Smoking Cessation therapy is a cost-effective intervention to avoid tooth loss in Brazilian subjects with periodontitis: an economic evaluation.

BACKGROUND: Smokers present a higher prevalence and severity of periodontitis and, consequently, higher prevalence of tooth loss. Smoking cessation improves the response to periodontal treatment and reduces tooth loss. So, the aim of this study was to evaluate the efficiency in resources allocation when implementing smoking cessation therapy vs. its non-implementation in smokers with periodontitis. METHODS: We adopted the Brazilian public system perspective to determine the incremental cost-effectiveness (cost per tooth loss avoided) and cost-utility (cost per oral-related quality-adjusted life-year ([QALY] gained) of implementing smoking cessation therapy. Base-case was defined as a 48 years-old male subject and horizon of 30 years. Effects and costs were combined in a decision analytic modeling framework to permit a quantitative approach aiming to estimate the value of the consequences of smoking cessation therapy adjusted for their probability of occurrence. Markov models were carried over annual cycles. Sensitivity analysis tested methodological assumptions. RESULTS: Implementing the therapy saved approximately US$ 100 over the time horizon accompanied by a slightly better effect, both in CEA and CUA. Considering uncertainties, the therapy could be cost-effective in the most part of simulated cases, even being cheaper and more effective in 35% of cases in which the oral-health related outcome is used as effect. Considering a willingness-to-pay of US$100 per health effect, smoking cessation therapy was cost-effective, respectively, in 72% and 99% of cases in cost-utility and cost-effectiveness analyses. CONCLUSIONS: Implementation of smoking cessation therapy may be cost-effective, considering the avoidance of tooth loss and oral health-related consequences to patients.

Orthodontics in the oral health care network of the Unified Health System (SUS).

This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

Oral health policies and decision-making process in Brazil, Colombia and Chile.

Public health policies are crucial for the well-being of the general population; however, the health systems of developed countries still do not include oral health in its system. Thus, it is necessary to understand the process of decision-making in oral health policies to create opportunities for countries to achieve an overall positive health outcome, including oral health. This study aimed to identify the factors influencing the inclusion of oral health on the political agenda in Brazil, Colombia, and Chile. The study sample involved decision-makers at political, technical, and academic levels. The extracted data were analyzed using the software Maxqda® and Kingdon´s theoretical model; defining interactive variables that produce a "window of opportunity" to define the agenda and the insertion of theme in formulating public policies. The decision-making process regarding oral health is influenced by many factors like the need to improve the overall oral health of the population, identified through national epidemiological studies, and the importance of individuals in positions involving political decision-making, who advocate for oral health. Strategies were developed in partnership with the academy that focused on the health rights of the population provided by law; territorial and national programs were also developed. The inclusion and creation of oral health policies depend on actors who advocate for thematic and scientific evidence to support decision-making. A close relationship between academia and stakeholders and knowledge translation is important for the development of public policies that can be effective for health systems.

Response to college students' mental health needs: a rapid review.

OBJECTIVE: To present strategic options to support the adoption of mental health strengthening policies for university students in the field of health, to be implemented by university institutions. METHODS: Rapid review, without period delimitation, with searches carried out from May to June 2020, in 21 sources of bibliographic data, including gray literature. The following keywords were used: mental health, students and university. The selection process prioritized systematic reviews of mental health interventions for university students in health care courses, and also considered other types of review and relevant primary studies. RESULTS: Forty-five studies were included: 34 systematic reviews, an evidence synthesis, an overview, a scope review, three narrative reviews, three experience reports and two opinion articles. The evidence from these studies supported the development of four options: 1) to establish and support policies to strengthen the mental health of students in health care courses; 2) to integrate mental health care programs, expand their offer and facilitate access by students; 3) to promote educational programs and communication strategies related to contemporary psychic suffering and its confrontation, so that students can get to know the services and resources and identify strengthening practices; 4) to continuously monitor and assess the mental health needs of students in health care courses. CONCLUSIONS: The options are challenging and require universities to establish institutional commissions to implement a policy to strengthen the mental health of university students in the health area, with the ability to recognize the different health needs, including manifestations of psychic suffering ; to integrate the university's internal actions with each other and with the services of the Unified Health System; to implement and monitor the actions that make up the mental health policy.

Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation.

Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.

Sedentary behavior, unhealthy food consumption and dental caries in 12-year-old schoolchildren: a population-based study.

This study analyzed the association between sedentary behavior (SB), unhealthy food consumption, and dental caries amongst 12-year-old schoolchildren. An epidemiological survey was carried out in the five largest cities (> 80,000 inhabitants) of the State of Mato Grosso do Sul, Brazil. Data were collected on decayed, missing and filled teeth index (DMFT), sociodemographic characteristics, SB, unhealthy food consumption, and water fluoridation status. The analysis was based on the theoretical framework established by J Sisson. Structural equation models were performed to test the association of dental caries experience with sociodemographic, contextual, and behavioral factors. The mean DMFT index in the five cities was 1.02 (95%CI: 0.39-1.66). Higher sedentary behavior (more than 2 hours/day) [standardized coefficient (SC) = 0.21 95%CI: 0.07-0.39] and higher unhealthy food consumption (more than 4 times/week) [SC = 0.23 (0.10-0.45)] were associated with higher DMFT index than their counterparts. Also, cities with fluoridated water were associated with lower DMFT index [SC = -0.85 (-1.20--0.50)]. Families who had a per capita income above the poverty line had a direct association with unhealthy food consumption [SC = -0.24 (-0.38--0.11)]. Unhealthy food consumption mediated the association of sedentary behavior on DMFT index [SC=0.07 (0.02-0.13)]. Sensitivity analysis confirmed the findings. Sedentary behavior mediated by unhealthy food consumption had a significant association with dental caries experience. Public policies must address transdisciplinary actions to reduce sedentary behavior and unhealthy food consumption and promote water fluoridation.

Diagnosis of mucosal changes and hospitalized oral cancer patients in Brazil: influence of socioeconomic factors.

This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman's correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.

Periodontal disease and its impact on general health in Latin America: LAOHA Consensus Meeting Report.

Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.

Orthodontics in the oral health care network of the Unified Health System (SUS)

Abstract This observational study aimed to describe and analyze data from two external evaluations of the National Program for Improving Access to and Quality of Dental Specialty Centers (PMAQ CEO), held in 2014 and 2018 in Brazil, which evaluated Dental Specialty Centers (CEO) using a national and census approach. We selected questions through a search in the microdata of the first and second evaluations. The groups were analyzed independently. To compare the groups, nonparametric tests were performed (Mann Whitney U). The formulated hypotheses were: there would be no differences between the data of these groups (h0) and there would be differences between the data of these groups (h1). For qualitative nominal variables, frequency distribution was verified and association tests were performed (chi-square test). The significance level for this study was set at 5%. We observed that orthodontic treatments were found in about 13% of the CEO. Regarding human resources, most professionals were specialists or had MSc or PhD degrees; were civil servants; had been hired by direct administration; or had been hired via public tender. Regarding the work process and inclusion of the CEO in the health care network, we observed a greater number of services that use single and electronic medical records, greater presence of services monitoring and analyzing goals, greater knowledge about monthly average of absenteeism (for 2018); and larger number of services with referrals from primary health care centers (for 2014). Expanding the view on orthodontics and including preventive, interceptive, and corrective treatments at different points in health care networks are essential strategies for achieving comprehensive care in universal health systems.

Odontologia do Trabalho: o estado da arte, indicando trilhas para a promoção da saúde em contextos contemporâneos de labor - revisão de escopo / Occupational Dentistry: the state of the art, indicating paths for health promotion in contemporary work contexts - scoping review

Resumo O campo da Odontologia do Trabalho tem considerado lastro teórico-científico. Esta revisão de escopo objetiva desvelar o estado da arte acerca do tema em sete bases de pesquisas indexadas, considerando quase 100 anos de publicações (1921-2020). Das 337 produções inicialmente identificadas, realizou-se recorte para os últimos seis anos (2015-2021/janeiro), aplicando-se metodologia proposta pela extensão do Prisma para revisões de escopo (Prisma-ScR). Contudo, plataformas de revisões rápidas usadas para tomada de decisões em formulações de políticas públicas ou em aperfeiçoamentos de sistemas de saúde responderam por apenas 20 publicações, enquanto a amostra de 34 produções revelou peculiaridades: pesquisas privilegiam regimes de trabalho; associam o campo de estudo e prática ao modelo stricto sensu da saúde ocupacional; desconsideram concepções amplas e humanizantes do campo da Saúde do Trabalhador; tendem a priorizar a própria saúde ocupacional odontológica e parecem reduzir o conceito do acidente de trabalho a doenças. Tais questões precisam ser superadas se a perspectiva for manter-se em vanguarda, promovendo saúd e e segurança em contextos contemporâneos de trabalho, pois, embora seja evidente a transversalidade desse campo de saberes e práticas, é necessário mais, é preciso ousar para retirá-la da invisibilidade, seja em organizações privadas ou públicas de trabalho.

Abstract The field of Occupational Dentistry has considered theoretical-scientific ballast. This scoping review aims to reveal the state of the art on the subject in seven indexed research bases, considering almost 100 years of publications (1921-2020). Of the 337 productions initially identified, a cut was made for the last six years (2015-2021/January), applying the methodology proposed by the PRISMA extension for scope reviews (PRISMA-ScR). However, rapid review platforms used for decision making in formulating public policies or in improving health systems accounted for only 20 publications, whereas the sample of 34 productions revealed peculiarities: research favors work regimes; associates the field of study and practice with the stricto sensu model of occupational health; disregards broad and humanizing concepts in the field of Worker's Health; tends to prioritize its own occupational dental health, and seems to reduce the concept of work accidents to illnesses. Such issues need to be overcome if the perspective is to remain at the forefront, promoting health and safety in contemporary work contexts, since, although the transversality of this field of knowledge and practices is evident, more is needed, daring to remove it from invisibility whether in private or public work organizations is necessary.

Análise das urgências odontológicas durante a pandemia da covid-19 / Analysis of dental emergencies during the COVID-19 pandemic

Aim: to analyze, between 2019-2021, the quantitative changes in dental emergencies (DE) in Brazil and its regions. Materials and Methods: Data collected in the Primary Care Health Information System (SISAB) from 2019 to 2021. The DE represented by dentoalveolar abscess (DAA) and toothache (TA). 2019 was the control (non-pandemic), and 2020-21 the exposure year. Durbin-Conover's Friedman and Post-Hoc tests used a significance level of 5%. The data's organization used the percentage difference to facilitate analysis. Results: For Brazil in 2021, the percentage difference with 2019 suggests that DAA (-2.16%, p=1.0) and TA (+14.94%, p=0.064) returned to values after fall of 2020. The South region, in 2020, had no decrease in DAA (-5.48%, p=0.436) and TA (+3.7%, p<0.001) in 2020, and an increase in both in 2021 (DAA: +26.86%, p<0.001; TA: +51.06%, p<0.001). Discussion: In 2021, in Brazil, limited elective access and resumption of DAA and increase in TA suggest worsening the oral health and quality of life. The DAA and TA results in the South region do not provide plausible evidence to understand the unchanged values in 2020 and the considerable increase in 2021. Conclusion: Regardless of the pandemic, elective access still struggles to offer universal acessing, equitable, and the need of investments are essentials to prevent public services from becoming just gateways for relieving pain and suffering.

Objetivo: analisar, entre 2019-2021, as alterações quantitativas nas urgências odontológicas (UO) no Brasil e suas regiões. Materiais e Métodos: Dados coletados no Sistema de Informação em Saúde da Atenção Básica (SISAB) no período de 2019 a 2021. A representação das UO foi pelo abscesso dento-alveolar (ADA) e dor de dente (DD). O ano de 2019 foi o ano de controle (não pandêmico) e 2020-21 os de exposição. Os testes Friedman e Post-Hoc de Durbin-Conover utilizaram nível de significância de 5%. Os dados foram organizados pela diferença percentual para facilitar a análise. Resultados: Para o Brasil em 2021, a diferença percentual com 2019 sugerem que o ADA (-2,16%, p=1,0) e a DD (+14,94%, p=0,064) retomaram os valores, após a queda de 2020. A região Sul, em 2020, não teve queda em ADA (-5,48%, p=0,436) e DD (+3,7%, p<0,001) em 2020, e aumento em ambos em 2021 (ADA: +26,86%, p<0,001; DD: +51,06%, p<0,001). Discussão: Em 2021, no Brasil, o limitado acesso eletivo e a retomada da ADA e aumento da DD sugerem piora na saúde bucal e na qualidade de vida. Os resultados de ADA e DD na região Sul não apresentam evidências plausíveis para compreender a inalteração de valores em 2020 e o considerável aumento em 2021. Conclusão: Independentemente a pandemia, o acesso eletivo ainda luta para ser universal, equânime e os investimentos precisam ser retomados para evitar que os serviços públicos se tornem em apenas portas de entrada de alívio dor e sofrimento.

Geographic Distribution of Brazilian Dentists: Motivation and Perception for Migration / Distribuição Geográfica dos Dentistas Brasileiros: Motivação e Percepção para a Migração

The Human Resources for Health (HRH) are considered as being crucial for the organization of the health systems and for the population health conditions; in this context, the purpose of this work is 1) to identify the current geographic distribution situation of Brazilian dentists, 2) to identify and analyze the perception and motivations of Brazilian dentists who migrated to the interior of the country. A case study approach was used and the data were collected from different sources (Federal Council of Dentistry, Health Graduation Indicators System, Geocapes, Brazilian National Institute of Geography and Statistics) using the mixed method, from the quantitative-qualitative exploratory sequential model, the qualitative phase was analyzed by using the "grounded theory" approach. The findings point out that the county has a great stock of dentists and that it significantly increased in recent years; however, it is poorly distributed over the territory, particularly when the differences between the interior and the capitals of the country are analyzed. The main category of the grounded theory was "The opportunities changing the ways to consolidate the professional"; the interviews point out that the dentists' place of birth and the opportunities over their professional career were crucial to determine the distribution of dentists throughout the Brazilian territory. It's concluded that Brazil has a dentistry workforce stock; however, it faces the results of the lack of HRH regulation policies which include dentistry. Such reality enhances the health gaps in some country regions and market saturation in major urban centers.(AU)

Os Recursos Humanos em Saúde (RHS) são considerados fundamentais para a organização dos sistemas de saúde e para as condições de saúde de uma população, nesse contexto o objetivo desse trabalho é 1) identificar a situação atual da distribuição geográfica de dentistas brasileiros 2) identificar e analisar a percepção e motivações de dentistas brasileiros que migraram para o interior do país. Foi utilizada a abordagem de estudo de caso e os dados foram coletados a partir de diferentes fontes (Conselho Federal de Odontologia, Sistema de Indicadores das Graduações em Saúde, Geocapes, Instituto Brasileiro de Geografia e Estatística), utilizando o método misto, a partir do modelo exploratório sequencial quantitativo-qualitativo, a fase qualitativa foi analisada por meio da abordagem da "teoria fundamentada". Os achados apontam que o país apresenta um grande estoque de dentista, e que houve uma grande expansão nos últimos anos, no entanto este apresenta-se mal distribuídos pelo território, principalmente quando analisado as diferenças entre o interior e as capitais do país. A categoria central da teoria fundamentada foi "As oportunidades mudando os caminhos para consolidar o profissional", as entrevistas apontam que o local de nascimento dos dentistas e as oportunidades durante sua trajetória profissional foram decisivas para determinar a distribuição de dentistas no território brasileiro. Conclui-se, que o Brasil apresenta estoque de força de trabalho em odontologia, porém enfrenta os resultados da falta de políticas de regulação de RHS, que inclua a odontologia. Essa realidade acentua os vazios sanitários em algumas regiões do país e saturação do mercado nos grandes centros.(AU)

Oral health policies and decision-making process in Brazil, Colombia and Chile

Abstract Public health policies are crucial for the well-being of the general population; however, the health systems of developed countries still do not include oral health in its system. Thus, it is necessary to understand the process of decision-making in oral health policies to create opportunities for countries to achieve an overall positive health outcome, including oral health. This study aimed to identify the factors influencing the inclusion of oral health on the political agenda in Brazil, Colombia, and Chile. The study sample involved decision-makers at political, technical, and academic levels. The extracted data were analyzed using the software Maxqda® and Kingdon´s theoretical model; defining interactive variables that produce a "window of opportunity" to define the agenda and the insertion of theme in formulating public policies. The decision-making process regarding oral health is influenced by many factors like the need to improve the overall oral health of the population, identified through national epidemiological studies, and the importance of individuals in positions involving political decision-making, who advocate for oral health. Strategies were developed in partnership with the academy that focused on the health rights of the population provided by law; territorial and national programs were also developed. The inclusion and creation of oral health policies depend on actors who advocate for thematic and scientific evidence to support decision-making. A close relationship between academia and stakeholders and knowledge translation is important for the development of public policies that can be effective for health systems.

Atraumatic Restorative Treatment (ART) as Public Policy: a Scoping Review / O Tratamento Restaurador Atraumático (ART) como Política Pública: uma Revisão de Escopo

This scoping review aimed to identify, describe, and analyze the use of Atraumatic Restorative Treatment (ART) as public policy. Inclusion criteria: studies on public oral health policies; dental caries; ART. Exclusion criteria: clinical studies; specific interventions; studies that report public policies that do not use ART as a strategy for caries treatment. The search was conducted in PubMed, BVS, Epistemonikos, Health Systems Evidence, and Rxforchange. The selection process and data extraction were performed by two authors independently according to the stages and categories of a conceptual framework. Of the 2253 eligible articles, 139 were duplicates, and 1680 were not included after reading the title and abstract. After assessing the full text, 414 articles were excluded. Twenty articles were included. Nineteen were conducted in nine countries (South Africa, Bolivia, Cambodia, Egypt, Mexico, Tanzania, East Timor, Tunisia, and Zimbabwe), and one in the Americas. The studies reported high prevalence of dental caries and lack of access to restorative procedures in health services as common problems. Policy developments followed a similar process, with the presence of governments, conceptual use of scientific evidence, and induction by the World Health Organization. Regarding implementation barriers, the included studies mentioned the lack of supplies and lack of induction by managers,while in relation to the facilitators, permanent education and professional practice were mentioned. Cohort studies have shown a survival rate greater than 80% after one year of follow up of the restorations performed. The findings of this review indicate that the use of ART in public policies is promising, however, its use is still in an early stage. (AU)

Esta revisão de escopo teve como objetivo identificar, descrever e analisar o uso do Tratamento Restaurador Atraumático (ART) como política pública. Critérios de inclusão: estudos sobre políticas públicas de saúde bucal; cáries dentárias; ART. Critérios de exclusão: estudos clínicos; intervenções específicas; estudos que relatam políticas públicas que não utilizam o ART como estratégia para o tratamento de cárie. A pesquisa foi realizada no PubMed, BVS, Epistemonikos, Health Systems Evidence e Rxforchange. O processo de seleção e extração de dados foram realizados por dois autores, de forma independente, de acordo com as etapas e categorias de um quadro conceitual. Dos 2.253 artigos elegíveis, 139 eram duplicados e 1.680 não foram incluídos após a leitura do título e do resumo. Após avaliação do texto completo, foram excluídos 414 artigos. Vinte artigos foram incluídos. Dezenove foram realizados em nove países (África do Sul, Bolívia, Camboja, Egito, México, Tanzânia, Timor Leste, Tunísia e Zimbábue) e um nas Américas. Os estudos relataram alta prevalência de cárie dentária e falta de acesso a procedimentos restauradores nos serviços de saúde como problemas comuns. Os desenvolvimentos de políticas seguiram um processo semelhante, com a presença de governos, uso conceitual de evidências científicas e indução da Organização Mundial da Saúde. Quanto às barreiras de implementação, foram mencionadas a falta de insumos e a falta de indução por parte dos gestores. Quanto aos facilitadores, foram citados a educação permanente e a prática profissional. Estudos de coorte mostraram sobrevida superior a 80% após um ano de acompanhamento. Os achados desta revisão indicam que a utilização da ART nas políticas públicas é promissora, porém, sua utilização ainda é incipiente. (AU)

O processo de trabalho em saúde bucal coletiva em tempos de pandemia: a contribuição da teleducação com a teleodontologia / The work process in collective oral health in times of a pandemic: the contribution of tele-education with teledentistry

A pandemia da COVID-19 impôs ações assertivas em todos os níveis da sociedade. Aqui se relata o apoio emergencial na Resposta Rápida do Núcleo de Evidências e Análises Econômicas da Faculdade de Odontologia da Universidade de São Paulo (EvipOralHealth) para a coordenadoria estadual de saúde bucal de São Paulo, em prol da tomada de decisão e ressignificação do processo de trabalho. Foram implementadas duas estratégias de teleodontologia para a educação permanente (EP) dos trabalhadores de saúde bucal: 1. Lives com pesquisadores, estudantes, gestores e trabalhadores das diversas áreas da saúde pública e da Odontologia para estabelecer marcos teóricos; 2. Ambulatórios virtuais - via webconferência. Reuniu-se gestores e trabalhadores para a condução de diálogos de políticas sobre o dia a dia do enfrentamento e de adaptações e condições de trabalho de cada região. A experiência revela a importância da relação ensino-serviço-comunidade efetiva, pautada na tradução do conhecimento e na construção de espaços de troca possibilitando a implementação de práticas, programas e políticas. Precisamos repensar as estratégias de EP, sermos mais ágeis, mais flexíveis, menos acadêmicos e capazes de adaptar conteúdos e formatos às necessidades. A teleodontologia e a teleducação podem conferir escala e fazer chegar mais facilmente o conhecimento aos que necessitam.

Brazilian Oral health teams in primary care and oral cancer: Results of a national evaluation

Abstract Oral cancer is one of the most prevalent cancers in Brazil. An understanding of how public policies are implemented to address this problem can contribute to the construction of solutions. The "Programa de Melhoria do Acesso e da Qualidade" (PMAQ-AB and PMAQ-CEO) at the level of primary and secondary care are evaluations that also collect data on prevention and monitoring strategies for oral cancer. This study aimed to analyze the results of the incorporation of oral health teams to evaluate the strategies adopted by Brazil regarding the impact on the diagnosis of oral cancer. Of the 17,202 family health teams evaluated, 72.10% had oral health teams (OHT). Considering the strategies for prevention, screening, campaign, and follow-up of suspected cases, 72.27% of the campaign teams and 59.09% of the teams who accompanied suspected cases had OHT. In secondary care, more than 65% of the teams in the Southeast and South regions registered cases of oral cancer, and the referral network was more represented. The inclusion of OHT had a positive impact on campaign actions, follow-up, referral to specialists, and registration of suspected cases throughout Brazil.

Processo de mentoring: análise da percepção do estudante da disciplina de Gestão e Planejamento em Odontologia da FOUSP / Mentoring process: analysis of students' perception of the discipline of Management and Planning in Dentistry at FOUSP

O objetivo da presente pesquisa foi analisar a percepção dosestudantesde graduação do último ano do Curso de Odontologia da Faculdade de Odontologia da Universidade de São Paulo (FOUSP) em relação ao processo de mentoring. A amostra foi de 122 estudantes que estavam matriculados na disciplina de Gestão e Planejamento daFOUSP, os quais foram divididos em grupos de 8 integrantese, durante o semestre, as reuniões de tutoria eram realizadas pelos pós-graduandos, para debater questões pessoais e profissionais. Ao final do semestre os estudantes responderam a um questionário sobreoprocesso dementoringrealizado e a respeito de pontos positivos e negativos da disciplina. O treinamento dos tutores foi realizado no semestre anterior, juntamente com um estudo piloto com 20 graduandos. Foi realizada uma análise de correspondência para a avaliação da disciplina com o mentoringe uma análisequantitativa textual por meio do softwareIramuteq para avaliação das respostas da questão aberta. Dos estudantes incluídos, 96,7% participaram da pesquisa.Quanto àavaliação da disciplina, 55,1% dos respondentes aconsideraram boa e 33,9%como ótima. Em relação ao processo de mentoring, 62,7% consideraram ótimo e 32,2% bom. Quando questionados quais eram os pontos positivos da disciplina, 48,3% dos estudantes destacaram a tutoria. Ao verificar a coocorrência e conectividade das palavras, foi constatada uma forte relação entre os termos reunião, grupo, aluno e futuro. Diante disso, é possível concluir que a percepção do aluno de graduação é positiva em relação ao processo de mentoring, no qual além de ser um processo de instrução, serve também de apoio para o aluno do último ano (AU).

This study aimed to analyze the perception of graduate students in the last year of the Dentistry Course at the University of São Paulo School of Dentistry (FOUSP) ofthe mentoring process implemented in the discipline of Management and Planning. The sample comprised 122 students enrolled in the Management and Planning discipline at FOUSP. During mentoring, students were divided into groups of eight members, and tutoring meetings were held by post-graduate students to discuss personal and professional issues. At the end of the semester, students answered a questionnaire about the mentoring process and the positive and negative aspects of the discipline. Tutors were trained in the previous semesteralongsidea pilot study with 20 graduate students. A correspondence analysis was conducted to evaluate the discipline, and a quantitative textual analysis using the Iramuteq software was used to assess the responsesto the open questions. Approximately 97% of the students participated in the survey. The majority rated the discipline as good (55.1%) and excellent (33.9%). Regarding the mentoring process, 62.7% considered the activities excellent and 32.2% good. When asked about the strengths of the discipline, 48.3% of students highlighted tutoring. When verifying the co-occurrence and connectivity of the words, a strong relationship was found between the terms "meeting," "group," "student," and "future." Thus, graduate students' perception ofthe mentoring processis positive, which in addition to being aninstructional process,also serves as support for the final year at the university (AU).

Diagnosis of mucosal changes and hospitalized oral cancer patients in Brazil: influence of socioeconomic factors

Abstract This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman's correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.

Response to college students' mental health needs: a rapid review / Resposta a necessidades em saúde mental de estudantes universitários: uma revisão rápida

ABSTRACT OBJECTIVE To present strategic options to support the adoption of mental health strengthening policies for university students in the field of health, to be implemented by university institutions. METHODS Rapid review, without period delimitation, with searches carried out from May to June 2020, in 21 sources of bibliographic data, including gray literature. The following keywords were used: mental health, students and university. The selection process prioritized systematic reviews of mental health interventions for university students in health care courses, and also considered other types of review and relevant primary studies. RESULTS Forty-five studies were included: 34 systematic reviews, an evidence synthesis, an overview, a scope review, three narrative reviews, three experience reports and two opinion articles. The evidence from these studies supported the development of four options: 1) to establish and support policies to strengthen the mental health of students in health care courses; 2) to integrate mental health care programs, expand their offer and facilitate access by students; 3) to promote educational programs and communication strategies related to contemporary psychic suffering and its confrontation, so that students can get to know the services and resources and identify strengthening practices; 4) to continuously monitor and assess the mental health needs of students in health care courses. CONCLUSIONS The options are challenging and require universities to establish institutional commissions to implement a policy to strengthen the mental health of university students in the health area, with the ability to recognize the different health needs, including manifestations of psychic suffering ; to integrate the university's internal actions with each other and with the services of the Unified Health System; to implement and monitor the actions that make up the mental health policy.

RESUMO OBJETIVO Apresentar opções estratégicas para apoiar a adoção de políticas de fortalecimento da saúde mental de universitários da área da saúde, a serem implementadas por instituições universitárias. MÉTODOS Revisão rápida, sem delimitação de período, com buscas realizadas de maio a junho de 2020, em 21 fontes de dados bibliográficos, incluindo literatura cinzenta. Utilizaram-se as palavras-chave: saúde mental, estudantes e universidade. O processo de seleção priorizou revisões sistemáticas sobre intervenções em saúde mental para estudantes universitários em cursos da área da saúde, e considerou, também, outros tipos de revisão e estudos primários relevantes. RESULTADOS Foram incluídos 45 estudos: 34 revisões sistemáticas, uma síntese de evidências, um overview, uma revisão de escopo, três revisões narrativas, três relatos de experiência e dois artigos de opinião. As evidências desses estudos apoiaram a elaboração de quatro opções: 1) estabelecer e apoiar políticas de fortalecimento da saúde mental de estudantes dos cursos da área da saúde; 2) integrar programas de atenção à saúde mental, ampliar sua oferta e facilitar seu acesso pelos estudantes; 3) promover programas educacionais e estratégias de comunicação relacionadas ao sofrimento psíquico contemporâneo e ao seu enfrentamento, para que os estudantes conheçam os serviços e recursos e identifiquem práticas de fortalecimento; 4) monitorar e avaliar continuamente as necessidades em saúde mental dos estudantes dos cursos da área da saúde. CONCLUSÕES As opções são desafiadoras e exigem que as universidades estabeleçam comissões institucionais para implementar uma política de fortalecimento da saúde mental dos estudantes universitários da área da saúde, com capacidade de reconhecer as diversas necessidades em saúde, incluindo as manifestações de sofrimento psíquico; integrar ações internas da universidade entre si e aos serviços do Sistema Único de Saúde; implementar e monitorar as ações que compõem a política de saúde mental.