Análise do atendimento odontológico a pacientes com obesidade na atenção primária à saúde e conhecimento de cirurgiões-dentistas sobre a associação entre obesidade e doença periodontal

Abstract

Nowadays, obesity is considered a moderate risk factor for periodontitis, in addition to other frequent oral problems in these individuals. Knowing this, the Health Unic System (SUS) adopts the paradigm that the prevention and treatment of chronic diseases is more effective with multidisciplinary action. The objective of study 01 is to evaluate the access to dental care of obese individuals in primary health care (PHC) and forwarding to the periodontics specialty in the years 2018 and 2019, while the objective of study 02 is to evaluate the knowledge of dentists (DC) about the relationship between obesity and periodontal disease in Brazil. The history of dental care was assessed using data from the Health Information System for Primary Care (SISAB) reports. For study 1, the dependent variables were: the percentage of obese people who had dental care in PHC who were or were not forwarded for periodontics. The independent variables were: the population estimate of the municipality; the Municipality's Human Development Index (IDHM); Gini index; estimate of population coverage of oral health in the Family Health Strategy (ESF) and the existence of a Dental Specialty Center (CEO) in the city. Descriptive analysis and calculation of measures of: central tendency, dispersion and position were performed in the SPSS software. For study 02, a specific instrument was developed that was used to estimate the quality of knowledge and practices of the FHS HCs regarding the interrelationship between obesity and periodontal disease. The questionnaire was prepared through Google forms, the recruitment of these professionals was done through emails, social networks, Instagram and WhatsApp. The initial questions were related to the demographic data of the sample and the others related to the knowledge of professionals on the subject: oral health in general, periodontal disease, obesity and the relationship between these disorders. The sample was defined after a pilot study that was carried out in the city of João Pessoa with 10 dentists who were inserted in the FHS, and a sample of 186 individuals was calculated. With study 1, it was found that, between the years 2018 and 2019, there was a significant increase in the percentage of dental appointments of people with obesity in PHC (p<0.001). The need for investment in intervention policies was also demonstrated in the regions with the highest concentration of obese people: Midwest and North. Study 2 showed that the majority of DSs had a low level of knowledge about the association between obesity and periodontitis. However, most of the DSs that presented with adequate knowledge were exclusively inserted in the public sector and had postgraduate degrees, which reinforces the importance of investments in the area of permanent education. It is hoped that these results can help in the development of strategies that improve comprehensive care for patients with obesity in the context of Brazilian PHC.