Controle de placa no primeiro molar permanente: análise de custo/benefício

Abstract

Aim: To evaluate the effectiveness and efficiency of plaque self-control in first permanent molars. Methods: Two hundred seventy eight schoolchildren, 6-8 years of age, from two public schools in the city of Belo Horizonte, MG, Brazil, participated in this study. The sample was calculated by an estimate of proportion. The examinations were performed without prior tooth brushing at schools with mobile dental offices by two calibrated professionals. The teeth were categorized according to the eruption stages: not erupted (0), partially erupted (1), and fully erupted (2), as well as regards the presence of stagnant plaque on the occlusal surface: without visible plaque (0), restricted to pits and fissures (1), easily detectable (2), and fully covered by plaque (3). Collective dental advice activities for proper tooth brushing were developed with emphasis on the first permanent molar. After six months, another evaluation, along with reinforcement of advice on proper tooth brushing, were performed. The data were submitted to the odds ratio (OR), Mann-Whitney test, and logistic regression in BioEstat 5.3 program. Results: Teeth in the eruption process showed a greater probability of presenting plaque than did those after full eruption (OR=0.52 [0.40-0.68]; p <0.0001), in the first examination. A reduction of 13% in the presence of stagnant plaque in the first permanent molars was observed after having provided educational advice. The partially erupted teeth showed a greater reduction of the presence of plaque (18%) than did the teeth after full eruption (13%). The time spent for the program was approximately 53 hours, with a total cost of R$637.34 (~R$1.23/child). Conclusion:Dental advice for proper brushing techniques to remove stagnant plaque on the first permanent molar was effective and efficient in the control of dental caries, especially when in infraocclusion.