue of oral hygiene performed in a less correct. Hence we planned to study and realize it was a step.
-The study covered the six districts of Centro (Aveiro, Viseu, Guarda, Castelo Branco, Coimbra and Leiria)?
-We have an approach-mostly in the district of Viseu and after studies in other districts.
-Do not be abusive to say it is a study of the Center?
-No. All districts in the Central region were visited. If you ask me: It was done fairly? Not true, the region where more focused was the district of Viseu, where we include all public schools in the second and third cycles and secondary schools, except the first cycle and the pre-school.
-The study was done in partnership with the Faculty of Medicine, Medical University of Porto. Why this partnership?
-I did my graduate training, including master's and doctorate at the Faculty of Medicine of Porto. Then they were friends, were contacts of research, my taste for investigation came during my time in Porto. Another aspect is that one of the topics presented [the study], the issue of oral health behaviors among adolescents in the central region, was studied by the doctor Nelio Veiga, my graduate student and did his Masters in Public Health at the School of Medicine Port. This kind of two in a university also makes the legitimate co-author of the study.
-This privileged link opens the way for other studies in the School of Health of Viseu?
-This is not the first study done in partnership with the Faculty of Medicine of Porto. We worked on the prevalence of obesity in the district of Viseu, in partnership with the College. Also a few years ago, and I remind myself to work with greater visibility, we conducted another study on sexual behavior in adolescents.
-There are others in development?
-There are others in the pipeline. One with the School of Health at the University of Aveiro we're doing, but it is still early to lift the veil.
-This type of work is a constant in the School of Health of Viseu?
-Yes. In the investigation that our teachers have to perform under its post-graduate training, there has been caution on the part of their advisors, that such research may be different from what is done with the purpose of defending a thesis.
-Different in what way?
-Research-only makes sense if it turns into knowledge, and knowledge is the service of citizens, of all who need to consult scientific research, consult the evidence to care. I think that was part of our care to do research that can answer specific questions of specific populations.
-What are the general results of the study that brought us to this conversation?
-In conclusion we can say that one in five teens do not brush your teeth. We are talking about 20 percent.
-This is bad or very bad?
-It is bad enough. The ideal was that from an early age instilled in children is oral hygiene habits, passing by brushing your teeth, brush your tongue, brush your gums, deep down, take a careful hygiene in the mouth and teeth. Then say that only one of four teens (25 percent) brush their teeth twice or more per day, assuming that brushing twice a day is the minimum. Another note that is important to remember that if they brush their teeth twice or more per day, use of dental floss at least once a day and regular visits to the dentist twice a year, we found that less than two percent of our teenagers have oral health habits correct. Another note, to say it is amazing that 20 percent of teens have no idea of what the dental floss.
-What else surprised?
-This question-flossing.
-Have you found reasons for this?
-Probably never heard of, and admit that not happen in all this teaching consultations. Often, there are basic issues, emerging more and more disturbing. If the person goes to the doctor because it hurts the tooth, it should be talking about flossing?
-The results were worse than expected?
-I think so. We are talking about young people between 12 and 18 years and hoped they were more informed. I still lack a fifth note [of the findings of the study] to say that young people from less educated social classes - determined based on the school that the father or mother had - were those who had worse oral hygiene, visiting less dentist, was where the highest prevalence of adolescents who did not know the end tooth.
-We also have to add here a financial issue of their parents?
-This is another question. These health issues add, that is, it is not known, it is poor, do not go to health care, there is no information about where to turn, etc., etc.. All this is kind of a snowball when it comes to education.
-Oral health is also a social problem?
-If you ask what is the most common disease in the Portuguese society, certainly I will say it is the myocardial infarction, cancer or stroke. But if we see the numbers as cold as they should be seen, the most prevalent disease in the Portuguese society is tooth decay. We forget that dental caries is an infectious disease with a major component. And if you do the question: Who ever had tooth decay? Probably 99.9 percent either have or have ever had.
-How do you make a good brushing of the mouth?
-In one of my tickets for youth hostels, one day I shared a room with a Norwegian and hygiene morning when I went to the showers came across that the individual was dealing with oral hygiene. I came, I did my oral hygiene, shaving unpacked, showered, and when I returned to the base, he continued with his oral hygiene. This reflects the importance that we give to the questions of others and give oral hygiene. After meals, it is always convenient to oral hygiene, morning and evening is the minimum requirement. Using a suitable brush should be replaced every three months.
-What is a suitable brush?
-Must be a soft brush, is a principle.
-The market has good brushes?
-Yes, yes. When asked whether they should use electric or manual toothbrush, the answer I give is: use as well. The physician should indicate the proper brush in each case.
-And the toothpaste?
-Tags [market], are marked with the amount of fluoride recommended by the World Health Organization.
-The study shows that boys are more lax than girls. Is there any explanation for this?
-I have no explanation.
-This should be the target of an individual study?
-When doing research, in whatever area is always in the same study looked at men and women, a good research practice demands that we separate men and women to one side to another, without any prejudice or interpretations. Being a man is to be different for women and has an explanation of the problems with sex.
-When do young people go to the dentist?
-Those who belong to more privileged economic classes seek the dentist on a regular basis and a more routine.
-And soon?
-Yes. Check The Dentist opened some doors. We have children with four / five years or even earlier. The first visit should be as soon as possible for the child to play with the dentist and realized that this ghost has a tendency to disappear.
-The program Dental Check is working? There are already some criticism.
-I believe that is not working by feature and I've said that does not reach all children, but the little we do good is always welcome. The message goes on.
-What more can be done through the mouth of the young?
-I think it's so bad that the little we can do is welcome. I'm sure a toothbrush and toothpaste cost a tenth part of what is necessary to spend time to make an oral rehabilitation.
-You are talking about the failure of prevention?
-Of course. In the overwhelming majority of cases, if the patient reaches this state is because primary prevention has failed.
-The problem is not just the young, the elderly is a difficult age. Do you agree?
-There is a slice of our elderly oral health call [what they do] is an attack. That health will be someone who has pain that feels psychologically and socially affected? This is more important than we think.
-Treat your teeth in Portugal is very expensive. This is also a barrier to the oral health of the Portuguese?
-We must be realistic, there are many people who can not afford a consultation.
-There should enter the National Health Service.
-Do not believe in austerity plans that might happen, but easier access to those lower classes who can not afford. I must admit I find that people who have difficulty paying the simple consultation of 40 euros or 50 euros.
-There are more dentists in Portugal?
-I usually tell my students that this world today, as I see it, must be understood in the logic of the global village that everyone is talking about. We have to run. People must be willing to leave, to make the leap. Since there, there are opportunities for success in various parts of Europe and the world. If they start to be too many for us? Maybe so, but there are other areas where it starts to be more supply and less demand.
-What is the relationship between health of the mouth with our health?
-We talked of obesity, malnutrition ... the teeth are not just for chewing, are used for various things, even to smile. Those who have no teeth with which one can make effective chewing, of course this will be reflected in terms of digestion, the nutrients are not absorbed as efficiently and downward anything can happen: gastrointestinal problems, digestive disorders, the malabsorption of food, malnutrition. Then, if we consider that a poorly maintained mouth is a mouth where there are many different species of microorganisms, these microorganisms themselves may be related to a set of diseases, the level of the heart, kidneys, acute articular rheumatism, sinusitis and all other diseases that today are known to have a direct relationship. It happens quite often appear in patients with horrible pain clinics in the face, head, ear pain, ringing, etc.. And often appear after being found in ENT, to be seen by a neurologist, a psychiatrist and by colleagues in other specialties. It is impossible to be healthy, well-being seen as physical, mental and social, if there is a proper oral health.
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