Autopercepção e condições de saúde bucal em adultos em situação de rua

Abstract

In the homeless population, oral health is poor and is being used with pain, suffering, mutilation and deprivation. Understanding individuals' self-perception of their oral condition reveals the importance of addressing social and psychological aspects in the health-illness process. This research aimed to evaluate the self-perceived impact of oral health conditions on the quality of life of homeless adults in the city of Juiz de Fora –Minas Gerais. The oral health of the homeless population is precarious, without intersectorality between public policies. The distance between social challenges and the premises of the National Oral Health Policy are those that make access to oral health unfeasible. We sought to understand, from the perspective of these individuals, how to conceive oral health care and its impacts on their quality of life, in addition to the reasons that lead to seeking health care, an analysis that contributes to oral health. For this, a cross- sectional analytical research was carried out in four institutions that house residents in a permanent and transient homeless situation, located in Juiz de Fora. Data were collected through structured interviews and oral observation, as well as oral health assessment and self-perception, and the OHIP-14 (Oral Health Impact Profile-14) and ICSB (Community Oral Health Indicator) indicators, which characterized them regarding demographic factors, psychosocial and clinical aspects related to oral health. To evaluate or access dental services, the protocol applied in the National Oral Health Survey was used. A dependent variable of the study was the impact of oral health on quality of life (OHIP-14). Data description used frequency and central tendency measurements. The OHIP-14 domains were analyzed for normality by the Kolmogorov- Smirnov test, and their nonparametric distribution was verified. In order to associate the outcome impact of sociodemographic and oral health conditions (self-perception, SSCI and access to service) on the quality of life of PSR, their medians and interquartile distance were compared by the Mann-Whitney and Kruskal-Wallis tests. Multiple linear regression gathered the significant variables (p<0.05) of the OHIP-14 domain bivariate analysis. The regression analysis (table 5) kept the female gender in the final model, revealing worse scores for OHIP-14 and self-perception in Oral Health, with an emphasis on the impacts on psychological disability, psychological discomfort and social disadvantage. Oral health revealed physical limitations, physical and psychological disabilities. He associated the presence of more teeth to these physical impacts and the presence of inflamed gums, the absence of the need for a prosthesis and the use of private services with the worse perception of the psychological disability domain. Oral health in the homeless population is susceptible to oral lesions, with sequelae in their daily lives. Establishing oral health and reducing its effects on the quality of life of the mentioned population is a public health challenge. It is necessary in this group, that the evaluation of clinical and subjective characters in oral health, occurs concurrently, so that their needs are met with equity, in favor of social well-being.