COVID-19 pandemic and impact on dental education: perception of Brazilian dental students

Aim: The aim of the present study is to assess the perception of undergraduate students on the impact of the COVID-19 pandemic on Brazilian dental education. Methods: This crosssectional study was conducted using an online questionnaire hosted in Google Forms platform and publicized on Instagram® and Facebook®. The questionnaire was available between July 8-27, 2020. Absolute and relative frequencies were obtained for variables of interest using Pearson's chi-squared and considering 95% confidence intervals. Prevalence of learning resource variables according to self-reported skin color, educational institution, and Brazilian region were presented using equiplots. Results: A total of 1,050 undergraduate dental students answered the questionnaire. Most students reported being in full-distance learning mode. Among the undergraduate students, 65.4% reported perceiving a very high impact in dental education, and 16.6% of students reported not being able to follow distance learning. In addition, 14% reported not having a personal laptop or desktop to study with, with this condition being more prevalent among non-white than white individuals. Conclusion: We conclude that Brazilian dental students perceived a high impact of COVID-19 on dental education, as well as one-sixth of the students reported not having adequate resources to continue with distance learning. It is important that different policies are developed at the institutional and governmental levels to reduce the impact of the pandemic on dental education

Use of Health Services and Family Health Strategy Households Population Coverage in Brazil.

The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Use of Health Services and Family Health Strategy Households Population Coverage in Brazil / Utilização dos Serviços de Saúde e Estratégia Saúde da Família Cobertura da População Domiciliar no Brasil

Abstract The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.

Resumo O objetivo deste estudo é descrever o perfil de utilização dos serviços de atenção primária à saúde, estimado pela Pesquisa Nacional de Saúde (PNS), da população residente em domicílios cadastrados e não cadastrados na Estratégia de Saúde da Família (ESF), nos anos de 2013 e 2019. Estudo transversal realizado com microdados dos inquéritos nacionais de saúde entre 2013 e 2019. A amostra originou-se de uma amostra mestra, composta por um conjunto de unidades de áreas selecionadas em um cadastro. Variáveis ​​sexo, idade, cor da pele, renda, escolaridade, autopercepção de saúde, domicílio cadastrado na ESF, atendimento médico no último ano, tipo de serviço que você procura quando está doente foram selecionados. As variáveis ​​dependentes foram uso de serviços de saúde e uso de serviços públicos de saúde. As variáveis ​​dependentes e independentes foram descritas com os respectivos intervalos de confiança e foi realizada regressão logística ajustada para cada desfecho analisado. Nos serviços públicos de saúde, menor renda, ter doenças crônicas (hipertensão arterial ou colesterol alto), estar grávida e ter uma autopercepção de saúde ruim estiveram associados à maior utilização de serviços de saúde nos dois períodos. Morar em domicílios cadastrados na ESF foi associado aos serviços de saúde mais utilizados (públicos ou privados). A estratégia de saúde da família é uma estratégia importante para expandir o acesso de forma igualitária.

Validation of the Brazilian version of Primary Care Assessment Tool (PCAT) for Oral Health - PCATool Brazil Oral Health for Professionals.

This study verified the internal consistency and reliability of an instrument to evaluate dental services in Primary Health Care (PHC). In order to verify the factor validity, a factor analysis with principal component extraction and varimax orthogonal rotation method was used. Factors with three or more items with factor loadings greater than 0,35 were selected. This instrument's reliability was verified using internal consistency (total item correlation >0,30 and Cronbach alpha = or >0,70)). 562 dentists participated in the study. In the factor analysis, ten factors were kept, which explain 40,95% of the total variation. Regarding the internal consistency, only 3 items presented insufficient correlation. Also on internal consistency, using Cronbach's alpha, the following values of the coefficients were identified: Access (0.55), Continuity (0,74), Care Coordination (0,55), Coordination - Information System (0.21), Comprehensiveness of Services Available (0,91), Comprehensiveness of Services Provided (0,79), Family Orientation (0.66), Community Orientation (0,87), Cultural Competence (0,81). For the success ratio of the scale, all results were higher than 88%, less the "Information Systems" component (21%).

Impact of the COVID-19 pandemic on prenatal, diabetes and medical appointments in the Brazilian National Health System.

OBJECTIVES: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. METHODOLOGY: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. RESULTS: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 - 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 - 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 - 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 - 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. CONCLUSION: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

Validation of the Brazilian version of Primary Care Assessment Tool (PCAT) for Oral Health - PCATool Brazil Oral Health for Professionals / Validação da versão brasileira do Primary Care Assessment Tool (PCAT) para Saúde Bucal - PCATool Brasil Saúde Bucal para Profissionais

Abstract This study verified the internal consistency and reliability of an instrument to evaluate dental services in Primary Health Care (PHC). In order to verify the factor validity, a factor analysis with principal component extraction and varimax orthogonal rotation method was used. Factors with three or more items with factor loadings greater than 0,35 were selected. This instrument's reliability was verified using internal consistency (total item correlation >0,30 and Cronbach alpha = or >0,70)). 562 dentists participated in the study. In the factor analysis, ten factors were kept, which explain 40,95% of the total variation. Regarding the internal consistency, only 3 items presented insufficient correlation. Also on internal consistency, using Cronbach's alpha, the following values of the coefficients were identified: Access (0.55), Continuity (0,74), Care Coordination (0,55), Coordination - Information System (0.21), Comprehensiveness of Services Available (0,91), Comprehensiveness of Services Provided (0,79), Family Orientation (0.66), Community Orientation (0,87), Cultural Competence (0,81). For the success ratio of the scale, all results were higher than 88%, less the "Information Systems" component (21%).

Resumo Este estudo verificou a consistência interna e a confiabilidade de um instrumento para avaliar os serviços odontológicos na Atenção Primária à Saúde (APS). Para verificar a validade dos fatores, foi utilizada uma análise fatorial com extração de componentes principais e método de rotação ortogonal varimax. Foram selecionados fatores com três ou mais itens com cargas fatoriais maiores que 0,35. A confiabilidade deste instrumento foi verificada usando consistência interna (correlação total de itens >0,30 e alfa de Cronbach = ou >0,70). 562 dentistas participaram do estudo. Na análise fatorial, foram mantidos dez fatores, o que explica 40,95% da variação total. Quanto à consistência interna, apenas 3 itens apresentaram correlação insuficiente. Ainda na consistência interna, utilizando o alfa de Cronbach, foram identificados os seguintes valores dos coeficientes: Acesso (0,55), Continuidade (0,74), Coordenação de Atenção (0,55), Coordenação - Sistema de Informação (0,21), Abrangência dos Serviços Disponíveis (0,91), Abrangência dos serviços prestados (0,79), Orientação familiar (0,66), Orientação comunitária (0,87), Competência cultural (0,81). Para a taxa de sucesso da escala, todos os resultados foram superiores a 88%, menos o componente "Sistemas de Informação" (21%).

Impact of the COVID-19 pandemic on prenatal, diabetes and medical appointments in the Brazilian National Health System / Impacto da pandemia COVID-19 no Pré-natal, Diabetes e consulta médica no Sistema Único de Saúde Brasileiro

ABSTRACT: Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Results: Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 - 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 - 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 - 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 - 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. Conclusion: The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

RESUMO: Objetivos: O objetivo do presente estudo foi descrever o impacto da pandemia de covid-19 na Atenção Primária à Saúde (APS) Brasileira. Métodos: Estudo ecológico retrospectivo realizado com dados de municípios brasileiros, obtidos nos sistemas de informação do Sistema Único de Saúde (SUS). Os desfechos do estudo foram as consultas médicas, procedimentos de pré-natal e tratamento de diabetes. A exposição foi a ocorrência da pandemia de covid-19, a partir do primeiro caso notificado no Brasil. Regressões binomiais negativas de efeitos mistos multinível foram utilizadas para analisar a associação entre o número de procedimentos por 10.000 habitantes e a pandemia de covid-19. Resultados: Dados de 5.564 municípios brasileiros foram incluídos no presente estudo. Em relação à consulta médica, a maior redução devido à pandemia em curso ocorreu em maio (IRR = 0,27, IC95% 0,24 - 0,30). Para os procedimentos de pré-natal, a redução foi de 65% (IRR = 0,35, IC95% 0.32 - 0.38), também em maio. Ainda assim, os procedimentos de tratamento do diabetes tiveram maiores reduções em abril (IRR = 0,24, IC95% 0,11 - 0,53) e maio (IRR = 0,19, IC95% 0,09 - 0,43) de 2020. De fevereiro a dezembro de 2020, a pandemia de covid-19 impactou significantemente o total de procedimentos avaliados. Conclusão: Os achados mostraram uma redução de procedimentos de pré-natal, diabetes e consultas médicas realizadas na Atenção Primária à Saúde (APS) do Brasil, após o início da pandemia de covid-19.

Prevalência e conhecimento do uso de protetores bucais personalizados em praticantes de esportes / Prevalence and knowledge of the use of personalized mouth protectors in sports practitioners

Objetivo: descrever a prevalência e os conhecimentos sobre o uso de protetores bucais personalizados (PBP) por atletas e professores. Métodos: estudo transversal descritivo realizado em 2016 no município de Piratini, RS. Os participantes eram atletas e professores de escolas e centros de treinamento. Foram coletados dados socioeconômicos, sobre conhecimentos, práticas, experiências e uso de PBP. Os dados foram analisados de forma descritiva com o programa EpiData Analysis, V2.2.3.187. Resultados: a amostra foi composta por 40 atletas e 7 professores, com idades entre 17 e 45 anos. A prevalência do uso de PBP entre os atletas foi de 32,5% (13) e 55% (22) não tinham conhecimento sobre PBP. Além disso, 77,5% (31) dos atletas e 100% (7) dos professores não saberiam indicar um profissional para confeccioná-los. Conclusão: o conhecimento sobre o uso de PBP é escasso, mas, contudo, há uma parcela de atletas que faz uso para a prática de esportes. Destaca-se a importância da necessidade de se investir em políticas de educação em saúde sobre protetores bucais em escolas, academias e centros de treinamento esportivo.(AU)

Objective: to describe the prevalence and knowledge about the use of personalized mouth protectors (PMP) by athletes and teachers. Methods: cross-sectional descriptive study carried out in 2016 in the Piratini/RS city. Participants were athletes and teachers from school and training centers. Socioeconomic data, knowledge, practices, experiences and use of PMP were collected. Data were analyzed in a descriptive with the EpiData Analysis program V2.2.3.187. Results: the sample consisted of 40 athletes and 7 teachers, aged between 17 and 45 years. The prevalence of PMP use among athletes was 32.5% (13) and 55% (22) were not knowledge of PMP. In addition, 77.5% (31) of the athletes and 100% (7) of the teachers did not know to indicate a professional to make them. Conclusion: the knowledge about the use of PMP is scarce and on the other hand, there is a portion of athletes that makes use for the practice of sports. It is important to emphasize the need to invest in health education policies on mouth protectors in schools, gyms and sports training centers.(AU)

[Is oral health associated with the presence of depressive symptoms among the elderly?] / A Saúde bucal está associada à presença de sintomas depressivos em idosos?

The scope of this study was to describe the prevalence of depressive symptoms measured by the Geriatric Depression Scale-EDG - 15 and test the association of oral health variables and depressive symptoms in a population of the elderly linked to eleven Family Health Units in the south of Brazil. It involved a cross-sectional study with 439 elderly individuals. A standardized questionnaire was used to obtain socio-economic and oral health variables of the study. The clinical variables of oral health were obtained by a qualified dentist. The symptoms of depression, which was the scope of the study, were obtained by the Geriatric Depression Scale-EDG -15. The prevalence of depressive symptoms was 18.3% (CI95% 14.6-21.8). Analyzing the exposure variables and depressive symptoms through adjusted Poisson regression analysis, individuals with 1 to 9 teeth (PR = 1.68; CI95% 1.06-2.64, p = 0.012), with a perception of dry mouth (PR = 2.23; CI95% 1.52-3.28, p < 0.001) and perception of pain in the mouth (PR = 2.11; CI95% 1.10-4.07, p = 0.036) have a higher prevalence of depressive symptoms. The study identified a significant prevalence of depressive symptoms and that oral health variables are associated with the presence of depressive symptoms in the elderly population.

O objetivo do estudo foi descrever a prevalência de sintomas depressivos medidos por meio da Escala de Depressão Geriátrica­EDG - 15 e testar a associação de variáveis de saúde bucal com sintomas depressivos em uma população de idosos vinculados a onze unidades de saúde da família do Sul do Brasil. Estudo transversal com 439 idosos. Foi utilizado questionário padronizado para a obtenção das variáveis socioeconômicas e de saúde bucal. As variáveis clínicas de saúde bucal foram obtidas por um dentista treinado. Os sintomas depressivos desfecho do estudo foram obtidos por meio da Escala de Depressão Geriátrica­EDG - 15. A prevalência dos sintomas depressivos foi de 18,3% (IC95% 14,6-21,8). Analisando as variáveis de exposição e os sintomas depressivos, por meio da análise regressão de Poisson ajustada, os indivíduos com 1 a 9 dentes (RP = 1,68; IC95%1,06-2,64, p = 0,012), com percepção de boca seca (RP = 2,23; IC95%1,52-3,28, p < 0,001) e de dor na boca (RP = 2,11; IC95% 1,10-4,07, p = 0,036) tiveram maiores prevalências de sintomas depressivos. O estudo identificou uma prevalência importante de sintomas depressivos e que as variáveis de saúde bucal estão associadas à presença dos mesmos na população idosa.

A Saúde bucal está associada à presença de sintomas depressivos em idosos? / Is oral health associated with the presence of depressive symptoms among the elderly?

Resumo O objetivo do estudo foi descrever a prevalência de sintomas depressivos medidos por meio da Escala de Depressão Geriátrica-EDG - 15 e testar a associação de variáveis de saúde bucal com sintomas depressivos em uma população de idosos vinculados a onze unidades de saúde da família do Sul do Brasil. Estudo transversal com 439 idosos. Foi utilizado questionário padronizado para a obtenção das variáveis socioeconômicas e de saúde bucal. As variáveis clínicas de saúde bucal foram obtidas por um dentista treinado. Os sintomas depressivos desfecho do estudo foram obtidos por meio da Escala de Depressão Geriátrica-EDG - 15. A prevalência dos sintomas depressivos foi de 18,3% (IC95% 14,6-21,8). Analisando as variáveis de exposição e os sintomas depressivos, por meio da análise regressão de Poisson ajustada, os indivíduos com 1 a 9 dentes (RP = 1,68; IC95%1,06-2,64, p = 0,012), com percepção de boca seca (RP = 2,23; IC95%1,52-3,28, p < 0,001) e de dor na boca (RP = 2,11; IC95% 1,10-4,07, p = 0,036) tiveram maiores prevalências de sintomas depressivos. O estudo identificou uma prevalência importante de sintomas depressivos e que as variáveis de saúde bucal estão associadas à presença dos mesmos na população idosa.

Abstract The scope of this study was to describe the prevalence of depressive symptoms measured by the Geriatric Depression Scale-EDG - 15 and test the association of oral health variables and depressive symptoms in a population of the elderly linked to eleven Family Health Units in the south of Brazil. It involved a cross-sectional study with 439 elderly individuals. A standardized questionnaire was used to obtain socio-economic and oral health variables of the study. The clinical variables of oral health were obtained by a qualified dentist. The symptoms of depression, which was the scope of the study, were obtained by the Geriatric Depression Scale-EDG −15. The prevalence of depressive symptoms was 18.3% (CI95% 14.6-21.8). Analyzing the exposure variables and depressive symptoms through adjusted Poisson regression analysis, individuals with 1 to 9 teeth (PR = 1.68; CI95% 1.06-2.64, p = 0.012), with a perception of dry mouth (PR = 2.23; CI95% 1.52-3.28, p < 0.001) and perception of pain in the mouth (PR = 2.11; CI95% 1.10-4.07, p = 0.036) have a higher prevalence of depressive symptoms. The study identified a significant prevalence of depressive symptoms and that oral health variables are associated with the presence of depressive symptoms in the elderly population.

Can implant surfaces affect implant stability during osseointegration? A randomized clinical trial.

This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson's correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.

Private dental insurance expenditure in Brazil.

OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008-2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population.

Can implant surfaces affect implant stability during osseointegration? A randomized clinical trial

Abstract This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson's correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.

Private dental insurance expenditure in Brazil / Gastos privados com planos exclusivamente odontológicos no Brasil

ABSTRACT OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008-2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population.

RESUMO OBJETIVO Quantificar as despesas domiciliares per capita e estimar o percentual de domicílios brasileiros que gastaram com planos exclusivamente odontológicos. MÉTODOS Foram analisados dados de 55.970 domicílios que participaram da Pesquisa de Orçamentos Familiares em 2008-2009. Os gastos domiciliares anuais per capita com planos exclusivamente odontológicos (empresarial e particular) foram analisados segundo os estados da federação e as características socioeconômicas e demográficas dos domicílios (sexo, idade, cor da pele e escolaridade do chefe do domicílio, renda familiar e presença de idoso no domicílio). RESULTADOS Apenas 2,5% dos domicílios brasileiros relataram gastos com planos exclusivamente odontológicos. O valor per capita despendido somou em média R$5,10, sendo a maior parte composta por planos odontológicos particulares (R$4,70). Entre as caraterísticas do domicílio, maior escolaridade e renda estiveram associadas com maior gasto. São Paulo foi o estado com maior gasto domiciliar per capita (R$10,90) e maior prevalência de domicílios com dispêndios (4,6%), enquanto Amazonas e Tocantins apresentaram os menores valores, ambos com gasto inferior a R$1,00 e com menos de 0,1% de domicílios, respectivamente. CONCLUSÕES Apenas uma pequena parcela dos domicílios brasileiros desembolsa com planos exclusivamente odontológicos. O mercado de odontologia suplementar na assistência em saúde bucal abrange uma restrita parcela da população brasileira.

[Private spending on oral health in Brazil: analysis of data from the Family Budgets Survey, 2008-2009]. / Gastos privados com saúde bucal no Brasil: análise dos dados da Pesquisa de Orçamentos Familiares, 2008-2009.

The aim was to analyze Brazilians' private spending on dental care and oral hygiene products. Data were analyzed from 55,970 households in the Family Budgets Survey, 2008-2009. Expenditures were analyzed by major geographic region, state, state capital, and household socioeconomic and demographic characteristics (sex, age, head-of-household's skin color and schooling, per capita household income, and presence of elderly in the household). Brazilians spent an average of BRL 42.19 per year on dental care and BRL 10.27 on oral hygiene products. The study detected social inequalities in the distribution of these expenditures according to household residents' characteristics and the different geographic regions, states, and state capitals. The current study evidenced quantitative and specific details on Brazilians' spending on dental care and oral hygiene products. Monitoring and assessment of these expenditures are fundamental for evaluating and orienting public policies in oral health.

Gastos privados com saúde bucal no Brasil: análise dos dados da Pesquisa de Orçamentos Familiares, 2008-2009 / Private spending on oral health in Brazil: analysis of data from the Family Budgets Survey, 2008-2009 / Gastos privados con la salud bucal en Brasil: análisis de datos de la Encuesta de Presupuestos Familiares, 2008-2009

Resumo: O objetivo foi analisar os gastos privados com assistência odontológica e produtos de higiene bucal dos brasileiros. Foram analisados dados de 55.970 domicílios pesquisados na Pesquisa de Orçamentos Familiares de 2008-2009. Os gastos foram descritos segundo macrorregiões, estados e capitais do Brasil e de acordo com características socioeconômicas e demográficas dos domicílios (sexo, idade, cor da pele e escolaridade do chefe, renda domiciliar per capita e presença de idoso no domicílio). Os brasileiros gastaram em média no ano R$ 42,19 com serviços de assistência odontológica e R$ 10,27 com produtos de higiene bucal. Desigualdades sociais na distribuição desses gastos segundo as características dos moradores dos domicílios e segundo as diferentes macrorregiões, estados e capitais do país foram encontradas. O presente estudo evidenciou com detalhes quanto e com o que gastam os brasileiros com assistência odontológica e com produtos de higiene bucal. O monitoramento e avaliação desses gastos são condições fundamentais para avaliação e orientação de políticas públicas em saúde bucal.

Abstract: The aim was to analyze Brazilians' private spending on dental care and oral hygiene products. Data were analyzed from 55,970 households in the Family Budgets Survey, 2008-2009. Expenditures were analyzed by major geographic region, state, state capital, and household socioeconomic and demographic characteristics (sex, age, head-of-household's skin color and schooling, per capita household income, and presence of elderly in the household). Brazilians spent an average of BRL 42.19 per year on dental care and BRL 10.27 on oral hygiene products. The study detected social inequalities in the distribution of these expenditures according to household residents' characteristics and the different geographic regions, states, and state capitals. The current study evidenced quantitative and specific details on Brazilians' spending on dental care and oral hygiene products. Monitoring and assessment of these expenditures are fundamental for evaluating and orienting public policies in oral health.

Resumen: El objetivo fue analizar los gastos privados con asistencia odontológica y productos de higiene bucal de los brasileños. Se analizaron datos de 55.970 domicilios seleccionados en la Encuesta de Presupuestos Familiares de 2008-2009. Los gastos fueron descritos según macrorregiones, estados y capitales do Brasil, y de acuerdo con características socioeconómicas y demográficas de los domicilios (sexo, edad, color de piel y escolaridad del cabeza de familia, renta domiciliaria per cápita y presencia del anciano en el domicilio). Los brasileños gastaron de media durante el año R$ 42,19 en servicios de asistencia odontológica y R$ 10,27 con productos de higiene bucal. Se hallaron desigualdades sociales en la distribución de esos gastos, según las características de los residentes de los domicilios, y conforme las diferentes macrorregiones, estados y capitales del país. El presente estudio evidenció con detalle cuánto y en qué gastan los brasileños respecto a la asistencia odontológica y productos de higiene bucal. El monitoreo y evaluación de estos gastos son condiciones fundamentales para la evaluación y orientación de políticas públicas en salud bucal.

Implantes, componentes e os honorários profissionais: o que agrega mais no custo final da Implantodontia? Análise de custos entre seis marcas comercialmente disponíveis no Brasil / Dental implants, components, and professional fees: what is most signifi cant factor in the overall cost of Brazilian implant dentistry? A cost analysis among six different commercially available brands

Objetivo: sistematizar e organizar o conjunto de informações relacionadas ao planejamento e manejo de custos na área de Implantodontia. Material e métodos: uma reabilitação mandibular (prótese total implantorretida com carregamento imediato e ancorada por cinco implantes) foi utilizada como referência para custos. Para determinação do valor total, foram somados os honorários e os custos do profissional com o consultório, com componentes cirúrgicos e protéticos para execução do caso, além dos custos laboratoriais. O custo total foi acrescido em 20% devido à taxa de risco do tratamento. Seis marcas comerciais foram selecionadas para realização dos orçamentos. Os valores de todos os componentes em moda corrente (Reais) foram expostos baseados em um denominador comum (X). Ainda, as porcentagens de custo de cada componente segundo o tipo de cilindro selecionado também foram descritas. Resultados: o valor do tratamento conforme o sistema de implantes variou entre 64,4 X e 209,6 X. No custo fi nal, a variação ficou entre 243,1 X e 441,4 X. Conclusão: embora este trabalho não tenha englobado no custo as sessões de retorno para acompanhamento e higienização, fratura de pilares protéticos e parafusos, perda de implantes e a fratura de dentes artificiais, a maior variação nos valores do tratamento refere-se aos sistemas de implantes selecionados. Entretanto, o uso de cilindros calcináveis ou de cilindros com base metálica não interferiu significativamente no custo total, o que favorece a postura clínica de utilizar componentes com partes pré-fabricadas para aliviar os problemas biológicos na interface implante/prótese.

Objective: to organize the information related to treatment and cost management for Implant Dentistry. Material and methods: a mandibular restoration (a five implant-retained prosthesis under immediate loading) was used as reference for cost analysis. To determine the overall value, professional, surgical, prosthetic component, and laboratory costs were added. The overall cost was increased in 20% due to the treatment risk. Six different commercial manufacturers were selected to present the costs. The values in the real currency (BRL) were converted to a common denominator (X). Also, the cost percentages associated to each prosthetic cylinder were also described. Results: the overall treatment value according to each implant system ranged from 64.4 X to 209.6 X. For the overall cost, the variation was between 243.1 and 44.1 X. Conclusion: although recall sessions have not been included in this paper (e.g. hygiene maintenance, abutment screw fracture/ loosening, implant loss, and artifi cial tooth fracture events), the great cost variation relates to the choice of the dental implant system. However, the use of pre-fabricated or plastic burnout cylinders did not signifi cantly interfere in the overall cost, which favors the use of pre-fabricated parts to alleviate the biological issues at the implant-prosthesis interface.

Experiência de cárie e utilização do serviço público odontológico por escolares: estudo descritivo em Arroio do Padre, Rio Grande do Sul, 2013 / Dental caries experience and use of public dental services by school children: a descriptive study in Arroio do Padre, Rio Grande do Sul State, Brazil, 2013 / Experiencia de caries y utilización del servicio público odontológico por escolares: estudio descriptivo en "Arroyo do Padre", Rio Grande del Sur, Brasil, 2013

OBJETIVO: descrever a utilização do serviço público odontológico e os índices de ceo-d e CPO-D no município de Arroio do Padre-RS, Brasil. MÉTODOS: estudo descritivo censitário com todos os residentes nas idades de cinco e 12 anos, em 2013; foram realizados exames bucais e aplicado questionário junto aos responsáveis. RESULTADOS: participaram do estudo 50 escolares, 22 com cinco e 28 com 12 anos de idade; as médias de ceo-d e CPOD foram de 3,9 e 1,3 respectivamente; na dentição decídua (ceo-d), houve predomínio do componente cariado (82%), e na permanente (CPO-D), o predomínio foi do componente obturado (65%); do total, 19 escolares apresentaram dentes cariados no momento do exame e destes, 13 haviam consultado com dentista da unidade básica de saúde. CONCLUSÃO: a maioria dos escolares apresentava história de cárie, possivelmente atribuída - em parte - à pouca exposição ao flúor, baixa escolaridade dos pais e pouca valorização da dentição decídua.

OBJECTIVE: to describe the use of public dental services and to assess deft/DMFT indexes in the city of Arroio do Padre, state of Rio Grande do Sul, Brazil. METHODS: this was a cross-sectional study of all children aged 5 and 12 living in the city in 2013 (N=50); the children underwent oral health exams and the adults responsible for them answered questionnaires. RESULTS: mean deft and DMFT were 3.9 and 1.3. In deciduous teeth (deft) there was predominance of the decay component (82%) while in the permanent dentition (DMFT) the filled component was predominant (65%); 19 children students had decayed teeth at the time of the examination and 13 of these had had a dental visit at the Basic Health Unit. CONCLUSION: most children presented caries history, which may be attributed in part to low exposure to fluoride, low parental education and little appreciation of deciduous teeth.

OBJETIVO: describir el uso de los servicios odontológicos públicos y los índices ceo-d y CPO-D en el municipio de Arroyo del Padre-RS, Brasil. MÉTODOS: estudio descriptivo censitario con todos los residentes de cinco y 12 años de edad en 2013; se realizó examen oral y se aplicó un cuestionario a los responsables. RESULTADOS: participaron 50 niños, 22 con cinco y 28 con 12 años de edad; los promedios de ceo-d y CPOD fueron 3.9 y 1.3, respectivamente; en dientes deciduos (ceo-d), hubo predominio del componente caries (82%), en la dentición permanente (DMF) hubo predominio del componente lleno (65%); del total, 19 niños presentaron dientes con caries al momento del examen y de estos 13 habían consultado con el dentista de la unidad básica de salud. CONCLUSIÓN: la mayoría de los estudiantes presentaron historia de caries, que se puede atribuir en parte, a la poca exposición al fluoruro, baja educación de los padres y poco aprecio de los dientes deciduos.

Avaliação da atenção secundária em saúde bucal do Centro de Especialidades Odontológicas de Pelotas, Rio Grande do Sul, 2012-2013 / Evaluation of Secondary Dental Health Care at the Dental Specialties Centre, Pelotas, Rio Grande do Sul, Brazil, 2012-2013 / Evaluación de la Atención Secundaria de Salud Bucodental del Centro de Especialidades, Pelotas, Rio Grande do Sul, en el período 2012-2013

OBJETIVO: avaliar a estrutura, o processo de cuidado e os resultados na endodontia, periodontia e cirurgia realizadas pelo Centro de Especialidades Odontológicas (CEO) de Pelotas-RS. MÉTODOS:foi realizado estudo transversal; avaliou-se o número de profissionais e equipos odontológicos do CEO, a forma de encaminhamento e agendamento e o manejo do absenteísmo; caracterizou-se a demanda e os encaminhamentos para a central de regulação no período de julho/2012 a junho/2013. RESULTADOS: foram atendidos 940 usuários e realizados 1.502 procedimentos, com 76,0% de tratamentos concluídos; o tempo médio de espera por atendimento foi de dois meses; 13% dos usuários encaminhados desistiram do tratamento; e existiam 849 usuários na fila de espera. CONCLUSÃO: o CEO/Pelotas-RS ficou aquém dos parâmetros de produção exigidos pelo Ministério da Saúde e precisa ampliar sua produção; a central de regulação necessita de protocolos que orientem as prioridades no atendimento; ademais, são necessários novos CEO no município.

OBJETIVO: evaluar la estructura, el proceso y los resultados en la endodoncia, periodoncia y cirugía del Centro de Especialidades Odontológicas (CEO) de Pelotas/RS. MÉTODOS: se hizo un estudio transversal; se evaluó el número de profesionales y equipos odontológicos del CEO, la forma de derivación y el marcado de consultas, y el manejo del absentismo; se caracterizaron la demanda y las remisiones para la central de regulación en el período de julio del 2012 a junio del 2013. RESULTADOS: se atendieron 940 usuarios y se realizaron 1502 procedimientos, con 76% de tratamientos concluidos; el promedio de espera por atención fue de 2 meses, el 13% de los usuarios abandonó el tratamiento y había 849 usuarios en espera. CONCLUSION: el CEO está por debajo de los parámetros de producción exigidos por el Ministerio de Salud y necesita adecuarlos; la central de regulación necesita protocolos que orienten las prioridades en la atención; además, la ciudad necesita nuevos CEOs.

OBJECTIVE: to evaluate the structure, care process and results of the endodontics, periodontics and surgery services at the Pelotas/RS Dental Specialties Centre (DSC). METHODS: this was a cross-sectional study; an evaluation was made of the number of dental professionals and teams at the DSC, forms of referral and appointment making and no-show management; demand for services and referral to the appointment control centre between July 2012 and June 2013 were characterized. RESULTS: 940 service users received care and 1,502 procedures were performed; 76.0% of procedures were concluded; average waiting time was 2 months; 13% of service users referred did not complete treatment and 849 were on the waiting list. CONCLUSION: DSC did not meet Ministry of Health required productivity parameters and needs to increase production; the appointment control centre needs protocols to guide care prioritization; moreover, the municipality needs additional DSCs.

Custo das hospitalizações por infecções focais dentárias em um município do sul do Brasil / Cost of hospitalizations for dental focal infections in a city in southern Brazil

Infecções focais dentárias podem causar complicações sistêmicas e resultar em internação hospitalar. Conduziu-se estudo descritivo de casos de infecções focais dentárias, perfil dos pacientes internados no Pronto-Socorro de Pelotas-RS, e estimativa dos custos dessas internações no período de 2008/2013 com dados provenientes da Faculdade de Odontologia da UFPel. A descrição das variáveis foi realizada por frequências absolutas e relativas, mediana, média/desvio-padrão. A estimativa do custo foi realizada por meio da média dos valores das Autorizações de Internações Hospitalares com CID K04/K05, repassados pela SMS-Pel. Dos 417 registros coletados, 52,8% eram mulheres, tinham entre 18-39 anos de idade (55,9%) e eram oriundos de Pelotas-RS (95%). A média etária foi de 25,5 anos (± 13,7 anos). Dos 417 indivíduos atendidos, 88,5% foram medicados, prevalecendo combinações de medicamentos (67,6%). A falta de registros foi observada para todas as variáveis, exceto sexo. Foram identificadas 63 internações. O custo médio para o município foi de R$ 347,67. Das urgências observadas, 6,9% eram decorrentes de infecções focais dentárias, sensíveis a intervenções na Atenção Básica. Considerando custos em internações de urgências odontológicas, e, sendo possível preveni-las, sugerem-se novas abordagens sobre o tema. É necessário qualificar registros para adequado monitoramento dessa demanda, verificando seu impacto na redução das internações... (AU)

Dental focal infections can cause systemic complications and result in hospitalization. We conducted a descriptive case study of dental focal infections, patients characteristics admitted to the Emergency Room of Pelotas, and estimated costs of hospital admissions in the period 2008/2013 with data from the School of Dentistry Federal University of Pelotas. The description of the variables was performed by absolute and relative frequencies, median, mean and standard deviation. The cost estimate was performed using average values of Authorizations Hospitalizations with ICD K04 / K05, provided by the SMS-Pel. Of the 417 selected records, 52.8% were women, aged between 18-39 years old (55.9%) and originating from Pelotas (95%). Mean age was 25.5 years (± 13.7 years). Of total 417 individuals, 88.5% were prescribed, whichever drug combinations (67.6%). The lack of records was found for all variables except sex. Were identified 63 hospitalizations. The average cost for the city was (R$ 347.67). Of the emergencies observed, 6.9% were due to sensitive interventions in primary care dental focal infections. Considering costs for dental emergencies admissions, and prevent thembeing possible, were suggest new approaches to the topic. It is necessary to qualify records for proper monitoring of this demand, checking its impact in reducing hospitalizations... (AU)